SOS: Speaking of Seniors - Medicare Over Nine Months Late
In December of 2015, a senior citizen client brought unpaid medical bills to my office and asked why the bills were not being paid according to the Medicare supplement insurance policy that he bought through this insurance agency. The client is from Merrillville, Indiana.
I reviewed the bills and made phone calls with the client to his insurance company and to Medicare. I requested that Medicare send copies of all his claims for several months.
Once our client brought those papers to our office for me to compare against the medical bills, it was easy for me to see what the problem was. I made another phone call to Medicare with the client and put the call on speaker phone so that the client could hear everything.
I asked the Medicare representative what Medicare records showed as the insurance coverage for our client. Medicare records still showed our retired client as having insurance coverage through his wife’s employer which was false. That insurance had ended months before our call. Medicare promised to fix the records within ten business days.
The client returned to my office for another call to Medicare on January 21, 2016. I wanted to check to make sure that Medicare had fixed the records. Medicare has disappointed our clients with broken promises in the past. We learned that Medicare had fixed the client’s record on January 6, 2016. That was right after we made the previous call.
The Medicare records should have been changed by May 1, 2015. But, Medicare failed to update the record until January 6, 2016. Medicare was over nine months late in its record keeping of our client. During that period, ALL MEDICAL CLAIMS WERE PROCESSED INCORRECTLY RESULTING IN EXPENSIVE MEDICAL BILLS FOR OUR CLIENT. But, after the record had been corrected, I wrote to every doctor, hospital, and laboratory that sent a bill to our client. In the letter, I explained Medicare’s mistake and asked them to refile any claim that had a balance. The processing of the claims after Medicare records were corrected should result in our client owing nothing.
All the help that I gave this client was FREE OF CHARGE. This insurance agency distinguishes itself by “going the extra mile” to help our clients with such problems. Does your insurance agency give this high level of service to its senior citizen clients? If not, why not?
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