Client Services
SPEAKING OF SENIORS
S.O.S. Speaking Of Seniors
Chesterton Client Forgot What He Bought
By Woodrow Wilcox
On June 8, 2023, I checked a medical bill sent by a client from Chesterton, Indiana. With some editing to protect his privacy, here is the letter that I sent to him.
I checked on this bill for you. Did you have a Plan F Medicare supplement insurance policy and then switch to a Plan G Medicare supplement policy? If you did, that would be the reason that you were surprised by this bill. A Plan G Medicare supplement insurance policy DOES NOT PAY the Medicare Part B annual deductible.
Medicare reviewed this bill and ruled that $209.36 was part of the $226 that you must pay as part of your Medicare Part B annual deductible. This year, $226 is the amount of your Medicare Part B annual deductible. This means that after the first $226 in this year of Medicare approved Part B claims, then Medicare and your insurance policy will pay 100% of Medicare approved Part B claims for the rest of the year.
Your insurance company did not refuse to pay something that it owed. Under a Plan G policy, you agreed to be responsible for the first $226 of Medicare approved Part B claims for this year. So, this bill is your bill and you should pay it.
If you have any other questions, ask the agent that helped you select this policy. I am not an agent.
Written on June 8, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S.O.S. Speaking Of Seniors
Hospital Sent Letter To St. John Client
By Woodrow Wilcox
On June 7, 2023, one of our clients from St. John delivered to me a letter from a local hospital. With some editing to protect the privacy of our client, here is the important information from the hospital letter.
We are writing to advise you that we received correspondence from Mr. Woodrow Wilcox on your behalf. In his correspondence, he advised that your secondary insurance New Era did not receive a claim for services rendered on 02/5/2023 – 02/06/2023. We sent to our billing team for review, and it was confirmed that a claim was not sent to New Era. We want to advise that we sent a claim to New Era on 05/30/2023 and is in processing. Please allow 30-45 days for your insurance to process the claim.
If I had not stepped into the matter with a letter to the hospital, the hospital would have continued to badger our client for payment despite the fact that her Medicare supplement insurance company NEVER GOT THE CLAIM INFORMATION FROM MEDICARER SO THAT IT COULD PROCESS AND PAY THE CLAIM.
The problem was not caused by our client, nor by the hospital, nor by the insurance company. IT WAS CAUSED BY MEDICARE AND ITS PEOPLE AND SYSTEMS NOT WORKING PROPERLY. This problem happens all over the country, hundreds or thousands of times each day. That is why I encourage insurance agents, elder law attorneys, and worship leaders who want to help seniors to get my book SOLVING MEDICARE PROBLEM$.
I’ve been helping seniors who use this insurance agency for over 20 years. I have saved our clients over three million dollars by fighting mistakes and fraud in the Medicare system. If you really care about helping seniors, get my book.
Written on June 7, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Checked Bill for Dyer Client
By Woodrow Wilcox
On May 23, 2023, I checked a medical bill that a client forwarded to me.
The client is a senior citizen from Dyer, Indiana.
With some editing to protect the privacy of our client, here is the letter that I sent to the client after checking the medical bill for her.
You sent a medical bill to our firm to be checked. It was given to me.
I phoned your Medicare supplement insurance company to learn what it knew of this bill.
It reported that it paid this bill. It sent a check to the medical firm on April 30, 2023. That check was cashed on May 9, 2023. The check number is XXXXXXXX. The date on the bill that was sent to you is April 27, 2023. So, it appears that this bill was paid by your insurance company only a few days after this bill was mailed to you.
Thank you for allowing us to help you with your insurance needs.
Written on May 23, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Doctors’ Billing Firm Sent False Bill
By Woodrow Wilcox
On May 15 and 16 I investigated a bill that a client got from the billing firm of some doctors. The client is from Munster, Indiana. On May 15, I read the first papers that the client gave me. I asked her for more papers if she had any. I made phone calls to her insurance company to get some information about the bill.
On May 16, the client dropped some more papers at our Munster office. The staff there forwarded the papers to me. I phoned the billing company with our client on the phone to confirm that I had her permission to speak and question for her.
I learned that the bill was false. The client’s insurance company sent a check with the payment in full over seven weeks earlier. I had a few choice words for the billing company. With some editing to protect the privacy of our client, here is the letter that I sent to the doctors’ billing company. Our client sent to our firm a bill from your firm for our review. The bill seeks a balance of $XXX on Account Number XXXXXXXXX for services rendered on 02/22/2023.
I checked with the client’s Medicare supplement insurance company to learn what it knew of this matter. It reported that your bill is false – bogus. It reported that it sent you full payment of this bill on 03/21/2023. The check number of the payment is XXX XXX XX. You should have received the payment by 03/28/2023. So, you should have received the payment more than six weeks ago. Are you six weeks late in entering payments in your accounting system? Please, phone the check clearing firm XXXXX at 877-XXX-XXXX and ask them to help you find the money. But stop billing our client to pay a bill that her insurance company already paid.
Written on May 16, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
One Client, Two Letters, Ten addresses
By Woodrow Wilcox
On May 15, 2023, I started working at my desk with a small pile of cases. The first one took most of my time. One client got three bills and a letter from a collection law firm. If the Medicare system worked well, the client would not have received any of these letters. Two of the bills were from a local hospital. One letter was from a local law firm to warn of a possible collection action for these hospital bills. One letter was from another medical firm seeking payment for overdue bills. The total number of claims reported on these bills was seven. Medicare sent only one of these seven claims to our client’s Medicare supplement insurance company. Medicare lost or forgot the other six claims which totaled $5,007.71. That is a lot of money to most seniors on retirement income. Seniors all over our country get hurt financially like this when Medicare fails to do what it is supposed to do and no one helps the senior fix the mess that Medicare made.
I wrote a letter to the hospital and another letter to the other medical firm. But I sent each letter to two people and two addresses at each medical firm (in case one person left the medical firm). Also, I sent a copy to the law firm, our client, and the agent at our firm who is connected with our client. In each letter, I gave specific facts about what went wrong and what must be done to fix the problem and help the medical firms get paid. It is a lot of work that I would not need to do if the Medicare system worked flawlessly. But it does not. Helping seniors fight mistakes and fraud in the Medicare system has kept me employed for over 20 years.
Written on May 15, 2023 by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Saved La Porte Client $138
By Woodrow Wilcox
On May 11, 2023, I got a phone call from the wife of a client in La Porte that I had been helping. She called to tell me some good news. The medical firm that had been billing our client $138 phoned her to tell her that the bill would be dropped. I had been helping the client because he got that bill for $138. The client’s wife told me that the medical firm discovered that they had a computer problem. Maybe the medical firm “discovered” the computer problem after I helped the client to question the accuracy of the bill.
There were other problems with the bill, too. When I checked things, I believed that either the medical firm or Medicare or both had made errors in processing the claim. But since the medical firm admitted their computer problem and agreed to drop the bill, my work of helping this client this time is ended. This insurance agency helps all our clients with such medical bill problems at no charge. If your insurance agent or agency does not give this high level of customer service, why not switch to our insurance agency?
Written on May 11, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Warned Biller to Fix Its Bad Math
By Woodrow Wilcox
On May 11, 2023, I wrote a letter to a medical biller to fix its bad math on a bill to a client from Griffith, Indiana. With some editing to protect the privacy of our client, here is the letter that I sent to the medical biller.
Dear Representative,
Someone at your firm made a big mistake on a bill sent to our client. Please, cooperate to fix your mistake. Here is the mistake.
Your bill to our client is dated 05/12/23 and seeks a balance of $596.08 on Account Number XXXXXXXXX for services rendered 01/30/2023. The original amount of the claim was $664. Medicare approved only $67.92. The secondary insurance company paid your firm $67.92. Our client owed you NOTHING. But your firm billed her for $596.08. All you did was subtract the $67.92 payment from the original billed amount of $664 instead of subtracting the $67.92 payment from the maximum that Medicare ruled you could charge — $67.92. Your math is all wrong.
The client received a Medicare Summary Notice with these figures. The Medicare Explanation of Benefits that your firm got has exactly the same information. I am referring to Claim # 18-XXXXX-XXX-XXX. Please, fix your mistake promptly so that we do not need to file a complaint against your firm with a government agency for failing to follow Medicare rules.
Written on May 11, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Steger Client Messed His Medical Bills
By Woodrow Wilcox
On March 27, 2023, I learned how a client from Steger messed his own medical bills because he acted without consulting his insurance agent. The client might have to pay more money because he goofed up Medicare records. The client bought a very good Medicare supplement policy through our agency. In fact, he bought the best kind of Medicare supplement policy – a Plan F which pays for any medical service that Medicare approves but does not pay entirely. Then, he went online and bought a Medicare Advantage plan. That automatically killed his wonderful Medicare supplement policy because Medicare stopped paying for medical services. Instead, the Medicare Advantage plan took the claims and started paying only a portion of medical bills. Under the Medicare Advantage plan, the client was required to pay co-pays, deductibles, and other fees when he got medical services.
In the Medicare system, Medicare Advantage plans cancel the flow of medical claims information to Medicare supplement plans. He wanted extra help with medical bills. Instead, he got less help because he did not know what he was doing and he did not consult his insurance agent who works at our firm. If he had, our agent would have cautioned him not to buy a Medicare Advantage plan. Because he bought a Medicare Advantage plan, his Medicare supplement plan will not be required to pay on any medical bills since he started the Medicare Advantage plan.
Here is a word of caution. Before you sign for any Medicare related medical insurance plan, consult an insurance agent near you. Medicare related insurance plans are complicated. They don’t all work the same way. The medications that you use or your health history can make different insurance plans treat you differently or cost more money. In this case, our client hurt himself financially. Don’t do the same to yourself.
Written on March 27, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
My Letter to the Griffith Town Council
By Woodrow Wilcox
On March 24, 2023, I wrote a letter to the Town Council of Griffith, Indiana. The same problem could have happened many other places. Here is the letter. A few months ago, ambulance services started charging a response fee of $900 per ambulance call that did not require immediate transport to a hospital.
Ambulance firms lobbied for a change in the law to compensate them when they did not have to transport someone to a hospital. These firms claimed that they were losing money on such calls. They joined together to lobby for the $900 response charge.
Yesterday, I got a call from one of our clients who lives in Griffith. She called for an ambulance when she fell and could not get back on her feet. She has Parkinson’s Disease. She got a bill for $900 from a local ambulance company. Some companies will negotiate the fee down. Some will not.
If you gave a contract to an ambulance company, its leaders knew about such calls when they asked for the contract. They did not complain about such calls then. They thought that responding to all calls would be profitable enough to ask you to let them serve your town. You gave them permission and then they joined with other ambulance firms to lobby for the $900 response charge.
if you can make an ordinance or rule that ambulance companies cannot charge $900 for a no run to the hospital call, it would be a great service to your residents who are already handicapped or elderly. Perhaps a rule limiting the $900 response charge to only $200 or so to keep the contract to serve your community could be accomplished. I don’t know the details of the lobby efforts of the ambulance companies. I just know that the $900 amount is hurting senior citizens that our agency serves. If you care about your town’s senior citizens, please explore how to help solve this problem. Thank you.
