On March 24, 2016, I sent a letter to the Chief Executive Officer of a hospital that was sending a bill to one of our clients and demanding money that I did not believe was owed by our client.
In such cases, I try to make my point in a polite but straightforward way. Tell me if I succeeded with this letter.
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Since my last letter to you dated March 16, our client brought to our office a detailed bill from your firm for our examination. The client and I phoned both her Medicare supplement insurance company and Medicare to compare the bill with the claim that your firm filed with Medicare. I found some problems which may help you to track down the source of your billing problem in this matter.
According to Medicare and the insurance company, your firm filed a claim for services rendered on 09/01/2015 with total original charges of $2,345. Your bill to our client shows a total original charge of $2,802. There is a difference in the total original charge figures of about $500. That difference indicates a problem in your systems or procedures.
In addition to this problem, the itemized bill has two entries for $160 for exactly the same laboratory services. In other words, it appears to be a double entry or double charge for exactly the same services on the same day. Did your data entry person make a mistake and charge the patient twice for the very same service? It appears that way to me.
In a few weeks, the client will receive the DUPLICATE MEDICARE SUMMARY NOTICE form that we requested. When she brings it to me, I will compare it with other items. I may have more questions for your firm at that time. Please, have a responsible professional check on this matter and tell me how to reach that person so that I don’t need to bother you about this problem anymore.
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See that? I can make a point nicely in a letter. In this case, I expect my work to help our client will result in a savings for our client of almost $500.
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that insurance agency over one million dollars by fighting mistakes and fraud in the Medicare system. He wrote the book SOLVING MEDICARE PROBLEM$.
© 2016 Woodrow Wilcox