S. O. S. – Speaking Of Seniors

Medicare Advantage is Different

S. O. S. – Speaking Of Seniors

S. O. S. – Speaking Of Seniors

Helped Widow Fix Medical Bill

By Woodrow Wilcox

On September 11, 2024, I wrote a letter to the patient billing department of a hospital in northwest Indiana.  I was helping a widow to fix a problem caused by Medicare.  I was working to save the widow $1,930.

With some editing to protect privacy, here is the letter that I sent the hospital.

The family of our client sent to us a bill from your firm and asked us to check why the secondary insurer had not paid it.

I phoned the late client’s Medicare supplement insurance company to learn what it knew of this bill.  It did not receive these claims from Medicare.  That is not the fault of our client or his surviving relatives.

To fix this problem as fast as possible so that your firm gets paid, please send both the original billed claims information and the Medicare EOB information for these claims to the insurance company’s claims department at this address.  [Here I gave the address.]

The help that I gave the widow was FREE OF CHARGE.  This insurance agency helps all our clients with similar medical bill problems without charging anything to the client.  We do that to demonstrate to the clients that we care about them and want them to be treated fairly and well.  If your insurance agent or insurance agency does not give this high level of customer service, shouldn’t you switch to an insurance agency that does?  This one does.

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 by fighting mistakes and fraud in Medicare medical billing.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on September 11, 2024 by Woodrow Wilcox.
 

S. O. S. – Speaking Of Seniors

Medicare Slow Record Update Caused Bills

By Woodrow Wilcox

On September 11, 2024, I made a phone call to Medicare with a client on the line, too.  The client is from Griffith, Indiana.  She and I attended Griffith High School together many moons ago.

In our conversation with the Medicare representative, we learned that Medicare failed to update our client’s Medicare record in a timely manner and that caused our client to be hounded for unpaid bills.  Many seniors don’t know that Medicare is slow to update its records of senior citizens who switch insurance coverage.  If a senior gets medical services before Medicare has updated the file on the senior, the senior is likely to get bills from medical firms that did not get paid because of Medicare’s slow work on updating files.

With some editing to protect privacy, here is the letter that I sent to medical firms that were billing our client for payment.

Our client brought medical bills and other papers to our office and asked us to review the problem of her bills not getting paid by Medicare or her secondary insurer.

I reviewed the information and phoned Medicare with her to discuss the claims.  Here is what we learned.

Our client was divorced and ended her coverage with her former husband’s health insurance plan on February 29, 2024.  Then, she had Medicare as her primary insurer starting March 1, 2024.  But Medicare took three and a half months to update her Medicare record.  During that time, she received medical services from your firm that were denied by Medicare because it was so slow to update her Medicare file.  That file was not updated until June 13, 2024.

Now that her Medicare file is accurate, please refile the claims that were denied previously.  The claim should be honored by Medicare and the secondary insurer when you file it this time.  Here is the account number to help you locate any bill with an outstanding balance.  Thank you for your cooperation.  [Account number cited here.]

All the help that I am giving the client is FREE OF CHARGE.  This insurance agency helps all our clients with such medical bill problems without charging the client anything.  It is the way that we demonstrate to our clients that we really do appreciate their business and want them treated fairly and well.  If the insurance agent or agency that you use does not give this high level of customer service, why don’t you switch to an insurance agency that does?  This one does.

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 by fighting mistakes and fraud in the Medicare billing system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on September 11, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Client Agreed to Be Billed

By Woodrow Wilcox

On September 10, 2024, I wrote a letter to a client about a medical bill that she agreed to pay.  With some editing to protect privacy, here is the letter that I sent the client.

On August 26, 2024, I wrote a letter to the medical firm that billed you.

A few days later the patient billing person phoned me.  She said that you signed an Advanced Beneficiary Notice (ABN) form.  I asked her to send you a copy of the signed form to refresh your memory.

If you did sign such a form, there is nothing that I can do to help you avoid paying for the service named in that form.

I have written published articles many times to warn seniors not to sign that form without understanding what it means.

Unfortunately, the client did not know that she should not sign an ABN.  When you go to a medical office, be careful to understand what you sign before you sign it.

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 by fighting mistakes or fraud in medical billing.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on September 10, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Claims Were Missing

By Woodrow Wilcox

On September 6, 2024, I wrote a letter to a medical firm for a client from Schererville, Indiana.  With some editing to protect privacy, here is the letter that I sent for the client.

Our client sent to our firm a bill from your firm for our review.  The bill seeks a balance of $885 on Account Number XXXXXXXX for two dates of service – 06/28/2024 and 08/23/2024.

I phoned the client’s Medicare supplement insurance company to learn what it knew of these claims.  It reported that it did not receive these claims from Medicare.  Then, I phoned Medicare to request duplicate Medicare Summary Notice forms regarding these claims be sent to the client.  Medicare could find only one claim that they believed your firm sent.  Medicare had no record of you ever sending a second claim.  Medicare could not tell me which one was missing because of HIPPA laws.

To solve this problem as fast as possible, please send both the original billing information and the Medicare EOB information on these claims directly to the secondary insurer at the following address.  [Claims address of the insurance company.]

Otherwise, you will need to wait for Medicare to send the EOB.  I am telling the client to send it to me when he gets it.  That is how I will learn what might have gone wrong with your claim.

Written on September 6, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Helped Hobart Client

By Woodrow Wilcox

On September 5, 2024, I helped a client from Hobart, Indiana.  She went to Florida for a visit and visited a hospital there, too.  She got a bill.  Her insurance company did not get a claim report from Medicare.  So, it did not pay anything on the claim that it never got.

The hospital billed our client for the amount that her insurance company would have paid if Medicare had sent the claim information to it.  This happens all the time.  The Medicare system relies on electronic communications systems that uses telephone, internet, and satellite.  If there is a break in the communication for even a second, thousands of bits of information are lost.

I believe that is what causes many of the failures of the Medicare system to get claim information to and from insurance companies that deal with  Medicare.

It is some work to try to fix the mess that this makes.  On the bill to the client, two addresses were given for the billing hospital.  But one was in Nashville and the other was in Cincinnati.  The hospital is in Florida.  I found the address for that.  I phoned the hospital.  But it uses a virtual assistant to answer the phone and will not transfer the caller to a different department or a real person unless the caller talks to a machine.  Sorry, I will not talk to a machine.

So, I sent copies of the following letter to three addresses of the patient billing manager of the billing hospital and one copy to the client.  Also, I phoned Medicare to request a copy of the claim report to be sent to the patient – our client.  When she brings that to me, I can help her more.  But for now, I’ve done all that I can do with this billing matter.

With some editing to protect privacy, here is the letter that I sent the hospital.

Our client sent to our firm a bill from your firm for our review.  The bill seeks a balance of $1,632 on Account Number XXXXXXXX for services rendered on 2/5/2024.

I phoned the client’s Medicare supplement insurance firm to learn what it knew of this claim.  It reported that Medicare did not send a report about this claim to it.  That is not the fault of the patient – our client.

To fix this problem and get your firm paid as fast as possible, please send both the original billing information and the Medicare EOB information about this claim directly to the secondary insurer.  Here is the address for you.

All the help that I gave this client was FREE OF CHARGE.  This insurance agency helps all our clients with medical billing problems like this one.  If your insurance agent or agency does not give this high level of customer service, shouldn’t you switch to an insurance agency that does?  This one does.

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 by fighting mistakes and fraud in the Medicare system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on September 5, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

A Letter To Every Medical Biller

By Woodrow Wilcox

On August 28, 2024, I sent letters to six medical firms about their bills to our deceased client.  With some editing to protect privacy, here is the letter that I sent to each medical biller.

The relatives of our deceased client sent to our firm one or more bill(s) from your firm for us to check.  A number of medical service firms sent bills.  Your firm was one of them.

I researched the bills with the secondary insurance firm.  We learned that some claims were not paid by the secondary insurance firm because our client let his policy lapse for a few days.  But he caught the mistake in time and reinstated his policy.

But some claims were processed without clearance from the reinstatement.  I spoke with a vice president of the secondary insurer today.  Those claims that were not paid will be reprocessed to be paid.

Please, accept this apology and be patient for payment of any outstanding balances.  Thank you.

Written on August 28, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

The Bills Totaled Over $43,000

By Woodrow Wilcox

On August 27, 2024, I wrote a letter to the patient billing manager at a local hospital requesting that certain information be sent to our client.  The client would then bring the information to me so that I could help with fixing a billing mess.

The client waited over a year and a half to bring the problem to me.  The information brought was not complete.  I could not help him with incomplete information.  The best source for the needed information was the hospital that was sending bills that were not getting paid.

With some editing to protect privacy, here is the letter that I sent to the hospital.

[Our client] and his wife delivered papers about bills with your firm and asked me to help fix whatever problems there were.

Unfortunately, they supplied no Medicare Summary Notice forms.  Those need to be ordered.  But I need to know about every DATE OF SERVICE.  I’m not sure that I have all the dates of service.

Please, send to our client a complete list of DATES OF SERVICE that have an outstanding balance.  I will instruct the client to deliver your list to me so that I can request the MSN forms that I need to assist them.

To help you with this requested project, here is a list of the account numbers or guarantor numbers that I found on the bills that they delivered to me.

Account #’s: XXXXXXX, XXXXXXX, XXXXXXX.

Guarantor #’s: XXXXXX.

This is all the information that I have to share with you.  I know this is some work.  But I need the information to get MSN forms and check with the secondary insurer whether it got any claim reports for your claims.  If Medicare attempted crossovers that failed, that would explain the mess.

Thank you very much for helping me to help our clients and get your firm paid in as timely a manner as possible at this point in time.

This is a huge project.  But we are helping the client at no charge.

Written on August 27, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

The Facts Changed And Cost More

By Woodrow Wilcox

On August 27, 2024, I wrote a letter to a client who was upset with us.  But the client changed the prescription medicine that he bought and changed the facts from what he had described to an insurance agent at our agency.

With some editing to protect privacy, here is the letter that I sent to the client.

I got a note to phone you today and I phoned you within 15 minutes of getting that message.

You were upset about what you paid for prescription medicine under a plan that you got through our agency.  I told you that I was not the manager over the insurance agent who helped you.  I took a message and forwarded it.  Then, you came to our office and met with a different agent.  The agent listened to you and then tried to explain things to you.  He thought that maybe I could explain things to you better.  I’ll try.

When you met with the original agent, you brought a list of medicines that you normally take.  He searched which plans gave a good price for those medicines.  The federal government classifies prescription medicines in tiers ranging from most expensive to least expensive.  We don’t make the rules for Medicare medicines.  But our agents do study the rules in order to guide clients to plans that will cost the least to the client.

But recently, you tried to get one medicine and could not.  So, you bought a substitute medicine that cost much more because it was a higher tier drug.  You never talked to our agent about the cost of the more expensive drug.  You changed the drug and the facts from what you discussed with the agent.  The change in the drug bought pushed you into the annual “donut hole” much faster than expected.  It is not fair for anyone to blame an agent for extra costs that were caused by a change in a drug or the facts from what was discussed with the agent previously.

If you want further help, you should call the insurance company to ask it to explain its calculations.  If you want my help, make an appointment with me and we will phone the insurance company together from my office.

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 by fighting mistakes and fraud in medical billing.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on August 27, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

The Hospital And Medicare Goofed

By Woodrow Wilcox

On August 26, 2024, I wrote a letter to a hospital in Illinois and the collection law firm that it used to pursue a client who lives in Dyer, Indiana.  With some editing to protect privacy, here is the letter that I sent.

Our client sent to our firm statements from your hospital and from the collection law firm [that your firm uses].  We helped the client order Medicare Summary Notice forms about claims on the papers received.  We reviewed the papers.  Here is what we learned.

The bill of $28.92 for Date of Service 06/09/22 was denied by Medicare.  The Explanation of Benefits that your firm received should have exactly the same information as the Medicare Summary Notice that the patient received.  Look at footnote “C”.  Medicare states, “You should not be charged for this code.  If there is a charge, you do not have to pay the amount.”  Here is the [law firm reference number for this.]

Your bill to our client claims an original charge of $217 on 06/14/22 with a balance of $15.14.  The client’s insurance company got no claims for 06/14/22.  But on the Medicare Summary Notice, it states that you filed the DOS as 06/13/22.  Here is the [law firm reference number for this].

For claims on DOS 06/10/22 and DOS 06/14/22, the insurance company received no claims.  If there are outstanding balances from these dates or other dates, please assume that the secondary insurance company did not get them in any attempt by Medicare to crossover the claims to the secondary insurer.  To solve this problem as fast as possible, send both the original billing information and the Medicare EOB information directly to the secondary insurer at the following address.

All the help that I gave this client was FREE OF CHARGE.  This insurance agency helps all clients with such medical bill matters to demonstrate that we really do care about our clients.  If your insurance agent or agency does not give this high level of customer service, shouldn’t you switch to one that does?  This one does.

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 by fighting mistakes and fraud in the Medicare billing system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on August 26, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Dear Patient Billing Manger

By Woodrow Wilcox

On August 26, 2024, I sent a letter to the patient billing manager of a medical firm that billed one of our clients who lives in Merrillville, Indiana.

With some editing to protect privacy, here is the letter that I sent.

Our client sent to our firm a bill from your firm and asked us to check it for accuracy.  We asked the client for a copy of the Medicare Summary Notice that pertains to this bill and that was furnished.  Your bill is erroneous.

The information that is on the client’s Medicare Summary Notice should be exactly the same as the information on the Medicare Explanation of Benefits that your firm received.  Look at footnotes “A” and “B” on your claim filed.

The equipment that you sold to the client is not covered by Medicare and she does NOT have to pay you for it.  You can appeal the ruling.  But until you do and get a favorable result on the appeal, DO NOT BILL OUR CLIENT when such is against Medicare rules.

The help that I gave our client was WITHOUT CHARGE.  We help all our clients with simple medical bill problems to demonstrate that we really do care about them.  If your insurance agent or agency does not give this high level of customer service, why not switch to a firm that does?  This one does.

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 by fighting mistakes and fraud in the medical billing system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered at book stores or online.

Written on August 26, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

FIGHTING PAYMENT “SKIMMING”

By Woodrow Wilcox

On August 26, 2024, I sent a letter to a medical service provider for a client from Crown Point, Indiana.  With some editing to protect privacy, here is the letter that I sent about the bill from the medical firm.

You sent a bill to our client and he forwarded it to our office.  He asked us to check your bill to him for accuracy.  I checked with the client’s Medicare supplement insurance company about your bill.  Your bill is false.  Here is why.

For Date Of Service (DOS) 04/04/24, the original charge was $637 and you billed a balance of $32.41.  But the insurance company sent you that balance on 04/29/24 and the tracking confirmation number is KXXXXXXXXXX.

For DOS 04/08/24, the original charge was $527 and you billed a balance of $19.10.  But the insurance company sent you that balance in the same payment as the previous one mentioned.

For DOS 04/11/24, the original charge was $527 and you billed a balance of 0.06 (six cents).  But the insurance company sent you a payment of $19.10 on 05/06/24 and the tracking confirmation number is KXXXXXXXXXX.

For DOS 04/18/24, the original charge was $527 and you billed a balance of 0.99 (ninety-nine cents).  But the insurance company sent you a payment of $19.10 on 05/13/24 and the tracking confirmation number is KXXXXXXXXXX.

This seems to be a pattern of someone within your billing department “skimming” payments by insurance companies to cause a false bill with a balance for a patient.  “Skimming” is a way to redirect a payment to an account that the skimmer wants to enlarge.  That is what I suspect is causing the problem.  If you need help finding the money, phone the insurance company at 972-XXX-XXXX.  Stop billing our client a false balance.

All the help that I gave this client was FREE OF CHARGE.  This insurance agency helps all our clients with such matters without charging anything to demonstrate to our clients that we really do care for them.  If your insurance agent or agency does not give this high level of customer service, why not switch to an insurance agency that does?  This one does.

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 by fighting mistakes and fraud in medical billing.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered at book stores or online.

Written on August 26, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Helped Senior in Covington, Indiana

By Woodrow Wilcox

Most of our insurance agency’s clients are in northwest Indiana or just across the state line in Illinois.  Some start in this area and move somewhere warmer.

On August 23, 2024, I helped a client who lived about 150 miles south from here.  I had been working on her case for almost two months.  The insurance company claimed one thing and the hospital claimed another thing.  The client and I were caught in the middle.

So, I wrote a letter to the supervisor of the claims department of the insurance company and explained the situation.  I was standing for our client getting help and not being harmed financially.  With some editing to protect privacy, here is the letter that I sent.

