Client feared Medicare officials

Written by Woodrow Wilcox. Posted in Senior Living

Published on May 01, 2019 with No Comments

On April 17, I met with a client at my office to review her medical bill problem.  The client is from Crown Point..

A few weeks earlier, she asked me for help.  We ordered some documents from Medicare to review together.  She brought those documents to our April 17 meeting.  She did not know how to read them.  I did.

The documents from Medicare showed that Medicare had overpaid the hospital for one service by $510.11.  Why would Medicare overpay a hospital for a medical service?

Here are the details from the official Medicare summary notice that our client received regarding one line item of a claim filed by a local hospital.  Amount facility charged: $1,265.57; Medicare approved amount: $1,265.57; Amount Medicare paid: $1,775.58.

Let me clarify what this official document from the federal Medicare bureaucracy states about this one line item in a claim report.  Medicare said that it would only approve a charge of $1,265.57.  But Medicare paid $1,775.58 for that service.  Thus, Medicare’s document admits that Medicare overpaid the hospita $510.11 on just one item on the bill.

If Medicare overpays single line items by $500 only 1,000 times per day, then Medicare is overpaying claims by half a million dollars per day.

I asked our client to let me prepare a letter for her to sign to draw this matter to the attention of our local congressman.  I believe that our elected public officials should be made aware of these kinds of mistakes by government bureaucracies.  But the client did not want to do that.  She was afraid of possible retaliation by Medicare officials.  She was afraid that reporting this would cause dishonest Medicare officials to target her and her future claims so that many claims would be denied by Medicare and she would end up with big bills to pay.  I could not persuade her otherwise.

All opinions, conclusions and recommendations expressed are those of the author and do not reflect the views of The Chronicle. Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville.  He has saved clients of that firm over two million dollars by fighting mistakes and fraud in the Medicare system.  He wrote the book Solving Medicare Problems (www.SolvingMedicareProblems.com).


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About Woodrow Wilcox


All opinions, conclusions or recommendations expressed are those of the author and do not necessarily reflect the views of The Chronicle.  Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana.  Wilcox has helped the clients of that agency save over one million dollars by finding and correcting medical bill errors that were caused by mistakes in the Medicare system.  For other articles by Wilcox, visit publishing websites including www.dakotavoice.com and www.americanclarion.com.

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