By Woodrow Wilcox
I just handled another serious Medicare Foul-Up bill for a senior citizen client. A hospital in Chicago was demanding about $100 more from the senior citizen. I reviewed the papers that the client had and phoned the insurance company.
For one of the dates of service in question, Medicare reported a bill of only $686 to the insurance company when the bill was really $1,187. I requested that the hospital send the information that it got from Medicare to the insurance company. That should fix the problem. While working on this problem, I started to wonder how much Medicare Foul-Ups cost senior citizens throughout America.
On an average day, I handle three serious and multiple minor problems caused by Medicare Foul-Ups. On July 15, I handled three serious Medicare Foul-Ups that prompted me to write an article on the subject that day.
The three serious problems for three different clients on that day were (1) Medicare failed to send the essential billing information to the correct insurance company for payment; (2) Medicare sent conflicting reports on medical charges to the doctor’s office and to the patient’s insurance company; (3) the Veterans Administration did not send the necessary information to a client’s insurance company for payment processing and VA officials were obstinate and did not want to cooperate with solving the problem.
If these incidents are statistically average, then the cost of Medicare Foul-Ups to senior citizens can be reasonably estimated. Here are my calculations.
If the average Medicare Foul-Up that is not fixed costs a senior citizen on Medicare an extra $100 in charges that are wrongfully charged to the senior citizen, then the total cost to all senior citizens can be calculated this way.
Our office handles 3 serious problems per day. Our agency has about 5% of the senior citizen market in our congressional district. So, 3 x 20 should equal 100% of average daily serious Medicare Foul-Ups in one congressional district. There are 435 congressional districts. So, there should be an average of 26,100 serious Medicare Foul-Ups per day in the U.S. If each unresolved foul-up costs a senior citizen $100 that the senior citizen should not have to pay, then serious Medicare Foul-Ups are costing America’s senior citizens $2,610,000 EVERY SINGLE DAY. Multiply that figure by 365 and the annual costs to senior citizens for serious Medicare Foul-Ups is $952,650,000. But, this is only for Medicare Part A and Part B problems. Medicare Part D (prescription drugs) is another engine of Medicare Foul-Ups. Also, because Medicare and VA clinics do not communicate well, each senior citizen veteran could be overcharged OVER ONE THOUSAND DOLLARS PER YEAR BECAUSE OF FOUL-UPS ON MEDICARE ANNUAL DEDUCTIBLE CALCULATIONS!
Many insurance agencies do not have the ability to help their senior citizen clients to save money by correcting serious Medicare Foul-Ups. So, those senior citizens are badgered with demands for payment of the wrongful bills until they pay them.
If you believe that having the federal government handle all healthcare matters will solve problems, you just don’t know the facts about how the federal government actually causes many problems that cost citizens and the healthcare system billions of dollars a year. If you helped senior citizens with these problems as I do, you would understand what I mean.
Note: Woodrow Wilcox is the senior problems resolution officer at Senior Care Insurance Services in Merrillville, Indiana which is one of the largest senior citizen oriented insurance agencies in the Midwest.
© 2008 Woodrow Wilcox