Medicare

The final frontier. Deciding when, if and how.
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Dionnfr
Posts: 65
Joined: Thu Mar 23, 2017 7:23 am

Medicare

Postby Dionnfr » Tue May 09, 2017 1:17 pm

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.
Implanted 07/10/2017 by Dr. Rambarran, Buffalo, NY. AMS LGX 18cm and 2cm rte. Great surgeon and really cares about his patient.
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Bionic_by_AMS
Posts: 574
Joined: Wed Apr 04, 2012 2:59 pm
Location: NJ

Re: Medicare

Postby Bionic_by_AMS » Tue May 09, 2017 1:39 pm

The doctor will submit the medical codes to Medicare prior to surgery ...
Robotic Prostrate surgery - Dec. 2011 - AMS 700 LGX Implant - 21 cm/3 cm RTE - June 2012
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DonBecker54
Posts: 350
Joined: Wed Dec 25, 2013 2:25 pm

Re: Medicare

Postby DonBecker54 » Tue May 09, 2017 2:17 pm

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.
Butchered by Dr. Douglas Milam, Vanderbilt University Medical Center, in January 2016. Lost 2" Before After
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warrenw
Posts: 445
Joined: Wed Feb 08, 2017 8:21 pm

Re: Medicare

Postby warrenw » Tue May 09, 2017 2:40 pm

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?
Implant - Dr Eid 12/2017, Titan Touch 20/21cm no RTE, 125cc reservoir
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GiRn56
Posts: 40
Joined: Mon Feb 27, 2017 12:33 pm

Re: Medicare

Postby GiRn56 » Tue May 09, 2017 3:25 pm

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.....
Severe Degenerative Disc Disease L5-S1
Major Depression
Chronic pain patient and Meds
Titan OTR 20 cm placed 4/12/17 per Dr Eid.
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dirtman1993
Posts: 523
Joined: Thu Feb 05, 2015 4:12 pm
Location: Beech Mountain

Re: Medicare

Postby dirtman1993 » Tue May 09, 2017 3:53 pm

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
Implanted March 2nd by Dr. Kramer with AMS/LGX. Had a problem lower left (scar tissue) and he placed a larger (thicker) implant as you can here on the YouTube video. Got all back, ED over 10 years before Implant.
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