Our client sent to our firm a bill from a medical firm and asked us to check why her policy with your firm did NOT pay the bill.  The bill is from (the hospital).

I contacted your firm and the medical firm.  Your people told me to tell the medical firm to send complete billing information.  So, I wrote to the medical firm.  Another bill came.  So, I phoned the medical firm and left a message for its billing manager.  [The manager] phoned me and told me that the medical firm sent complete claims information to your company several times.  But your firm did not respond with a payment.

We do not want our client to be financially harmed by anyone.  Please, take the time to check this and make sure the claim gets paid.  Thank you.

Copies of pertinent items are enclosed.

All the help that I have given this client was FREE OF CHARGE.  This insurance agency helps clients with such problems to demonstrate that we “walk the extra mile” and really care about our clients.  If your insurance agent or agency does not give this high level of customer service, shouldn’t you switch to one that does?  This insurance agency does.

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 in 21 years.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through book stores or online.

Written on August 23, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Helped Client With “Obamacare” Policy

By Woodrow Wilcox

On August 20, 2024, an agent in our office asked me to help his client who had a problem with a “Marketplace” or “Obamacare” insurance policy that we had sold to the client.

The problem was that the hospital goofed by assigning the client an anesthesiologist that was “out of network” with the “Obamacare” insurance policy that she had.  That increased the cost of the services way more than getting services from an anesthesiologist that would be “in-network”.  We believed that the fault was with the hospital.  So, I asked them to fix the problem so that the client would not be harmed financially.

With some editing to protect privacy, here is the letter that I sent to help the client with this problem.

Please, explain what your firm did.  Our client sent a bill to us to check.  It is not from your firm.  It is from [an anesthesiologist].  But she got the bill because your firm caused her to get the bill.

She went to your hospital for services.  She had a Marketplace (Obamacare) insurance policy.  She needed the hospital to be “in-network”, the doctor to be “in-network”, and the anesthesiologist to be “in-network” to get full assistance through her policy.

She chose the hospital and it was “in-network”.  She chose the doctor and the doctor was “in-network”.  But your firm – the hospital – chose the anesthesiologist.  Why did you choose an anesthesiologist that was not “in-network”?  The bill is over $7,000 for a person that has a Marketplace policy!

What can and will you do to fix this problem so that the patient is not harmed financially?

All the help that we are giving this client is FREE OF CHARGE.  We help all our clients with medical bill problems at no charge to demonstrate that we really do care for our clients.  If your insurance agent or agency does not give this high level of customer service, shouldn’t you switch to a firm that does?  This one does.

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 by fighting mistakes and fraud in the medical billing system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on August 20, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Helped Indian Immigrant Client

By Woodrow Wilcox

On August 16, 2024, I had a phone call with the manager of patient billing of a hospital in Lake County, Indiana.

The manager had read my letter and checked the facts.  He learned that I was correct that an employee of the hospital had made a mistake and charged our client co-pays for a few visits when no-copay was due because of the kind of Medicare policy that she bought through our insurance agency.  He let me know that he had ordered a refund to be sent to the patient.

This hospital patient billing manager was very pleasant.  I complimented him that he had a similar attitude to mine.  Each of us knows the system is far from perfect and each of us work to correct mistakes so that senior citizens are not harmed financially.

I can work with a hospital billing manager like that every day of the week.

Written on August 16, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Sent Second Letter To Biller

By Woodrow Wilcox

On August 15, 2024, I sent a second letter to a medical biller about a problem with its bill.  I did it for one of our clients in Fountain County, Indiana.

With some editing to protect privacy, here is the letter that I sent.

On July 19, 2024, I sent you a letter about a bill that your firm sent to our client.  A copy of that letter accompanies this letter.

Instead of cooperating so that your firm could be paid by the client’s Medicare supplement insurance company, your firm sent another bill for the same balance.  The statement is dated 08/05/2024.  It might be that you did not get the letter in time to process it and stop the sending of the new bill.  But just in case you misplaced the first letter, I am sending to you a copy of it with this letter.

Please, cooperate to comply with the request of the secondary insurer so that the matter will be resolved and I can close the file on this.  Your cooperation will mean that I won’t have to do the work to help the client file a complaint with a state and/or federal office against your firm for bad business practices.

All the help that I am giving to the client is FREE OF CHARGE.  This insurance agency helps clients with Medicare related medical billing problems without charge to demonstrate to clients that we really do care about them.  If your insurance agent or agency does not give this high level of customer service, why don’t you switch to an insurance agency that does?  Our agency does.

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 by fighting mistakes and fraud in the Medicare system.  Also, Woodrow Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on August 15, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Now, Will You Stop Billing Our Client?

By Woodrow Wilcox

On August 14, 2024, I sent a letter to a billing department for doctors at a hospital.  I wanted to learn if the billing firm was going to stop sending bills to our client.  I wanted to know if my work had saved our client over $2,200.  With some editing to protect privacy, here is the letter that I sent to the medical biller.

Previously, I sent you a letter dated August 5, 2024 in which I told you that the secondary insurer reported that Medicare denied certain claims on your bill to our client of Account Number XXXXXXXX for services rendered 12/15/23 and 12/16/23.  In that letter, I told you that the Medicare Summary Notice forms about the denied claims had been ordered.  I got the MSN reports today and reviewed them.

I have copies of two different letters sent to the provider by (a Medicare related firm) which are dated June 10 and June 25, 2024.  The first letter requested additional documents to consider the appeal and gave you only 14 days to furnish that.  The second letter states that the appeal of the denied services was unfavorable towards the provider but that you have 180 days to appeal.  (Your firm) is named as the appealing provider in each letter.  Did you appeal the decision or not?

I have a copy of an MSN report dated July 3, 2024 which states that the same claims were denied by Medicare after the June 25 notice of denial.  I have no knowledge of whether you did or did not file an appeal.  I would like to know if this bill matter is settled and you are not going to try to collect on claims that Medicare denied or otherwise.

Please, inform our client so that he can let me know your answer.

Written on August 14, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

The Client Started To Cry

By Woodrow Wilcox

On August 9, 2024, a client came to my office for our appointment.  I helped her to sort through the problems that some medical bills were giving her.  The day before this, her insurance agent came to me to get an appointment for her.

While I was helping her, she began to cry.  I think it was a cry of relief that, finally, someone was helping her with her medical bill problems.

The problems were not caused by her.  On one date, a hospital filed a claim properly with her Affordable Care Act (Obamacare) insurance policy.  But on another date, the same hospital did not file a claim with her insurance company.  Instead, the hospital simply gave her a self-pay discount.  Why did it do that and was that proper?  I wanted to check that.

We contacted two collection attorney offices.  One had taken over collecting on a medical bill that a collection company had been working to collect.  The collection company went out of business and the law firm took over trying to collect.  In our discussion with the collection law firm, I discovered that about $400 that the client sent to the original collection firm had not been acknowledged as received to the collection law firm that took over the account.

We phoned other parties to get help.  Some firms that we called simply told us to leave a message.

I did everything that I could do on one day.  The rest of my help will come later when we have more paperwork that we requested.  The client is getting help with the bills now.  She seemed to be less worried and more cheerful when she left my office than when she entered it.

Written on August 9, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Scolded Hospital For Bad Billing

By Woodrow Wilcox

On August 6, 2024, I wrote a letter for a client who lives in Valparaiso, Indiana.  The letter was to a hospital in northwest Indiana.  In the letter, I scolded the hospital for very sloppy and inaccurate medical billing.

With some editing to protect privacy, here is the letter that I sent to the hospital for our client.

Our client sent to our firm a bill from your firm for our review.  The bill is dated 07/23/24 and seeks a balance of $XXXX on Account Number XXXXXXXXX for services rendered on 04/23/24.

I phoned the client’s secondary insurer to learn what it knew of this bill.  It reported that YOUR BILL TO OUR CLIENT IS FALSE.  Here are the details.

The insurance company got the report about the claim and processed it.  The insurance company sent to [your firm] an electronic check for the balance of $XXXX for this claim on 05/17/24.  YOUR FIRM CASHED THAT CHECK ON 05/24/24.  So, your firm had full payment for the services to our client on 05/24/24 but you still sent a bill to the client to pay you $XXXX on 07/23/24.  That is almost TWO MONTHS AFTER YOUR FIRM WAS ALREADY PAID BY THE INSURANCE COMPANY.  Are you more than two months behind in your bookkeeping of accounts?

Please, correct your error and send our client a new bill with a correct balance of ZERO.  If you need help to find the money that you were paid, phone either the Payment Department at XXXXX Ins. Co. or phone the banking service which is XXXXX (banking system) at 855-XXX-XXXX.

Written on August 6, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

My Critical Letter to A CEO

By Woodrow Wilcox

On August 5, 2024, I sent a critical letter to the CEO of a medical firm and the chiefs of some of the company’s departments.  The letter was written to alert the CEO that several departments of the company were not working well and were hurting our client.

With some editing to protect privacy, here is the letter that I wrote to help the client.

Dear Executives,

Unfortunately, I am writing you because some people under your management are NOT doing their jobs well.  In order to help our client, I had to send this letter and its attachments to you.

In early July, I phoned your patient billing service and got a recording of the fax number for sending a fax and the address for sending a letter.  I sent the letter on July 8, 2024.

Our client got another bill from your firm.  So, I sent another letter on August 2, 2024.  Then, today, the first letter of July 8 was returned by the U.S. Mail for being undeliverable.  WHAT IS GOING ON WITH YOUR COMPANY?  IT SEEMS AS THOUGH YOU DO NOT WANT TO RESPOND TO ANYTHING THAT ALERTS YOU TO A PROBLEM IN YOUR SYSTEMS.

Today, I phoned the Merrillville office of your firm.  Someone there said that she would forward my call to your Patient Billing department.  But instead, she disconnected my call.

Please, pay attention to the previous correspondence so that I will not need to help the client file complaints against your firm for its bad business practices with state or federal officials.

All the help that I am giving this client is FREE OF CHARGE.  This insurance agency goes the “extra mile” to help our clients with such billing matters to demonstrate that we really do care for our clients.  If your insurance agent or agency does not give this high level of customer service, why not switch to a firm that does?

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 by fighting mistakes or fraud in the Medicare system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available from book stores or online.

Written on August 5, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

Ambulance Response Charge Again

 By Woodrow Wilcox

            On July 30, 2024, I wrote a letter to a client about the AMBULANCE RESPONSE CHARGE in Indiana.  With some editing to protect the client’s privacy, here is the letter that I sent to the client.

            You sent a bill to me to check for you.  I researched the bill and phoned you to discuss it with you.  Over the phone, you told me that you simply told your daughter that you were not feeling well.  Your daughter assumed that you needed an ambulance and phoned for an ambulance for you.  But you were not sick enough and you refused to be taken to a hospital.

            As I explained to you on the phone, because an ambulance was called but not needed because you did not feel sick enough to go to a hospital, neither Medicare nor your Medicare supplement insurance company will pay any of the ambulance bill.  And, Indiana law now makes you liable for an AMBULANCE RESPONSE CHARGE.  Many times, in northwest Indiana, ambulance companies charge a RESPONSE CHARGE of $900 per call.  You were fortunate that your local fire department responded and charged a RESPONSE CHARGE of only $256.

            You just sent to me the Medicare Summary Notice (MSN) that pertains to the bill.  It cites the claim and then gives a footnote that states, “Medicare does not pay for this item or service.” 

            I suggest you or your daughter pay the bill.  There is nothing that I can do about it to save you money.

Written on July 30, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

Hospital Sent Unmatching Info

 By Woodrow Wilcox

            On July 19, 2024, I checked a bill for a client who lives in central Indiana.  A hospital wanted a balance of $585.41.  With some editing to protect privacy, here is the letter that I sent to the Patient Accounts Manager at the hospital.

            Our client sent to our firm a bill from your firm for our review.  The bill seeks a balance of $585.41 on Account Number XXXXXXX for services rendered on 10/04/2023.

            I phoned the Medicare supplement insurance company of the client/patient.  I asked them what they knew about this claim.  Here is their response.

            Your firm keeps sending incomplete information about this claim.  The secondary insurer did not get a crossover of this claim from Medicare.  It requested from your firm the needed information on a paper claim.  But your firm sends a bill and Medicare EOB information that do not match.  The claim information must match for the secondary to send a check for the balance.  The senior citizen patient DID NOT CAUSE THE BILLING PROBLEM.

            Please, do the right thing and do not hound the senior citizen for a problem that she did not cause.  Instead, send both the original billing information and the Medicare EOB information (so that these items match) to the insurance company at the following address.

Written on July 19, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

The Part B Annual Deductible

 By Woodrow Wilcox

           On July 18, 2024, I wrote a letter to a client who forgot what kind of Medicare supplement insurance policy he had bought.  With some editing to protect privacy, here is the letter that I sent to him.

 You sent three medical bills to our firm for us to check for you.  Those were delivered to me to check for you.

I phoned your Medicare supplement insurance company to learn what it knew of these claims.

 The insurance company reported to me that Medicare ruled the balances on each of these bills were your Medicare Part B annual deductible.  This year, the Medicare Part B annual deductible is $240.  The balances on the three bills you sent added to exactly $240 ($85.71 + $33.27 + $121.02).

You bought a Plan G Medicare supplement insurance policy.  All Plan G policies, no matter which insurance company sells the Plan G policy, DO NOT PAY THE MEDICARE PART B ANNUAL DEDUCTIBLE.

 I’m sure that your agent explained that to you.  You just forgot.  You could have bought a policy that does pay the Part B annual deductible.  But those policies cost more money. 

Thank you for allowing us to help you with your insurance needs.  If you have any questions, contact the agent who helped you to select your policy.

Written on July 18, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

 A Hospital’s Broken Promise

 By Woodrow Wilcox

            On July 12, 2024, I phoned a client’s insurance company to check on a bill.  I was very disappointed that a key manager at the hospital had broken a promise to me about working together to resolve a medical bill problem for our client.

          With some editing to protect privacy, here is the letter that I sent to the manager of billing at the hospital.

            A few weeks ago, we had a great phone conversation in which you said that I just need to get things to you and you would handle any billing problems.

            So, I sent you a copy of my letter to the CEO of your hospital that I had sent just a few days earlier.

            Now, I learn from the health insurance company that it has not received any of the bill information that it requested from your firm.

            Note that on my letter dated June 7, 2024, I clearly gave the correct address for that insurance firm.  Why was NOTHING DONE?  Please, do what I asked so that this bill and problem can be resolved.

            If my letters don’t work, I will have to help the client file a complaint against the hospital for its bad business practices with the Office of Consumer Protection of the Indiana Attorney General.  I’ve done that on other occasions, too.

Written on July 12, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Forgot Medicare Part B Deductible

By Woodrow Wilcox

            On July 12, 2024, I wrote a letter to a client who forgot what she had bought through our insurance agency.  The client is from Lansing, Illinois.  With some editing to protect her privacy, here is the letter that I sent to remind her of what she bought.

            You sent a bill to one of our offices asking us to explain it.  That office forwarded the bill to me.

            I reviewed the papers and your letter to us.  Then, I phoned your insurance company to learn what it knew of this bill.  Here is the result.

            The original bill was $408.  Your insurance company got the information about the claim from Medicare on 02/15/2024.  Medicare approved a charge of $72.93.  Medicare paid $35.10.  Your insurance paid $8.60.  Medicare ruled that $29.23 was part of your Medicare Part B annual deductible for 2024.  You bought a Plan G Medicare supplement policy.  All Plan G policies, sold by any insurance company, DO NOT PAY THE MEDICARE PART B ANNUAL DEDUCTIBLE.

            There are policies that DO pay the Part B annual deductible but those policies cost more.  You did not buy a more expensive policy.  When you chose a Plan G policy, you agreed to pay the Part B annual deductible.  The $29.23 is part of that.

            If you have any questions, contact the insurance agent who helped you.

            Thank you for allowing us to help you with your insurance needs.

            This insurance agency helps all our clients who forgot the details of what they bought with a similar explanatory letter.  It is how we show clients that we really do care to treat them well.

Written on July 12, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

 Helping Widow Fight Medical Bills Totaling Over $200,000

 By Woodrow Wilcox

            On July 2, 2024, I helped a client from Highland file a complaint with the Indiana Attorney General’s Office of Consumer Protection against an insurance company and two hospital companies.  The combination of medical bills totaled over $200,000.  All the claims were for care to her late husband during his last weeks of life.

