By Woodrow Wilcox

I got an email about a doctor in Indiana who read the entire health care reform bill and sent a long and detailed letter to Senator Evan Bayh in which the doctor stated his concerns and objections to the health care reform bill.

I investigated to verify that the doctor and the letter were genuine.  I contacted the doctor and he sent me the letter that he sent to Senator Evan Bayh.

Here, without any other comment from me, is the doctor's letter to Senator Bayh.
 
My source for HR3200 is from the energycommerce website.  The link is http://energycommerce.house.gov/Press_111/20090714/aahca.pdf.

Dear Senator Bayh,


As a practicing physician, I have major concerns with the
health care bill (HR 3200) before Congress.  I spent the
last week reading this bill, which at over 1000 pages is
quite difficult to get through.  Have you read it? I'm
shocked by the brazenness of the government's intrusion into
the patient-physician relationship.  I'm especially
concerned about the creation of a central committee to
decide medical coverage decisions.   
 
Every physician and nurse I work with agrees that we need
to fix our health care system.  Our President's statement
last week in his health care press conference that
physicians are likely to make a patient care decision based
on reimbursement rather than a patient's best interest is
not helpful in moving this discussion forward.
 
As an anesthesiologist I'm responsible for life and death
decisions on a daily basis.  I always have my patient's
best interests at heart and I'm sure my physician colleagues
around the country do as well.
 
I ask you respectfully and as a patriotic American to look
at the following troubling sections I've read in the bill.
How can the following be in the best interests of the
country and our fellow citizens? Capitalized words within
quoted text are my emphasis.
 
SECTION 123 HEALTH CARE ADVISORY COMMITTEE
 
"A committee composed of 18 President-appointed individuals
and 8 Federal employees (26 non-elected citizens) to consist
of providers, consumer representatives, employers, labor,
health insurance issuers, experts in health care financing
and delivery, experts in racial and ethnic disparities,
experts in care for those with disabilities, representatives
of relevant governmental agencies and AT LEAST ONE
practicing physician OR
other health professional and an expert on children's
health."
 
This group will set coverage for the country...and other
than the surgeon general, a physician is not even guaranteed
to be on the committee.  Is our country ready to let 25 or
more non-elected, non-physicians make these decisions? This
is a direct intrusion into patient care and I for one do not
want a community organizer to have input on what type of
care my patients can receive.
 
SECTION 141  HEALTH CARE COMMISSIONER
 
The health care advisory committee will report to the
Health Care Commissioner, another non-elected Presidential
appointee who will make the final decisions for the nation's
healthcare benefits.
 
SECTION 246  SUBSIDIES FOR UNDOCUMENTED ALIENS
 
"Nothing in this subtitle shall allow Federal payments for
affordability credits on behalf of individuals who are not
lawfully present in the United States."
 
This states that taxpayer subsidies will not be given to
illegal aliens to obtain coverage but says nothing about
preventing them from obtaining healthcare in the US.  Under
current law NO patient, illegal or otherwise can be turned
away from an ER if urgent care is needed. Section 152 states
that "all health care and related services including
insurance coverage and public health activities covered by
this Act shall be provided without regard to personal
characteristics."  Will the current law be changed thereby
withholding care from a vulnerable group of individuals? 

 
SECTION 204
 
Language translation and linguistic appropriate services is
mandated.
This seems to apply to undocumented individuals as well.
 
SECTION 205
 
The government will use community organizations to sign up
eligible citizens for health plans.  Do you support using
an indicted organization like ACORN to do this?
 
SECTION 225 PROVIDER PARTICIPATION
 
This section states that Physician salaries will be
dictated on an annual basis.  How can you support taking
over the livelihood of all physicians and dictating the
terms?  This is pure socialism and to call it anything else
is disingenuous.
 
SECTION 131 REQUIRING FAIR MARKETING PRACTICES BY HEALTH
INSURERS
 
This section gives the government veto power over
advertising by private companies.  Again this is an example
of socialism where the government decides what the public is
allowed to be told.  How can you support this?
 