My letter was sent to help our client and any other senior citizens in Griffith even if they were not clients of the insurance agency where I work.
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that firm over three million dollars. Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through book stores or online.
Written on March 24, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Too Complicated for Most Seniors
By Woodrow Wilcox
A client brought medical bill papers to our Schererville office in the shopping center at the northeast corner of U.S. 30 and U.S. 41. That office copied the papers and sent them to me. I reviewed the papers and immediately knew it would be a complicated case. I phoned the client to come to my office to work with me. I needed the client with me to give permission for me to speak and question for the client on every phone call to comply with federal privacy protection law. The bill and Medicare Summary Notice about the bill showed me that the client’s Medicare file was fouled with false information. The bill was for $975 because Medicare refused to pay anything on it. Until the Medicare file got fixed, our client would continue to get bills like this that Medicare should but wouldn’t cover.
We phoned two offices of Medicare to try to fix the problem. But we had to phone an insurance company and a chiropractor’s office to pursue fixing the Medicare record. The problem was that the insurance company never told Medicare that our client had finished treatment for a car accident in 2021. When our client got treatment in 2023, Medicare refused to pay anything because it thought that the car accident matter never had been settled. The insurance company never got a final report from the doctor so that it could close its file and notify Medicare to end the car insurance matter. I know what happened. The insurance company sent money to our client instead of directly to the chiropractor. The chiropractor’s office did not know that it was supposed to notify the insurance company of the ending of treatment of our client. This system is too complicated for most seniors to work to fix. In addition to this, our client was a little “hard of hearing”. How is a senior on Medicare supposed to know how to fix a “bad info in Medicare file” matter? Fortunately for her, she got her Medicare supplement policy through our agency and I am helping her.
Written on March 22, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Hospital Already Got Paid
By Woodrow Wilcox
On March 14, 2023, I checked a medical bill that a client got from a hospital in Chicago. Our client is from Dyer, Indiana. The hospital already got paid by our client’s Medicare supplement insurance company over a month ago. But the hospital in Chicago was still billing our client for the same amount that our client’s insurance company had paid.
So, I sent a letter to the hospital and its medical billing firm. I recited the facts that we could prove to show that they were billing a senior citizen for the same amount that her insurance company already paid. With some editing to protect the privacy of our client, here is the letter that I sent to the hospital and its billing firm. Our client sent to our firm a bill from your firm for our review. The account number with (the billing firm) is with the address for (the billing firm). I phoned the client’s secondary insurer. That firm reported that it paid (the hospital) the balance of $1,556 on January 31, 2023. The check number is XXXXXXX. The claim number is XXXXXXXX. It was sent through the (banking firm) which can be phoned at 877-XXX-XXXX to verify payment. Please, correct your billing records and stop billing our client for an amount that her insurance company already paid to you.
Written on March 14, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Lowell Client Forgot
By Woodrow Wilcox
On February 21, 2023, I got a bill from a client in Lowell, Indiana. It was on my desk when I arrived at the office. The client was getting a bill for $147.19 from a medical firm. The client did not know why she was getting the bill. I checked it for her.With some editing to protect the privacy of our client, here is the letter that I sent to her after I checked the bill to make sure it was legitimate and accurate. You sent us a bill from (the medical firm) and asked us to check it. The bill seeks $147.19. It is your bill. You should pay it. Here is why. You bought a Plan G Medicare supplement policy. Plan G policies DO NOT pay the Medicare Part B annual deductible. This year, that figure is $226. The bill for $147.19 was for date of service 1/13/23. Another bill for date of service 01/04/23 was $78.81. Those two bills add to exactly $226. You are responsible for paying these bills because Medicare counted them to add to your Medicare Part B annual deductible.
Thank you for allowing us to help you with your insurance needs. If you have any questions, please contact your insurance agent.
Checking on medical bills that our clients question is one of the things that I do for our clients. The Medicare system is not perfect and it is not run by people who are perfect. When a medical bill needs to be checked for a client, we do that without charge. It is one way that we demonstrate that we really care for our clients. If your insurance agent does not give the same high standard of help to clients, why not switch to our insurance agency?
Written on February 21, 2023 by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Saved Client $9,626
By Woodrow Wilcox
On February 17, 2023, a client came to our office in Merrillville, Indiana. He brought a bill from a hospital in Chicago for $9,626. I made copies of the papers and went to my office to start checking it. Then, I asked the client to join me in my office so that we could make phone calls together.
First, we phoned his Medicare supplement insurance company. I told them about the bill and asked if they got the bill or not. They had not received any claim for the client this year yet. Then, we phoned the hospital in Chicago together. In that call, I learned what the problem was. The hospital filed the claim with Medicare and the client’s old insurance company. I corrected them and worked with them to change their files so that the claim could be filed correctly. It was a simple error that was probably caused by someone at the hospital being rushed or not paying attention. Getting the client’s file with the hospital will allow the hospital to file the claim correctly. Once the claim gets to Medicare and the correct insurance company, our client should have little or nothing to pay on the bill.
Written on February 17, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
STOPPED FALSE BILL TO PORTAGE SENIOR
By Woodrow Wilcox
On February 16, 2023, I investigated a bill that was sent to a client in Portage, Indiana. The bill was false. The medical billing firm tried to get the senior citizen to pay the balance AFTER the insurance company of the senior had already paid the balance to the medical firm. This happens more often than you might think. If no one helps the senior who get such a false bill, the senior ends up paying the balance, too. In such a case, the medical firm gets a bonus and the senior is hurt financially. With some editing to protect the privacy of our client, here is the letter that I sent to the medical firm.
The husband of our client brought a bill from your firm to our firm for our review. The bill is dated 02/03/2023 and seeks a balance of $65.16 on Account Number XXXXXXX for services rendered 10/03/22. The bill is false. Here is why.
I checked with our client’s Medicare supplement insurance company about this bill. That firm paid your firm the entire balance on 11/18/22 and your firm cashed the payment on 11/22/22. You got the money. Why didn’t you credit the payment correctly? Who goofed? Was it accidental or deliberate?
It was paid with an EFT service called Zelis. The check or transaction number is XXXXXXXXX. Since you did not credit the payment correctly, it is obvious that your firm has a problem with your bookkeeping and communication with the firm that you use to do the billing and collecting of payments. You should investigate what went wrong and correct it.
Please, send another bill to our client that shows the bill has a balance of zero.
Written on February 16, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Griffith Client Got a Bill
By Woodrow Wilcox
On February 14, 2023, I got a bill from a client in Griffith, Indiana. The client got the bill from a local hospital. The client bought a Plan F Medicare supplement insurance policy through our insurance agency. That is the best policy that can be bought. It pays on any bill that Medicare approves. The client wanted to know why he was getting a bill since he bought the best policy possible.
I investigated. With some editing to protect our client’s privacy, here is the letter that I sent to the hospital that billed him.
Dear Diane Burnell and staff,
Our client sent to our firm a bill from your firm for our review. The bill seeks a balance of $72 on Account Number XXXXXX for services rendered on 08/26/2022.
I phoned the secondary insurer to learn what it knew of this bill. It said that the Medicare EOB that they received said that Medicare denied this claim because it was filed as a routine preventative exam at the same time that another routine preventative exam was filed. That sounds like your firm may have accidentally filed the same claim twice. On your bill to our client, there is a credit of some payment. Why would Medicare pay anything on a claim that it denied because it was filed twice?
I requested that Medicare send an MSN to our client. When he gets that, he will bring it to me so that we can compare it with your bill to him.
Our client is not ignoring the bill. Please, check the work of your employees. If a mistake was made, please correct it and tell the patient what you did.
Thank you.
Written on February 14, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Bad Medical Billing
By Woodrow Wilcox
On February 6, 2023, a client delivered a medical bill to our Merrillville office for my review. I checked the bill and knew it was false. With some editing to protect the privacy of our client, here is the letter that I sent to a medical firm in Merrillville, Indiana.
Our client sent to our firm a bill from your firm for our review. The bill seeks $118.03 on Account Number XXXXXX for services rendered on 08/02/22 and 08/10/22. YOUR BILL TO OUR CLIENT IS FALSE! Here is why. On the charge of $2,600 on 08/02/22, Medicare allowed only $470.05 and Medicare paid $368.52. On the charge of $1,000 on 08/10/22, Medicare allowed only $120.08 and Medicare paid $94.14. Our client’s insurance company paid your firm the entire balance of $118.03 ($94.01 plus $24.02) by check sent on 09/15/22. Your firm cashed that check on 10/04/22. The check number is XXXXXXXX. You got the money. Why didn’t you apply it correctly toward the account? You goofed. Fix your bookkeeping and send a new bill to our client with a balance of zero on this matter.
Written on February 6, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
Helped Dyer Senior File Complaint
By Woodrow Wilcox
On January 20, 2023, I helped a client file a complaint against a medical firm in Indiana and its billing firm in Texas and against a collection firm in Tennessee. The client is from Dyer, Indiana. Last September, I wrote the medical firm and told them that our client’s Medicare supplement insurance company never got a claim report from Medicare. I asked them to send the important claim information to the insurance company so that it could pay the bill for $458. They ignored the letter and sent the bill to a collection firm. That is clearly unethical conduct. But it happens all the time.
In this case, I suspect that the Indiana medical firm used a sloppy, ignorant, and really bad billing firm in Houston, Texas. But the Indiana medical firm should have checked and tested any billing firm that it decided to use. If the medical firm does not protect its name from being harmed for unethical conduct when dealing with clients, then who should care about its reputation? With some editing, here is the complaint I helped our client file against the Indiana medical firm. I received a bill from the (medical firm). I asked the insurance agency that I use to check it for me. They did.
On September 1, 2022, the insurance agency sent a letter to the (medical firm) to correct the bill problem. The (medical firm) ignored that letter and sent my account to a collection firm. Please, get the (medical firm) to pay attention to letters to correct a medical bill problem. If their billing service does not cooperate and coordinate meaningful responses to such letters, then the billing service of the (medical firm) should be dismissed. Copies of documents accompany this attachment to my complaint. Please, help and protect me and other people who use (the medical firm) from unfair practices that hurt consumers in Indiana
Written on January 20, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. Speaking Of Seniors
My Letter to My Congressman
By Woodrow Wilcox
On January 19, 2023, I wrote a letter to my congressman about one big problem with the Medicare system. Following is the body of my letter.
Your staff knows of my work to help senior citizens correct Medicare related medical bill problems for the clients of the insurance agency where I work. When I have asked for specific help in specific cases, they have helped.
In this letter, I want to tell you about one specific problem that keeps coming when I help seniors. Please, ask Medicare if there is already a solution now. If there is not, let me work with your staff to suggest changes in Medicare law to fix this problem. When there is a problem with a medical firm in Indiana that uses a billing firm in Indiana, if the firms do not respond to my letters or phone calls to correct a billing error, I help the client file a complaint with the Indiana Attorney General’s Department of Consumer Affairs.
