SOS: Speaking of Seniors - Refile the Claim Correctly

On February 16, 2016, I helped a client from Saint John, Indiana. He came to my office with a medical bill and some other papers.

After reviewing the papers, the client and I made phone calls to the firm that sent the bill and Medicare. Following is part of the letter that I wrote to the medical billing firm after these phone calls.

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The result of these phone calls and our previous phone calls on other dates is the discovery that your firm FILED A CLAIM WITH MEDICARE INCORRECTLY. You filed it as a routine service when in fact it was not.

The Medicare representative read the footnote on this claim which explained why Medicare denied it. Medicare denies routine services. You should know that. A patient doesn’t go to a doctor and have the doctor order an x-ray picture for no good medical reason. You failed to give the medical reasons and proper coding to justify the medical service.

Our client did not cause this problem. Someone who worked on filing the claim caused the problem. Our client should not be harmed financially because of someone else’s mistake.

Please, correct the notes and coding with the claim and refile the claim with the correct information for proper processing of the claim.

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All the help that I gave this client was FREE OF CHARGE. This insurance agency distinguishes itself from others by “going the extra mile” to help our clients with such problems when the Medicare system fails to work properly. Does your insurance agency give this high level of service to senior citizen clients? If not, why not?

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Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana. That is the largest senior citizen oriented insurance agency in the Midwest. For over six years, Woodrow Wilcox has helped senior citizens with medical bill problems with Medicare and VA clinics. He has saved senior citizens over $1 million in wrongful charges. For more health care articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com. © 2013 Woodrow Wilcox. Re-published here with the permission of the author.

Woodrow Wilcox

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