On February 11 and 12 of 2021, protected the surviving family of our deceased client over $2,000. On February 11, I investigated the bill. On February 12, I wrote a letter scolding the firm that sent the wrongful bill.

This is what I do every day to protect our senior citizen clients from mistakes and fraud in the Medicare system.
I wish more people would learn how to help seniors to correct wrongful Medicare related medical bills.
The insurance agency where I work hired me to protect its clients from wrongful bills to demonstrate that the owners and staff really do care about our clients. It is an extra service that the agency is not legally required to give clients. Our clients seem to appreciate my work.

Following is the letter that I sent to protect the Cedar Lake family with some editing to protect our client’s privacy.

Dear Representative,

The family of our deceased client brought a bill from your firm to our firm for our review.
The bill seeks a balance of $2,114.69 on Account Number XXXXXXX for services rendered on three different dates in December 2020.
The date of the statement is 01/29/2021.

I phoned the client’s Medicare supplement insurance company to learn what it knew of this bill.
It reported that your bill to our client is FALSE. Here is why.

All the proper balances on the bill (i.e., $10.11, $19.05, $5.51, and $7.64) were paid by our client’s secondary insurer on 01/05/2021 in a bulk check for $149.86 via Electronic Funds Transfer (EFT) with transaction confirmation # XXXXXX. In other words, your firm got paid on 01/05/2021 but never bothered to credit our client’s account by the time you sent the bill on 01/29/2021.

Someone at your firm failed to credit that payment to the account of our client. In addition to that, someone at your firm failed to discount the bill for the Medicare adjustment.
That is a serious breach of Medicare rules. Your bill to our client is an attempt to wrongfully collect $2,114.69 from our client and her surviving family.
I consider that a very serious breach of ethics.

A duplicate Medicare Summary Notice on all these claims has been ordered. That document with the Explanation Of Benefits from the secondary insurer will confirm your failure to account for payments from Medicare and adjust the bill according to Medicare’s ruling for the claim adjustment.

Please, do the honest thing and correct your errors. If you believe anything that I have alleged in this letter is untrue, explain your position in writing.

Written on February 12, 2021 by Woodrow Wilcox