SOS: Speaking of Seniors - Hospital Wanted Client to Pay for Its Mistake

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hospitalA hospital in northwest Indiana sent a bill to our client for $476.40 for some laboratory work. Our client sent the bill to me and asked why he owed this since he had both Medicare and a Medicare supplement insurance policy that he bought through the insurance agency where I work.

I reviewed the bill and made two phone calls to Medicare with the client on the line to grant permission for me to speak and question on his behalf. In the first phone call, I requested a duplicate Medicare summary notice related to the services on the hospital bill to our client. In the second phone call, I spoke with a Medicare claims specialist. I asked her if the charges that were denied by Medicare on this bill were denied because the hospital failed to give notes and coding to demonstrate the medical necessity of the services provided. The Medicare claims representative checked the details of the claim that the hospital submitted to Medicare and confirmed that the only reason that some of the charges were denied was because the hospital failed to submit the claims properly with notes and codes that demonstrated the medical necessity of the medical services. 

On behalf of our client, I wrote a letter to the hospital which explained this and requested that it resubmit the claims after correcting the mistakes which someone at the hospital had made. I expect that when that is done our client will owe nothing and that I will have saved the client $476.40 and a bit of worry.

All the help that I gave to this client was FREE OF CHARGE. Senior Care Insurance Services distinguishes itself from other insurance agencies by giving a very high standard of service to our senior citizen clients. We “go the extra mile” to protect them from financial harm when a mistake happens in the Medicare system that could cost them money. Does your insurance agency give its senior citizen clients this high level of service? 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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