            In this case, I found evidence that she was being billed by two different hospital billing firms for the same services on the same dates of service.  Medicare denied almost everything in the claims.  If a claim is filed incorrectly, Medicare will deny the claims until they are filed correctly and in a timely manner.

            The insurance company was refusing to pay because it did not receive any of the claims within the 15 months allowed for filing a claim.  I highlighted the statements on the Medicare claims reports that showed the filings had been made within the 15-month period.  I believed that the original filings with Medicare had been filed timely but not correctly by Medicare rules.  If the billing companies had filed the claims correctly and timely, then the insurance company should pay on the claims.  If the billing companies did not file in a correct and timely way, then those firms should “EAT THE BILLS”.

            There were multiple issues in the widow’s case.  The Indiana Attorney General has more leverage to force the insurance company and the two billing companies to answer questions honestly than I have.  I wanted our client, the widow, to be treated honestly and well by all parties.  Helping her file the complaint against three companies was what I believed would help her the most.

Written on July 2, 2024 by Woodrow Wilcox.

S O S – SPEAKING OF SENIORS

 BEING RECOGNIZED

 By Woodrow Wilcox

            I stopped at a McDonald’s in Highland this week and was recognized by some clients of the insurance agency where I work.  I joined them to have my meal and talk with them.  There were eight or nine people.  Two were clients.

            One client said that she always read my articles.  She was my English teacher in nineth or tenth grade in high school.  She said that she remembered that I was a good writer even then.

            Another client told everyone that I was helping her with fighting a medical bill for over $39,000 and that she did not hear any more about that bill since when I wrote the biller a very detailed letter about why the bill was wrong.  Also, she told the group that when her husband died, I helped her cancel bills that totaled over $121,000.

            The other people gathered at the table asked me how I did it.  I explained that I just have a natural talent for looking at Medicare related medical bills and related documents, spotting a problem, and explaining why the billing was wrong.  Having that talent has kept me busy and employed at the same place for over 21 years.

            Now, I am nearing age 70 and want to teach others what I know about how to protect senior citizens from bad billing by Medicare contracted medical firms.  I have saved clients of our insurance agency over three million dollars.  I want to pass my knowledge to others so that more seniors can be helped and protected.

Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana.  He wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on June 20, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Some Mud Stuck

 By Woodrow Wilcox

            On June 12, 2024, I got some mud to stick.  There is an old saying that if you throw enough mud against a barn, eventually, some of it will stick.  That is what I told a client in my office that day in response to a compliment that she gave me for really making an effort to help her with a medical bill for $21,723.27.

            First of all, she did not get this billing problem from our insurance agency or an insurance policy that she bought through our firm.  She got the problem and the policy through a different insurance agent who works for another insurance firm.  She came to our insurance agency because she was so disappointed with the other insurance agent and policy.

            The agent that sold her a policy through our agency asked me to try to help her with a medical bill that she got when she used the previous insurance policy. 

            The client was bitten by her own dog.  She went to the emergency room of a local hospital.  The claim was filed with her Marketplace or “Obamacare” insurance policy.  The Marketplace policy denied the claim and refused to pay on the bill for over $21,000.

            The hospital that she went to use was not “in-network” for the Marketplace policy that she had.  That should not matter because she went to the hospital for emergency services.  The client lives with a relative on a Social Security check of less than a thousand dollars per month.  She was not able to sleep well or relax well with the big bill facing her.

            She and I sat in my office over half an hour listening to a recording asking us to be patient and wait to talk to someone in the hospital billing department.  After over half an hour of listening to that recording, I started searching the internet for information to contact officers and managers of the hospital to complain that the billing department was not answering the phone in a competent manner.  I even checked the Indiana Secretary of State’s website for the name and address that you need to sue the hospital.

            I got results because I phoned people as well as typed letters.  Within an hour, I had spoken to two high ranking hospital officials and got some results.  Now, the hospital will appeal the denial of coverage by the Marketplace insurance company and clearly inform that insurance firm that the patient’s visit was to the emergency department which did not require prior authorization.  Also, the chief of patient billing asked that I encourage our client to meet with his assistant to apply for a discount or forgiveness of any balance left after the insurance company pays its share.

            I’m glad that I was able to help the client.  Our firm helped this client AT NO CHARGE.  We help all our clients with insurance related medical bills in this way to demonstrate that we really do care about our clients.  If your insurance agent does not give this high level of customer service, shouldn’t you switch to a firm that does?

Note:  Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana.  He has helped clients of that firm save over three million dollars by fighting mistakes and fraud in the Medicare system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on June 12, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Her Insurance Company Acted Honorably

 By Woodrow Wilcox

            After working on a client’s problem, I wrote a letter to her on June 10, 2024.  The client is from Schererville, Indiana.  With some editing to protect the client’s privacy, here is the letter that I sent to her.

            Previously, I wrote to you and a vice president of the Medicare supplement insurance company that you selected through our insurance agency.  Today, I phoned that vice president to learn more after she researched your case.

            You had two different insurance policies with the same group of companies.  One policy covered you from December 2016 to December 2023.  The other policy covered you from December 2023 through now.

            The claims on the list you submitted for me to check were in 2022 and 2023.  Here are the results of my research.

            The claim for 01/15/2023 with a balance of $37.77 was part of your Medicare Part B annual deductible.  You have a Plan G supplement policy.  That does not cover the Medicare Part B annual deductible.  So, you will have to pay the $37.77.

            The claims for the four balances for $10 on the bill were refused by Medicare.  If Medicare denies a charge as covered, the insurance company will not pay on it.  Your policy is a Medicare supplement policy that pays the last 20% of any Medicare approved charge.  I don’t know why Medicare refused to cover these items.  That is why I asked you to bring the Medicare ruling reports to me so that I could determine if the medical service provider made a mistake when the claims were filed.  If a medical firm files claims incorrectly, Medicare will deny the claims until the claims are filed correctly.  But for now, you owe the $40 from the four $10 balance claims.

            The medical firm filing the claims was obligated to honor a 2% discount to you because it entered a contract with a medical discount plan.  It did not honor its commitment.  Your insurance company is reprocessing those claims to pay the final 2% so that you do not need to do that.  Your insurance company is acting honorably.  The medical firm you used did not act honorably to give you the 2% discount under the contract it entered with the medical discount group.

            If you have questions about this, contact your insurance agent.

Written on June 10, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

My Letter to the CEO of a Hospital

 By Woodrow Wilcox

               On June 7, 2024, I wrote a letter to the CEO of a hospital to tell him how bad and uninformed the people in the hospital’s patient billing department were.  With some editing to protect our client’s privacy, here is the letter that I sent to the hospital president and CEO.

               I wasted time yesterday and today with your patient billing people giving me bad information in response to a simple question.  Here is that question.

               What address should I use to send to an appropriate person or department at your hospital to explain that Medicare never sent claim information to the secondary insurer for one of your patients who is our client and to request that you send both the original billing information and the Medicare EOB information that you have for the claim directly to the secondary insurer?  Also, I’ll send the correct address to get that done.

               Because no one that I contacted in the patient billing department of your hospital knows how to answer that question, my time has been wasted by being misdirected to a billing office in Cary, NC and an office somewhere else. 

               Why don’t your patient billing people know how to respond to this request?  The Medicare system relies on a network of emails and satellite services.  When the message is broken by sun spots, lightning, or other causes, information is lost.  This happens hundreds of times each day.  Why not be prepared to fix the problem in order to be paid more quickly?

               In this case, the patient is [our client] with [this account information and this date of service].

               Medicare never sent any claim information to the secondary insurer for this.  This problem was caused by Medicare and not the patient or the patient’s secondary insurer.  To fix this problem so that your firm can be paid properly and promptly, send both the original billing information and the Medicare EOB directly to this address.

Written on June 7, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Helped Highland Senior with Bill

 By Woodrow Wilcox

            On May 28, 2024, I helped a 77-year-old client from Highland, Indiana.  She got a bill from a hospital in Lake County asking her to pay $1,632.

            With some editing to protect the privacy of our client, here is the letter that 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 $1,632 on Guarantor Number XXXXXX for services rendered from 01/11/24 through 01/18/24.

            I contacted the secondary insurer to learn what it knew of this claim.  It reported that it paid this balance to your firm with a check with number XXXXXXXX on 03/29/24.  The check has not been cashed yet.  The service used for sending the check was XXXXX (bank) with the phone number 855-XXX-XXXX.

            If you have received the check, please let our client know that.  If you have not received the check, please call XXXXX to get help to find and cash it.

            All the help I gave this client was FREE OF CHARGE.  This insurance agency helps clients in such billing matters to demonstrate to the client that we really do care for our clients.

            If your insurance agent or agency does not give this high level of customer service, why not switch to an insurance agency that does?

Written on May 28, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 Crack A Whip On Medicare

 By Woodrow Wilcox

            We need a President and a majority in Congress to CRACK A WHIP ON MEDICARE.  That is what over 21 years of helping senior citizens has taught me.

          When a senior citizen joins Medicare and gets a Medicare supplement insurance policy or other coverage, Medicare starts a file on that senior.  The problem is that when Medicare gets the information, it does not record that information right away.  It lags in doing its essential work.

          Likewise, when a senior citizen shops for a better or less expensive Medicare supplement policy or other Medicare related policy and switches to a different company, often Medicare does not update the file for months or years.

            That is so unfair to senior citizens.  Here is why.

           When that happens, the senior is paying for insurance that does not work because Medicare lags in updating the senior’s file.  The insurance company that the senior has does not get the claim information from Medicare to pay a claim.  The medical service provider starts to hound a senior citizen to pay the balance that the insurance company did not pay because it never got the claim information from Medicare.  This unfairly causes stress on the senior.

            We have computers now.  Why can’t Medicare update its records within three business days?  It is because no one in the federal government cares about a problem that seniors have because of a lack of good, responsible management by federal government officials and contractors.  If they can’t do the job correctly, why not fire them (or the contractor companies) and replace them with others who want to do the job in a correct and timely manner?

            The day that I wrote this article, a senior citizen from Crown Point brought to me a medical bill from a local hospital.  The hospital wants to be paid the balance owed on several dates of service.  I checked with the Medicare supplement insurance company.  Medicare had not sent any claims to the insurance company for several months.  The dates of service for the senior ranged from August 2023 through February 2024.  Medicare failed to send any of the five claim episodes to the senior’s Medicare supplement insurance company.  The insurance company stands ready and willing to pay the claims but it can’t get the federal agency managers, employees, and contractors to do their jobs in a professional and timely manner.  So, why do we keep these Medicare workers employed?

.

Written on May 20, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Fighting to Protect Widow from Medicare Mistakes

 By Woodrow Wilcox

On May 8, 2024, a pile of bills was delivered to our office in Merrillville.  They were given to me.

            One of the bills was for service to a widow.  The other bills were for services to her deceased husband.  Bills to her husband were coming from two different medical offices.  The total of unpaid bills to her late husband in the bunch was $660.38.

            I phoned the deceased client’s insurance company to learn what it knew about the unpaid claims.  It reported that Medicare never sent it the claims information so that the insurance company could pay its share.

            That happens a lot all over the country.  The Medicare system uses internet and satellite communication systems.  When those systems are disrupted by sun spots, lightening, or other problems, data is lost and insurance companies don’t get the claim information.  When this happens, medical firms and their collectors hammer senior citizens to pay bills that would have been paid if the Medicare system worked flawlessly.  But it does not.

            I work to put the pieces of information back together and get them to the proper parties so that senior citizen clients of this insurance agency are not wrongfully billed and hurt financially.

            How serious is this financial problem for seniors on Medicare?  Several times, I have estimated it.  I determine how much money our clients would have lost if I had not helped them.  Then, what percentage of seniors in our congressional district are our clients.  Then, multiply that by the number of congressional districts.  Each time, I get an estimate of OVER ONE BILLION DOLLARS PER YEAR.

            I want to teach others how to do this so that more senior citizens are protected from errors in the Medicare system.  Also, I have tried to get elected political people to pay attention to this problem with Medicare and work to reduce or eliminate it.  So far, I have not found any Democrat or Republican who wants to work with me to protect senior citizens from Medicare system errors.

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 by fighting mistakes and fraud in the Medicare system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through any book store or online.

Written on May 8, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Medicare and Hospital Goofed

By Woodrow Wilcox

            On May 7, 2024, I wrote a letter to a hospital in northwest Indiana for one of our clients.  With some editing to protect the privacy of our client and others, here is the letter that I sent to the hospital.

Dear Representative,

      Our client sent a bill from your firm to our firm for our review.  The bill seeks a balance of $2,138.30 on Account Number XXXXXXX for services rendered on 06/07/23 through 06/23/23.

I phoned the client’s Medicare supplement insurance company to learn what it knew of this claim.  Here is what it reported to me.

            It never received a Medicare Explanation of Benefits from Medicare on this claim.  It got your bill information on July 26, 2023.  On September 8 and December 14 of 2023, it requested that your firm send the Medicare EOB information that you got from Medicare so that it could check and pay on this claim.  YOUR FIRM NEVER RESPONDED TO GIVE THE INSURANCE COMPANY THE INFORMATION THAT IT REQUESTED.  The only reason that you have not yet received the balance on this claim is because neither Medicare nor your firm ever bothered to send complete claim information to the secondary insurer.

            If you still want to be paid, please send both the original billing information and the Medicare EOB information to the insurer at the address shown here.

Written on May 7, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 What Caused The Balance?

 By Woodrow Wilcox

            On May 2, 2024, I wrote a letter to a medical firm for a client from Dyer, Indiana.  The client had brought the bill to our office in Schererville and that office forwarded the bill to me to check for the client.

            With some editing to protect the privacy of our client, here is the letter that I sent to the medical firm.

            Our client sent to our firm a bill from your firm for our review.  The bill is dated 03/28/2024 and seeks a balance of $66.90 on Guarantor ID XXXXXX for services rendered during November 2023.

            I phoned the client’s Medicare supplement insurance company to learn what it knew of this claim.  It reported that the Medicare EOB that it received from Medicare showed no balance after the insurance company sent to your firm $657.30 which is exactly what your bill to our client shows the secondary insurer paid your firm.  So, how did you arrive at the balance of $66.90?

            I helped our client to request a current Medicare Summary Notice about this claim.  When he gets that, he is to get that to me to compare it against your bill.

            The only thing that I can think of possibly causing a balance is if you filed an amended claim and Medicare ruled on that without sending an updated ruling to the secondary insurer.  Please, check your calculations to spot if someone at your firm made a mistake.  If so, please correct it and report that to our client.

            Thank you.

Written on May 2, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

 Do You Want to be Interviewed on the Internet?

 By Woodrow Wilcox

           Are you one of the clients that I helped to check a bill and fight a mistake?

            I have helped many, many people.  When I started that work in 2003, this insurance agency had a little more than 2,000 clients.  Today, we have over 22,000 senior citizen clients. 

           I wrote the book SOLVING MEDICARE PROBLEM$ to teach what I had learned to do to help senior citizens fight billing mistakes in the Medicare system.

            Now, I would like to interview people that I have helped to post their stories on the internet.  I believe that sharing stories about the problems with the Medicare system and how to correct them will be helpful to anyone who wants to learn how to help senior citizens in their communities.

            If I helped you or a member of your family, and you want to appear on an internet interview, please phone this office at 219-736-9450 and tell them to ask me to contact you to arrange a time for the interview.

Note: Woodrow Wilcox is the senior medical bill caseworker at Senior Care Insurance Services in Merrillville, Indiana.  He has helped clients of that firm save over three million dollars by fighting to correct medical bill errors caused by the Medicare system.  Also, he wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on April 26, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

 Good News For Dyer Client

 By Woodrow Wilcox

            On April 12, 2024, I wrote a letter to a client to give him good news about a hospital bill.  With some editing to protect the privacy of our client, here is the letter that I sent.

            You sent a bill to our Schererville office for us to check for you.  The Schererville office forwarded the bill to me.  The bill sought a balance of $1,632 for services rendered at a local hospital during February of this year.

            I phoned the headquarters of the insurance company that you selected through our insurance agency.  I asked what they knew about this bill.  They already paid this bill.  Here are the details.

            The bill is dated March 26, 2024.  That is when the hospital sent the bill to you.  The insurance company sent the hospital a check on March 31, 2024.  On April 8, 2024, that check was cashed by the hospital.  So, the bill was paid.

            For that reason, I did not contact the hospital about this bill.  According to your insurance company, when it got the bill details from Medicare, it paid the bill quickly.  The problem should be solved.  Thank you for allowing us to help you with your insurance needs.

