By Woodrow Wilcox
On October 18, 2016, I wrote a letter to a medical firm in northwest Indiana to help a client from Dyer, Indiana. With some editing to protect our client’s privacy, here is the letter that I sent.
# # #
Our client sent to our office a bill from your firm for our review. The bill seeks a balance of $500 on Account Number XXXXX for services rendered on 07/25/2016.
I checked with the client’s Medicare supplement insurance company on what it knew of this bill. It reported that Medicare denied and zeroed the claim on this. The client and I requested a Medicare review form about this claim. It arrived and I compared it with your bill.
The Medicare review form should contain exactly the same information that your firm received from Medicare. Your bill to the client for $500 is for services that Medicare ruled you are not entitled to payment from Medicare or the patient. See footnote “D” of Claim # XXXX-XXXX. If you caught this problem and refiled the claim with corrected coding, realize that Medicare does not send revised Medicare review forms to Medicare supplement insurance companies. So, if that is the case, please send both the original billing information and the new Medicare information directly to the insurance company. Otherwise, accept the ruling of Medicare and do not bill our client for the $500.
# # #
The help that I gave our client was FREE OF CHARGE. This insurance agency distinguishes itself from others by helping our senior citizen clients with such billing problems for free. Does your insurance agent or agency give this high level of service to senior citizen clients? If not, why not?