That office has been quick to respond and “put fire under” the firm that did not want to cooperate with me. But when Indiana people go to Illinois for treatment, or when a firm uses an out of state biller, connecting with someone at the firm who will cooperate to correct a bill problem is very difficult and nearly impossible. I suggest that on every bill from any medical firm or biller, the correct contact information of the person or department responsible for taking complaints of medical bill problems that need to be corrected be clearly shown on the bill in at least 12-point type. The biggest problem in the Medicare system that costs senior citizens the most money is the breakdown of Medicare electronic communication system. Very often, Medicare never sends the claim information to a senior’s secondary insurer because of the breakdown.
If the secondary insurer does not get the claim information, it doesn’t pay the bill. The senior then starts to get hounded to pay a bill that the secondary insurer would have paid if it had received the claim. To help our client fix this, I contact the medical firm or biller and tell them that the secondary insurer never got the claim from Medicare. I tell them that to fix that problem as fast as possible, the billing firm should send the critical claim information to the secondary insurer and I give the address. This works to get the claim paid when I can find a competent and responsible person at the firm sending the bill.
That is why the contact information of a responsible department or person on a bill is so critical. Please, help. This is a continuing problem with the Medicare system that is costing lots of money and time to seniors on Medicare and those who help such seniors. In some of my published articles and in my book, I showed the calculations for how I estimated that the problem of Medicare failing to send claim information alone costs seniors on Medicare over ONE BILLION DOLLARS per year in wrongful bills to senior citizens.
Written on January 19, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Helped Client Understand Ruling
By Woodrow Wilcox
A client from Schererville got a letter from the federal government and didn’t understand it. He brought it to his insurance agent at our Schererville office near the Strack & Van Til store in a shopping center at U.S. 30 and U.S. 41.
Written on January 18, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Insurance Already Paid The Bill
By Woodrow Wilcox
On January 10, 2023, I wrote a letter to a medical billing firm to tell them that their bill to our client was false because his insurance company already paid the bill. The client was from Hobart.
Here is the letter with some editing to protect our client’s privacy.
Dear Representative,
The family of our client sent to our firm a bill from your firm for our review. Your bill to our client sought a balance of $3.37 on Account Number XXXXXX for services rendered on 07/27/22.
We checked this bill. It is false. Here is why. The client’s secondary insurance company sent your firm the balance of $3.37 by check on 12/13/22 and your firm cashed the check on 12/21/22. The check number is XXXXXXX.
The statement date of your bill to our client was 01/03/23. You had the payment in your bank account over a week before you sent the bill to our client. Why did you do that? Isn’t that dishonest? Please, correct your bookkeeping and do not send another bill to our client or his family.
Written on January 10, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Was There A Medicare Rules Change?
By Woodrow Wilcox
On January 10, 2023, I helped a client from Lowell with phone calls to Medicare, her Medicare supplement insurance company, and a dialysis firm.
Please, check to learn if there was a change in Medicare policy that occurred around October 2021.
Written on January 10, 2023, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
When They Hide From Questions
By Woodrow Wilcox
I have been helping a client from Saint John, Indiana who got medical services in Illinois for months. The latest bill is for $457 from a collection firm. The problem is that our client never got the original bill. In this case, the medical firm billing him is hiding from being contacted for questions about the bill. In my experience, that is a very common problem with medical bills from firms in Illinois.
New state and federal laws should be enacted and enforced to prevent medical firms from badgering patients to pay while refusing to provide meaningful contact information to responsible parties to answer questions about medical bills.
If you agree with me, contact your government officials and tell them you agree with this. It would really help if Medicare officials took and interest in protecting seniors from such unethical practices. Unfortunately, in my experience, they don’t.
Written on January 5, 2023 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
How It Really Works
By Woodrow Wilcox
On December 21, 2022, I got a letter with copies of four bills from a client in Cedar Lake, Indiana. Here is part of the letter that I sent to the client.
Written on December 21, 2022, by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
New Law – New Fee
By Woodrow Wilcox
A client from Highland, Indiana sent a bill for $900 to me to check. The bill is from an ambulance company for services given on June 9, 2022. I called the ambulance company and asked about it. The ambulance company told me that it was for a RESPONSE FEE. In this case, no one was taken to a hospital. Our client could not rise from his chair because of a problem with his knees. His wife let the ambulance people into the home and they helped the man to arise and go to his bed. That was it. No one was taken by ambulance to a hospital.
But the client was billed a RESPONSE FEE of $900. I started phoning people to ask about the RESPONSE FEE. One person told me that ambulance companies lobbied for a new law that was passed since Joe Biden took office. The ambulance companies complained that Covid added costs to every response. If no ambulance run was made, an ambulance company lost money by responding to help with a non-trip call. They wanted to be able to charge something for responding. Thus, the RESPONSE FEE was born.
So, remember that if you call for an ambulance with no intention of a run to the hospital, the assistance that you get probably will not be free.
Written on December 20, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
In Person Better Than On Phone
By Woodrow Wilcox
Whether you buy Medicare-related insurance through our agency or not, I recommend that you do business in person and not over the phone. If you buy a Medicare-related policy over the phone and you have a problem with a bill, are you going to call the salesman at a call center and get help? Doing business with a local agent allows you to go to someone to get help with a problem.
Our agents are trained in the differences in different policies. They listen to the client and try to match what the customer wants with what is available. This firm does not charge customers for advice. Insurance companies pay our firm to let customers know what the insurance company offers.
There are so many different types of Medicare Advantage plans that it is difficult to keep things straight – especially over the phone. I believe it is better to meet with someone face to face and get your questions answered so that you understand what you are getting.
Written on December 16, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
My Letter to Hillsdale College President Larry Arnn
By Woodrow Wilcox
On December 7, 2022, I wrote a letter to Larry P. Arnn, President of Hillsdale College. I asked him to work with me to make an online course on how to help senior citizens save money by fighting mistakes and fraud in the Medicare system. If you can help me to connect with him or someone else to work with me to do that, please do. Here is my letter to Mr. Arnn. Could I teach a class through Hillsdale College? You know how to present online courses. My course would teach people how to help senior citizens save money by fighting mistakes and fraud in the Medicare system. I have done that for almost 20 years. I have saved clients of this insurance agency over three million dollars.
I wrote the book SOLVING MEDICARE PROBLEM$ which is published by E-Book Time Publishing in Montgomery, Alabama.
I am 68 and do not want what I know about this to die when I do. I want to work with Hillsdale to help educate the people who serve seniors like insurance agents, ministers, and social service people. Enclosed are a few of my articles to help you understand the need. Thank you.
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana.
Written on December 7, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
A Medicare Advantage Appeal
By Woodrow Wilcox
On December 6, 2022, I helped the husband of one of our clients from Lowell. He drove her to a hospital for treatment. After a few days, the hospital wanted to move her to a rehab facility.
Written on December 6, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Helped South Holland Client
By Woodrow Wilcox
On December 6, 2022, I wrote a letter to help a client from South Holland, Illinois. She got a medical bill and sent it to me to check for her. With some editing to protect our client’s privacy, here is the letter that I sent to the medical company to fix the billing problem for our client. Our client sent our firm a bill from your firm for our review. The bill seeks a balance of $121.90 on Account Number XXXXXX for services rendered on 9/28/22. I phoned the client’s secondary insurer to ask about this bill. It said it did not receive any information about this bill from Medicare. That is not the fault of the patient or her insurance company. It is Medicare’s fault. The fastest way to fix this problem that Medicare caused is for you to send both the original claim information and the Medicare EOB information directly to the secondary insurer with the following contact information.
Written on December 6, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Medical Biller Never Filed With Medicare
By Woodrow Wilcox
On November 21, 2022, a client brought a medical bill to me to check it. The client is from Portage, Indiana. I copied and reviewed the bill. Then, I told the client that she could go home. I would write a letter to the billing firm and send her a copy of that letter. With some editing to protect the privacy of our client, here is the letter that I sent to the firm that sent her the bill. Our client brought to our office a bill from your firm for our review. The bill seeks a balance of $225.90 on Account Number XXXXXXX. There is no date of service on the bill. The client brought your letter in the envelope in which it came. I noticed that there were only pages 1 and 2 of a 4-page bill. It is obvious from the bill that your firm failed to file the claim with Medicare. The original billing amount and the balance are the same amount. There are no credits or adjustments on the bill. You know (or you should know) that you cannot bill a client on Medicare directly without first filing the claim with Medicare. Please, correct your error to comply with the law. File the claim with Medicare so that Medicare can send the Medicare EOB to the secondary insurer. Do not bother our client about this bill until you have filed the claim with Medicare and received a ruling.
Written on November 21, 2022, by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Medicare Made The Mess
By Woodrow Wilcox
On November 21, 2022, I wrote a letter to a medical biller for a client from Griffith, Indiana. The letter let the medical firm know that Medicare caused the problem with the bill. With some editing to protect the privacy of our client, here is the letter that I sent. Our client brought the revised, adjusted Medicare Summary Notices that we requested to our office today. The claims for your services were revised. We sent the modified copies to his secondary insurer to process. Please, allow time to fix the problem. Neither your firm nor the patient caused the billing problem. Medicare caused it by adjusting the claim(s) and never sending to the secondary insurer a copy of the adjusted Medicare EOB. The patient and I are working to fix the mess that Medicare caused so that your firm can get paid the proper amount.
Written on November 21, 2022, by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
A Big Bad Medicare Policy
By Woodrow Wilcox
On November 11, 2022, I met with a client from Griffith, Indiana. We phoned Medicare together to try to resolve a medical bill problem. We spoke to four Medicare representatives including a senior Medicare claims representative. After the phone call, I helped the client to file a complaint against Medicare for a really bad policy that could cost many seniors substantial amounts of money. Here is the problem. When a claim is filed with Medicare, Medicare is supposed to rule on that claim and send a Medicare Explanation of Benefits to the doctor or hospital and to the Medicare supplement insurance company. The same information is supposed to be sent to the senior citizen patient in a Medicare Summary Notice. If Medicare makes a ruling on a claim and then changes that ruling, it will not send an Adjusted Medicare Explanation of Benefits to the insurance company. It will send an Adjusted Medicare Summary Notice to the senior citizen after 30 to 90 days. Medicare representatives told me that Medicare does not send a revised ruling to the Medicare supplement insurance company of the senior because THE LAW DOES NOT REQUIRE MEDICARE TO DO THAT. Instead, Medicare imagines that the senior citizen will somehow know to send a copy of the revised claim report to the senior’s insurance company. How many seniors do you know that know and understand that? Not many if any!
This means that Medicare supplement insurance companies don’t get the information so that they can work on fixing the problems caused by Medicare’s revised rulings. That would be easier for seniors. Instead, the insurance companies never get notified and the senior citizens get hounded to pay medical bills that their insurance companies would pay if only Medicare had notified them about the revised rulings. So, seniors get hounded to pay bills that they really don’t owe as a direct and proximate result of this BIG BAD MEDICARE POLICY.
I hope you’ll join me in urging Congress to fix this problem that costs innocent seniors millions of dollars annually.
Written on November 11, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Good News on a Monday Morning!
By Woodrow Wilcox
On Monday morning, November 7, 2022, I got a “good news” message delivered to me. The $3,855 ambulance bill of our client in Cedar Lake went away. Yes, my efforts resulted in saving the client $3,855. In the previous week, the client met with me. He had a mixed message when he met with me. He had received another bill for $3,855 from the ambulance company. But then, he got a phone call from someone at the ambulance company reporting to him that the ambulance bill was not owed. So, I phoned and wrote a letter to someone at that ambulance company with whom I had previously worked. I asked whether the phone call that the bill no longer existed was actual. The response was that it was true.