Written on April 12, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

April 16 Anniversary

By Woodrow Wilcox

            On April 16, 2024, I will have worked at Senior Care Insurance Services for 21 years.  I started on April 16, 2003.

            Soon after that, I started writing about what I was doing to help senior citizens who were our clients when they had problems with the Medicare system.

            To believe that the Medicare system is perfect is unrealistic.  Every humanly designed system has flaws.  I have diligently exposed and explained the flaws that I have found in the Medicare system.  I have tried to get the attention of political officials to expose and work to correct those flaws.  I have not found any Democrat or Republican office holder to take action to protect seniors from financial harm that is caused by faults in the Medicare system.

            No one can say that I did not try to get political office holders to help.  Maybe after I stop doing this work, someone else will have better luck to get help from political office holders.

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 by correcting medical bill problems.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through book stores or online.

Written on April 2, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Senior

Helped Lowell Client Write Biller

 By Woodrow Wilcox

            On March 14, 2024, I phoned Medicare with a client to get an important fact before I wrote a letter to a medical biller

With some editing to protect the client’s privacy, here is the letter that I sent to the medical billing firm.

            Our client and her husband sent to our office a bill from your firm for our review.  Your bill to our client is dated 1/31/2024 and seeks a balance of $330 on Guarantor Number XXXXXXX for services rendered on 11/06/23.

            I investigated this and found that your firm filed the claim INCORRECTLY with Medicare.  The Medicare EOB that you got from Medicare should have exactly the same information as the Medicare Summary Notice that the client got.  Check footnote “A” on the claim for the $330 original billing under Claim XX-XXXXX-XXX-XXX.  The footnote explains that the service was denied because your firm filed the claim as an “Annual Wellness Visit” when it should have been filed as a “Welcome to Medicare” visit.

            Please, refile the claim properly.

            The help that I gave this client was FREE OF CHARGE.  This agency helps clients with such billing problems without charge to demonstrate that we really do care for our clients.  If your insurance agent or agency does not give such a high level of customer service, why not switch to one that does – like this one.

Written on March 14, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Helped Crown Point Client File Complaints

By Woodrow Wilcox

            On March 11, 2024, I helped a client from Crown Point file complaints against a firm in Florida.

            The firm was working together with other firms to send the client and his wife test kits which they never ordered and then filed claims with Medicare to get money from Medicare and the client’s Medicare supplement insurance company.

            For over 20 years in my job, I have collected addresses to which complaints should be sent.  There are different addresses to which people should send complaints depending on the facts of the matter and whether it involves violations of federal or state laws.

            In this case, we sent complaints (with copies of evidence) to the Medicare Claims Office, the Medicare Inspector General, the Fraud Complaints office of Medicare, and the Consumer Protection Offices of both the Florida and the Indiana State Attorney General.

With some editing, here is part of the letter.

Dear Representatives,

 I received packages of test kits from (a lab company).

         I never requested the test kits and never used them.  But I got Medicare Summary Notices that (the lab company) BILLED MEDICARE.  This was a fraudulent billing of Medicare.  The date of service was 12/11/2023 for Claim # XXXXX and 01/10/2024 for Claim # XXXXX.  The Medicare Summary Notice states that these were ordered by PXXXXX D. AXXXXXX.  I do not know anyone with this name.  In addition to this, women named TXXXX and VXXXXXX phoned me twice a day for weeks offering to help me use the test kits.  They wanted me to send the test kit samples to a firm in Lake Worth, FL.

          Accompanying this letter are copies of papers that I received from the firm (a lab company) or related firms.

Written on March 11, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

 False Claims on Medical Bill

 By Woodrow Wilcox

            On February 27, 2024, I sent a polite letter to a billing firm in another state that was trying to collect money from one of our clients who died soon after the medical treatment of the bill.  The letter upset the widow of our client because it claimed that her husband had no supplemental insurance after Medicare.

            I read the letter and understood her concerns.  This bill had a small bill balance.  But if he had no insurance, bigger bills would be coming.  That frightened her.

            Fortunately, I have collected the names and contact information of some people who work at billing firms and have asked me to contact them if I find any problems.  I had such a contact for the company that sent the bill that alarmed the widow.

            With some editing to protect people’s privacy, here is the letter that I sent to the contact at the firm and sent a copy of it to the widow.

            Accompanying this letter is a copy of the first page of a bill that you sent the deceased client and which his widow read.

            I don’t know who prepared this letter, but there are four FALSE STATEMENTS in this letter to which I want to draw your attention.  If the bill has false statements and it is sent through the U.S. Mail with the intent to induce someone to pay a bill that is not owed, then that is a statement that could harm your firm.  So, I am being a friend to you and your firm by showing this to you and alerting you to the potential harm it could do to your firm.

            The four false statements are these:

“You are receiving this statement because your insurance carrier denied our claim.”

            “At this time the balance due is your responsibility.”

            “Coverage not in effect at time of service (02-09-24).”

            “01/11/24 XXXXXXXXXX Life Ins. Company coverage not in effect at time of service.”

            I phoned the vice president of XXXX XXXX Life Ins. Co.  She reported to me that the policy has been in effect since 9/1/2017.  If you are not connecting with the correct insurance company, then send both the original billing information and the Medicare EOB information about this claim directly to the correct company at this address. (I stated the correct address here.)

Written on February 27, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 Over Three Hours in One Day

 By Woodrow Wilcox

            On Tuesday, February 27, 2024, I worked over three hours to resolve one client’s multiple problems with claims to Medicare.  I spent a few hours on his earlier visits for the same problems, too.

            Medicare was not honoring any claims that it was getting for this client from doctors, hospitals, or labs.  According to Medicare, our client had another insurance that was responsible before Medicare was.  That problem was caused by a car accident in 2015 that the auto insurance company failed to report was settled.  Medicare needs to get a report from a car insurance company that the matter was settled before it will remove the car insurance company from the Medicare file of the senior citizen.  That must be done so that claims are processed correctly to the Medicare related insurance company.

            If a senior citizen needs to go to a doctor or other medical service provider while a car accident is being settled, the doctor or other person filing the new claim must check the part of the claim form that states the service is not related to a no fault insurance matter.

            The original responsibility for sending the report was not handled well by the original claims adjuster.  Nor was it handled properly by subsequent claims adjustors.  But on February 27, 2024, I got hold of the supervisor of claims adjustors and he was very quick to see the problem and work to resolve it.

            But there was another problem with a bill from a pathology lab service.  The claim was not filed with Medicare using the name that the pathology lab service used when sending the bill to our client.  This is a common problem with doctors, hospitals, labs, and other firms.  They file the claim with Medicare under one business name but send the bill to the client under another business name.  These business entities should keep their billing record keeping straight.  If they don’t, and Medicare learns of the false filing, the medical service provider should be stopped from collecting any balance from either Medicare or the patient.

            The Medicare system of billing has major faults.  It needs someone to have authority to force corrections and penalties for non-compliance.

            In this case, I helped a patient who is 89 years old and has some trouble hearing and understanding people in person or on the telephone.  He needed my help and I was glad to provide it.

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 or online.

Written on February 27, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 A Wonderful Card From A Client

 By Woodrow Wilcox

            On February 13, 2024, I got a wonderful card from a client and his family.  Over the years, I have received many cards from clients that I helped with Medicare related medical bill problems.  Some clients did not send me a card but took me to lunch.  I appreciated every kindness extended to me.

            But the card that I got on February 13, 2024 had a handwritten note that was very special to me.  I want to share part of that note here.

Dear Woody,

            My family and I are deeply grateful for your compassion, service, and expertise.  You have made a tremendous positive impact on so many people, and that does not go unnoticed.  I especially appreciate your written articles by which you educate all of us about cases that you solved and the issues that you mitigated.  You taking the time and effort to share your wisdom even after a long, exhausting day of battling enormous healthcare institutions is genuinely astounding and a rare, precious gift.

            May God grant you excellent health, a long life, and many more decades of winning battles and touching lives.  Thank you for all that you do and, most importantly, for being who you are.

            This note really encouraged me.  I really appreciated it and the family that sent it to me.  I recently returned to work after being in a hospital and rehab center. 

Written on February 13, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 My Letter to the Indiana Attorney General

 By Woodrow Wilcox

            On February 12, 2024, a client from Munster visited my office in Merrillville and brought a letter that he got from an unknown and undisclosed firm that wanted him to call them.  He asked me if our insurance agency had sent it to him.  We did not.

           I read the letter and considered it sneaky and unethical.  So, I wrote a letter to the Indiana Attorney General about it.  Here is that letter.

Dear Attorney General,

            A few weeks ago, a senior citizen client of this insurance agency got a letter that did not identify who sent it.  He was confused and thought the letter was from our insurance agency.  He is our client.  Our insurance agents met with him and counseled with him to find an insurance policy that he could afford and that would meet his needs.

            He phoned the firm that sent the letter.  The letter was from a firm in Texas that then marketed our client to another insurance company as a lead. 

            We do not object to marketing and competition.  We DO OBJECT to misleading marketing that does not clearly identify who is sending something to a person (especially a senior citizen). 

            I wrote an article about the problems caused by the first letter.  A copy of that article is enclosed.  Today, the same senior citizen brought another similar letter to our office to check if our firm sent it.  We did not.  A copy of the letter that the client just received is enclosed.

            To protect Indiana senior citizens and the insurance agencies in Indiana who market ethically, please work to stop such sneaky and unethical marketing from other firms.

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

Written on February 12, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 My Letter to a Hospital CEO

 By Woodrow Wilcox

            On February 9, 2024, I happened to read an article that clued me on the proper address to send a letter to the CEO of a hospital system in northwest Indiana.  So, I wrote to him to ask him to help improve his hospital to tackle some problems.  With some editing to protect privacy, here is the letter that I sent to him.

            I’m writing to you about three problems that reoccur.  You need to know about a problem to have a chance to fix it.  I suspect you are the kind of leader who wants to fix problems.

            First, I phoned your CBO to learn your address.  I dialed the number 219-XXX-XXXX.  I got a recorded message that the message box was full and then a report that the operator was not available and that I should call again.  That is NOT a professional response to anyone who has a question or problem about billing.

            Second, I had a good working relationship with your business representative TXXXXXXX CXXXXXXX, but have not spoken with her for some time.  I just want to give credit where credit is due.  I help the clients of our insurance agency when there is a billing question or problem.

            Third, there are reoccurring problems in the Medicare system.  I’d like your help to streamline responses to some of them.  One is that Medicare does not update its files in a timely manner.  Enclosed is a copy of an article by me about how that hurts patients and medical service providers.  The other major problem is that Medicare often fails to send claims information to the secondary insurer because the internet connection is lost for a moment and data is not delivered.  When I learn that happened to our client, I ask doctors and hospitals to send both the original billing information and the Medicare EOB information that they have directly to the secondary insurer and I give the address to do so.  Please, make sure your billing people know how to do this.  It will get your firm paid faster.

            Thank you for your attention and assistance.

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

Written on February 9, 2024 by Woodrow Wilcox.

Speaking Of Seniors

 Clients Got Big Refunds

 By Woodrow Wilcox

            Sometimes, clients get insurance policies mixed up.  The agent did not make the mistake.  The client did.  That is what happened to a couple from Crown Point.  Our agency counseled them to get Medicare supplements from Bankers Fidelity Life Insurance Company.  But then, they responded to a TV ad from Humana Insurance Company for a Medicare Advantage plan.  That kicked them off the Medicare supplement plan.  For two years, they paid the premiums for a supplement plan that they could not use.

            When we learned of this, we helped them ask Bankers Fidelity for a refund of premiums paid while they could not use that policy.  Bankers Fidelity did not argue against a refund.  It was a very unusual case.  I had to get the facts and present them to the insurance company.  Then more calls were made to remind and prod people to do their jobs.  Finally, the refunds came.  I want to commend Bankers Fidelity for its fair treatment of our clients.  The couple got a combined refund of $13,200 according to their son.

            The son wrote a note to me that said, “My parents wanted to let you know they appreciated what you did to get things started.”  All the help that I gave this couple was FREE OF CHARGE.  We help couples with similar problems to demonstrate that we really do care about our clients.

Written on February 8, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 Gotta Follow Da Rules

 By Woodrow Wilcox

            On January 29, 2024, I wrote a letter to a client about following the rules to help him with his problem.  With some editing to protect his privacy, here is the letter that I wrote.  Read and learn something about the Medicare system.

            Your agent asked me to check a claims statement for you for Date Of Service (DOS) 10/23/23.

            Your agent’s records show that you had a policy with one insurance company on that date (# XXXX).  But the claims report you sent showed what appears to be a policy number that goes with a different insurance company (XXXX).

            For this reason, I suspect that Medicare failed to update your file to show that you don’t have one insurance company any more.  Medicare is slow regarding updates.  Enclosed is an article that I wrote on this topic.

            In order to fix this problem, you, or your power of attorney representative, should phone Medicare at 800-633-4227 and ask what Medicare records show as your current Medicare related policy.  If it is wrong, ask if it can be corrected on that phone call or if you need to call the Medicare coordination of benefits phone number (855-798-2627) to get it fixed.

            I can’t help you unless you, or your power of attorney, are on the phone with me.  Let me know what you want to do.

            The help that I am giving this client is FREE OF CHARGE.  This firm helps clients with such matters to demonstrate our concern for them.

Written on January 29, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors 

The Biggest Problem With Medicare 

By Woodrow Wilcox 

 What is the biggest problem with Medicare?  My over 20 years of experience helping senior citizens fight various problems with Medicare tells me that it is the lazy, sloppy, unprofessional work of the federal government, federal employees, federal contractors, and federal contractor employees on one matter – getting things done in a timely manner. 

Medicare fails to process paperwork in a timely manner.  Here are three cases of that.   

Today (December 21, 2023), I got a bill for a client that was rejected by Medicare because its record said that he did not have the insurance policy that our agency sold him.  He did have it, but Medicare never updated its records in over half a year.  Our agency sold him a policy over a month before it became effective on 02/01/2023.  A medical firm filed a claim for service on 08/15/2023 and Medicare reported that the client did not have the policy because Medicare failed to update its records.  Medicare was over six months tardy in updating its record on the client.  This lack of timely updating costs money, time, and patience of the hospitals, doctors, insurance companies and insurance agencies to work through the problem to process the claims properly. 

 Medicare should be able to update new information within three business days.  If it can’t do that, why should managers and employees of Medicare and its contractors keep their jobs?  The slow way they work causes problems for seniors on Medicare and the various parties that try to serve seniors under the Medicare system. 

This slow work ethic of Medicare hurt another client recently, too.  Medicare failed to update his record by over six months.  When the client and I got a Medicare representative on the phone, the person admitted his record was not updated and promised it would be by a certain date.  We wrote to the medical firms about the problem and asked them to file again after that stated date.  They got told the same thing as before.  We contacted Medicare again and they told us that the file was updated but not until three months after they promised it would be updated. 

            Medicare messed up my file with it slow service, too.  My new insurance started March 1, 2023.  But Medicare did not even start to update my file until I called them on September 13, 2023 to scold them for not updating it sooner and screwing up claims that were filed since March 1, 2023. 

            I have helped many seniors with various Medicare bill problems in over 20 years.  But the biggest problem is getting the Medicare system and the people in the Medicare system to work in a professional and timely manner. 

            Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana.  He has saved clients of that insurance agency over three million dollars by fighting bad billing.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered from book stores and online. 

Written on December 21, 2023 by Woodrow Wilcox. 

S. O. S. – Speaking Of Seniors 

Helped 92-year-old Client from Saint John 

 By Woodrow Wilcox 

On December 13, 2023, I wrote a letter to a medical firm in northwest Indiana about a bill that it sent to a client in Saint John, Indiana. 

  With some editing to protect the privacy of our client (and others), here is the letter that I sent. 

 Our client sent to us a bill from your firm to check for her.  The bill seeks a balance of $XXXXX on Guarantor ID XXXXXX for services rendered on 4/3/23 and 10/30/23. 

 I checked with the client’s secondary insurer to learn what it knew of the bill.  It reported that Medicare never sent these claims to it.  That is not the fault of the patient. 

            To fix this problem made by Medicare as fast as possible, please send both the original claim information and the Medicare EOB information on these claims directly to the claims department of the patient’s secondary insurer at the following address. 

            There is another matter that I did not mention in the letter but that I will mention here.  The medical billing firm included a false message on the bill to our client.  The false message stated, “Notice: This is a bill.  Based upon information from your health plan, you owe the amount shown.” 

