By Woodrow Wilcox
On February 21, 2020, I got a bill from one of our clients who wanted me to check it. The client is from Portage, Indiana.
The bill was from a well-known laboratory. The firm wanted $708 from our client. I checked the bill. The firm was not entitled to that balance because the laboratory firm never filed the claim correctly with Medicare.
By never filing the claim with Medicare but billing our client directly, the laboratory had violated Medicare rules and regulations for firms contracted with Medicare.
Below is my letter to the laboratory firm with some editing to protect the privacy of our client.
Our client sent to our firm a bill from your firm for our review.
The bill seeks a balance of $708 on Invoice 03302529 for services rendered 02/07/20.
I phoned the client’s Medicare supplement insurance company to learn what it knew of this claim.
IT REPORTED THAT MEDICARE NEVER SENT THIS CLAIM TO IT.
The bill appears to indicate that your firm NEVER SENT THIS CLAIM TO MEDICARE AS REQUIRED IF YOU ARE CONTRACTED WITH MEDICARE. It appears that your firm attempted to by pass the correct procedure in order to bill the Medicare patient directly in violation of Medicare rules and regulations.
Please, cancel this bill and file the claim correctly. If you have filed the claim with Medicare, send both the original billing information and the Medicare EOB information directly to the secondary insurance company at the following address:
All the help that I gave this client was FREE OF CHARGE. This insurance agency takes pride in our reputation for “walking the extra mile” with our clients in such Medicare medical billing problems. If your insurance agency does not give this high level of customer service, why not switch to an agency that does? Ours does!
Written on February 21, 2020 by Woodrow Wilcox