 
SECTION 312. EMPLOYER RESPONSIBILITY TO CONTRIBUTE TOWARDS
EMPLOYEE AND DEPENDENT COVERAGE.
 
This Bill mandates employer-paid coverage for part-time
employees and families which will be a huge burden for small
businesses.  Overall, the compliance regulations and
associated costs for physicians, employers and insurance
providers is enormous.  Also, random audits are authorized
with the full cost of the audit to be paid by the person or
entity being audited.  Do you support random, costly
intrusions into physician's offices?
 
SECTION 431  DISCLOSURES TO CARRY OUT SUBSIDIES
 
The Health care commissioner and others in government will
have full access to your tax returns.  On Pages 58 and
195  Government will have real-time access to individuals
finances & a National ID Healthcard will be
issued. Officers & employees of HC Administration
will have access to ALL Americans finances /personal
returns.  Quite an intrusion of privacy.
 
SECTION 1128H 
 
Under Medicare, every prescribed drug, device or medical
supply has to be disclosed to the government or a penalty of
$10,000 to $100,000 applies.  Just think of the cost of
complying with this rule.
 
SECTION 1501
 
The health commissioner will approve expansion of physician
residency training positions with preference being given to
primary care and disadvantaged applicants.  Do you want the
best and brightest to be our future doctors or those
selected by the government? This section also suggests that
specialty positions will not be expanded.  This will lead
to a diminishing specialist base and a loss in quality
care.  The obvious intention is to limit specialist care
and I think the country needs to be aware of this.
 
SECTION 155  SEVERABILITY.
 
"If any provision of this Act, or any application of such
provision to any person or circumstance, is held to be
unconstitutional, the remainder of the provisions of this
Act and the application of the provision to any other person
or circumstance shall not be affected."
 
Why put this in? Do you think the bill is so radical that
you are trying to block the Supreme Court from striking it
down?
 
SECTION 1233 ADVANCE CARE PLANNING CONSULTATION (pages
424-431)
 
Page 425 Lines 22-25, 426 Lines 1-3: Government provides approved
list of end of life resources.  Government MANDATES program for orders for end of life every 5 years. The Government decides it should be involved in end of life care.
 
Page 428 Lines 17-25: Additional advanced care planning consultations
will be used frequently as patients health deteriorates.
 
Page 429 Lines 1-3: "advanced care consultation" may
include an ORDER for end of life plans.
 
Page 429 Lines 13-25: The Government will specify which Doctors or other individuals can write an end of life order.
 
Page 431-2  The Government mandates that "quality measures on end of life care" be measured and reported. 
 
While advanced planning is always a good thing, this decision is best made with the physician, patient and family.  The majority of health care dollars are spent in the last year of a citizen's life.  Mandating government intrusion and reporting of end of life care brings up the question of rationing.  This section is quite vague on listing protections for seniors.  Can you reassure me Senator that rationing is not the goal of this section of the bill? 
 
Other troubling sections I discovered:
 
Pages 65-66 Section 164: Describes a subsidized plan for retirees
and their families in unions & community
organizations.  Why the special treatment?
 
Page 84 Section 203 HC bill: Government mandates ALL benefit
packages for private care plans in the Exchange.
 
Page 85 Line 7 HC Bill: Specifications of Benefit
Levels for Plans = The Government will ration your Healthcare!
 
Page 85 Line 7 HC Bill: Specifications of Benefit Levels
for Plans. AARP members - Will your Health care be
rationed?
 
Page 102 Lines 12-18 HC Bill: Medicaid Eligible
Individuals will be automatically enrolled in Medicaid. No choice.
 
Page 121 lines 11-17: Doctor or provider payment will be at medicare rates under the public option.  Medicare pays well under market rates and many physicians currently subsidize or cost-shift from private patients to provide care to seniors.  If medicare rates are mandated, access to care will suffer.  Do you support paying physicians at medicare rates under the public option Senator?
 
Page 124 lines 24-25 HC: No company can sue the government on price
fixing. No "judicial review" against Govt Monopoly.
 
