Medicare Supplement Billing Problem

[insurance0707]

I just received an email from a client. He went last January for a physical and it was not coded correctly. He is now getting a bill a year later for this physical and they told him they coded it wrong but they cannot go back and code it differently after 1 year has gone by, they told him he is responsible for this bill.

Any suggestions on how to get this fixed? I think they should write it off because it was there mistake not the clients

 

[HealthGuy]

Wasnt Michelle Obama supposed to right these Medicare wrongs?

 

[G.Gordon]

Exactly, they lose, their mistake. Had that happen with the shingles vaccine. Doc's office went next door and got it, gave it, then tried to bill Medicare B. No dice, the office bills were paid, but the vaccine was kicked back. It should have been picked up by the patient and paid for by his pdp. They were trying to get their $220 mistake out of him. I called and explained that it's not the clients fault, the client would not be paying, etc. They agreed.

 

[billyg]

I just received an email from a client. He went last January for a physical and it was not coded correctly. He is now getting a bill a year later for this physical and they told him they coded it wrong but they cannot go back and code it differently after 1 year has gone by, they told him he is responsible for this bill.

Any suggestions on how to get this fixed? I think they should write it off because it was there mistake not the clients

This is clearly the medical office's error. They are require to file the claim correctly with Medicare and they did not. If it were my client, I would advise him to speak with the Doctor (not the billing clerk), explain that his office already admitted their error, and that the patient show not be held responsible. Most likely the doctor will agree. If not, he can always file a complaint with Medicare against the doctor for failing to file the claim as they are required.

 

[G.Gordon]

I've never told a client to talk to the doc... not needed. Billing clerks have all the authority they need to write off a bill. Minor issue in the scope of things.

 

[billyg]

I've never told a client to talk to the doc... not needed. Billing clerks have all the authority they need to write off a bill. Minor issue in the scope of things.

Neither have I, haven't had to. But in the OP he indicated that the office staff is telling the patient that even though they made the error (and we know they have the authority to write it off), they are demanding payment from the patient. In this case, I would talk to the Doc. Everyone in the office works for the Doc, and it is the Docs reputation and license at stake.

 

[G.Gordon]

... license at stake. Really? Not beating on ya, but lighten up. It's not that big of a deal.

The agent should call. I do it for all of my clients with billing concerns. Not an issue. They billing office will usually drop the issue 99% of the time when someone else is involved. Initially they try to get it paid by someone, even the patient, but a little push back and they let it go. Can't blame em for trying.

 

[Frank Stastny]

The agent should call. I do it for all of my clients with billing concerns. Not an issue. They billing office will usually drop the issue 99% of the time when someone else is involved. Initially they try to get it paid by someone, even the patient, but a little push back and they let it go. Can't blame em for trying.

I do the same. I have never had it be a problem.

 

[billyg]

... license at stake. Really? Not beating on ya, but lighten up. It's not that big of a deal.

OK, you're right. Sometimes I get riled up.

Still, it is his reputation.

 

[DS4]

I would tell the physicians office to go pound sand.