FrankTalk.org

Just one question on Medicare.

How did you know Medicare was going to cover the implant, did your doctor get prior approval or just performed the surgery and then bills for the procedure.

Did Medicare ever reject a claim for anyone.

The doctor will submit the medical codes to Medicare prior to surgery ...

Get the medical codes and call Medicare yourself just to double-check. I can't tell you how many doctors' offices screwed up codes for treatments I've had for various problems.

Does Medicare require any proof that the implant is medically necessary?
Does a doctor need to show that you tried other therapies (drugs, pumps, injections, etc) before an implant is approved?

warrenw wrote:Does Medicare require any proof that the implant is medically necessary?
Does a doctor need to show that you tried other therapies (drugs, pumps, injections, etc) before an implant is approved?

When you contact Dr Eid for your initial eval. You have to fill out preliminary paperwork that will ask you those questions. Then you will need to provide your medical records to back up the information you provided. I went from pills straight to implant and skipped injections. My local urologist was good with me going to an implant. Dr Eid offered injections,but had no issues as well doing surgery. YMMV.....

I never had to provide any previous medical records for Dr. Kramer except the pre-op medical tests. Medicare and BCBS covered everything. I had no records about my ED as no one ever treated except for giving me pills.

Good luck