In August, I reviewed the bill with the client and spotted a problem with the ambulance bill for $3,855. I helped the client file an appeal with Medicare. In that appeal, I attached documents that alerted Medicare to what I believed were errors in how the claim was filed with Medicare by the ambulance company. Apparently, Medicare agreed with the appeal. The $3,855 ambulance bill went away. Probably, the claim was refiled with Medicare with the corrections that would cancel the bill to our client. The client thanked me for the work that I did in helping him file the appeal. Why wouldn’t he? I saved him $3,855.
Written on November 7, 2022, by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Please, Confirm or Correct
By Woodrow Wilcox
On November 4, 2022, I sent a letter to a person at an ambulance company with whom I regularly work to check ambulance bills for our clients.
I was helping a 78-year-old client from Cedar Lake, Indiana who got a bill for $3,855. With some editing to protect our client’s privacy, here is the letter that I sent to the ambulance company representative. I have phoned you and left you messages for you over the past three days. If you are ill or on vacation, excuse me for my attempts to reach you. I don’t want to be a pest to you and I don’t want to be negligent in helping our client.
A few days ago, the client got a letter telling him that he still owed your firm $3,855 for ambulance services. Recall that I told you that I would help the client appeal Medicare’s decision on this ambulance ride because I thought it was filed improperly. A few days after the client got the latest bill from your firm, he got a phone call from someone who said that he was with your firm. He told our client that he did not owe your firm anything. I believe that is a signal that our appeal to correct the error on the bill worked. The client cannot remember the name of the person who phoned him to give good news about the bill. Please, check this and confirm or correct the information that the bill is settled and that my client owes your firm nothing. Thank you.
Written on November 4, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
The “Big Lab” Failed to File the Claim
By Woodrow Wilcox
On November 1, 2022, I worked on a case for a client in Highland, Indiana. I checked the bill and found that the big lab company failed to file the claim with Medicare. But they wanted our client to pay the bill.
With some editing to protect the privacy of our client, here is the letter that I sent to the “big lab” company.
Our client sent our firm a bill from your firm for our review. The bill seeks $534.31 on Account Number XXXXXX-XXXX for services rendered on 7/20/21.
I phoned Medicare to request a copy of the Medicare Summary Notice about this claim to be sent to our client. But Medicare representative XXXXXXXXX XXXXX told me that no claim was ever filed for this Medicare enrollee during July 2021. So, your firm NEVER FILED A CLAIM for services on 07/20/2021. You know that sending a bill directly to a patient on Medicare without filing a claim with Medicare is against Medicare rules and regulations.
You caused this problem. Fix it by filing the claim with Medicare. Do not report this bill as being tardy to “ding” our client’s credit report or we will help her to file appropriate complaints against your firm.
Written on November 1, 2022, by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
A ONE-TWO PUNCH!
By Woodrow Wilcox
Recently, I helped a 95-Year-Old man and his family reduce two medical bills. He is from Gary. Her daughter told me that her mother, the man’s wife, was very worried about the two bills. One bill was for $4,860.50. I reviewed that bill and found a mistake problem in the bill. I contacted the medical biller, explained their mistake, and asked them to refile the claim with Medicare to correct their mistake and not hurt our client and his family. The firm listened and cooperated with me. That made the bill for $4,862.50 go away. The second bill was for $1,725.00. That bill was caused by a bad policy of Medicare. Our client needed to be transported from a hospital in Chicago to a rehabilitation firm. Someone at the hospital in Chicago did not accurately describe the choices to the family. They asked the man to be transported to the rehabilitation firm in Crown Point. All the other choices were in Illinois. They wanted the man to be close to family to visit him. Medicare approved only the first 20 miles of transporting the man. The rest of the trip would be charged to the family. The bill came to $1,725. I think that the Medicare policy of a 20-mile limit is ridiculous. But I don’t write Medicare rules. We should let a patient recover near home and the family ambulance/medical car company did nothing wrong. The bill was caused by Medicare’s 20 miles-only coverage policy. I negotiated a compromise bill of $400. I appealed to the transport firm’s sense of wanting to treat the patient and his family with compassion and kindness.
Altogether, I saved our client and his family $6,187.50. All the help that I gave this client was FREE OF CHARGE. This insurance agency helps our clients with Medicare related medical bill problems without charge 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 October 13, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
The Ambulance Contact Tried to Help
By Woodrow Wilcox
On September 27, 2022, I got an unusual letter from a contact at an ambulance company. The ambulance company representative was being pleasant and helpful. I wrote to our client about this. With some editing to protect the privacy of our client, here is the letter that I sent to her.
Today, I received a letter from the ambulance company that billed you $7,243. It was a helpful letter.
On September 7, 2022, I wrote to the ambulance company telling them that there was a problem with the bill that it sent to you. I told them what we were doing to find the problem and get it corrected. I asked them to be patient because you were not ignoring the bill.
A person that I know at the ambulance company did a little research to help you. In her letter to me, she said that she believed there was a problem that needed us to contact the Medicare coordination of benefits office.
When you get the Medicare Summary Notice forms about the ambulance bill, call me to make an appointment to bring those to me and make phone calls with me. That will be the fastest way for me to research the problem and help you with it.
All the help that I am giving the client is FREE OF CHARGE. We know that the Medicare system is far from perfect. We care about our senior citizen clients. We help them when they have Medicare related medical bill problems. It shows that we really care about our clients. If your insurance agent or agency does not give this high level of customer service, why not switch and use our agency?
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that firm over three million dollars by fighting mistakes and fraud in the Medicare system. Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through book stores and online.
Written on September 27, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Medicare Caused the Extra Work!
By Woodrow Wilcox
On September 27, 2022, one of our clients phoned her agent to ask about a medical bill problem that I researched and worked on last month. Her agent asked me about it. He told me that she got another bill for the same problem. I reviewed the file to remember what I had done to help the client. On August 31, 2022, I sent a letter to the chief of the billing department at a local hospital to request that the hospital send certain critical claim information to our client’s Medicare supplement insurance company so that the claim could be paid to the hospital. The insurance company told me that it never received the claim information from Medicare.
It takes some time and works to get this done. I suspect that the second bill to our client was sent automatically before the hospital could send the claim information to our client’s insurance company.
In the almost 20 years that I have helped our senior citizen clients, Medicare’s failure to send claims information to Medicare supplement insurance companies is the biggest problem with the Medicare system.By biggest problem, I mean the one that happens most often.
I don’t know who is claiming that the Medicare communications system is working wonderfully, but that’s just not so. When Medicare fails to send claims information to insurance companies, claims don’t get paid and seniors get hounded to pay bills that their insurance companies would pay if the companies got the claims information from Medicare. When I wrote my book on Medicare problems, I calculated an estimate of the losses throughout our country based on my experience in this area. I estimated that Medicare’s failure to send claim information to insurance companies and causing seniors to be hounded to pay wrongful bills cost seniors over one billion dollars per year.
I have tried to get political leaders of both major parties interested in fixing this problem. But I have not found any politician who really cares enough about seniors to push to fix this or any of the other problems with Medicare that I have cited many times in the more than 1,000 published articles that I have written.
The fact that my employer pays me to help our senior citizen clients with medical bill problems is clear evidence that the owners, managers, and staff of this insurance agency really care about our senior citizen clients. If your insurance agent or agency does not give this high level of customer service to you, why not switch to our insurance agency?
Written on September 27, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Saved 95-year-old Gary Resident $4,862.50
By Woodrow Wilcox
On September 23, 2022, I got word from the daughter of a Gary resident that her father got a letter that told him that a bill for $4,862.50 had been corrected and that the balance was zero.
On July 8, 2022, I had written a letter for our client to the medical biller. I explained what I had discovered about the bill when I researched it. I told the firm what it needed to do to correct the mess and get paid a proper amount under Medicare rules. The firm followed my advice. Then, it sent a letter to our client stating that the corrections had been made and that our client owed nothing.
There are problems in and with the Medicare system. Whether caused by mistake or fraud, if the problems are not corrected, senior citizens get wrongful bills for amounts that they do not owe. I know. I’ve been helping senior citizens fight mistakes and fraud in the Medicare system for almost 20 years.
All the help that I gave this client was FREE OF CHARGE. This insurance agency helps our clients with Medicare-related medical bill problems for free just because we care about our clients and don’t want them to be harmed by such problems. If your insurance agent or agency does not give this high level of customer service, why don’t you switch to Senior Care Insurance Services?
Written on September 23, 2022, by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Helped Client Complain Against Medical Firm
By Woodrow Wilcox
On September 19, 2022, I met with a client from Crown Point, Indiana. A medical billing firm was harassing him with a “bad” bill. So, I helped the client file a complaint with the Consumer Protection Office of the Indiana Attorney General.
With some editing to protect the privacy of our client, here is the overview page of the complaint against the medical firm. I received a bill from (the medical firm). I took the bill to my insurance agency for advice and help. The agency administrator helped me. We contacted my insurance company and learned that (the medical firm) sent a bill to the insurance company on 04/29/21 and 08/30/21. But, each time, the biller omitted the “ICN” number. The “ICN” number distinguishes a claim bill from others that are similar. The “ICN” number is vital to getting payment. The “ICN” number prevents a biller from intentionally or accidentally getting paid more than once for a claim.
The agency administrator wrote a letter to the billing parties to get them to send a claim to the insurance company with the “ICN” number so that the bill could be paid. The billing parties did nothing. On September 19, 2022, I got another bill from the billers and took it to the insurance agency I use. The administrator phoned the insurance company about it. The billers never sent any bill with the “ICN” number. Now, that the filing deadline of fifteen months has passed, the insurance company will not pay the bill even if the billers sent a bill now with the “ICN” number.
The bill was caused by the bad and unethical business practices of one or both billing parties. People at those firms made the mistake and now they want me to pay for their mistakes. Those are bad and unethical business practices that harm consumers. Please, help me and prevent these firms from doing the same to others. Accompanying this cover letter are copies of items verifying items in this letter. When I help a client file a complaint like this, I always include an overview page to help the people at the Indiana Attorney General’s office clearly understand the wrong being done to our client by the firm wronging our client.
Written on September 19, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Is The Bill Legal?
By Woodrow Wilcox
On September 16, 2022, I wrote a letter to a client to tell her that I could not help her anymore with a bill regarding services to her late husband.
With some editing to protect the privacy of our client and her family, here is the letter that I sent. Today, you delivered to my office a copy of the letter from the nursing home which is dated September 12, 2022. That letter was sent in response to the letter that I sent to the nursing home to ask why a member of their staff signed the Advance Beneficiary Notice which is the basis for the bill that was sent to you.
The firm claims that one of their representatives (the staff member) spoke on the phone with you and one of your daughters and that in that conversation, you granted her permission to sign an Advance Beneficiary Notice on your behalf for the treatment of your late husband. If you did not give that person permission to sign the Advance Beneficiary Notice, then the nursing home is lying to get money. I am not a lawyer. But I seriously doubt that one person can legally give such permission to another person over the phone regarding the medical services given to a third person who is the patient.
