Some people seem to think its fair game to try and defraud seniors. Fraudulent Medicare claim denial letters are on the rise.
This is a story that we heard from one of our clients. He received a letter in the mail that said one of his claims had been denied by his insurance company. Understandably baffled, the well organized senior took all his documentation to someone for help. He had a complete record of all his medical expenses relating to the claim his insurance company supposedly denied.
When the person he went to for help did some checking around, it turned out the letter stating the insurance company denied his claim was false. His insurance company never got the claim from Medicare. He could even prove that because he had the summary notice that Medicare sent him. The claim got paid and the client saved about $100.
What happened here is that a medical service provider did a totally dishonest thing and sent a bill with false information to a senior citizen to get them to pay money they “did not owe.” This amounts to outright fraud. It’s shocking that someone would go to those lengths to rip elderly people off.
If at any time you get something in the mail that doesn’t make sense, tells you a claim has been denied and you don’t recall the details, or says you need to pay more money out-of-pocket, call a reputable Medicare insurance broker, who will be more than pleased to help you figure out what’s going on. Medicare brokers have extensive knowledge in this area and understand that when you have trouble with something, it is upsetting and confusing.
Don’t automatically pay a denied claim difference. Check the details, check your records and check with the doctor’s office. Make sure you “do” keep records of all your trips to see a doctor, what procedures you may have had done, and any medications you may take. It’s also a good practice to keep any and all notices you get from any insurance company. Help is always at hand just by making a phone call. Don’t become a victim of fraud.