Page 203 Line 13-15 HC: "The tax imposed under this
section shall not be treated as tax" Why the deception?
 
Page 265 Section 1131: Government mandates & controls
productivity for private HC industries.
 
Page 268 Section 1141: Government regulates rental &
purchase of power driven wheelchairs.
 
Page 272 Section 1145: TREATMENT OF CERTAIN CANCER HOSPITALS

Cancer treatments are expensive and represent the latest in research, technology and understandably cost a lot of money.  This section, like others is vague in details. Senator, how will rationing of the latest advances be avoided?
 
Page 280 Section 1151: The Government will penalize hospitals for
whatever Government deems preventable re-admissions.  A good medical
outcome is never guaranteed! This is a crazy rule and may actually increase costs as hospitals and doctors will be hesitant to release sick patients!
 
Page 316-317: PROHIBITION on doctor ownership/investment.  Failure to    disclose ownership is a 10,000 dollar fine for each occurrence.
Government again dictating to Doctors what/how much they can own!
 
Page 317-318 lines 21-25, 1-3: PROHIBITION on expansion
 
Government is mandating hospitals or surgery centers cannot expand. Hospitals have an opportunity to apply for exception BUT community input is required. Will ACORN have a say in this?
 
Page 335 L 16-25 Pg 336-339: Government mandates establishment
of outcome based measures.
 
This is another way to justify rationing care.  Every physician learns early in their training that each patient is unique and that a mandate for care will work for some but not for others.  Learning to accept uncertainty is part of what makes our profession special and different. Rigid care mandates will result in decreased quality of care. This type of mandate also implies that physicians don't have the best interests of their patients in mind which is nonsense. In other single-payer systems outcome based measures are ROUTINELY used to ration care.  In the UK, a patient with macular degeneration must become blind in one eye before treatment is offered to the other eye!
 
Page 354-355 Sec 1177: Government may RESTRICT enrollment of
Special needs people to certain times and will review special needs plans and make recommendations  "as the secretary of HHS deems appropriate."
 
Something the public needs to know.
 
Page 379 Sec 1191: Govt creates more bureaucracy -
Tele-health Advisory Committee.
 
Page 469: Community Based Home Medical Services = Non
profit organizations. 
 
Should we expect ACORN nursing homes in the future?
 
Page 472 Lines 14-17: PAYMENT TO COMMUNITY-BASED
ORIGINATION. One monthly payment to a community-based
organization. Like ACORN?
 
Page 489 Sec 1308: The Government will cover Marriage &
Family therapy.
 
Why should this be a mandate that all taxpayers pay for?
 
Page 494-498: Government will cover Mental Health Services
including defining, creating, rationing those services.
 
As for the dangers, costs, and failure of electronic
communication upon which this bill is dependent on, the
following article must be studied:
The computerization of Britain's National Health Service
has been an expensive fiasco. Why does Obama want to emulate
it?
(link:www.weeklystandard.com/Content/Public/Articles/000/000/016/744qvzuo.asp)
 
It is also apparent that the Congress will not require
themselves to use the public plan as required for most
Americans.  Why the double standard?
 
Will abortion services be covered with taxpayer money?
 
Why is there no mention in HR3200 of malpractice reform?  Many studies show that defensive medicine is a major contributor to the cost of medical care in our country.
 
 
Senator, I guarantee that I personally will do everything
possible to inform patients and my fellow physicians about
the dangers of this legislation.  Our country was not founded on
the socialist principles that make up this bill.  There are
many other ideas and policies that could be adopted that
will not destroy the good aspects of our current health
system and cover those who currently are without coverage.
I implore you to use a nonpartisan mind to consider these
other options. If you vote for a bill that destroys private
medicine and the doctor-patient relationship, I will do
everything in my power to make sure you and other supporters
of this flawed bill lose your job in the next election. 
 
 Respectfully,
 
Stephen E Fraser MD

WILL YOUR SENATORS AND CONGRESSMAN ACT RESPONSIBLY?