If that is legal, then you should pay the bill of $811.28 plus interest. If that is not legal, then you should consider getting a lawyer to fight it. Or, you might file a small claims lawsuit to fight it since many lawyers would not take such a case with a small amount in dispute. Any lawyer you consult should appreciate the paper trail I helped create to clarify the issues in this matter. I care about our clients and I help them all that I am able. I do well. But this is a matter where the medical facility claims that what they did is legal and I am not sure that it is. I have my doubts. But I cannot and do not give you any advice on whether it is or is not legal.
I have helped you all that I can. I can’t help you further because of the legal question. It is up to you whether to just pay that bill or fight it. I wish you well whatever your decision is. I worked to help this client for over a month. All the help that I gave her was FREE OF CHARGE. If your insurance agent or agency does not give this high level of customer service, why not switch to Senior Care Insurance Services?
Written on September 16, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Another Bad Medicare System Design
By Woodrow Wilcox
On September 15, 2022, I phoned Medicare with an 82-year-old client from Crown Point, Indiana. She got a bill for $204.16 from a medical equipment firm in Florida. She wanted to know if she should pay the bill or not. Here is the problem in the Medicare system. Our client got the service on July 6, 2022. The company sent the bill within a month. But now, Medicare sends claims reports to senior citizens on Medicare every three months. So, doctors, clinics, labs, hospitals, and others send a bill monthly. The senior gets a bill and has nothing from Medicare to compare with the bill for three months. The senior doesn’t know whether the claim is correct or not.
While Medicare has not yet sent the claim report with its ruling, some medical firms start to hound a senior to pay the bill balance. This is not fair to seniors. Sometimes – make that often – a senior pays a bill that has a mistake or other problem. Seniors pay to avoid credit problems that an unpaid bill can cause. This is a big flaw in the Medicare system that often hurts senior citizens on Medicare. This and the other flaws in the Medicare system that I have noted in past articles are evidence of bad design and bad systems in the Medicare system.
I wish that more people would care enough about senior citizens’ Medicare claims problems to start learning how to help seniors with These problems. A good first step to learning how to help seniors would be to get my book SOLVING MEDICARE PROBLEM$ which is available through bookstores and online. Do you or someone you know care enough to help the senior citizens in your circle of friends?
Written on September 15, 2022, by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Our Complaint Worked
By Woodrow Wilcox
In June of this year, a Serbian-American client from Crown Point brought a medical bill to my office and asked me to help him with a medical bill for $695.75. He wanted to know if he should pay for it.
I researched the bill. I told him NOT to pay it. On June 20, 2022, I sent a polite but firm letter to the medical firm which said to them that the bill was wrong, why it was wrong, that they should fix their billing system, and that the firm should make the balance zero because that was what our client owed.
The medical firm ignored my letter and sent another bill to our client for $695.75. That was not a smart move for the medical firm. On July 18, 2022, I helped our client file a complaint against the medical firm with the Indiana Attorney General’s office of Consumer Protection. Often, I help clients file such a complaint one or two times per month. On September 12, 2022, the wife of our client phoned me to tell of the results. She was kind enough to bring the response information to me so that I could copy it and keep the copies in the file regarding her husband. I copied a letter from the Attorney General’s office and a copy of the notes that our client’s wife took of the conversation she had when a representative of the medical firm that wrongly billed our client phoned them. The representative apologized profusely for the medical firm’s error of sending a false and wrongful bill to our client. Before I helped the client, he was being “pushed” to pay a wrongful bill of $695.75. After I helped our client, he owed nothing.
Written on September 12, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
She Did It!
By Woodrow Wilcox
A client from Munster sent me a bill from a local hospital to check for her. Also, she sent me a payment demand letter from a collection law firm regarding that bill from the hospital. I wrote a letter to the hospital and the law firm to tell them that our client was not ignoring the bill. She was getting our help to check the bill for accuracy and compliance with Medicare rules. I wrote to the client and told her that when she got the claim report from Medicare, get it to me to compare with the bill. She forgot to do that. I phoned her to remind her of that. She brought the report to our Munster office. Danielle MacDonald at our Munster office copied the Medicare report and found the problem with the bill. The hospital sent the claim to Medicare with erroneous coding with a “GY”. If a hospital codes a service with a “GY”, it means that the hospital believes that it is a service for which Medicare will pay nothing. When the hospital realized that it made that error, it refiled the claim without the “GY” in the coding. But Medicare caught that and refused to pay for the service because Medicare thought that the hospital dishonestly or mistakenly changed the coding and refiled just to get some more money from Medicare. Because Medicare refused to pay for the service, the hospital and its law firm were trying to force the patient to pay the bill of $388 that was caused solely by the hospital’s error. Danielle caught the problem and phoned the hospital to chastise it. It was totally unfair to our client to bill her for the $388 difference when it was the hospital billing department that made the mistake and caused the problem. Danielle caught it. I started the information collection process but Danielle caught the problem and resolved it for our client. She did it!
Written on August 18, 2022, by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
I Got A Bad Feeling About It
By Woodrow Wilcox
On August 18, 2022, I wrote a letter to a pharmaceutical company for the widow of one of our clients. It was a special letter because I had a bad feeling about the bill. It was missing some information that normally came on a legitimate bill. So, I wrote a letter that did not disclose everything that I knew. I wrote a letter to test the firm. I just suspected that the bill might not be legitimate. I wanted to protect the widow from a false bill. If the bill is legitimate, the company will have no problems with answering my questions.
With some editing to protect our client and his widow, here is the letter that I sent. Your firm sent a bill to [ our client] who is deceased. His family sent the bill to our firm for review. Your bill shows no date of service. It shows invoice # XXXXXXXX. It seems that the date for preparing this bill to send was August 11, 2022. The Invoice Date given on the account is 05/31/2022. But it is not clear if that means the date of delivery or something else. Was this medicine given at a hospital or by mail or some other delivery service?
What documents do you have to show that [ our client] requested your services? Whatever you have, send copies to his family at the address you have. We need this information to help the family connect your firm with the correct Medicare-related insurance company to process a payment correctly.
Written on August 18, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
A Letter About an Ambulance Bill
By Woodrow Wilcox
On August 17, 2022, I wrote a letter to a doctor and a hospital about a very high ambulance bill that a client from Cedar Lake got. With some editing to protect the privacy of our client, here is the letter that I sent. Our client sent an ambulance bill to me and asked me to help appeal it. The bill for ambulance service from [northwest Indiana to a hospital in Chicago] on 06/24/2022 claimed that it was a NON – EMERGENCY drive. The bill totaled $3,855. It seems strange to me that an ambulance ride from your location to the location in Chicago would be for a non-emergency purpose. If the treatment could be done at your facility, why would you send the patient to Chicago?
I believe that someone at your firm misinformed the ambulance people and they marked the ride as non-emergency. If such a ride is for non-emergency purposes, then a MEDICARE FIRM should be called and NOT an ambulance. I believe that your personnel and your firm have a legal duty to act competently and professionally in serving patients. Someone who works at a medical firm and who calls for patient transportation should know the difference between the need for MEDICARE and AMBULANCE. Someone at your firm made a big mistake regarding transporting our client that day. That mistake is a direct and proximate cause of his high ambulance bill. I am requesting that the doctor send a letter to our client that states the circumstances that would demonstrate that the ambulance ride was needed for emergency purposes. Or, in the alternative, that the patient advocate sends a letter that the hospital personnel who called for the ambulance mistakenly failed to explain the emergency nature of the ride to the ambulance personnel. If it was an emergency ride, Medicare will accept it as within Medicare coverage. The bill to our client for $3,855 will be reprocessed and lowered.
Written on August 17, 2022, by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
She Just Forgot
By Woodrow Wilcox
On August 15, 2022, I wrote a letter to a client to remind her of what she forgot from the time she met with one of our agents and selected the policy that she wanted. With some editing to protect the privacy of this client, here is the letter that I sent to her. You sent to our office a bill from (your doctor’s office) for services you received on 04/11/22 and the Explanation of Benefits from your insurance company. You have a balance due on this bill of $39.53. This bill is accurate and correct. You should pay it. Here is why.
The federal government standardized all Medicare supplement policies to avoid confusion for senior citizens on Medicare. You bought a Standard Plan G Medicare supplement policy. All Standard Plan G policies pay the same no matter which insurance company you use. Plan G policies DO NOT PAY the Medicare Part B annual deductible. This year, that is $233. Medicare ruled that $39.53 of this bill was part of the $233 Part B annual deductible. Medicare ruled that. Your insurance company had nothing to do with that ruling. That is why you should pay the bill for $39.53.
After Medicare rules that you have met the Part B annual deductible, then Medicare and your insurance company will pay 100% of all Medicare-approved Medicare Part B claims for the rest of the year. That is how it works.
if you have any questions about this, please get in touch with your insurance agent.
Thank you for allowing us to help you with your insurance needs.
Written on August 15, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Plan F Versus Plan G Explained – Again
By Woodrow Wilcox
On August 10, 2022, I wrote a letter to a client in Valparaiso to explain how her insurance policy worked. The problem she had was not remembering the major difference between the two most common Medicare supplement policies.
With some editing to protect the privacy of our client, here is the letter that I sent to her. You sent a medical bill to our Valparaiso office. They forwarded it to me to check for you. I phoned your insurance company to learn what it knew of this bill. You should pay the bill of $96.22 from (the medical firm). Here is why. You bought a Plan G Medicare supplement policy. Plan G policies DO NOT pay the Medicare Part B annual deductible. This year, that is $233. After you pay the first $233 of Medicare-approved Medicare Part B claims in 2022, then Medicare and your Medicare supplement insurance policy will pay 100% of all Medicare-approved Part B claims for the rest of the year.
If you have questions about this, please contact your insurance agent. Thank you for allowing us to help you with your insurance needs.
Written on August 10, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
A Day Was Missing
By Woodrow Wilcox
After 5 pm on August 8, 2022, I got some claims documents from our Schererville office. The next day, August 9, 2022, I worked on the clients’ claim problems.
The first one was caused by an omission of claim information in the Explanation of Benefits that the Medicare supplement insurance company got from Medicare. A whole day of medical services and charges was missing. The insurance company never got the claim information for that day. So, it never knew that our client got medical services on that day. To help our client, I wrote a letter to the patient billing department of a local hospital. 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 $XXXX on Guarantor Number XXXXXXXXX for services rendered on 11/26/21 through 12/02/21. The original billed amount for that DOS was $42,427.45. I phoned the client’s secondary insurer to learn what it knew about this claim. It reported that Medicare sent it an EOB for DOS 11/27/21 through 12/02/21 with an original billed amount of only $33,331.50. There was no claim for services on 11/26/21. Obviously, an error occurred somewhere. That is not the fault of our client – your patient.
Please, contact the secondary insurer to review this matter and share whatever information is needed to correct this matter. It may be that you will need to share the claims information from 11/26/21 that is missing. Please, do whatever is needed to get this corrected. Our client bought a Plan F policy which will cover everything that Medicare approves. So, there should be no balance for our client to pay. Thank you for your cooperation. Here is how to contact the secondary insurer:
Written on August 9, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
They Ticked Me!