            The client’s Medicare supplement insurance plan company never got the claims from Medicare.  So, the statement on the bill is absolutely false and it was sent through the U.S. Postal Service to pressure our senior citizen client to pay a balance on a bill that was wrongfully calculated and presented to our client.  Why isn’t that considered a form of MAIL FRAUD on a senior?  Why aren’t medical firms and their billing firms prosecuted for such things? 

            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 by fighting mistakes and fraud in the Medicare system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through a book store or online. 

Written on December 13, 2023 by Woodrow Wilcox. 

S. O. S. – Speaking of Seniors 

A Nice Note 

 By Woodrow Wilcox 

 On December 12, 2023, a client brought a nice note to the Merrillville office with a one-page document. 

  The note said, “Mr. Wilcox, Thank you for all the help you gave me.  They (the insurance company) finally paid the bill.  Thanks again.” 

 Our client’s Medicare supplement insurance company accidentally failed to pay one claim to a local hospital for services in March 2023.  It paid all the other bills it was obligated to pay.  But it missed one. 

            I phoned the insurance company with our client on August 23, 2023 and got the representative to see and admit that the insurance company made a mistake in failing to pay the final $875.10 that it owed.  The representative estimated it would take 30 days to correct.  It took a little more than 60 days to correct.  On November 10, 2023, the final check was cut and the hospital was paid. 

            The client got help from our agency to connect with his insurance company in a positive way to prod them to notice the mistake and correct it.  We helped the client AT NO CHARGE.  This insurance agency helps all clients with medical bill problems without charging anything.  The Medicare system does not work perfectly.  It is easier for us to spot problems and solutions than our clients.  We give this help to demonstrate to our clients that we really do care for them and want to treat them fairly. 

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 by correcting medical bill problems.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered from book stores or online. 

Written on December 12, 2023 by Woodrow Wilcox

S. O. S. – Speaking Of Seniors 

 A Reason Why Indiana Residents  Should Avoid Illinois 

By Woodrow Wilcox 

 On December 11, 2023, I learned a reason for a balance on an ambulance bill for a resident of Schererville, Indiana.  It was a policy of Medicare. 

  With some editing to protect the privacy of our client and others, here is what I wrote to the client. 

  I phoned the ambulance company and got a return call. 

The representative was quite clear about the balance of the ambulance bill.  You owe that balance because of a policy of Medicare. 

 You were taken from a hospital in Chicago to a rehabilitation facility in Indiana.  Medicare said that it would not cover that distance because you could have gone to a rehabilitation facility much closer to the hospital. 

 This is just one more reason that for years I have been telling Indiana residents not to go to Illinois for medical services if they can avoid it.  So many things can go wrong with the billing of services when the Indiana – Illinois state line is crossed.   

 Don’t believe me?  Now, you have a bill for almost $400 that proves I’m correct about that. 

I think that the Medicare policy of not paying to transport a patient close to where the patient lives is a bad policy.  I believe that a patient is going to have an easier time healing and heal more quickly if the patient is near friends and relatives who can visit the patient to love and encourage the patient during the healing process.  Apparently, the people running Medicare don’t think like I do. 

Written on December 11, 2023 by Woodrow Wilcox. 

S. O. S. – Speaking Of Seniors 

Helped Lowell Client with Medical Bill 

 By Woodrow Wilcox 

 On December 11, 2023, a client visited my office to get my help.  The client was from Lowell, Indiana. 

 With some editing to protect the privacy of our client and others, here is the letter that I sent to his doctor and the laboratory that took his samples. 

Our client brought to our office some paperwork today and asked for our review.  I examined your bill and the secondary insurance Explanation of Benefits.  He had no Medicare Summary Notice that pertained to your bill. 

 We spoke with Medicare representatives about your bill to our client.  Medicare is sending the MSN that pertains to the (laboratory) bill to our client.  Over the phone, the Medicare representatives told us that the claims were denied because the information provided in the claim DID NOT SUPPORT THE NEED FOR THE MEDICAL SERVICE.  So, (the laboratory) failed to include necessary information in the claim that was filed with Medicare.   

  But we don’t know if this was caused by (the doctor) failing to provide the information to (the laboratory) or if (the laboratory) simply filed the claim incorrectly.  Please, check the information provided to (the laboratory) by (the doctor) and the information included in the filing of the claim by (the laboratory). 

  We do know that the same lab work was done on 9/29/20, 10/04/19, and 5/13/19 and that Medicare approved those claims for the exact same service.  So, we think the claim was simply filed incorrectly and should be refiled correctly.  Please, review this matter and help to correct it. 

Written on 12/11/2023 by Woodrow Wilcox. 

 S. O. S. – Speaking Of Seniors 

Client Complained to Congressman 

 By Woodrow Wilcox 

 On November 29, 2023, I helped a client with a medical bill problem that was caused by Medicare.  After I helped, the client complained to his Member of Congress.  With some editing to protect the client’s privacy, here is his note to the congressman. 

I switched from an employer’s health insurance plan to Medicare and a Medicare supplement plan effective 10/01/22.  But Medicare failed to update my file in a timely manner. 

The administrator at the insurance agency that I use helped me learn what was wrong and helped me make phone calls and write letters to correct the problem. 

In the spring of 2023, we had a phone discussion with several Medicare representatives at both regular Medicare call centers and with the Coordination of Benefits office.  We were told that the problem would be corrected by March 4, 2023.  So, we asked the University of Chicago to refile the claims after that date.  They did and the claims were still denied because the problem was not corrected by March 4. 

According to Medicare representative CXXXXXXXX LXXXX, who works at a Medicare call center in Texas, my file was not updated and corrected until September 21, 2023.  So, I started on Medicare Part B and a Medicare supplement plan on 10/01/22, but my Medicare record was not updated until 09/21/23.  That is unprofessional conduct on the part of Medicare, its systems, its managers, and its employees. 

This kind of behavior by Medicare hurts senior citizens financially and emotionally.  Will you do anything to stop it?  You should work with Woodrow Wilcox to get more information on the many problems with Medicare that hurt seniors.  Let me know why I had to endure such bad service by Medicare. 

Written on November 29, 2023 by Woodrow Wilcox. 

 S. O. S. – Speaking Of Seniors 

 Letter and Phone Call Mislead Immigrant 

 By Woodrow Wilcox 

 On November 27, 2023, a client who is an immigrant from Italy brought papers to our Merrillville office to get my help with a problem. 

 He got a letter from an insurance agency in Texas asking him to phone them.  The letter did not clearly state who sent the letter.  He thought it was from our insurance agency.  So, he called. 

  The insurance agency in Texas bounced our client’s phone call around to different people and confused him further.  Then, the firm in Texas helped him apply for a Medicare Advantage policy with an insurance company that the Texas firm represented. 

The agent at our office spent over half an hour with this client to help him select a Medicare Advantage plan that fit his health needs and budget.  The application through the firm in Texas cancelled the work that we had done with the client. 

 To help this client, I copied every paper that he had that related to the problem.  Then, he and I phoned the insurance agency in Texas and the insurance company that got the application.  I explained the situation and described how the agent of the Texas agency had harmed the immigrant client financially through the deceptive tricks employed to mislead an immigrant senior citizen.  I got their attention and cooperation to correct the misleading things and cancel the application made through the insurance agency in Texas. 

This was a lot of work.  The client apologized to me for causing all the work that he saw me do for him.  I suggest that seniors NOT respond to letters or phone calls from insurance agents or agencies that do not have an office near their home.  Agents who live near you have a stake in serving you well.  They care about their reputation in the community and are more likely to serve you well when a problem arises.  If you do business with an insurance agent or agency in another state, how will they help you if a problem arises? 

Written on November 27, 2023 by Woodrow Wilcox. 

S. O. S. – Speaking Of Seniors 

Bad Math On Bill 

By Woodrow Wilcox 

 On November 6, 2023, I wrote a letter to a hospital and its medical biller to complain about bad math on the bills to our client.  

With some editing to protect the privacy of our client, here is the letter that I wrote. 

 Our client sent to our firm two bills from your firm for our review with dates 9/17/23 and 10/20/23.  I found some big problems with your bills.  You seek a balance of $39.02 from our client on ID # XXXXXXXX.  The bill is NOT clear about the date of service but it looks like 03/30/23. 

Your bills state that the original charge was $210, that you were paid $210 by insurance, that there is a $39.02 downward insurance adjustment, but that the patient still owes $39.02.  How does $210 minus $210 minus $39.02 equal a $39.02 balance?  Whether you are using a person or a computer to do your math, that math flunks third grade math.  How many other mistakes on other bills are you making?  Should we help our client complain about your bad math to Medicare or the consumer protection division of Indiana’s Attorney General? 

 I phoned the patient’s insurance company.  It reported that there is some kind of billing problem with your firm and some other rural medical firms.  That insurance company is trying to figure out the problem and solve it.  As you can see, the mathematical mistakes that your firm is doing is at least a significant cause of the problem.  Please, be patient and communicate with the secondary insurer which is Bankers Fidelity Life Insurance with the phone 866-458-7499. 

Written on November 6, 2023 by Woodrow Wilcox. 

S. O. S. – Speaking Of Seniors 

Wrote Letter to Radiologists for Client 

 By Woodrow Wilcox 

  On November 3, 2023, I wrote a letter to radiologists who were billing our client because I thought I found some errors in the bill.  With some editing to protect the privacy of our client, here is the letter that I wrote. 

  Our client sent to our firm a bill from your firm for our review.  The bill seeks a balance of $1,070 on Account # XXXXXXXX for services rendered 04/27/23.  I reviewed the bill and found what I believe are errors. 

  Your firm acknowledged payments from Medicare and the secondary insurer.  But you made no adjustments according to what Medicare discounted. 

  We have requested both the Medicare Summary Notice (MSN) from Medicare and the Explanation of Benefits from the secondary insurer. 

 WE INSTRUCTED OUR CLIENT THAT WHEN SHE GETS THOSE ITEMS SHE MUST FORWARD OR BRING THEM TO OUR OFFICE SO THAT WE CAN COMPARE THOSE ITEMS WITH YOUR BILL TO OUR CLIENT.  Getting those items will take about three weeks. 

  After we have compared the items, we will write to you again with details that are not available now.  So, be patient.  Our client is NOT ignoring your bill to her.  She is simply getting our help to determine the accuracy of the bill. 

Written on November 3, 2023 by Woodrow Wilcox. 

S. O. S. – Speaking Of Seniors 

 Seniors and Car Accidents 

 By Woodrow Wilcox 

On November 2, 2023, I wrote a letter to an insurance company to get help to fix erroneous information in a senior’s Medicare file. 

 When a senior is in a car accident and a claim for health is made, Medicare assumes that all the medical services given to that senior are related to the accident until the car insurance company notifies Medicare that the claim is settled.  I have been told that box on a Medicare claim form can be checked by a doctor or other medical service firm to clarify that the current claim is not related to an accident.  But that is usually overlooked. 

In this case, Medicare failed to update the senior’s record for almost ten years.  Fixing this matter is a lot of work.  It is a lot of detailed work. 

 With some editing to protect the privacy of our client and others, here is the letter that I sent to an insurance company about a car accident and one of our clients. 

 Our client’s Medicare records and claims are being messed up.  Medicare claims that it never received notice from your firm that his injuries from the car accident case of October 17, 2013 were closed.  Medicare has relied on bad information in his file for almost TEN YEARS. 

 If your firm failed to file notice with Medicare that this case was closed, then I believe your firm failed its professional responsibility toward this client.  If Medicare failed to update the file of this client after receiving notice from your firm, then people at Medicare failed in their professional responsibility.   

 I want to know who caused the harm to this client.  Medicare still believes that your firm is primarily responsible for medical bills for him rather than Medicare.  Bills are not being paid in accordance to Medicare’s normal rules.  The widow is being hounded to pay bills that she never should have gotten. 

Did your firm file notice with Medicare in a timely manner?  If so, on what date?  What can you do and what evidence can you send to us to help us correct Medicare records in a timely manner? 

Written on November 2, 2023 by Woodrow Wilcox. 

S. O. S. – Speaking Of Seniors 

 Medicare Ruled Against the Bill 

 By Woodrow Wilcox 

   On November 1, 2023, I wrote a letter to a medical firm and its biller to tell them to stop billing our client.  I could insist on that because I had proof that Medicare ruled against the bill to our client. 

  With some editing to protect people’s privacy, here is the letter that I sent to the medical firm and its medical billing service. 

The family of our client finally got the correct Medicare Summary Notice (MSN) with the report about the claim that you billed to our client for services on 08/05/2023.  The MSN should have exactly the same information as what your firm got on the Medicare EOB form that was sent to you.  Look at the claim and the footnote.  Medicare ruled that your firm could not charge our client the $130 that you billed because “payment [for that service] is included in another service received on the same day.” 

 By billing our client $130, I believe you are violating your legal obligation to abide by Medicare’s ruling.  You could appeal the ruling.  But, as it stands now, you must not bill our client $130.  So, until you get a favorable ruling because of an appeal, stop billing our client $130. 

 Written on November 1.2023 By Woodrow Wilcox

 S. O. S. – Speaking Of Seniors 

 Helped Son With His Mother’s Bill 

 By Woodrow Wilcox 

On October 26, 2023, I wrote a letter to a medical billing firm to help resolve a bill for a client who had passed away.  I was working with the son of our client to resolve a bill.  With some editing to protect privacy, here is the letter that I sent. 

 The family of our late client asked me to check the bill that your firm sent to her on 09/04/23.  That bill sought a balance of $130 for services on 08/05/23.  The Invoice Number of the bill is XXXX-XXXXX. 

 On October 4, we contacted Medicare to request the Medicare EOB (MSN) regarding your bill.  Instead, Medicare sent claims filed during July of 2023.  We phoned Medicare again today to request the MSN.  Please, be patient to allow this. 

Your bill to our client shows no payments or adjustments by Medicare.  Did you file a claim with Medicare or not?  If you did, and you already have the Medicare EOB, please send both the original billing information and the Medicare EOB information for this claim directly to the secondary insurer.  Our records show that she had a policy with XXXX / X X.  Thank you. 

Written on October 26, 2023 by Woodrow Wilcox. 

S. O. S. – Speaking Of Seniors 

Doctors Got Paid Twice 

 By Woodrow Wilcox 

The doctors of a medical firm in Porter County got paid twice for the same balance.  Their firm was paid by the client’s Medicare supplement insurance company and then the medical firm persuaded our client to pay the same balance. 

On October 18, 2023, I wrote a polite but firm letter that the medical firm should refund the money that our client paid.  With some editing to protect the privacy of our client (and maybe others), here is the letter that I wrote. 

Our client sent to our firm a bill from your firm with information that he paid the bill.  He asked us to review your bill and other papers.  I did.  Your firm made a big mistake.  You owe our client some money.  Here is why. 

 You billed our client $182.24 and got him to pay you on 09/29/23 with check 2446.  But his Medicare supplement insurance company paid the same bill to your firm on August 18, 2023 and your firm cashed the payment on 08/25/23.  You had the payment from the insurance company over a month before you persuaded our client to pay the same balance after Medicare paid its portion. 

Here are some details.  The amount of the check was $212.78 because it was a bulk check to your firm.  It was paid by a virtual credit card with confirmation token XXXXXXXX.  It was paid through the banking system XXXXX which you can phone at 855-XXX-XXXX to get help to fix your bookkeeping. 

Since you were paid the balance by both the client and his insurance company, please refund our client the $182.24 that you wrongfully persuaded him to pay you. 

Written on October 18, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

A Security Breach 

 By Woodrow Wilcox 

 On October 13, 2023, I wrote a letter to a client to tell what I could and could not do to help him with a problem.  With some editing to protect privacy, here is the letter that I sent to the client. 

 Today, someone brought to our office a copy of a letter that you got from XXXXXXX Health about a breach in security that could affect you. 

 I am not an attorney.  I cannot represent you in this matter.  The only thing that I could do is help you to file a complaint with the Indiana Attorney General’s Office of Consumer Protection. 

  But any attorney could help you do that, too.  An attorney could help you do other things to protect your personal information that I cannot do. 

 I suspect that you will need to hire an information protection service like LifeLock or Legal Shield for the rest of your life.  I could help you join those, too.  But I would not be able to take any action for you beyond that. 

Let me know if you want my help in the matters where I can help you or if you just want to find an attorney.  I wish you well. 

Written on October 13, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

My Victim Letter 

By Woodrow Wilcox 

 I am a victim of some faults in the Medicare system.  People who support big government want us to believe that the Medicare system is without faults.  How wrong they are. 