By Woodrow Wilcox

            The House version of the Health Care Reform Bill (H.R. 3200) is over 1,000 pages long.  The Senate version of the bill is over 1,500 pages long.

            When Congress recessed for August, members were surprised that so many citizens went online to read the proposed law.  Many Senators and House members did not bother to read the proposed law.  Instead, they just gave talking points which were false and written by the bill's supporters. 

            Naturally, at "town hall" meetings when a Senator or Congressman gave false talking points which demonstrated a lack of knowledge about the proposed law, MANY VOTERS BECAME UPSET. 

            Many members of the Senate and the Congress have a bad habit of NOT READING AND STUDYING THE PROPOSED LAWS BEFORE VOTING ON THEM.  THIS BAD HABIT DEMONSTRATES A LACK OF RESPONSIBILITY BY EACH OF THE ELECTED OFFICIALS.

            Every Senator and Congressman must take an oath in which the member swears to "protect and defend the Constitution of the United States against all enemies. . . ."  How can a Senator or Congressman fulfill that duty by voting on a proposed law without reading and understanding it before voting on it?  It can't be done.

            Earlier this year, many members of Congress and the Senate voted for the "Stimulus Bill" without even reading it.  Nancy Pelosi persuaded all but twelve Democrats in the House to vote for the stimulus package without even reading it first.  Many Senators voted for it without reading it, too.  All the Senators and Congressmen who voted for that without reading it first were blatantly irresponsible.

            Maybe there was a section in the bill for re-establishing slavery or other laws that most citizens would dislike.  How would a Senator or Congressman know about such distasteful clauses if the Senator or Congressman never read the bill before voting on it?

            As the Senate and the House consider the revised version(s) of a health care reform bill, let us insist that they be responsible about it.  We should insist that every Senator and House member read and study the proposed law on health care reform and that they allow ample time for the citizens to read the proposals so that the citizens can advise their representatives on how those representatives should vote.

Note: For other articles or videos by Woodrow Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

OPEN LETTER TO PRESIDENT, SENATORS, & CONGRESSMEN

By Woodrow Wilcox

            An elderly woman phoned me because she read an article by me in a local newspaper.  The senior citizen is from Lansing, Illinois.

            I listened to her story.  She fell at a local drug store, was taken to a hospital, and got some stitches.  The hospital got paid by Medicare, the woman's insurance company, and by the drug store's insurance company.  Now, Medicare wants its money back.  But, the woman does not have the money.  When she phones Medicare's bill collector's phone number, she gets a recorded instruction to contact the company via the internet.  The woman is 85 years old and does not know how to use the internet.

            Normally, I would not help because I'm not supposed to help seniors who are not clients of the insurance agency where I work.  I have helped senior citizens with medical bill problems that were caused by Medicare and by the VA medical clinic system for over six years.  I have saved elderly clients of this insurance agency over $600,000 by canceling bad medical bills.

            In this case, I decided to help this woman on my own time and at my own expense.  Over the last six years, I have written over 100 articles about problems with the Medicare system.  Many of the articles can be read at www.medicareproblems.net.  I wrote all those articles and distributed them to newspapers around the country on my own time.

            I'm not trying to boast.  I just want to explain that I help senior citizens who have problems with Medicare.  I care about senior citizens.  I'm not sure that the President and some Senators and Congressmen do care about seniors.

            There are problems with Medicare, the VA Clinics, and Medicaid.  There are problems with other health care segments, too.  But, no one can fix a problem by not listening to reasonable, responsible people who have experience in the field.

            That is what I am accusing the President and some Senators and Congressmen of doing - not listening.  The Democratic leaders and many Democratic members of the Senate and the House fashioned "their" health care reform bill without listening to the concerns of many respected people. 

            Rather than bringing people together to reach a consensus, the President and his allies have done exactly the opposite.  No proposal by a Republican or a moderate Democrat was considered.  The legitimate concerns of the dissenters were not reviewed to allow compromises to correct problems in the bill.  The President and/or his allies called opponents of "their" health care reform bill "Nazis" and "racists" instead of listening to legitimate concerns about the bill.  The President and/or his Democrat allies called health insurance company executives and employees "greedy" and "special interests" instead of listening to the legitimate objections of those people.

