Caught Hospital Mistake

WOODROW WILCOX

On March 7, 2023, I wrote a letter to a hospital to protect our client from being wrongly charged $1,322.

With some editing to protect the privacy of our client, here is what I sent to the hospital.

Our client sent to our firm a bill from your firm for our review. The bill seeks a balance of $1,322 on Account Number XXXXXXXX for services rendered on 02/11/22. I believe that the bill is false. Here is why.

The client gave me his copy of the Medicare Summary Notice. That should have exactly the same information as what your firm got from Medicare in the Medicare Explanation of Benefits. Here is what my teammate Danielle MacDonald and I found in the MSN form.

Your firm mistakenly billed the man twice for the same things and Medicare caught your mistake. Look carefully at Claim # XXXXXXXX-XX. There are four items on the list of services that were marked as denied. The four items add to $1,322 -- the amount that Medicare denied. These items with an “M” footnote are duplicate claims. In each case, one claim was accepted and approved by Medicare and one claim was denied by Medicare because it was a duplicate. Look at footnote “M” on the ones that were denied. It states, “This is a duplicate of a charge already submitted.” Thus, your firm is trying to bill the patient for amounts that Medicare has ruled you cannot bill him. You are clearly in violation of Medicare rules.

Please, stop billing our client for the $1,322. If you believe that we have erred, explain that in writing addressed to our client. Our client will forward your response to us.

All the help that Danielle MacDonald and I gave the client were FREE OF CHARGE. This insurance agency helps our clients with Medicare related medical bill problems without charge. It is just one way that we demonstrate to our clients that we really do care about them. If your insurance agent or agency does not give clients this high standard of customer care, why don’t you switch to our insurance agency?

Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that firm over three million dollars. Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through book stores and online.