 For over 20 years, I have helped senior citizens who were harmed by faults in the Medicare system.  Some people who work for Medicare don’t work very hard or very professionally to avoid harm to seniors.  In my case, Medicare did not update my file at least six months.  The doctors and other medical services that helped me during that time did not have their claims processed properly.  Thus, I got bills that I should not have received.   

I have helped others with this same issue many times.  So, I knew what to do.  After I got Medicare to correct its records with an update, I wrote to the medical service providers.  With some editing to protect privacy, here is the letter that I sent to doctors and a hospital. 

On September 12, 2023, I learned that Medicare had not updated my file. 

I tried a Medicare Advantage plan from January 1 to February 28, 2023.  I switched back to Medicare plus a Medicare supplement plan starting March 1, 2023. 

My supplement insurance company notified Medicare about the switch on March 10, and Medicare sent a confirmation of receipt of the notification on March 15. 

BUT MEDICARE NEVER ACTUALLY UPDATED MY FILE. 

If you filed a claim for services rendered to me between March 1 and October 1, 2023, it was not processed correctly.  PLEASE, REFILE THE CLAIM. 

I contacted Medicare to correct the file.  Then, I contacted Medicare to make sure that the file has been corrected. 

I did not cause this problem.  You did not cause this problem.  The lazy, sloppy, unprofessional people at Medicare caused this problem.  Please, cooperate with me to fix this by refiling your claim.  Thank you. 

Written on October 12, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

The Complaint Worked 

 By Woodrow Wilcox 

 On October 3, 2023, the husband of one of our elderly clients brought a letter to our Merrillville office to give me.  He thanked me for my work to save his wife (and him) from a big bill for a short ambulance ride. 

Previously, I had worked with the husband to file a complaint with the Indiana Attorney General’s office of Consumer Protection.  We filed a complaint against both a hospital and an ambulance company. 

 The facts were that when the man’s wife was discharged from the hospital, he had come to get her in his van and take her the three blocks distance to go home.  But she could not move her legs to help her husband and a guard at the hospital lift her into the van.  So, someone at the hospital called for an ambulance instead of calling for a “medicar” which would have cost less. 

 The ambulance charged the elderly couple $1,689 to take her three blocks to get home.  It was NOT an emergency so Medicare would pay NOTHING.  I know the difference between an ambulance and a “medicare”.  So should every employee of a hospital that is responsible for calling for one of those two services.  If they phone the wrong service, the hospital should take responsibility for the error and pay whatever will make the patient financially whole from that error. 

  In this case, the ambulance company reduced the bill to $262.69 and the couple paid that.  That is about what a “medicare” service would have charged.  Really, the ambulance company did nothing wrong.  It was the hospital employee that called the wrong service to help the patient get home.  That’s why I hope the hospital will pay the ambulance company the balance of the bill that it reduced to our client. 

Written on October 3, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

A $4,233 Question 

 By Woodrow Wilcox 

 Our agent Sam Ulayyet brought me some papers to examine on September 27, 2023.  The papers were about billing charges to a client who lives at Lakes of the Four Seasons in Crown Point, Indiana. 

I reviewed the papers and wrote a letter to the medical firm’s billing office.  With some editing to protect the privacy of our client and others, here is my letter to the medical firm. 

Our client gave me some papers about a bill and charges by your firm to her.  She asked us to review the papers. 

I found something that seemed strange.  Your firm charged her credit card twice on 01/05/2022.  The first time was at 8:33 AM for $4,000.  The second time was at 8:41 AM for $233.  But in the Medicare Summary Notice forms from Medicare that she gave me, I could find no services from your firm that correlated with such charges.  It seemed like your firm charged $4233 on a date when no medical services were rendered. 

It might be that the patient did not deliver all the paperwork to me.  Please, help me to understand what medical services were rendered to connect with the charges on 01/05/2022 for $4,233. 

Send your response to our client.  She will then share it with me. 

Written on September 27, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

Doctors and Hospitals Hurting Seniors 

 By Woodrow Wilcox 

 What if someone called for an ambulance for you but you did not need an ambulance?  In northwest Indiana, it could cost you hundreds or thousands of dollars.  Here are two cases that I am working to help two clients. 

When one of our clients left a hospital, someone at the hospital called for an ambulance.  No details about needing an ambulance were given in the claim filed with Medicare.  So, Medicare ruled that the ambulance ride was a non-emergency ride and refused to pay anything of the $1,749 one mile only ambulance ride. 

 If there was no emergency, then the hospital employee should have called for a Medicare service which would have cost only about $250.  If there was a medical reason that only an ambulance could be used to protect the life and health of our client, the hospital person should have given that information to the ambulance company to include in the filing of the claim with Medicare.  In either case, I see a hospital employee as making a big mistake.  Hospital employees who call for ambulances or Medicars for patients should know the difference and be professional enough to call the right party for transport of the patient.  If they don’t, the hospital should be sued for malfeasance. 

In another case, a clerk at a doctor’s office called for an ambulance for a patient.  But the patient, our client, did not feel bad and refused to go to a hospital.  The ambulance company billed our client $900 for a RESPONSE CHARGE.  She never called for an ambulance.  Why wasn’t the clerk who called for the ambulance or her employer charged for the RESPONSE CHARGE? 

The system now in place is a threat to everyone in Indiana if anyone can call for an ambulance and cause a RESPONSE CHARGE to be billed to someone else. 

Written on September 22, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

Complaint to IL Attorney General 

 By Woodrow Wilcox 

On September 15, 2023, I typed a letter for our client to sign so that we could add details to our complaint with the Illinois Attorney General against a doctor, medical firm, and medical billing firm. 

With some editing to protect the privacy of our client and other parties, here is the letter that I typed for the client. 

You wrote to me asking for an Explanation of Benefits from either Medicare or the secondary insurance company or both.  None is available because the medical firm never filed the claim properly. 

 My insurance agent’s office phoned Medicare for me to request a Medicare Summary Notice about this claim and was told there is no record of such a claim being filed.  I believe that a medical firm has 15 months from the date of service to file a claim.  After that, the claim is dead and cannot be filed or collected. 

 Enclosed is a copy of the bill dated 01/02/23.  Note the entries.  The total original charge is $457.  They claim to have sent the claim to various parties, but none responded.  So, it is likely that none got the claim because it was not properly filed.  The medical firm just needed to send the claim to Medicare properly and then Medicare should have crossed over the claim report to the secondary insurer.  That would be my Medicare supplement insurance company. 

 To verify that NO SUCH CLAIM WAS EVER FILED by the provider, you will need to phone Medicare and/or my secondary insurer as we did.  The release that I signed and am sending to you with the copy of an info sheet that we used to ask about this will give you what you need to check this – my Medicare ID and my insurance policy ID.  Look on the bill to get the name of the doctor, the firm that is billing, the date of service, and other info.  The phone number to Medicare is 800-XXX-XXXX and the phone number to my insurance company is 866-XXX-XXXX. 

 The medical billing firm did not follow the rules of Medicare originally and the medical firm is not following the rules of Medicare to file timely or kill the bill.  When I and my insurance agent’s office have tried to bring this to their attention, the medical firm and its biller have “given us the run around routine”. 

The bad business practice of this medical firm and its biller hurts consumers.  Please, put a stop to their bad business practices. 

All the help that I am giving this client is FREE OF CHARGE.  Our firm helps all clients with medical billing problems to demonstrate that we really do care about our clients.  If your insurance agent or agency does not give this high level of customer service, why not switch to our insurance agency? 

Written on September 15, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

Bad Hospital Bookkeeping 

 By Woodrow Wilcox 

 On September 13, 2023, the husband of one of our clients brought a bill and other paperwork to me at our office in Merrillville, Indiana.  The client lives in Valparaiso, Indiana. 

 A hospital in Chicago was still billing her for a balance of $89.65 despite the fact that she already paid it.  She had copies of the bills to show the hospital ignored the payment and a copy of the cancelled check to show it had been paid.  It looked to me as thought the billing service that the hospital used (in the state of Maine) had cashed the check but not credited our client’s account.  This has happened with other medical billing firms, too.  It is why I urge Congress to regulate medical billing firms more tightly. 

 Lucky for my client that in 20 years of working such cases, I have built a contact list of many people who work at medical firms.  I had a contact at the hospital that sent our client the bill.  I phoned the contact and asked for a fax number to which I should send proof that the bill was already paid.  The next day, that contact phoned our office to give me the fax number. 

I believe that my work will get the hospital in Chicago to stop its wrongful, repeating billing of our client. 

 All the work I did to help this client was FREE OF CHARGE.   This agency helps our clients with medical bill problems without charging a cent to demonstrate that we really do care about our clients.  If your insurance agent or agency does not give this high level of customer service, why not switch to our agency? 

Written on September 14, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

Government Goof-ups 

 By Woodrow Wilcox 

 On September 12, 2023, I was denied medical services at a clinic in Lake County, Indiana.  But I understood why.  I’ve been working with the Medicare system for over 20 years helping other people to fix Medicare federal foul-ups.  So, I understood the cause and knew the remedy.  Most senior citizens on Medicare would not be as mellow about it as I was. 

Many politicians want us to believe that the Medicare system works all the time.  It doesn’t.  Believing that a human designed and operated system will work flawlessly is unrealistic thinking.  When flaws are found, they need to be fixed right away.  If the flaws in the Medicare system are not fixed, they will continue to hurt seniors financially. 

During my first few years of helping our senior citizen clients with Medicare billing problems, I wrote an article in which I explained my calculations for the belief that just one reoccurring Medicare problem was costing seniors on Medicare over one billion dollars per year in false medical bills.  The problem continues to exist.  I have not been able to find any politician who wants to take the lead in fixing Medicare problems to protect senior citizens financially. 

In my case, Medicare was over six months late in updating my file.  All the medical claims for services during that time period will need to be refiled once Medicare records are fully updated.  I’ll need to wait ten more days before I can get medical services without another foul-up by Medicare.   

A few months ago, I helped a client with the same problem.  Because I helped him “kick” Medicare into updating his file, I was able to save him $34,699.79 in wrongfully calculated medical bills. 

 Forgive me if I don’t seem impressed by the Medicare billing system. 

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 by fighting mistakes and fraud in the Medicare system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through book stores or online. 

Written on September 13, 2023 by Woodrow Wilcox

S.O.S. Speaking Of Seniors 

I Wrote and Typed the Letter 

 By Woodrow Wilcox 

On September 5, 2023, an 86-year-old client from Crown Point brought me the claim reports that I helped her order from Medicare.  After reviewing the forms, I decided that it would be better if I wrote a letter for our client to sign for sending to her doctor.  I thought that would make a stronger impression on the doctor. 

 With some editing to protect the privacy of our client, here is the letter that I typed for her to sign.  I made copies for her and the file before I mailed the letter. 

Why do you employ people to file Medicare claims when they don’t know how to file claims with Medicare? 

 I just got my Medicare Summary Notice forms for the dates of service that you billed a balance to me.  Each of the items that your firm billed to me were denied by Medicare because your firm filed the claim without information to justify the medical need for that service.  The Medicare EOB that your firm got for each service should have exactly the same information that is on my Medicare Summary Notice reports. 

For date of service May 19, 2022, Medicare ruled that you filed two items incorrectly and that “The information provided does not support the need for this service or item.” 

 For date of service August 18, 2022, one item was rejected by Medicare for the same reason – your firm failed to state a medical need for the service. 

 For date of service November 17, 2022, two items were rejected by Medicare for that reason – your firm failed to state a medical need for the service. 

 For date of service February 1, 2023, one item was rejected by Medicare for the same reason – your firm failed to state a medical need for the service. 

 Your firm failed to file the claims correctly and you want me to pay the balances caused by your staff or claims contractor who failed to do the job correctly.  If your firm knew or suspected that Medicare would not cover the service, then you should have explained that to me and had me sign an Advance Beneficiary Notice form.  I don’t remember signing any such form.  You should cancel the bill because your firm’s mistakes caused the balances. 

All the help I gave this client was FREE OF CHARGE.  This insurance agency helps all clients with such medical billing problems at no charge to demonstrate that we really do care about our clients.  If the insurance agent or agency that you use does not give this high level of customer service, why don’t you switch to our insurance agency? 

Written on September 5, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

Protected Lowell Resident From Bill Mistake 

 By Woodrow Wilcox 

On August 29, 2023, I checked a bill sent by an 87-year-old client from Lowell and wrote a letter to protect her from someone else’s mistake.  I believe my work will save her $1,057.54. 

 With some editing to protect the privacy of our client, here is the letter that I sent to a hospital in Lake County, Indiana. 

 Our client sent to our firm a bill from your firm for our review.  The bill seeks a balance of $1,057.54 on Guarantor Number XXXXXX for services rendered on January 18 and 19 of 2023. 

 I phoned the secondary insurance company of the client to learn what it knew.  As soon as I directed the representative’s attention to what I suspected was an incorrect handling of the claim, she understood and sent the claim to be reviewed again.  I believe that this will result in the claim being paid. 

 Our client did not cause the delay.  Someone at her secondary insurer made a mistake and that is being reviewed for correction.  Please, be patient. 

All the help that I gave this client was FREE OF CHARGE.  This insurance agency helps our clients with such medical bill problems without charge to demonstrate that the owners, managers, and staff really care about our clients.  If your insurance agent or agency does not give this high level of customer service, why not switch to an agency that does – like this one? 

Written on August 29, 2023 by Woodrow Wilcox

S.O.S. Speaking Of Seniors 

Helped Florida Widow Fight A Mess! 

By Woodrow Wilcox 

 Some retired clients moved from Indiana to Florida.  After a while, the husband died and the widow had a mess on her hands.  She sent her agent papers regarding a bill for $1,600.  Her agent gave the papers to me. 

 The husband died in April 2023.  The bill was from March 2023.  The medical firm gave the bill to a collection firm only two months after the husband’s death.  I guess medical bill collection moves fast in Florida. 

I checked the claim with the late husband’s Medicare supplement insurance company.  It reported that Medicare never sent the claim information about the bill so that the insurance company could pay it.  That happens a lot. 

To help the widow, I sent a letter to the collection firm.  With some editing to protect the privacy of the widow and her late husband, here is the letter that I sent. 

  The widow (of our client) sent documents to me to review and help her with this bill for her late husband.  I checked the bill with the patient’s Medicare supplement insurance company.  It reported that Medicare NEVER SENT THE CLAIM INFORMATION TO IT.  That is a common failure of the Medicare system.  It is not the fault of the patient or the widow.  It is the fault of MEDICARE. 

 To fix this problem as fast as possible, either your firm or the medical firm that you represent must send to the claims department of the secondary insurer BOTH THE ORIGINAL BILLING INFORMATION AND THE MEDICARE EOB INFORMATION ABOUT THIS CLAIM.  That address follows. 

Medicare fails to send claim information often.  Accompanying this letter is a copy of an article that I wrote recently.  I have written over 2,000 articles about Medicare problems.  Also, I authored the book SOLVING MEDICARE PROBLEM$.  Trust me.  What I am telling you to do MUST BE DONE. 

 Please, deal fairly with the patient and his widow.  I am working to protect them from sloppy work by Medicare. 

Written on August 25, 2023 by Woodrow Wilcox

S.O.S. Speaking Of Seniors 

Helped Polish Woman From Highland 

 By Woodrow Wilcox 

 On August 16, 2023, a Polish immigrant client brought a bill to our office to ask if she should pay the bill.  The client is from Highland, Indiana.  I checked it for her and wrote a letter to the biller.  With some editing to protect her privacy, here is the letter that I wrote and sent to the medical biller. 

 Our client brought a bill from your firm to our firm for our review.  The bill seeks a balance of $250.18 on Account Number XXXXXXXX for services rendered on 12/27/22, 01/03/23, and 01/19/23. 

I phoned the client’s Medicare supplement insurance company to learn what it knew of these claims.  It reported that MEDICARE NEVER SENT THE CLAIM INFORMATION about these claims to it.  That is not the fault of the patient, nor her insurance company, nor your firm.  IT IS THE FAULT OF MEDICARE. 

To fix this problem as fast as possible, please send both the original billing information and the Medicare EOB information that you have for these claims directly to the secondary insurer.  Here is the contact information for you. 

All the help I gave to this client was FREE OF CHARGE.  The Medicare system is NOT perfect.  Problems occur.  Since we know the system better than our clients, we help with billing problems without charge to demonstrate to our clients that we care about them.  If your insurance agent or agency does not give this high level of customer service, why don’t you switch to a firm that does – like this one? 

