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Medicare Benefits

Contact Info

Medicare Claims Analysts
252-522-7812
252-522-7805
252-522-7076

Email:
pfs@lenoir.org

“Medical Necessity” is a term that has been used in recent years by Medicare and may not be familiar to you. “Medical Necessity” means that there are procedures and services physicians may prescribe for you that they may feel are necessary to manage your health. However, Medicare may not pay for certain services based up on their policies.

In the past, Medicare has covered most procedures. With the emergence of MRI, CT Scan, and other sophisticated and costly services  and procedures as the diagnostic methods of choice, it is important for you to know what procedures and services will be covered by asking your physicians and or Medicare. We also encourage you to discuss with your physicians other treatment options available to you that may give them the information that they need to treat you. If your physician orders a procedure or service that Medicare may not cover, you may be asked to sign an Advance Beneficiary Notice (ABN). The ABN informs you in advance that Medicare is not likely to pay for the procedure or service, and that you will be responsible for payment. By signing the ABN, you are indicating that you understand and agree to be personally and fully responsible for payment.

Medicare beneficiaries are responsible for deductibles and co-insurance. If you receive services as an outpatient or in outpatient observation, you will be billed for non-covered oral drugs and some injectable drugs that fall under the category of Self-Administered. Please refer to the online version of National Medicare Handbook at www.medicare.gov or call 1-800-633-4227 if you need more information.

Do You Have Any Options?

You can agree to be financially responsible for the procedure by signing the ABN form, or you can refuse the test or services. If you refuse the test or services, you will also be asked to sign a form indicating you’ve elected not to have the service. If you request the services and will not sign the ABN, you will still be responsible for payment. If you need services that are not covered by Medicare, you will be responsible for payment. You have the right to appeal a Medicare decision not in your favor. If you would like to appeal a Medicare decision, or have other Medicare questions, please contact the Medicare beneficiary hotline at 800-633-4227.

 
CAREER OPPORTUNITIES

HealthLink - Winter 2016

Check out the latest edition of the Lenoir HealthLink! Download the PDF...

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HealthLink - Fall 2015

Check out the latest edition of the Lenoir HealthLink! Download the PDF...

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HealthLink - Winter 2015

Check out the latest edition of Lenoir HealthLink! Download the pdf

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Affordable Care Act and Healthcare Marketplace

Lenoir Memorial plays a vital role in educating uninsured patients about their coverage options and helping them navigate the Marketplace.  There are several ways to apply for health coverage.  You can apply online using a laptop or desktop computer.  (You may not be able to complete the application using a smartphone or tablet.)  You can also fill out a paper application, apply over the telephone or apply in person at certain sites.  Find out more about the different ways to apply here.  Certified Application Counselors (CAC) are available within Lenoir Memorial to educate consumers and aid them in completing an application for coverage.   If you have questions or wish to set up an appointment, you may contact Terrence Body, social worker at 252-522-7977, a patient accounts counselor at 252-522-7000 or call 800-318-8596 at any time of day, seven days a week.  Or visit HealthCare.gov.

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HealthLink - Fall 2014

Check out the latest edition of Lenoir HealthLink! Download the pdf.

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Advances in Cholesterol Management

Dr. Vikram Gahlot from Kinston Cardiology Associates wil speak about cholesterol management.  Learn more about the new American Heart Association cholesterol treatment guidelines and the goal to help people live longer, healthier lives. There have been advances in medications and you may want to learn more about how cardiologists evaluate and better treat high cholesterol levels these days.  Make sure you are not stuck in the old mindset of treatment.  Free to the public and sponsored by the McCain Heart Center. 

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Metabolic Syndrome - How does it affect the heart?

Dr. Kirollos from Kinston Cardiology Associates will speak on, large waistlines, high triglycerides, low HDL, blood pressure, and blood sugar and how these issues can relate to the metabolic conditions in your body and especially your heart.  Learn how to prevent or delay dangerous metabolic syndrome and heart problems by learning important characteristics and stategies of self-care. Fee to the public and sponsored by the McCain Heart Center.

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Heart Healthy Heart at Every Size

Lisa Alphin, RN, BS, ES and program director of Cardiac Rehabilitation will present on this interesting topic.  Lisa will emphasize an approach to being healthier through supporting individuals and families for positive health behaviors that include healthy minds, exercise and eating healthy.  A weight-neutral approach steers away from weight-focused barometers of success that can lead to frustration, perceptions of failure and negative overall results.  Improving health includes embracing different body shapes and sizes and focusing on personal practices to improve overall well-being. Free to public and sponsored by the McCain Heart Center.

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Do You Have Low T?

Dr. Lee Cox, Lenoir Urology, will discuss what testosterone is and why it declines over time.  He will inform attendees about common symptoms of lowering testosterone levels includinging fatigue, weakness, loss of sex drive.  Find out what tests can be done to measure it and treatments.

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HealthyLife Weigh 2016 series

This weight management program focuses on weight loss goals supported by healthier nutrition practices and increased physical activity.  It is ideal for the individual needing to lose 10-40 pounds, and at a stage of readiness where lifestyle changes can be made. Nutrition education is delivered in a 4 week program led by a registered dietitian in the Minges Wellness Center at Lenoir Memorial.  The program is a modified form of the national program, HealthyLife Weigh, and focuses on the necessary formula for permanent weight loss: balancing calorie intake from food and calorie output through physical activity.  We will assist you in making permanent lifestyle changes to help you get to and stay at a healthy body weight.  This is not a diet but a new way of incorporating positive eating and activity habits. Each series consists of 4 classes that cover portion control, nutrition, grocery shopping, and emotional eating.  Participants will receive 2 months membership in the Minges Wellness Center with an individual exercise plan developed with an exercise specialist. Required registration may be completed by calling 252-522-7014.  Cost is $150.  Dates and times: Jan 6,13,20, 27 @ 8:30 a.m., Feb, 8,15,22, & 29 @4:00 p.m., March 10,17,24 &31 @ 12:00 p.m., Apr 6,13,20 & 27 @ 4:00 p.m., May 3,10,17,24 @ 8:00 a.m., Jun 1,8,15 &22 @ 12:00 p.m., July 7,14,21 & 28 @ 4:00 p.m., Aug 10,17,24, & 31@ 8:30 p.m.,Sept 6,13,20 & 27 @ 12:00 p.m., Oct 5,12,19,26 @ 4:00 p.m. and Nov 8,15,22 & 29 @ 8:00 a.m.

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