MEDICARE SYSTEM MAKES FRAUD EASY

My job is to help senior citizens with medical bill problems that were caused by mistakes in the Medicare system. I do my job well.

On July 17, 2015, I received a phone call from a client asking why he got a statement from his insurance company that it had paid a claim to a hospital when he had not gone to a hospital. I asked him to send me the document.

When I got the insurance company’s explanation of benefits form, I learned that the claim was filed for services rendered at Jackson County Schneck Memorial Hospital in Crown Point, Indiana. That hospital is not in Crown Point. Crown Point is in Lake County about 200 miles from that hospital in Seymour, Jackson County, Indiana. I know where Seymour is. I go there for family reunions. Some of my cousins were elected to office in Jackson County.

I investigated further and learned that the address in Crown Point which was used in the claim for the hospital is the address of a residence – not a hospital or other medical facility.

But, Medicare processed the claim as though it were legitimate. Our client’s insurance company paid $447.54 that it should not have paid. Medicare paid $1,789.94 on this false claim. Because of this fraud, insurance customers will pay higher premiums and tax payers will pay more taxes.

When I phoned Medicare to get the correct address to send a letter to alert the government that there was a strong possibility of fraud in this matter, the Medicare representative – who said her name was “Kay” – hung up on me.

I just could not let this go. I just had to report this. I found the address of the Office of the Inspector General of the Department of Health and Human Services. I’ll be typing a letter to that office.

If the Medicare system were designed well, the false address in Lake County, Indiana for a hospital in Jackson County, Indiana should have shut down the claim with the false information and prevented the federal government and the insurance company from paying anything until the information was corrected. In our present Medicare system, it is just too easy to defraud the federal government and insurance companies. When that happens, innocent citizens pay higher premiums and higher taxes.

Note: Woodrow Wilcox is 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 correcting medical bill errors from mistakes in the Medicare system. He wrote the book SOLVING MEDICARE PROBLEM$.

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www.WoodrowWilcox.com
Written on July 21, 2015 by Woodrow Wilcox