By Woodrow Wilcox
On October 25, 2016, I wrote a letter to a client. She thought that we would help her to file a claim with Medicare. We don’t do that. We do help a client to avoid financial harm whenever a mistake or fraud causes a problem with a Medicare claim. But, we don’t file original claims. Following is the body of a letter that I sent to our client to explain this.
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In our phone conversation today, you told me that you always pay your doctor in Chesterton when you visit because he is not contracted with Medicare.
THAT MEANS THAT YOU MUST FILE THE CLAIM WITH MEDICARE WITH PROOF THAT YOU PAID ALREADY.
Medicare will process your claim and send a payment to you which would equal what Medicare would have paid if the doctor were contracted with it. Likewise, your Medicare supplement insurance company will pay only what Medicare directs it to pay on the claim.
I DON’T BELIEVE THAT YOU WILL BE FULLY REIMBURSED.
This office is not capable to FILE ORIGINAL CLAIMS. No one in our office is trained for that and we do not have the manpower, equipment, or computer programs to assist with that. We will help with correcting mistakes or problems with a bill AFTER A CLAIM IS FILED. That is all we can do to help you.
I phoned your Medicare supplement policy insurance company to learn if it had any “short-cut” services for helping you file a claim with Medicare and it reported that it did not. To learn how to file a claim with Medicare, you need to call 800-633-4227.
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Everyone at this insurance agency really cares about our senior citizen clients. We do more than most insurance agents or agencies to protect our clients from mistakes and fraud in the Medicare system. But, we don’t file claims.