            Citizens who read the health care reform bill (H.R. 3200) online and attended town hall meetings with their congressional representatives were shocked, insulted, and angered to realize that many of their congressional representatives never read the proposed law and just parroted some false talking points written by the supporters.

            Presidential candidate Barack Obama promised to bring people together.  But, he and his Democrat allies in Congress have used arrogance, smugness, rudeness, insults, and disinformation to alienate many people in the country including other Democrats.

            The President and his Democrat allies in Congress should stop the rudeness, listen to the legitimate concerns of those who object to problems in the current bill, and change the proposed law to get rid of the legitimate objections.  No one can get other people's cooperation by refusing to listen and casting insults.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For articles and videos by Woodrow Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

S. O. S. - SPEAKING OF SENIORS

HEALTH CARE REFORM IDEAS OF WOODROW WILCOX

By Woodrow Wilcox

            During the discussion of various versions of health care reform bills, many people have asked me for my ideas.  I resisted giving my ideas because I wanted to focus on explaining to voters why the ideas that Obama and his allies proposed were so bad.

            But, now, I believe that the time is right to share my ideas for health care reform.  This brief article gives only an outline of some of my ideas because all my ideas can not fit into a short article.

1. Reduce taxes to make health care more affordable.  The federal income tax is too high and does not recognize human existence expenses.  It allows banks, businesses, corporations, and other legal fiction entities to subtract existence expenses from gross receipts, but it does not allow humans to do the same for their existence expenses.  I believe that the first $100,000 per year that an individual earns and the first $200,000 per year that a married couple earns should be free of all federal and state income taxes.  This idea is more completely explained in my published article "End Anti-Human Income Taxes In America".  That article can be found on the internet at various places including my website www.woodrowwilcox.com.

2. Let's help the senior citizens who lived through the "Great Depression" and/or World War Two by not asking them to pay for Medicare supplemental insurance.  These people and their families sacrificed so much for our country.  Why can't our country make their lives just a little easier by letting Medicare cover 100% of their medical expenses instead of forcing these seniors to pay money every month for a Medicare supplement insurance policy?

3. Don't nationalize health care.  But, do militia-ize health care.  People who are citizens of the U.S. can be members of both the federal militia and the state militias.  Aliens - both legal and illegal - can not be members of the militia.  There is no compelling national interest to control health care costs for all citizens.  There is a compelling national interest to control health care costs for members of the militias.  In this way, an alien coming into this country would have to be willing to pay whatever costs for health care that circumstances would require.  But, a member of the militia would have health care costs controlled to make sure that members of the militia are in reasonably good health in case of being called to active duty in an emergency.

4. Insist on free or inexpensive medical care for the birth of new citizens who will be future members of our federal and state militias.  No abortions should be allowed except for circumstances such as to save the life of the mother.  The unborn child is a future member of the militia.  There is a compelling federal and state interest to protect the unborn child.  Also, this means that people who are poor - but not violent criminals or drug addicts - can get free or low cost health care because they are honorable members of the militia no matter what their economic status. Violent criminals and drug addicts are not fit for militia service because violent criminals and drug addicts can not be trusted to be sober, responsible, and restrained with any weapons that are in the militia arsenal.

5. Don't ask doctors to borrow hundreds of thousands of dollars to go to medical school and hundreds of thousands of dollars for medical equipment to start a medical practice, but then tell them that they can not charge what must be charged to pay the loans, pay their help, and provide a good living for themselves.  There is a compelling national and state interest for a good number of doctors, nurses, and aides to meet the medical needs of our population.  So, I propose the establishment of Militia Medical Colleges which would be similar in public support to the Army, Navy, and Air Force academies.  Also, if a doctor agrees to accept militia patients at a regulated militia medical service rate, then the doctor should get the medical equipment needed without borrowing to pay for it.  The current system of forcing doctors to borrow and pay interest for their education and start up costs benefits bankers and financiers.  I want to change the system so that it benefits doctors, nurses, aides, and patients much more.

