MEDICARE CLAIMS CROSSOVER DID NOT WORK

On July 20, 2015, I investigated a medical bill problem for a senior citizen from Munster, Indiana.

A hospital in Illinois was billing her for substantial balances regarding services on two dates. She did not understand why since she bought a very good Medicare supplement policy.

I learned that the Medicare crossover of claims did not work. That is the system in which Medicare reports its findings to the Medicare supplement insurance companies. Without the vital information, the insurance companies don’t know about a claim to pay.

For Date of Service 10/14/2014, the bill stated a total original charge of $1,305. But, Medicare reported only $1,069 of that to the client’s insurance company. For Date of Service 02/10/2015, the bill stated a total original charge of $4,294. But, Medicare reported only $3,105 of that.

To fix this problem, I wrote a letter to the hospital which explained this and requested that it send certain essential billing and claims information directly to the client’s Medicare supplement insurance company.

I gave the insurance company’s claims address. Then, I thanked the hospital for cooperating with us to make sure that a senior citizen does not have to pay more than the proper amount just because someone in the Medicare system made a mistake.

The help that I gave this client was FREE OF CHARGE. The owners, managers, and staff of this insurance agency care about our senior clients and we “go the extra mile” to protect them from financial harm when something goes wrong in the Medicare system. Does your insurance agent or agency give this high standard of service to senior citizen clients? If not, why not?

Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that agency over one million dollars by correcting medical bill errors that were caused by mistakes in the Medicare system. He wrote the book SOLVING MEDICARE PROBLEM$.

© 2016 Woodrow Wilcox

www.WoodrowWilcox.com