By Woodrow Wilcox
On August 4, 2022, an agent in the office asked me to research a bill for a client. The client was upset that her insurance company did not pay a medical bill. I researched the matter. The medical firm that sent the bill sent me in circles when I contacted it to get a good address for sending a letter to correct the bill. That is a bad business practice that many medical firms use. They “ticked” me. With some editing to protect the privacy of our client, here is the letter that I sent to the medical billing firm. Our client sent to our firm a bill from your firm for our review. The bill is dated 07/15/2022 and seeks a balance of $XXXX on Account Number XXXXXXXX for services rendered 12/25/2021.
I phoned the client’s Medicare supplement insurance company to learn what it knew of this bill. It reported that it did not get claim information about this bill until June 14, 2022. It processed and paid the balance of $XXXX THE SAME DAY THAT IT GOT THE CLAIM. Your firm got its check (# XXXXXX) on 07/22/2022. There are some problems with this bill and your business practices. You spelled the client’s name two different ways on the bill (i.e., XXXX XXXXX and XXXXX XXXXX). When I phoned the number on the bill (i.e., 888-XXX-XXXX) to ask for an address to the correct person or department to address a letter about an incorrect bill, I was told that I could phone 629-XXX-XXXX. I called that number and got a recording telling me that I should phone the first number 888-XXX-XXXX. When someone wants to help you correct your bad billing, you send them in circles to frustrate them. That is clearly a bad business practice. We are considering filing a complaint against your firm for your bad business practices. The complaint would be filed with the Consumer Protection Division of the Indiana Attorney General. If your bad business practices are not corrected, I am confident that those practices will get you into expensive trouble. Please, correct your records to show that our client owes nothing to the bill that you sent to her.
Written on August 4, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
No, We Don’t Do That
By Woodrow Wilcox
On August 3, 2022, a man brought papers to our office for his friend who is our client. The client wanted us to help her file a claim. Two weeks ago, another client asked me to file a claim with Medicare. No, we don’t do that. This firm is an insurance agency. We are not trained, qualified, or equipped to file Medicare or other medical claims. I won’t even try. Both clients mentioned failed to ask the medical service provider if it was contracted with Medicare and would file claims with Medicare. Not every doctor or medical service provider does. In Hammond, Indiana, there is one medical firm and doctor who will not file any claim with Medicare because of a technical rule under the “Affordable Care Act” (Obamacare). He is a nice doctor and he treated our client well in an emergency. I respect him. But he won’t risk violating an Obamacare rule and getting into trouble. Seniors should always ask if the medical firm is contracted with Medicare and will file claims with Medicare. People who have a Medicare Advantage plan should always ask if both the facility and the doctor or other billing party are within the network. Don’t assume that if the facility is “in-network” the doctor must be “in-network”, too. Despite all this, I am trying to help the client who had her friend deliver papers. I heard of a discount program that might be available to her. I called the vice president of the insurance company with which she has her Medigap policy. The vice president was on vacation but agreed to phone me next Monday when she returns from her vacation. That is all that I can do for now.
Written on August 3, 2022, by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Helped Gary Police Retiree
By Woodrow Wilcox
On July 25, 2022, a Gary Police retiree that I helped stopped at the Merrillville office to thank me for helping her. Previously, Medicare was billing her over $1,300. Then, Medicare billed her $850. I had helped her file complaints about the wrong figures.She did not know where or how to file complaints to get the matter resolved. I did. She got a letter and a phone call promising her that the matter had been fixed. I asked her to bring a copy of the letter to me so that I could close the file.
Written on July 25, 2022 by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Helped Schererville Senior with $92.50 Bill
By Woodrow Wilcox
On July 8, 2022, I researched a medical bill for $92.50 for a client from Schererville. On that date, I sent a polite letter to the medical billing firm to tell them that the bill was already paid by the insurance company more than two years earlier.
On July 19, 2022, the client visited our Schererville office to ask for more help. The medical billing company sent another bill and demanded payment within 10 days. Our client had phoned the biller and cited part of my letter of July 8. The billing representative was “rough” and demanding. Our Schererville office administrator Maha Shahwan phoned the medical biller while the client was there. The medical biller was “rough” and demanding with Maha, also. Then, Maha phoned me and told me what had happened. I asked the client to come to my office that day and she did.
Together, we made phone calls. I asked the first telephone representative of the billing company to connect me with a supervisor. I got a good billing supervisor. I arranged to fax and email to him the letter that I sent on July 8. He got it and asked for a few days to research what I said in the letter. On July 21, that billing supervisor phoned me to tell me that he researched my letter and concluded that I was correct. He was correcting the bill to show a zero balance. I asked him to send a letter to our client to put her mind at ease. He promised to do that. I phoned our client and told her the good news. She was very glad to learn the matter was settled.
All the help that Maha Shahwan and I gave to this client was FREE OF CHARGE. We help all clients with Medicare-related billing problems without charging anything. It is a way for us to prove that we really do care about our clients. If your insurance agent or agency does not give this high level of customer service, why not switch to one that does?
system. Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available from bookstores and online.
Written on July 21, 2022, by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
They Didn’t Obey the Rules!
By Woodrow Wilcox
On July 18, 2022, I helped a man who is an immigrant from Eastern Europe. He got a bill for $695.75 for medical services. Previously, I had helped him to investigate the billing problem and wrote a letter to the billing firm to fix it. But the medical biller ignored my letter and sent a letter demanding payment within ten days. So, I helped the client file a complaint with the Indiana Attorney General at the Consumer Protection Division. I help clients file such a complaint about 12 to 24 times per year. With some editing to protect the privacy of our client, here is the attached explanation of complaint that was sent with this complaint. You should read this and see how it is structured in case you ever need to file a complaint. Get the complaint form at the website for the office that handles consumer complaints. Every state has a similar office to help consumers.
I got services on March 28, 2022 from XXXXX XXXXXX, Inc. That firm sent a bill to me for $695.75. (See accompanying copy.) The administrator at the insurance agency that I use helped me request a Medicare Summary Notice (MSN) about this bill. The MSN clearly states at footnotes “s” and “t” on page 18 of 31 that the maximum that can be charged is $7.22. (See accompanying copy.) The administrator sent a polite letter to XXXXX XXXXXX about the fact that Medicare ruled that $695.75 of the claim was denied because “payment was included in another service received on the same day.” (See accompanying copy.). Instead of following Medicare’s ruling, XXXXX XXXXXX ignored Medicare’s ruling and sent a collection letter dated 07/07/2022. (See accompanying copy.) In the collection letter, XXXXX XXXXXX demanded payment of the false balance within ten days. Since XXXXX XXXXXX refuses to adhere to the rules and rulings of Medicare and frightens senior citizens with demand for payment letters in violation of Medicare rules, XXXXX XXXXXX should be punished for its bad business practices. Please, help protect me (and any other senior citizens being wrongfully bullied by XXXXX XXXXXX by forcing that firm to stop billing me for money that Medicare ruled is not owed.
Written on July 18, 2022 by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Helping 95-Year-Old Man From Gary
By Woodrow Wilcox
On July 8, 2022, I wrote a letter to a medical firm about a bill for $4862.50 that it sent to a client who is 95 and lives in Gary, Indiana.
With some editing to protect the privacy of our client, here is the letter that I sent to the medical firm that billed him.
The family of our client sent to our firm a bill from your firm for our review. The bill seeks $4862.50 for services rendered on four dates in June. I phoned the client’s Medicare supplement plan insurance company to learn what it knew of your claims on this bill. It reported that Medicare never sent any of these claims to it.
We requested duplicate Medicare Summary Notice forms from Medicare. Those take up to three weeks to arrive. When the client gets those, his family will bring them to me to review with him. But Medicare said that there was no such claim for date of service 06/27/2022.
So, we know that there are problems with the bill that you sent to our client. We just don’t know exactly what kind of problems. Be patient. Our client is not ignoring the bill. Instead, he is getting our help to make sure that the bill is accurate and filed properly.
Written on July 8, 2022 by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Medicare Refused $450 of Claim
By Woodrow Wilcox
On July 7, 2022, I helped a client with a bill for $450. The client is from Highland, Indiana.
I got the bill at our office the previous day at about 5 pm. I started working on the bill the next day. I spoke with the client’s Medicare supplement company. It reported that Medicare denied part of the bill that totaled over $5,000. But the insurance company did not know why.
To help the client, a copy of the Medicare report about the claim was requested to be sent to him. When he gets it, it needs to be brought to me to review with him.
Right now, I do not know why Medicare denied $450 of the claim, but approved everything else. It sounds like the medical service company did not file the claim correctly on one item. But that is just a guess.
Whatever it is, I’ll help the client. I have a good record of helping clients of this insurance agency. But I can’t guarantee success in eliminating the bill. I just investigate and help the clients as much as possible.
Written on July 7, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Serious Problems with Obamacare Policies
By Woodrow Wilcox
How does the Affordable Care Act (Obamacare) really work? Basically, it is an insurance program for people under 65 who do not qualify for Medicaid. It is under a different set of rules. It expects patients to negotiate with medical service providers any balance that the Obamacare insurance policy does not pay if you go outside the network. Many times, a client checked with a hospital to make sure that it was in-network but the doctor assigned to the case was not in-network. How many people do you know who can skillfully negotiate about a bill with a hospital, laboratory, or doctor? Doesn’t that seem unrealistic? I think it is one of the unrealistic aspects of Obamacare insurance policies. But the law is the law and rules are rules. Recently, two clients had negative experiences with Obamacare policies that our agency sold to them. Not many insurance companies offer Obamacare policies in Indiana. So, these people who don’t have insurance through an employer and are not old enough to have Medicare got Obamacare policies. Each chose the same company.
One was being told by the insurance company that it had negotiated the medical bill from $1,050 to zero. But the medical firm told the client that the Obamacare insurance company had negotiated nothing and that the bill was still $1,050.
The other person had a much bigger bill. She was told by a hospital that she owed $131,573.79. The Obamacare insurance company told her that it had negotiated with the hospital a discount of $121,620.64 and that the patient owed only $1,661.09. Then, the Obamacare insurance company told the client that it had paid the hospital $37,671.14 and that the patient owed the hospital only $200. In another letter, the Obamacare insurance company told the patient that it had paid the hospital $40,013.24. But the hospital claims that the patient still owed $58,430.51.
In each of these Obamacare cases, the patient didn’t know what to believe. Neither did I when I went through the papers with those clients. To help each client, I typed and prepared an appeal to the Indiana Department of Insurance. In each case, the insurance company claimed one thing and the medical firm claimed another. We asked the Indiana Department of Insurance to review the matter and inform our clients of the results.
Written on June 28, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Helping a Widow
By Woodrow Wilcox
On June 21, 2022, I helped a widow with a bill from the final days of her husband’s life. The bill was not being paid. Their agent alerted me to the problem and provided some papers to help me research the problem for the widow.
To help the widow, I asked her to join me on some phone calls. One was to the Medicare supplement insurance company and one was to Medicare. She granted me permission to speak and question on behalf of her and her late husband. We tried to phone the medical service provider, but all we got was a recording telling us to leave a message. Instead of leaving a message, I typed a letter. With some editing to protect the privacy of our clients, here is the letter that I sent to the medical firm that sent the bill for $811.28.
