The dr.s office is telling me that Aetna has not responded to their billing, and that my mom and dad owe the money.
I would suggest that Aetna be contacted and read them what the bill says. They can then either advise you or maybe request a copy of the bill.

Also, Medicare only paid $ 1.67 of a $ 125.00 bill
Did they maybe have a deductible that had to be met yet for the year?

Sue

you'd have to see in the medicare handbook (bunch of half truths at best) does cover eye care..now i do know they coverd mom's eye surgery but can't remember if her "normal" eye care (glasses)

also contact aetna agent. you'll probably get better results from them...

ok did a search and found this

Here is a link that might be useful: http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=1593

Here in Iowa, Medicare only pays a small amount and the doctor or hospital usually agree to accept that as payment in full. When I had surgery on my arm last year, the surgeon bill was way over $1,000 and Medicare paid less than $200 which she accepted as payment in full.

thanks for the link, Susan... My mom does have diabetes, and she and my dad both had cataract surgery...in fact, I think his bill is from his cataract surgery.
I need to find some phone numbers, and make some calls... again, thanks.

My guess is that they need to rebill-- they probably used the wrong codes. However a bill from January also means that they didn't meet their deductible yet. No, I don't think that there is any rule about how long after a medical visit they can send a bill. They were probably audited and found that they had not collected on this claim. If this was just an office visit, it was probably all about the deductible.

I was an insurance agent, only worked with Medicare folks. You should call the insurance company and see what is going on, imo.

for 30 years I worked for Medicare. let's review a few things. by law the drs office has to accept Medicare assignment. that means whatever Medicare determines is reasonable and customary is the amount the doctor is owed. Ex: dr. charge: $300, Medicare approves $200, Medicare pays 80% of $200 which is $160, Aetna would pay 20% or $40 and no more money would be owed to the dr. Now the questions you must answer are 1. was the dr visit covered?if yes,had the deductible for 2008 been met? if not you would have to pay the decutible first, but most importantly did the dr off file the charges in a timely matter. Ask for proof from the drs office. DO NOT BE INTIMIDATED, if not they will have to eat their mistake. the proof they show you should be a payment voucher from Medicare showing the claim rec'd, paid, denied or applied to the deductible.
email me if you have more ??? btw, it is too late to refile. Medicare is currently processing charges from 2010, all of 2009, and the last three months of 2008 (oct,nov, and dec) jingle2405@yahoo.com

thanks Robin!! I talked to the girl at the eye dr.s, She said to check back in a couple of weeks, as they have not posted all the payments yet. Kinda surprised me, cause the first time I talked to her was back on 3/3/10...you would think that they would want to deposit their money.
But I may take you up on your offer to privately e-mail you depending on what she tells me.

by law the drs office has to accept Medicare assignment.

Depends on what the Dr's contract is with Medicare.

If the doctor has OPTED OUT of Medicare, he doesn't have a contract with Medicare and you must pay cash.

If the Dr is PARTICIPATING with Medicare....yes, they cannot charge more than the Medicare assignment, and Medicare will pay 80%, and your Atena Medicare supplement will pay the remaining 20$ - after your yearly Medicare deductable has been met.
BUT....if the Dr's contract is NON-PARTICIPATING in Medicare, then the doctor is limited to billing 115% of the Medicare allowable charge. The doctor is also required to bill Medicare on the patients' behalf, but doesn't actually receive payment from Medicare. The payment goes to the patient, who is expected to pay the doctor the full 115% directly.

Monica is right-some doctors have Opted out of Medicare. My husband's doctor is one of them. It costs us $150 every visit. DH has cut baCk to seeing thiS doctor onLy once in three weeks.