Written on August 16, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

I Want to Teach 

 By Woodrow Wilcox 

 I am almost 69 years old.  For over 20 years, I have helped senior citizens who are on Medicare and clients of the insurance agency where I work to fight mistakes and fraud in the Medicare system.  I have saved clients of this firm over three million dollars by fighting mistakes and fraud in the Medicare medical billing systems.  I have written way over 2,000 articles about billing problems in the Medicare system. 

I believe that I can help more seniors by teaching what I know how to do.  I want to teach that so that when I die, the knowledge and skills that I have will not die with me. 

I am exploring forming some new company or non-profit through which I can teach these things. I am open to ideas about how to do this.  I want to spotlight the billing problems in the Medicare system to a national audience to build pressure for changes that will make life easier for millions of senior citizens on Medicare. 

If you have ideas for helping me to achieve this, or know someone who can help me to accomplish this, please contact me.  I work at Senior Care Insurance Services in Merrillville, Indiana. 

Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana.  Since Wilcox started working there in 2003, it has grown from 2,000 senior citizen clients to over 20,000 clients.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through book stores or online. 

Written on August 8, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

The Problem With Foreign Call Centers 

 By Woodrow Wilcox 

On July 26, 2023, I made phone calls to various numbers of a medical billing firm with a client from Saint John, Indiana.  It was a frustrating and grueling hour plus session. 

Our client lives in Indiana but crossed the state line to use a medical firm in Illinois.  The firm does not want to talk to us about how it made some mistakes that caused the client’s Medicare supplement insurance firm to never get the claim to pay it.  They don’t want to follow Medicare rules.  They just want our client to pay the bill. 

When we phoned, we got a medical billing call center in El Salvador, Central America.  We got bounced around to three people.  The last one was Gabriella.  We talked until she wanted the Medicare number of our client.  He was on the phone and could have given me permission to state it or he could have stated it.  But I stopped that to protect our client and the privacy of his personal information. 

If a person in a foreign call center gets your Social Security number or your Medicare number, and passes it to someone else, how could an American prosecutor investigate the matter to find the guilty parties and prosecute them? 

 Every company doing business in the U.S. that uses an offshore call center is risking protected information of its customers in the U. S.  The company doing business in the U.S. is using the foreign based call center to increase its profits without regard for the safety of the protected information of people in the U.S. 

If the foreign based call centers were forced to relocate in the U.S., and someone did a criminal act with protected information, it would be much easier for investigators and prosecutors in the U.S. to find the criminals and bring them to justice.   

Many communications companies in the U.S. are related and aligned together with companies that own satellite services or other firms that promote doing business internationally.  I don’t believe that these firms or their leaders care about or even think about protecting senior citizens on Medicare or Social Security.   

In my view, a President or a Member of Congress that does not want to stop the use of foreign call centers (especially in medical services) is no friend to any senior citizen or anyone else who lives in the U.S.A.  The politicians that promote or protect the use of foreign call centers are enemies of everyone living in the U.S. because they support risking the privacy of people’s protected information.  That could lead to identity theft that could harm residents of the U.S. 

Written on July 26, 2023 by Woodrow Wilcox. 

S.O.S. Speaking Of Seniors 

Such A Deal! 

By Woodrow Wilcox 

On July 19, 2023, a client from brought a medical bill for me to check.  The client is from Porter County, Indiana. 

He bought a policy with which I was not familiar.  When he met with our agent Moe Qader, Moe asked him about what kind of health problems he was likely to have and how much he could afford.  Moe DID NOT just recommend any policy.  He learned about the client and his needs before recommending a policy. 

I had helped this client with medical bill problems in the past.  He told me that he brought the bill for $1,850 to have me check it before he paid any of it. With the client present, I phoned the agent Moe Qader because he was more familiar with the policy and how it worked than I was.  I wanted accurate information to help the client. 

The bill was correct.  The client got a policy that has deductibles, co-pays, and out of network charges.  But the bill for $1,850 was just a co-pay of $370 per day for five days in the hospital.  That was the amount he owed with the policy that he bought.   

If you ask me, the client made out like a bandit.  The total bill was for $135,670.80.  The credit adjustments reduced the bill by $126,749.50.  His insurance company paid $7,071.30.  He owed only $1,850.  He was in the hospital for five days. 

 I’m proud of Moe Qader for listening to the client and helping the client select a policy that really helped the client.  Oh, I forgot to tell you something.  The monthly premium for the health insurance policy that Moe recommended to the client was only $24 per month. 

We can’t always guess the best policy for the client.  But our agents are good and they do their best to make an educated guess about which choices seem to be the best for the client. 

Written on July 19, 2023 by Woodrow Wilcox. 

 S. O. S. – Speaking Of Seniors

 A Hospital’s Broken Promise

 By Woodrow Wilcox

            On July 12, 2024, I phoned a client’s insurance company to check on a bill.  I was very disappointed that a key manager at the hospital had broken a promise to me about working together to resolve a medical bill problem for our client.

          With some editing to protect privacy, here is the letter that I sent to the manager of billing at the hospital.

            A few weeks ago, we had a great phone conversation in which you said that I just need to get things to you and you would handle any billing problems.

            So, I sent you a copy of my letter to the CEO of your hospital that I had sent just a few days earlier.

            Now, I learn from the health insurance company that it has not received any of the bill information that it requested from your firm.

            Note that on my letter dated June 7, 2024, I clearly gave the correct address for that insurance firm.  Why was NOTHING DONE?  Please, do what I asked so that this bill and problem can be resolved.

            If my letters don’t work, I will have to help the client file a complaint against the hospital for its bad business practices with the Office of Consumer Protection of the Indiana Attorney General.  I’ve done that on other occasions, too.

Written on July 12, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Forgot Medicare Part B Deductible

By Woodrow Wilcox

            On July 12, 2024, I wrote a letter to a client who forgot what she had bought through our insurance agency.  The client is from Lansing, Illinois.  With some editing to protect her privacy, here is the letter that I sent to remind her of what she bought.

            You sent a bill to one of our offices asking us to explain it.  That office forwarded the bill to me.

            I reviewed the papers and your letter to us.  Then, I phoned your insurance company to learn what it knew of this bill.  Here is the result.

            The original bill was $408.  Your insurance company got the information about the claim from Medicare on 02/15/2024.  Medicare approved a charge of $72.93.  Medicare paid $35.10.  Your insurance paid $8.60.  Medicare ruled that $29.23 was part of your Medicare Part B annual deductible for 2024.  You bought a Plan G Medicare supplement policy.  All Plan G policies, sold by any insurance company, DO NOT PAY THE MEDICARE PART B ANNUAL DEDUCTIBLE.

            There are policies that DO pay the Part B annual deductible but those policies cost more.  You did not buy a more expensive policy.  When you chose a Plan G policy, you agreed to pay the Part B annual deductible.  The $29.23 is part of that.

            If you have any questions, contact the insurance agent who helped you.

            Thank you for allowing us to help you with your insurance needs.

            This insurance agency helps all our clients who forgot the details of what they bought with a similar explanatory letter.  It is how we show clients that we really do care to treat them well.

Written on July 12, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

 Helping Widow Fight Medical Bills Totaling Over $200,000

 By Woodrow Wilcox

            On July 2, 2024, I helped a client from Highland file a complaint with the Indiana Attorney General’s Office of Consumer Protection against an insurance company and two hospital companies.  The combination of medical bills totaled over $200,000.  All the claims were for care to her late husband during his last weeks of life.

            In this case, I found evidence that she was being billed by two different hospital billing firms for the same services on the same dates of service.  Medicare denied almost everything in the claims.  If a claim is filed incorrectly, Medicare will deny the claims until they are filed correctly and in a timely manner.

            The insurance company was refusing to pay because it did not receive any of the claims within the 15 months allowed for filing a claim.  I highlighted the statements on the Medicare claims reports that showed the filings had been made within the 15-month period.  I believed that the original filings with Medicare had been filed timely but not correctly by Medicare rules.  If the billing companies had filed the claims correctly and timely, then the insurance company should pay on the claims.  If the billing companies did not file in a correct and timely way, then those firms should “EAT THE BILLS”.

            There were multiple issues in the widow’s case.  The Indiana Attorney General has more leverage to force the insurance company and the two billing companies to answer questions honestly than I have.  I wanted our client, the widow, to be treated honestly and well by all parties.  Helping her file the complaint against three companies was what I believed would help her the most.

Written on July 2, 2024 by Woodrow Wilcox.

S O S – SPEAKING OF SENIORS

 BEING RECOGNIZED

 By Woodrow Wilcox

            I stopped at a McDonald’s in Highland this week and was recognized by some clients of the insurance agency where I work.  I joined them to have my meal and talk with them.  There were eight or nine people.  Two were clients.

            One client said that she always read my articles.  She was my English teacher in nineth or tenth grade in high school.  She said that she remembered that I was a good writer even then.

            Another client told everyone that I was helping her with fighting a medical bill for over $39,000 and that she did not hear any more about that bill since when I wrote the biller a very detailed letter about why the bill was wrong.  Also, she told the group that when her husband died, I helped her cancel bills that totaled over $121,000.

            The other people gathered at the table asked me how I did it.  I explained that I just have a natural talent for looking at Medicare related medical bills and related documents, spotting a problem, and explaining why the billing was wrong.  Having that talent has kept me busy and employed at the same place for over 21 years.

            Now, I am nearing age 70 and want to teach others what I know about how to protect senior citizens from bad billing by Medicare contracted medical firms.  I have saved clients of our insurance agency over three million dollars.  I want to pass my knowledge to others so that more seniors can be helped and protected.

Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana.  He wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on June 20, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Some Mud Stuck

 By Woodrow Wilcox

            On June 12, 2024, I got some mud to stick.  There is an old saying that if you throw enough mud against a barn, eventually, some of it will stick.  That is what I told a client in my office that day in response to a compliment that she gave me for really making an effort to help her with a medical bill for $21,723.27.

            First of all, she did not get this billing problem from our insurance agency or an insurance policy that she bought through our firm.  She got the problem and the policy through a different insurance agent who works for another insurance firm.  She came to our insurance agency because she was so disappointed with the other insurance agent and policy.

            The agent that sold her a policy through our agency asked me to try to help her with a medical bill that she got when she used the previous insurance policy. 

            The client was bitten by her own dog.  She went to the emergency room of a local hospital.  The claim was filed with her Marketplace or “Obamacare” insurance policy.  The Marketplace policy denied the claim and refused to pay on the bill for over $21,000.

            The hospital that she went to use was not “in-network” for the Marketplace policy that she had.  That should not matter because she went to the hospital for emergency services.  The client lives with a relative on a Social Security check of less than a thousand dollars per month.  She was not able to sleep well or relax well with the big bill facing her.

            She and I sat in my office over half an hour listening to a recording asking us to be patient and wait to talk to someone in the hospital billing department.  After over half an hour of listening to that recording, I started searching the internet for information to contact officers and managers of the hospital to complain that the billing department was not answering the phone in a competent manner.  I even checked the Indiana Secretary of State’s website for the name and address that you need to sue the hospital.

            I got results because I phoned people as well as typed letters.  Within an hour, I had spoken to two high ranking hospital officials and got some results.  Now, the hospital will appeal the denial of coverage by the Marketplace insurance company and clearly inform that insurance firm that the patient’s visit was to the emergency department which did not require prior authorization.  Also, the chief of patient billing asked that I encourage our client to meet with his assistant to apply for a discount or forgiveness of any balance left after the insurance company pays its share.

            I’m glad that I was able to help the client.  Our firm helped this client AT NO CHARGE.  We help all our clients with insurance related medical bills in this way to demonstrate that we really do care about our clients.  If your insurance agent does not give this high level of customer service, shouldn’t you switch to a firm that does?

Note:  Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana.  He has helped clients of that firm save over three million dollars by fighting mistakes and fraud in the Medicare system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on June 12, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Her Insurance Company Acted Honorably

 By Woodrow Wilcox

            After working on a client’s problem, I wrote a letter to her on June 10, 2024.  The client is from Schererville, Indiana.  With some editing to protect the client’s privacy, here is the letter that I sent to her.

            Previously, I wrote to you and a vice president of the Medicare supplement insurance company that you selected through our insurance agency.  Today, I phoned that vice president to learn more after she researched your case.

            You had two different insurance policies with the same group of companies.  One policy covered you from December 2016 to December 2023.  The other policy covered you from December 2023 through now.

            The claims on the list you submitted for me to check were in 2022 and 2023.  Here are the results of my research.

            The claim for 01/15/2023 with a balance of $37.77 was part of your Medicare Part B annual deductible.  You have a Plan G supplement policy.  That does not cover the Medicare Part B annual deductible.  So, you will have to pay the $37.77.

            The claims for the four balances for $10 on the bill were refused by Medicare.  If Medicare denies a charge as covered, the insurance company will not pay on it.  Your policy is a Medicare supplement policy that pays the last 20% of any Medicare approved charge.  I don’t know why Medicare refused to cover these items.  That is why I asked you to bring the Medicare ruling reports to me so that I could determine if the medical service provider made a mistake when the claims were filed.  If a medical firm files claims incorrectly, Medicare will deny the claims until the claims are filed correctly.  But for now, you owe the $40 from the four $10 balance claims.

            The medical firm filing the claims was obligated to honor a 2% discount to you because it entered a contract with a medical discount plan.  It did not honor its commitment.  Your insurance company is reprocessing those claims to pay the final 2% so that you do not need to do that.  Your insurance company is acting honorably.  The medical firm you used did not act honorably to give you the 2% discount under the contract it entered with the medical discount group.

            If you have questions about this, contact your insurance agent.

Written on June 10, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

My Letter to the CEO of a Hospital

 By Woodrow Wilcox

               On June 7, 2024, I wrote a letter to the CEO of a hospital to tell him how bad and uninformed the people in the hospital’s patient billing department were.  With some editing to protect our client’s privacy, here is the letter that I sent to the hospital president and CEO.

               I wasted time yesterday and today with your patient billing people giving me bad information in response to a simple question.  Here is that question.

               What address should I use to send to an appropriate person or department at your hospital to explain that Medicare never sent claim information to the secondary insurer for one of your patients who is our client and to request that you send both the original billing information and the Medicare EOB information that you have for the claim directly to the secondary insurer?  Also, I’ll send the correct address to get that done.

               Because no one that I contacted in the patient billing department of your hospital knows how to answer that question, my time has been wasted by being misdirected to a billing office in Cary, NC and an office somewhere else. 

               Why don’t your patient billing people know how to respond to this request?  The Medicare system relies on a network of emails and satellite services.  When the message is broken by sun spots, lightning, or other causes, information is lost.  This happens hundreds of times each day.  Why not be prepared to fix the problem in order to be paid more quickly?

               In this case, the patient is [our client] with [this account information and this date of service].

               Medicare never sent any claim information to the secondary insurer for this.  This problem was caused by Medicare and not the patient or the patient’s secondary insurer.  To fix this problem so that your firm can be paid properly and promptly, send both the original billing information and the Medicare EOB directly to this address.

Written on June 7, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Helped Highland Senior with Bill

 By Woodrow Wilcox

            On May 28, 2024, I helped a 77-year-old client from Highland, Indiana.  She got a bill from a hospital in Lake County asking her to pay $1,632.

            With some editing to protect the privacy of our client, here is the letter that 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 $1,632 on Guarantor Number XXXXXX for services rendered from 01/11/24 through 01/18/24.

            I contacted the secondary insurer to learn what it knew of this claim.  It reported that it paid this balance to your firm with a check with number XXXXXXXX on 03/29/24.  The check has not been cashed yet.  The service used for sending the check was XXXXX (bank) with the phone number 855-XXX-XXXX.

            If you have received the check, please let our client know that.  If you have not received the check, please call XXXXX to get help to find and cash it.

            All the help I gave this client was FREE OF CHARGE.  This insurance agency helps clients in such billing matters to demonstrate to the client that we really do care for our clients.

            If your insurance agent or agency does not give this high level of customer service, why not switch to an insurance agency that does?

Written on May 28, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 Crack A Whip On Medicare

 By Woodrow Wilcox

            We need a President and a majority in Congress to CRACK A WHIP ON MEDICARE.  That is what over 21 years of helping senior citizens has taught me.

          When a senior citizen joins Medicare and gets a Medicare supplement insurance policy or other coverage, Medicare starts a file on that senior.  The problem is that when Medicare gets the information, it does not record that information right away.  It lags in doing its essential work.

          Likewise, when a senior citizen shops for a better or less expensive Medicare supplement policy or other Medicare related policy and switches to a different company, often Medicare does not update the file for months or years.

