By Woodrow Wilcox
In early December 2014, a client sent me a copy of a letter from a federal agency. The letter explained that the client would get a check for $527 from the federal government in about 45 days. Then, the government would get its money from the hospital in Illinois that ignored Medicare rules and forced our client to pay $527 to avoid harm to his credit or being sued.
The client had already paid the $527 to the hospital in Illinois when he came to our office to ask why the Medicare supplement insurance policy that our insurance agency had sold to him did not pay the bill.
When I investigated the matter with our client, I learned that the hospital filed a claim incorrectly and that Medicare ruled that the hospital could not charge our client $527. I wrote three polite-but to the point-letters to the hospital asking it to refund the wrongfully collected money from our client and to file the claim correctly if it wanted any money for the service.
After the hospital refused to refund our client’s money, I helped our client file a complaint against the hospital for not following Medicare billing rules, for ignoring a ruling of Medicare, and for using the mail and phone to wrongfully extract $527 from our client. Our client paid that to the hospital before seeing me in order to avoid negative credit reports or a lawsuit from the hospital.
Medicare’s Screening Investigation Unit contacted the hospital to ask for its side of the story. The hospital ignored the request for information from this federal government agency. That was a bad move for the hospital.
The final result of this story is that our client will get his money back and the federal government is sure to get its money back from the hospital. I suspect that the hospital will have a few additional expenses from this matter, too.
I wrote three polite letters to the hospital in Illinois in which I asked it to follow Medicare rules and return our client’s money. The money was extracted from our client through the hospital’s threats of credit damage or lawsuit. When my letters to the hospital didn’t work, I had to do something else. Sometimes, you must play rough.
All the help that I gave to this client was FREE OF CHARGE. The owners, managers, and staff of this insurance agency really do care about our senior citizen clients. We “go the extra mile” to protect our senior citizen clients whenever mistakes or misdeeds in the Medicare system threaten to cause our clients some financial harm. Does your insurance agency give this high level of service to its senior citizen clients? If not, why not?
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that insurance agency over one million dollars by correcting medical bill errors in the Medicare system. He even wrote the book SOLVING MEDICARE PROBLEM$ (www.solvingmedicareproblems.com).
© 2014 Woodrow Wilcox