By Woodrow Wilcox
On June 4, 2019, I helped a retired doctor with a medical bill. Together, we made phone calls to Medicare, his insurance company, and a hospital in Illinois that was billing him for $2,343.95. The retired doctor is from near Valparaiso, Indiana.
The first two phone calls to Medicare and his insurance company were to narrow the possible causes of the big, unpaid bill. Once I confirmed my suspicion of what caused the big bill, we phoned the hospital’s billing department.
I informed the representative that I knew for sure that the hospital had filed the claim incorrectly because I had the proof in my grubby little paws. The retired doctor had a Medicare Advantage policy. Medicare sent a Medicare Summary Notice to the patient. That is proof that the hospital filed the claim as though the patient had a Medicare supplement policy. Claims for the two types of policies are filed differently. The hospital had filed the claim incorrectly and caused the big bill to the patient.
The billing representative realized that I was correct. She arranged for the claim to be refiled correctly. She did some quick calculations and told the patient and me that she expected the bill to drop to only $40. That would be the co-pay allowed by the patient’s real policy. So, I was able to fix this medical bill problem. But, I could not go back in time and fix a problem that an insurance agent at another firm had caused.
The insurance agent at the other firm advised the retiring doctor to simply fill out some paperwork from a packet and mail it in for a Medicare Advantage policy. I am not an agent, but I know that if the retiring doctor had purchased a Plan F Medicare supplement policy, he would have a policy with no co-pays which allowed him to get medical services throughout the U.S. Instead, with the policy that he bought through another insurance agent, he has had to pay over $10,000 in co-pays in just two years.
Some friends told the retired doctor to leave the insurance agent with the bad advice and become a client of our agency -- Senior Care Insurance Services. In my first effort for him, I saved him over $2,300.
Written on July 23, 2019 by Woodrow Wilcox