            That is so unfair to senior citizens.  Here is why.

           When that happens, the senior is paying for insurance that does not work because Medicare lags in updating the senior’s file.  The insurance company that the senior has does not get the claim information from Medicare to pay a claim.  The medical service provider starts to hound a senior citizen to pay the balance that the insurance company did not pay because it never got the claim information from Medicare.  This unfairly causes stress on the senior.

            We have computers now.  Why can’t Medicare update its records within three business days?  It is because no one in the federal government cares about a problem that seniors have because of a lack of good, responsible management by federal government officials and contractors.  If they can’t do the job correctly, why not fire them (or the contractor companies) and replace them with others who want to do the job in a correct and timely manner?

            The day that I wrote this article, a senior citizen from Crown Point brought to me a medical bill from a local hospital.  The hospital wants to be paid the balance owed on several dates of service.  I checked with the Medicare supplement insurance company.  Medicare had not sent any claims to the insurance company for several months.  The dates of service for the senior ranged from August 2023 through February 2024.  Medicare failed to send any of the five claim episodes to the senior’s Medicare supplement insurance company.  The insurance company stands ready and willing to pay the claims but it can’t get the federal agency managers, employees, and contractors to do their jobs in a professional and timely manner.  So, why do we keep these Medicare workers employed?

.

Written on May 20, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Fighting to Protect Widow from Medicare Mistakes

 By Woodrow Wilcox

On May 8, 2024, a pile of bills was delivered to our office in Merrillville.  They were given to me.

            One of the bills was for service to a widow.  The other bills were for services to her deceased husband.  Bills to her husband were coming from two different medical offices.  The total of unpaid bills to her late husband in the bunch was $660.38.

            I phoned the deceased client’s insurance company to learn what it knew about the unpaid claims.  It reported that Medicare never sent it the claims information so that the insurance company could pay its share.

            That happens a lot all over the country.  The Medicare system uses internet and satellite communication systems.  When those systems are disrupted by sun spots, lightening, or other problems, data is lost and insurance companies don’t get the claim information.  When this happens, medical firms and their collectors hammer senior citizens to pay bills that would have been paid if the Medicare system worked flawlessly.  But it does not.

            I work to put the pieces of information back together and get them to the proper parties so that senior citizen clients of this insurance agency are not wrongfully billed and hurt financially.

            How serious is this financial problem for seniors on Medicare?  Several times, I have estimated it.  I determine how much money our clients would have lost if I had not helped them.  Then, what percentage of seniors in our congressional district are our clients.  Then, multiply that by the number of congressional districts.  Each time, I get an estimate of OVER ONE BILLION DOLLARS PER YEAR.

            I want to teach others how to do this so that more senior citizens are protected from errors in the Medicare system.  Also, I have tried to get elected political people to pay attention to this problem with Medicare and work to reduce or eliminate it.  So far, I have not found any Democrat or Republican who wants to work with me to protect senior citizens from Medicare system errors.

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 by fighting mistakes and fraud in the Medicare system.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through any book store or online.

Written on May 8, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Medicare and Hospital Goofed

By Woodrow Wilcox

            On May 7, 2024, I wrote a letter to a hospital in northwest Indiana for one of our clients.  With some editing to protect the privacy of our client and others, here is the letter that I sent to the hospital.

Dear Representative,

      Our client sent a bill from your firm to our firm for our review.  The bill seeks a balance of $2,138.30 on Account Number XXXXXXX for services rendered on 06/07/23 through 06/23/23.

I phoned the client’s Medicare supplement insurance company to learn what it knew of this claim.  Here is what it reported to me.

            It never received a Medicare Explanation of Benefits from Medicare on this claim.  It got your bill information on July 26, 2023.  On September 8 and December 14 of 2023, it requested that your firm send the Medicare EOB information that you got from Medicare so that it could check and pay on this claim.  YOUR FIRM NEVER RESPONDED TO GIVE THE INSURANCE COMPANY THE INFORMATION THAT IT REQUESTED.  The only reason that you have not yet received the balance on this claim is because neither Medicare nor your firm ever bothered to send complete claim information to the secondary insurer.

            If you still want to be paid, please send both the original billing information and the Medicare EOB information to the insurer at the address shown here.

Written on May 7, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 What Caused The Balance?

 By Woodrow Wilcox

            On May 2, 2024, I wrote a letter to a medical firm for a client from Dyer, Indiana.  The client had brought the bill to our office in Schererville and that office forwarded the bill to me to check for the client.

            With some editing to protect the privacy of our client, here is the letter that I sent to the medical firm.

            Our client sent to our firm a bill from your firm for our review.  The bill is dated 03/28/2024 and seeks a balance of $66.90 on Guarantor ID XXXXXX for services rendered during November 2023.

            I phoned the client’s Medicare supplement insurance company to learn what it knew of this claim.  It reported that the Medicare EOB that it received from Medicare showed no balance after the insurance company sent to your firm $657.30 which is exactly what your bill to our client shows the secondary insurer paid your firm.  So, how did you arrive at the balance of $66.90?

            I helped our client to request a current Medicare Summary Notice about this claim.  When he gets that, he is to get that to me to compare it against your bill.

            The only thing that I can think of possibly causing a balance is if you filed an amended claim and Medicare ruled on that without sending an updated ruling to the secondary insurer.  Please, check your calculations to spot if someone at your firm made a mistake.  If so, please correct it and report that to our client.

            Thank you.

Written on May 2, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

 Do You Want to be Interviewed on the Internet?

 By Woodrow Wilcox

           Are you one of the clients that I helped to check a bill and fight a mistake?

            I have helped many, many people.  When I started that work in 2003, this insurance agency had a little more than 2,000 clients.  Today, we have over 22,000 senior citizen clients. 

           I wrote the book SOLVING MEDICARE PROBLEM$ to teach what I had learned to do to help senior citizens fight billing mistakes in the Medicare system.

            Now, I would like to interview people that I have helped to post their stories on the internet.  I believe that sharing stories about the problems with the Medicare system and how to correct them will be helpful to anyone who wants to learn how to help senior citizens in their communities.

            If I helped you or a member of your family, and you want to appear on an internet interview, please phone this office at 219-736-9450 and tell them to ask me to contact you to arrange a time for the interview.

Note: Woodrow Wilcox is the senior medical bill caseworker at Senior Care Insurance Services in Merrillville, Indiana.  He has helped clients of that firm save over three million dollars by fighting to correct medical bill errors caused by the Medicare system.  Also, he wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.

Written on April 26, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

 Good News For Dyer Client

 By Woodrow Wilcox

            On April 12, 2024, I wrote a letter to a client to give him good news about a hospital bill.  With some editing to protect the privacy of our client, here is the letter that I sent.

            You sent a bill to our Schererville office for us to check for you.  The Schererville office forwarded the bill to me.  The bill sought a balance of $1,632 for services rendered at a local hospital during February of this year.

            I phoned the headquarters of the insurance company that you selected through our insurance agency.  I asked what they knew about this bill.  They already paid this bill.  Here are the details.

            The bill is dated March 26, 2024.  That is when the hospital sent the bill to you.  The insurance company sent the hospital a check on March 31, 2024.  On April 8, 2024, that check was cashed by the hospital.  So, the bill was paid.

            For that reason, I did not contact the hospital about this bill.  According to your insurance company, when it got the bill details from Medicare, it paid the bill quickly.  The problem should be solved.  Thank you for allowing us to help you with your insurance needs.

Written on April 12, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

April 16 Anniversary

By Woodrow Wilcox

            On April 16, 2024, I will have worked at Senior Care Insurance Services for 21 years.  I started on April 16, 2003.

            Soon after that, I started writing about what I was doing to help senior citizens who were our clients when they had problems with the Medicare system.

            To believe that the Medicare system is perfect is unrealistic.  Every humanly designed system has flaws.  I have diligently exposed and explained the flaws that I have found in the Medicare system.  I have tried to get the attention of political officials to expose and work to correct those flaws.  I have not found any Democrat or Republican office holder to take action to protect seniors from financial harm that is caused by faults in the Medicare system.

            No one can say that I did not try to get political office holders to help.  Maybe after I stop doing this work, someone else will have better luck to get help from political office holders.

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 by correcting medical bill problems.  Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through book stores or online.

Written on April 2, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Senior

Helped Lowell Client Write Biller

 By Woodrow Wilcox

            On March 14, 2024, I phoned Medicare with a client to get an important fact before I wrote a letter to a medical biller

With some editing to protect the client’s privacy, here is the letter that I sent to the medical billing firm.

            Our client and her husband sent to our office a bill from your firm for our review.  Your bill to our client is dated 1/31/2024 and seeks a balance of $330 on Guarantor Number XXXXXXX for services rendered on 11/06/23.

            I investigated this and found that your firm filed the claim INCORRECTLY with Medicare.  The Medicare EOB that you got from Medicare should have exactly the same information as the Medicare Summary Notice that the client got.  Check footnote “A” on the claim for the $330 original billing under Claim XX-XXXXX-XXX-XXX.  The footnote explains that the service was denied because your firm filed the claim as an “Annual Wellness Visit” when it should have been filed as a “Welcome to Medicare” visit.

            Please, refile the claim properly.

            The help that I gave this client was FREE OF CHARGE.  This agency helps clients with such billing problems without charge to demonstrate that we really do care for our clients.  If your insurance agent or agency does not give such a high level of customer service, why not switch to one that does – like this one.

Written on March 14, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

Helped Crown Point Client File Complaints

By Woodrow Wilcox

            On March 11, 2024, I helped a client from Crown Point file complaints against a firm in Florida.

            The firm was working together with other firms to send the client and his wife test kits which they never ordered and then filed claims with Medicare to get money from Medicare and the client’s Medicare supplement insurance company.

            For over 20 years in my job, I have collected addresses to which complaints should be sent.  There are different addresses to which people should send complaints depending on the facts of the matter and whether it involves violations of federal or state laws.

            In this case, we sent complaints (with copies of evidence) to the Medicare Claims Office, the Medicare Inspector General, the Fraud Complaints office of Medicare, and the Consumer Protection Offices of both the Florida and the Indiana State Attorney General.

With some editing, here is part of the letter.

Dear Representatives,

 I received packages of test kits from (a lab company).

         I never requested the test kits and never used them.  But I got Medicare Summary Notices that (the lab company) BILLED MEDICARE.  This was a fraudulent billing of Medicare.  The date of service was 12/11/2023 for Claim # XXXXX and 01/10/2024 for Claim # XXXXX.  The Medicare Summary Notice states that these were ordered by PXXXXX D. AXXXXXX.  I do not know anyone with this name.  In addition to this, women named TXXXX and VXXXXXX phoned me twice a day for weeks offering to help me use the test kits.  They wanted me to send the test kit samples to a firm in Lake Worth, FL.

          Accompanying this letter are copies of papers that I received from the firm (a lab company) or related firms.

Written on March 11, 2024 by Woodrow Wilcox.

 S. O. S. – Speaking Of Seniors

 False Claims on Medical Bill

 By Woodrow Wilcox

            On February 27, 2024, I sent a polite letter to a billing firm in another state that was trying to collect money from one of our clients who died soon after the medical treatment of the bill.  The letter upset the widow of our client because it claimed that her husband had no supplemental insurance after Medicare.

            I read the letter and understood her concerns.  This bill had a small bill balance.  But if he had no insurance, bigger bills would be coming.  That frightened her.

            Fortunately, I have collected the names and contact information of some people who work at billing firms and have asked me to contact them if I find any problems.  I had such a contact for the company that sent the bill that alarmed the widow.

            With some editing to protect people’s privacy, here is the letter that I sent to the contact at the firm and sent a copy of it to the widow.

            Accompanying this letter is a copy of the first page of a bill that you sent the deceased client and which his widow read.

            I don’t know who prepared this letter, but there are four FALSE STATEMENTS in this letter to which I want to draw your attention.  If the bill has false statements and it is sent through the U.S. Mail with the intent to induce someone to pay a bill that is not owed, then that is a statement that could harm your firm.  So, I am being a friend to you and your firm by showing this to you and alerting you to the potential harm it could do to your firm.

            The four false statements are these:

“You are receiving this statement because your insurance carrier denied our claim.”

            “At this time the balance due is your responsibility.”

            “Coverage not in effect at time of service (02-09-24).”

            “01/11/24 XXXXXXXXXX Life Ins. Company coverage not in effect at time of service.”

            I phoned the vice president of XXXX XXXX Life Ins. Co.  She reported to me that the policy has been in effect since 9/1/2017.  If you are not connecting with the correct insurance company, then send both the original billing information and the Medicare EOB information about this claim directly to the correct company at this address. (I stated the correct address here.)

Written on February 27, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 Over Three Hours in One Day

 By Woodrow Wilcox

            On Tuesday, February 27, 2024, I worked over three hours to resolve one client’s multiple problems with claims to Medicare.  I spent a few hours on his earlier visits for the same problems, too.

            Medicare was not honoring any claims that it was getting for this client from doctors, hospitals, or labs.  According to Medicare, our client had another insurance that was responsible before Medicare was.  That problem was caused by a car accident in 2015 that the auto insurance company failed to report was settled.  Medicare needs to get a report from a car insurance company that the matter was settled before it will remove the car insurance company from the Medicare file of the senior citizen.  That must be done so that claims are processed correctly to the Medicare related insurance company.

            If a senior citizen needs to go to a doctor or other medical service provider while a car accident is being settled, the doctor or other person filing the new claim must check the part of the claim form that states the service is not related to a no fault insurance matter.

            The original responsibility for sending the report was not handled well by the original claims adjuster.  Nor was it handled properly by subsequent claims adjustors.  But on February 27, 2024, I got hold of the supervisor of claims adjustors and he was very quick to see the problem and work to resolve it.

            But there was another problem with a bill from a pathology lab service.  The claim was not filed with Medicare using the name that the pathology lab service used when sending the bill to our client.  This is a common problem with doctors, hospitals, labs, and other firms.  They file the claim with Medicare under one business name but send the bill to the client under another business name.  These business entities should keep their billing record keeping straight.  If they don’t, and Medicare learns of the false filing, the medical service provider should be stopped from collecting any balance from either Medicare or the patient.

            The Medicare system of billing has major faults.  It needs someone to have authority to force corrections and penalties for non-compliance.

            In this case, I helped a patient who is 89 years old and has some trouble hearing and understanding people in person or on the telephone.  He needed my help and I was glad to provide it.

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 or online.

Written on February 27, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 A Wonderful Card From A Client

 By Woodrow Wilcox

            On February 13, 2024, I got a wonderful card from a client and his family.  Over the years, I have received many cards from clients that I helped with Medicare related medical bill problems.  Some clients did not send me a card but took me to lunch.  I appreciated every kindness extended to me.

            But the card that I got on February 13, 2024 had a handwritten note that was very special to me.  I want to share part of that note here.

Dear Woody,

            My family and I are deeply grateful for your compassion, service, and expertise.  You have made a tremendous positive impact on so many people, and that does not go unnoticed.  I especially appreciate your written articles by which you educate all of us about cases that you solved and the issues that you mitigated.  You taking the time and effort to share your wisdom even after a long, exhausting day of battling enormous healthcare institutions is genuinely astounding and a rare, precious gift.

            May God grant you excellent health, a long life, and many more decades of winning battles and touching lives.  Thank you for all that you do and, most importantly, for being who you are.

            This note really encouraged me.  I really appreciated it and the family that sent it to me.  I recently returned to work after being in a hospital and rehab center. 

Written on February 13, 2024 by Woodrow Wilcox.

S. O. S. – Speaking Of Seniors

 My Letter to the Indiana Attorney General

 By Woodrow Wilcox

            On February 12, 2024, a client from Munster visited my office in Merrillville and brought a letter that he got from an unknown and undisclosed firm that wanted him to call them.  He asked me if our insurance agency had sent it to him.  We did not.

           I read the letter and considered it sneaky and unethical.  So, I wrote a letter to the Indiana Attorney General about it.  Here is that letter.

Dear Attorney General,

            A few weeks ago, a senior citizen client of this insurance agency got a letter that did not identify who sent it.  He was confused and thought the letter was from our insurance agency.  He is our client.  Our insurance agents met with him and counseled with him to find an insurance policy that he could afford and that would meet his needs.

            He phoned the firm that sent the letter.  The letter was from a firm in Texas that then marketed our client to another insurance company as a lead. 

            We do not object to marketing and competition.  We DO OBJECT to misleading marketing that does not clearly identify who is sending something to a person (especially a senior citizen).