6. Establish a system of militia medical clinics.  A good model for this is the Hoosier Healthcare clinic system in northwest Indiana. (www.hoosier-healthcare.com).  This clinic system lets patients visit the clinic as often as desired for only $25 per month for one person or $40 per month for a family.  Also, Hoosier Healthcare clinic patients can get a prescription filled at a local pharmacy for only $4.  And, the clinic is a for-profit enterprise which does not need a massive subsidy from taxpayers.

7. Regulate the price of prescription drugs.  Most new prescription drugs are developed and/or clinically studied with the help of tax incentives and research at colleges, universities, laboratories, and other entities that have tax exempt status.  So, the public is already subsidizing the development of prescription drugs with substantial tax breaks.  So, let the public have a say in the pricing of prescription drugs.  But, only regulate prices - don't "strangulate" prices to make it totally unprofitable to develop new medicines.

            The only problem with my ideas for improving the health care system is that lobbyists of special interest groups in D.C. (the district of corruption) won't like my ideas.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  Wilcox has saved the senior citizen clients of that firm over $600,000 in bad medical bill charges that were caused by mistakes made by Medicare and the VA health system.  For other articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

S.O.S. - SPEAKING OF SENIORS

SAVED CLIENT FROM $253.01 LAB BILL

By Woodrow Wilcox

            A client drove over 85 miles one way for my help with a laboratory bill of $253.01.

            The client lived closer to our office in the past.  But, she moved away from this area and kept her Medicare supplement insurance policy with our firm because she was happy with our service.

            She brought a bill from a laboratory for $253.01 and asked for help to resolve it. 

            I checked with the client's insurance company.  Medicare never sent the claim to the insurance company.  I wrote a letter to the laboratory company and explained that the bill did not get paid because Medicare never sent the claim to the client's insurance company.

            In the letter, I requested that the laboratory send the essential information on the claim directly to our client's insurance company.  I am confident that when that is done, the claim will be paid.  This will save our client $253.01.

            Millions of other senior citizens around the country need this kind of help, too.  Medicare fails to send claims information to insurance companies often.  Then, claims don't get paid.  Don't blame the insurance companies.  They can't be expected to pay claims that they never get.

            When senior citizens' claims don't get paid, the senior citizens are bombarded with payment demand letters and phone calls until they pay.  Isn't it sad that senior citizens pay for bills that they really don't owe just because the Medicare system works so badly?

            If Obama and his allies in Congress succeed in forcing a national health care system that is modeled on Medicare onto the entire population, then everyone can start to experience medical bill problems that are similar to the $253.01 bill that our client experienced.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For other articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

MEDICARE UPDATE OVER SIX MONTHS BEHIND

By Woodrow Wilcox

            An elderly lady phoned me with a problem on October 14, 2009.  She is a client of this insurance agency.  She is from Knox, Indiana.

            In April of this year, she notified her insurance company that she was canceling her Medicare supplement policy with it to switch to a different insurance company.

            The "old" insurance company notified Medicare that it would not be our client's insurance company as of May 1, 2009.  The "new" insurance company notified Medicare that it would be the client's insurance company as of May 1, 2009.

            But, in the middle of October 2009, the client reported that Medicare had not yet made the switch.  Her doctor's office phoned her and said that they were not getting paid within the normal time period.

            The client phoned Medicare.  A Medicare representative told her to contact her "old" insurance company to tell them not to send "cross-over" information to Medicare any more.  But, the "old" insurance company stopped doing that over six months ago.

            The client does not want her doctor or his assistants to be upset with her because of slow payment.  But, the slow payment problem is not being caused by either the patient or her insurance companies.  The slow payment problem is being caused by Medicare's failure to forward claim information to the correct insurance company in a timely manner.

