A client phoned me about a bill for $153 on June 22, 2015. He was upset. The client is from Portage, Indiana.
He wanted to know why he got a bill for $153 despite having both Medicare and a Medicare supplement insurance policy through this insurance agency. I told him that I did not know why. I asked him to send the bill to me.
I got the bill and checked with his insurance company on June 24, 2015. I learned that Medicare denied (disallowed) $153 of a bill that he got from a hospital. I put the client on a three way call with Medicare to learn the reason for the denial. The client gave Medicare representatives permission for me to speak and question on behalf of our client. My questioning led to the reason for the denial.
Someone at the hospital pushed a form in front of our client and said something like, “And you need to sign this.” The client did not read it or question the form’s content or meaning. It was an ADVANCE BENEFICIARY FORM. The form stated that the hospital believed that Medicare would not approve one or more particular medical services, that our client wanted those medical services anyway, and that our client agreed to pay the charges if Medicare did not approve or allow those charges.
After finishing the call with Medicare, I phoned the client again. I told him that neither our insurance agency nor the insurance company that we recommended to him had caused this problem. Someone at the hospital who pushed the form to him and told him to sign it caused the problem. He realized that. He thanked me for helping him discover the reason for the $153 bill. He will pay it.
I don’t have a magic wand. I just do what I can to help our clients. In the past, I have written several articles warning senior citizens about ADVANCE BENEFICIARY NOTICE forms. If you sign one, you will be stuck with a bill and there is nothing that I can do to help you avoid paying that bill. So, read and question every form that a clerk at a hospital or doctor’s office gives you to sign. Otherwise, you may get stuck with a bill that you never expected.
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that insurance agency over one million dollars by correcting mistakes in the Medicare system. He wrote the book SOLVING MEDICARE PROBLEM$ (www.solvingmedicareproblems.com).
© 2015 Woodrow Wilcox