The family of our client brought to our firm a bill from your firm for our review. Today, with the widow on the phone to grant me permission to speak and question on behalf of the family, we phoned both the secondary insurer and Medicare about your bill. We requested Medicare Summary Notice forms about the claims. Those should arrive in about fifteen business days. The surviving family will bring those to me to compare with your bill.
But already, I expect to find some problems with your bill. The Medicare representative with whom we spoke told us that one or more of the services on the bill were never filed with Medicare. The representative was XXXXX XXXX who works at a Medicare call center in Kansas. I do not know that is true. But it is true that the Medicare representative told us that. Also, there seems to be some confusion of which medical service provider gave which service.
Your billing the surviving family long before the Medicare Summary Notice forms were sent so that the bill can’t be compared to Medicare’s ruling on each claim seems extremely unfair. Do not demand payment until the federal documents have been received and some time has been allowed for review.
All the help that I gave the widow was FREE OF CHARGE. This agency “goes the extra mile” to help our clients when a Medicare related billing problem occurs. If your insurance agent or agency does not give this high level of customer service, why not switch to an agency that does? This one does.
Written on June 22, 2022 by Woodrow Wilcox
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Polish, English, and Medical Bills
By Woodrow Wilcox
On June 2, 2022, I met with two Polish speaking clients in my office. Both could speak some English, too. But the client with the problem was more limited in English. His friend, another client, accompanied him. She was the widow of another Polish speaking client that I had helped years ago. She was much stronger in English and made it easier for me to help her friend – our client with the problem. Together, we made phone calls to Medicare and to medical billers. the source of the problem was that our client switched from one Medicare supplement insurance company to another on 01/01/2022. Medicare did not update its files for about ten weeks. Medicare was not forwarding all the claims to the correct, new insurance company. I wrote letters to each of the medical billing firms explaining that if the balances were not paid by the time they got my letter, it meant that the correct secondary insurer never got the claims. If that happened, I asked them to send the essential claim information to the correct insurance company and then I gave the proper address for that.
All the help that I gave this client was FREE OF CHARGE. I spent over two hours helping the client and it did not cost him anything. This insurance agency is proud of its reputation for giving this high level of customer service to our senior citizen clients. If your insurance agent or agency does not give this kind of great service to you, why not switch to use our insurance agency?
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Agency 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 and online.
Written on June 2, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
A Fouled Medicare File
By Woodrow Wilcox
On May 27, 2022, I sent a letter to a client to tell him that his Medicare file had inaccurate information added to it. That caused his medical bills not to be paid by Medicare or his Medicare supplement insurance company. The problem will continue until the Medicare file is corrected.
With some editing to protect the privacy of our client, here is the letter that I sent to our client. You took medical bills to one of our offices for our review. The bills were forwarded to me.
On April 25, I sent a letter to the first hospital that sent a bill. In the latest papers that you sent to me, there was a letter from that hospital which stated that Medicare ruled that it would not pay on bills because Medicare’s records state that you have another insurance – XXX – as your primary insurer as of 02/01/2022.
This means that your Medicare records are fouled with incorrect information. None of your medical bills will be paid by Medicare or your supplement insurance until Medicare’s records are corrected.
I can help you with this. I have helped other people to get their Medicare records corrected. It is a drawn-out process. I need you to make an appointment to come to my office in Merrillville. We need to make phone calls together. In each phone call, you will need to give permission for me to speak and question on your behalf. Fixing someone’s Medicare record after it has been fouled with misinformation is a process that takes a few weeks – once the initial phone calls to Medicare are made. So, the sooner we get started, the sooner your problem can be fixed. Call me for an appointment as soon as possible.
All the help that I am giving to this client is FREE OF CHARGE. This insurance agency helps clients with Medicare-related medical bill problems without charging the client a cent. It is a way in which we demonstrate to our clients that we really do care for them and want to treat them very well. If your insurance agency does not give this high level of customer service, why not switch to this agency and get treated well?
Written on May 27, 2022
by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Protected Portage Patient
By Woodrow Wilcox
On May 12, 2022, the husband of a client brought bills and papers for me to check and explain to him. His wife got a medical bill for $85.09. I researched the matter and discovered that the client’s Medicare supplement insurance company paid the bill before the bill to our client was sent to her. The insurance paid the bill on April 22 and the medical firm cashed the payment on April 26. The bill was printed and sent to our client on April 28. If our client had paid the bill when she got it, the medical firm would have received the balance due payment twice. I wrote a letter to the medical firm citing the facts and told them they got paid and should not expect any more money from our client. When I finished writing and sending the letter, the client’s husband said to me, “Wow! Now, you’ve saved me over $1,200.” I asked him to remind me about how he arrived at that total. He reminded me of how I had helped him and his wife in the past. He was right. I had saved him over $1,200.
Written on May 12, 2022
by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
The Claim was Denied by Medicare
By Woodrow Wilcox
On May 10, 2022, I worked on a bill that was sent to a client in Hammond, Indiana. The bill was for $133.After I studied the bill, I went to work on it. With some editing to protect the privacy of our client, here is the letter that I sent to the medical firm that billed our client. Our client sent to our firm a bill from your firm and some other papers for our review. The bill seeks a balance of $133 on Account Number XXXXXXXXX for services rendered 09/17/21.
I phoned the client’s Medicare supplement plan insurance company to learn what it knew of this bill. It told me that Medicare denied this claim. Of course, the secondary insurer will not pay on a claim that Medicare denied. So, I helped the client request a Medicare Summary Notice (MSN) about the claim. That will arrive in about three weeks. When the client gets it, he will deliver it to me so that we can review it.
Until then, please check your filing of this claim. I suspect that the claim was misfiled. If an appropriate service is filed correctly, it usually does not get rejected. The claim was not filed under your firm’s name but under the name XXXXX XXXXX. So, please do review how the claim was filed. If you made a mistake, please correct it so that the claim can be paid properly. Thank you.
All the help that I gave this client was FREE OF CHARGE. This insurance agency helps all our clients with Medicare billing problems without charge. It is our way of showing that we really do care about our clients. If your insurance agent or agency does not give this high level of customer service to clients, why not switch to this insurance agency because we do help clients with such problems.
Written on May 10, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
Saved Dyer Client Over $3,000
By Woodrow Wilcox
On May 6, 2022, I researched a medical bill from a hospital to a client in Dyer, Indiana. The bill sought $3,818 from our client. I found the problem with the bill. It was another case of Medicare failing to send the claim report to the client’s insurance company. The insurance company was willing to pay its portion of the bill. But it never got the claim information from Medicare.
I wrote a pleasant letter to the hospital. When the hospital does what I ask, almost the entire bill will be paid by the insurance company. I say “almost” the entire bill because the client purchased a policy that does not pay the Medicare Part B annual deductible. So, the client will need to pay a small part of the bill but the rest will be paid by his Medicare supplement insurance company.
If I had not helped this client, the hospital would have hounded him to pay the bill for $3,818. All the help that I gave this client was FREE OF CHARGE. This agency helps clients when a Medicare related medical bill is fouled by a mistake in the Medicare system. We “go the extra mile” to help our clients and show that we really do value 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 May 6, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking Of Seniors
A Bill from Los Angeles
By Woodrow Wilcox
On April 28, 2022, I helped an 81-year-old client from Dyer, Indiana. He had traveled to the Las Vegas area and needed some x-ray service in Henderson, Nevada. He got a bill from a billing firm in Los Angeles for the medical services that he received in the Las Vegas area.
I reviewed the bill the day earlier and phoned the client to leave a message. He phoned me on April 28 and agreed to stay online while I made a three-way call to his Medicare supplement insurance company. In the phone call, with the client on the line, I asked some questions of the insurance company and the particular bill. What I suspected was true. The insurance company never got the medical bill claim report from Medicare. It could not pay a bill that it never got from Medicare. This happens a lot.
I wrote a letter to the medical firm and its billing service citing the facts. With some editing to protect the privacy of our client, here is the letter that I sent to the medical firm and its billing company. Our client sent to our firm a bill from your firm for our review. The bill from your firm seeks a balance of $416 on Account # XXXXXXXX for services rendered 03/10/2022. The Account # was not clear. I did not have a clean copy of the bill. That is what Account # seems to be. I phoned our client’s Medicare supplement plan insurance company to learn what it knew of this bill. It reported that it never received this claim from Medicare. That is not the fault of the patient – our client. It is Medicare’s fault. Your bill shows an original balance of $416 with no adjustments or payments by Medicare. So, your bill evidences confirmation of the secondary insurer’s statement that Medicare never sent any ruling on this claim.
To fix this problem as fast as possible, please send both the original billing information and the Medicare EOB information that you have directly to the secondary insurer at the following address.
I expect my letter will result in our client owing nothing except the Medicare Part B annual deductible because that was the kind of policy he bought. All the help that I gave this client was FREE OF CHARGE. This insurance agency “goes the extra mile” for our clients to fix Medicare medical bill problems. 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.
Written on April 28, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – SPEAKING OF SENIORS
BAD BOOKKEEPING AT MEDICAL FIRM
By Woodrow Wilcox
On April 14, 2022, I helped a 75-year-old senior citizen client from Munster, Indiana. She got two medical bills from two different medical firms that were both wrong. I researched the bills and wrote letters to both firms to correct their billing errors. In each case, the senior citizen was being billed a false amount when the real balance was zero. In one case, I suspected that maybe the bill was already fixed because of the pattern of the dates of correspondence between the medical firm, the insurance company, and our client. I simply wrote a letter restating the facts and asking the firm to make sure that the balance was zero.
In the second case, I found more serious problems with the bill. With some editing to protect the privacy of our client, here is the letter that I sent about the more serious medical bill problem. Our client sent to our firm a bill from your firm for our review. The bill is dated 03/24/22 and seeks a balance due of $113.17 on Account Number XXXXXXX for services rendered 11/13/21.
I phoned the client’s Medicare supplement plan insurance company to learn what it knew of this bill. It reported that your bill is false. Here is why. Your bill states that the secondary insurer paid your firm only $1.90 on 03/21/2022 and that there is a balance of $113.17. That is false. The secondary insurer paid your firm the entire balance of $113.17 on 3/15/22 by an EFT draft with token # XXXXXXXX which your firm cashed on 3/17/22. Someone is not marking your account books correctly. If you need help to fix your bookkeeping, please contact the secondary insurer for help.
All the help that I gave this client was FREE OF CHARGE. This insurance agency has built a reputation for “going the extra mile” for our clients in such medical billing problems. If your insurance agent or agency does not give this high level of customer service, why not switch to an agency that does?
Written on April 20, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – SPEAKING OF SENIORS
Bad Bill From Hospital
By Woodrow Wilcox
On April 19, 2022, I wrote a letter to a local hospital to tell it that its bill to our 94-year-old client was a false bill.The client sent to me the bill and another paper. I received the papers from the client that morning and went to work on the case. 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 is dated 04/04/22 and seeks a balance of $72.96 on Account # XXXXXXXX for services rendered 03/16/2022.I phoned the client’s Medicare supplement plan insurance company to learn what it knew of this claim. It reported that your firm’s bill to our client is false. Here is why. The insurance company sent payment to your firm on 03/06/22. The payment was made by EFT with confirmation token KXXXXXXXX. If you need help to learn or remember how to get this money, phone the insurance company’s policy services line at 800-XXX-XXXX for assistance. Please, correct your records to show that this bill was paid. Thank you.