            This kind of problem happens all the time.  Medicare is not a perfect system.  No private or government health care insurance system is perfect.  But, the private insurance companies seem to act quicker to correct mistakes than the government bureaucracy employees do.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  Wilcox has helped senior citizens to cancel over $600,000 in wrongful charges that were caused by mistakes at Medicare.  To find more articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

MEDICARE SURPRISED SENIOR WITH ALMOST $300 BILL

By Woodrow Wilcox

            Medicare made a mistake and caused a senior citizen immigrant woman to get an unexpected bill for $296.53.  Because the woman is a client of this insurance agency, I helped her to correct Medicare's mistake at no charge.

            Medicare failed to send the claims information to our client's insurance company.  For that reason, a medical laboratory sent to our client the bill with a balance of $296.53.

            Our client is an elderly woman who is an immigrant from Eastern Europe.  She was surprised and stressed about getting such a bill.  The Medicare system is confusing at times for many people and even more so for immigrants.

            After checking with the client's Medicare supplement insurance company, I sent a letter to the medical laboratory company.  But, because my experience has taught me that this particular laboratory company is so big that it has difficulty within its billing department, I sent letters to three billing department addresses including the office of the vice president of billing.  So, I went an extra mile to help our elderly client.

            Following is a paragraph of the letter that I sent to the medical laboratory company.

***

            I checked with our client's Medicare supplement insurance company.  It never got this claim from Medicare.  Please, send the original billing information and the Medicare EOB information that you have on this claim to the insurance company.  Following is the contact information that you need to do that.

***

            In this case, I saved our client almost $300 and some stress.  But, such problems happen all the time all over the country with mistakes at Medicare costing senior citizens money because they don't get help to fix the billing problems and they end up paying bills that they don't really owe.  That is sad.  I have saved senior citizens over $600,000 by helping them to cancel wrongful charges that were caused by mistakes at Medicare.  In past articles, I have given my calculations for why I believe that mistakes at Medicare cost senior citizens over a billion dollars per year.

            If Obama and his allies in Congress establish a national health care system that is modeled after Medicare, then everyone in America can expect to start having such billing problems.  Obama promised "change", but that would not be a good "change" for America.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For other articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

MEDICARE MESSED MEDICAL BILL OF MERRILLVILLE WOMAN

By Woodrow Wilcox

            Every day, I help senior citizens with medical bill problems that were caused by mistakes made by Medicare and/or the Veterans Administration medical clinics.

            There are several possible causes of errors made by the federal government that cause senior citizens and veterans problems.  The main source of error is the electronic data systems.

            The federal government's electronic data system causes the most problems.  The system relies on telephone lines and satellite uplinks and downlinks for sending and receiving information about senior citizens, their identities, and their medical bills.

            When there is a problem with the system, data becomes distorted or lost.  When that happens, the medical bills of senior citizens on Medicare don't get paid correctly or at all.

            If Obama and his allies in Congress impose a national health care system on everyone, then everyone can expect these kinds of problems with their medical bills.  I have helped senior citizens to correct bills of a few dollars and of over $200,000.

            For over six years, I have helped senior citizens with Medicare billing problems and have written over 100 articles about such problems.  Many of the articles can be read at www.medicareproblems.net.

            Following is an excerpt of a letter that I sent to one of our clients after checking on an unpaid medical bill which caused her worry. 

***

            The bill for $63.68 from St. Mary Medical Center was received by your Medicare supplement insurance company on October 15.

            The federal government's Medicare system FAILED TO SEND THE BILLING INFORMATION TO YOUR INSURANCE COMPANY by the normal means of "electronic crossover" which is a high-tech "email" system.

            Your insurance company was able to obtain a "hard" (paper) copy of the claim on October 15 and is processing the claim now.  The insurance company has up to 30 days to process a claim once it receives it.

            I wanted you to know that we checked on this bill for you and that you should allow some time for your insurance company to process this claim.

***

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  Wilcox has saved senior citizens over $600,000 by canceling wrongful medical bills that were caused by errors made by the federal Medicare and/or Veterans Administration health care systems.  For other articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

MEDICARE HITS MUNSTER WOMAN WITH BILL

By Woodrow Wilcox

            A client of this insurance agency was surprised when Medicare refused to help pay for a pelvic and breast exam and a pap smear.  The client is from Munster, Indiana. 

