On May 30, 2017, I helped a client with a Medicare related medical bill problem. The client is from Crown Point, Indiana.
The client brought to me a bill that he had received. He wanted me to review the bill and tell him if he should pay it or if the bill was a mistake.
I checked the bill and found the problem. The medical service provider filed the claim incorrectly. The bill itself admitted that the claim was filed incorrectly. Our client owed nothing. Here, with a few edits to protect privacy, is the letter that I wrote for this client to the medical firm that billed him.
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Dear Representative,
Our client brought a bill from your firm our office and asked us why he got the bill despite the fact that he has a Medicare supplement insurance policy. The bill is dated 04/03/2017 and seeks a balance of $95 on Account Number XXXXX for services rendered on 02/24/2017.
YOUR BILL TO THE CLIENT EXPLAINS WHY THERE IS A BALANCE. YOU FILED THE CLAIM INCORRECTLY! The bill states that on 03/06/17, you filed the claim to Anthem BCBS as the primary insurer. He has a Medicare supplement policy and the insurance ID that he presented to your staff states that he has a Medicare supplement policy.
The correct filing procedure is to send the claim to Medicare because Medicare is the primary insurer and Anthem BCBS is the secondary insurer. THE BILL THAT YOU SENT TO OUR CLIENT PROVES THAT YOUR FIRM FILED THE CLAIM INCORRECTLY. THAT IS WHY THERE IS A BALANCE. YOUR MISTAKE IS NOT THE FAULT OF OUR CLIENT.
If you are a Medicare contracted medical service provider, then you are obligated to file the claim correctly to Medicare AND NOT DIRECTLY TO THE PATIENT OR THE SECONDARY INSURER. Please, file this claim correctly. If our client has already paid on this bill, return the payment promptly because you have no right to keep it.
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The help that I gave this client was FREE OF CHARGE. This insurance agency regularly “goes the extra mile” to help our clients in such situations. Does your insurance agent or agency give this high level of service to senior citizens who use Medicare? If not, why not?
*** Woodrow Wilcox *** is a Life and Liberty News contributor and the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that insurance agency over one million dollars by fighting mistakes and fraud in the Medicare system. He wrote the book SOLVING MEDICARE PROBLEM$ (www.SolvingMedicareProblems.com) and posts articles at www.WoodrowWilcox.com.