All the help that I gave this client was FREE OF CHARGE. This agency helps clients with such medical bill problem to demonstrate that we really do care about our clients. If your insurance agent or agency does not give this high level of customer service, why not switch to an agency that does? This one does.
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that firm over three million dollars. Also, Wilcox wrote the book Solving Medicare Problem$ which is available through book stores and online.
Written on April 19, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – SPEAKING OF SENIORS
THEY ALREADY GOT THE MONEY
By Woodrow Wilcox
On April 13, 2022, I wrote a letter to a medical service or supply firm for a client who lives in Valparaiso. I researched the medical billing problem and wrote the letter. With some editing to protect the privacy of our client, here is the letter that I sent to the billing firm.
Our client sent to our firm a bill from your firm for our review. The bill from your firm seeks a balance of $147.16 on Account Number XXXXXX for services rendered on 02/23/2022. I phoned the client’s Medicare supplement plan insurance company to learn what it knew of this claim. The secondary insurer reported that your bill to our client is false. Here is why. The insurance company paid your firm $168.10 in March. That was a combination of part of the client’s Part B annual deductible and coinsurance. The $168.10 was part of a bulk payment of $242.16. The payment was made by Electronic Funds Transfer (EFT) through XXXXXXX. To verify this, contact XXXXXXX at 877-XXX-XXXX.
Please, do not bother our client about this bill any more. You have been paid. Our client was charged NOTHING for our assistance. This insurance agency cares about our senior citizen 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? This one does.
Written on April 13, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – SPEAKING OF SENIORS
HELPED 82-YEAR-OLD DYER CLIENT
By Woodrow Wilcox
On April 6, 2022, I wrote a letter to a hospital in northwest Indiana to help a senior citizen client who lives in Dyer, Indiana. The bill from the hospital was delivered to me the night before that by Maha in our Schererville office.
It was another case of Medicare failing to send the claim information to the senior’s insurance company. With some editing to protect the privacy of our client, here is the letter that I sent to the hospital. I am confident that the bill for $99 will be resolved because the hospital involved has a good record of cooperating with me. Our client sent to our firm a bill from your firm for our review. The bill seeks a balance of $99.00 on Guarantor Number XXXXXX for services rendered on 11/16/21. I phoned the patient’s secondary insurer to learn what it knew of this bill. It reported that Medicare never sent this claim to it. That is not the fault of the patient.
To fix this problem as fast as possible, please send both the original billing information and the Medicare EOB about this claim to the secondary insurer at the following address. All the help that I gave this client was FREE OF CHARGE. This insurance agency helps our clients with such Medicare related billing matters to demonstrate our commitment to treat our senior citizen clients well. If your insurance agent or agency does not give this high level of customer service, why don’t you switch to an agency that does? Our agency does.
Written on April 6, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking of Seniors
Protected Widow from Hobart
By Woodrow Wilcox
On March 30, 2022, a widow of one of our clients brought an unpaid bill to me to check for her. I was able to research the matter and send a letter to the billing firm the same day.
On my phone call with an insurance company representative, the representative said, “But we paid on all the claims that we got. What’s the problem? I can give you the check numbers and the dates we sent the payments.”
He did not understand my questions. I did not doubt that the insurance company had paid every claim that it received. I wondered if it had not received the claims. I specified my questions to ask if a claim for a date of service with an original billed amount of X had been received by the insurance company. I went through each of seven dates of service. The representative got the gist of my questions while he was answering “No” to each of my specific questions. The only reason that the insurance company had not paid the bills for those dates was that Medicare never bothered to send the claims for those bills to our client’s Medicare supplement insurance company. You can’t blame an insurance company for not paying a bill that Medicare never bothered to send to it.
If I had not helped the widow with this bill, she would have been hounded to pay a bill that never should have been sent to her. This problem happens thousands of times per day all around our country because the Medicare communications system breaks apart many times per day. I was able to help this widow with this bill. Other people need to learn how to help seniors with these kinds of Medicare related medical bills. If you want to start to learn, get my book SOLVING MEDICARE PROBLEM$.
All the help that I gave this widow was FREE OF CHARGE. This insurance agency “goes the extra mile” to help our clients with such problems. It is our way of proving that we really do care about our clients.
Written on March 30, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
S. O. S. – Speaking of Seniors
Saved Valparaiso Client $125
By Woodrow Wilcox
On March 23, 2022, I researched a bill for $125 for a client from Valparaiso and wrote a letter to the medical service company.
With some editing to protect the privacy of our client, here is the letter that I sent.
Our client sent to our firm a bill from your firm for our review. The bill seeks a balance of $125 on Account # XXXXXX for date of service 09/08/2021.
I phoned the client’s Medicare supplement plan insurance company to learn what it knew of this bill. It reported that Medicare never sent such a claim to the insurance company. That is not the fault of our client – your patient. It is Medicare’s fault.
To fix this problem as fast as possible, please send both the original billing information and the Medicare EOB information for this claim/bill directly to the secondary insurer at the following address. Thank you.
If I had not helped this senior citizen client to correct this billing problem, she would have been hounded to pay a medical bill that she really did not owe.
All the help that I gave this client was FREE OF CHARGE. This insurance agency “goes the extra mile” to help our clients with such billing problems. If your insurance agent or agency do not give this high level of customer service, why not switch to an insurance agency that does? This one does.
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that firm over two million dollars by fighting mistakes and fraud in the Medicare system. Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which can be ordered through book stores or online.
Written on March 23, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
Slow Medicare Records Update Caused Bills
By Woodrow Wilcox
On March 16, 2022, a client from Chesterton met me at my office a second time and learned that most of his bill problems had been resolved since our first meeting on March 3, 2022.
On July 31, 2021, the client ended his coverage with his former employer’s health insurance plan. On August 1, 2021, Medicare became his primary insurer and his secondary insurance was a Medicare supplement plan that our insurance agency helped him get.
But Medicare did not update his Medicare records that Medicare was his primary insurer as of August 1, 2021 until November 4, 2021. That’s what we discovered in our phone call to Medicare on March 16, 2022.
The Medicare Summary Notice forms (Medicare’s report of claims) that were dated as processed and sent to the client on December 8, 2021 reported that medical services received by our client on September 1, 22, and 23 of 2021 had all been rejected by Medicare because Medicare records had not been updated in a timely manner.
Medicare was refusing to pay anything on the claims because Medicare records still showed that our client was under primary insurance coverage from his former employer. That had ended on July 31, 2021. Medicare did not even bother to update his records until November 4, 2021. The report of medical claims filed for this client was still wrong on December 8, 2021 when the Medicare Summary Notice forms were sent to our client.
On March 16, 2022, when the client was with me in my office, we learned from Medicare that four claims had been resubmitted, approved, and paid. This means that my previous letters of March 3, 2022 had worked. In those letters, I asked medical services to refile the claims that had been denied. I told them that Medicare’s slow update of our client’s Medicare file had caused the claims to be denied. I reminded them that was not the fault of our client – their patient. I asked them to refile the claims and they did. That saved our client a lot of worry and hassle. Also, it saved our client $872.
The Medicare system is far from perfect. If no one helps a senior citizen to fix the medical bill problem, then the senior who gets a wrongful bill because of the Medicare system’s blunders is hounded to pay a bill that is not really owed. I have not been able to get any Member of Congress – Democrat or Republican – to care enough about seniors to want to help reform the Medicare system to correct its many faults. I estimate that the faults of Medicare are costing senior citizens over a billion dollars per year in wrongful medical bills.
All the help that I gave this client was FREE OF CHARGE. This insurance agency has built the reputation of “going the extra mile” for our senior citizen clients. If your insurance agent or agency does not have a high standard of customer service, why not switch to an insurance agency that does? Our agency does.
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that agency over two million dollars by fighting mistakes and fraud in the Medicare system. Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through book stores or online.
Written on March 21, 2022 by Woodrow Wilcox.
SPEAKING OF SENIORS
Hospital Apologized for Error in Bill
By Woodrow Wilcox
On March 14, 2022, I received a letter from a client in Hebron, Indiana. The letter contained a copy of the letter of apology from a hospital in northwest Indiana.
On January 19, 2022, I had written a letter to the hospital to explain their error and that their bill to our client was wrong. The balance of the bill should have been zero because the hospital was already paid by the insurance company and the balance from the client’s deductible portion was already paid by the client.
The letter from the hospital is dated February 16, 2022. In the letter, the hospital stated, “We are writing to advise you that we received correspondence from Mr. Wilcox of Senior Care Insurance Services on your behalf regarding a bill that you received for $124.95.” The hospital explained that their technical error had caused the problem and that they adjusted the bill balance to zero.
All the help that I gave this client was FREE OF CHARGE. This insurance agency helps our clients with Medicare related medical bill problems to demonstrate that we really do care about our clients. If your insurance agency does not give this high level of customer service, why don’t you switch to our insurance agency?
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients over two million dollars by fighting mistakes and fraud in the Medicare system. Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through book stores or online.
Written on March 14, 2022 by Woodrow Wilcox
SPEAKING OF SENIORS
HELPED 89-YEAR-OLD HIGHLAND CLIENT
By Woodrow Wilcox
On February 24, 2022, I wrote a letter to help an 89-year-old client from Highland, Indiana. He got a bill for $634.90 that he did not deserve. The cause of the bill was the fact that Medicare never sent the claim information to his Medicare supplement insurance company. You can’t blame an insurance company for not paying a bill that it never got from Medicare. With some editing to protect the privacy of our client, here is the letter that I sent to the medical firm that billed our client for $634.90.
Dear Representative,
Our client sent to our firm a bill from your firm for our review. The bill seeks a balance of $634.90 on Invoice Number XXXXXX with Client ID Number XXXXXX for services rendered on 10/28/2021. The statement is dated 02/09/2022 and claims that the bill is past due.
I phoned the client’s Medicare supplement insurance plan company to learn what it might know about this bill. IT REPORTED THAT MEDICARE NEVER SENT THIS CLAIM TO IT. That is not the fault of the patient or his insurance company. If your firm filed the claim properly, then it is entirely Medicare’s fault. This failure of Medicare to send claims information to secondary insurers is a serious and growing problem with the Medicare system. I hope that you want to treat our senior citizen client as fairly as you would want someone in your family treated.
To fix this problem as fast as possible, please send both the original billing information and the Medicare EOB information that you have for this claim directly to the secondary insurer at the following address: XXXX.
All the help that I gave this client was FREE OF CHARGE. This agency helps our clients with such Medicare billing problems AT NO CHARGE to demonstrate that we really do care about our senior citizen clients. If the insurance agent or agency that you use does not give this high level of customer service, shouldn’t you switch to an insurance agency that does? Our agency does.
Note: Woodrow Wilcox is the senior medical billing case worker at Senior Care Insurance Services in Merrillville, Indiana. He has saved clients of that firm over two million dollars. Also, Wilcox wrote the book SOLVING MEDICARE PROBLEM$ which is available through bookstores and online.
Written on February 24, 2022 by Woodrow Wilcox
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