The client in this article is not the same client that I reported to have that problem in a previous article.  The facts are almost the same, though.

The woman's doctor billed Medicare for the medical services and Medicare disallowed the claims because the services were performed outside the time limitations that Medicare has set for such services.  So, Medicare denied the claims and now the senior citizen is stuck with the $105 bill for non-covered services of a pelvic and breast exam and a pap smear.

When a federal agency is faced with budget problems, new rules and regulations are invented to help the federal agency stretch its budget so that everyone at the federal agency will get paychecks on time.  A bureaucracy serves the bureaucracy really.

Obama and his allies in Congress are trying to pass a law to make a national health care system based on Medicare.  If that happens, millions more Americans will get stuck with unexpected medical bills when the federal agency over healthcare will make new rules and regulations to stretch the budget and make sure that all the employees of the new bureaucracy get their paychecks on time. 

In such a case, health care consumers will be the big losers.  The patients will get some very unexpected bills for medical services that they thought would be covered by the government health care system.  Surprise, surprise!

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  Wilcox has helped senior citizens to cancel over $600,000 of wrongful medical bills that were caused by mistakes at Medicare and the VA health care systems.  For more Medicare related articles or videos by him, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

MEDICARE MISTAKE "KILLED" SENIOR

By Woodrow Wilcox

            A "dead" client walked into my office.  I have a copy of the letter of condolence from his Medicare supplement insurance company to the family of the "dead" client.

            How can a "dead" man walk into my office to give me a copy of such a letter?  The answer is simple.  Medicare goofed again!

            Someone at Medicare misunderstood that when a hospital uses the abbreviation "D.O.D", it means "date of discharge", not "date of death".

            So, Medicare advised the "dead" man's insurance company of his death.  The insurance company sent a sympathy letter to the family of the "dead" man. 

            BUT, THE MAN IS NOT DEAD.

            This story is humorous.  But, it is sad, also.  It makes the point that MEDICARE MAKES MISTAKES.  When Medicare makes mistakes, it costs time, money, and effort to fix the problems.

            For over six years, I have helped senior citizen clients of this insurance agency to fix problems caused by mistakes at Medicare.  I have saved our clients over $600,000 in wrongful medical bill charges that were caused by mistakes at Medicare.  For over six years, I have written articles about Medicare mistakes causing problems for senior citizens.  Many of my articles can be read at www.medicareproblems.net.

            If a national health care system which is modeled on Medicare is imposed on our nation, then millions more people will experience the problems which Medicare has caused for senior citizens for years.

Note: Woodrow Wilcox is the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest.  For other articles and videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.tv, and www.woodrowwilcox.com.

OPEN LETTER TO PRESIDENT, SENATORS, & CONGRESSMEN

By Woodrow Wilcox

            An elderly woman phoned me because she read an article by me in a local newspaper.  The senior citizen is from Lansing, Illinois.

            I listened to her story.  She fell at a local drug store, was taken to a hospital, and got some stitches.  The hospital got paid by Medicare, the woman's insurance company, and by the drug store's insurance company.  Now, Medicare wants its money back.  But, the woman does not have the money.  When she phones Medicare's bill collector's phone number, she gets a recorded instruction to contact the company via the internet.  The woman is 85 years old and does not know how to use the internet.

            Normally, I would not help because I'm not supposed to help seniors who are not clients of the insurance agency where I work.  I have helped senior citizens with medical bill problems that were caused by Medicare and by the VA medical clinic system for over six years.  I have saved elderly clients of this insurance agency over $600,000 by canceling bad medical bills.

            In this case, I decided to help this woman on my own time and at my own expense.  Over the last six years, I have written over 100 articles about problems with the Medicare system.  Many of the articles can be read at www.medicareproblems.net.  I wrote all those articles and distributed them to newspapers around the country on my own time.

            I'm not trying to boast.  I just want to explain that I help senior citizens who have problems with Medicare.  I care about senior citizens.  I'm not sure that the President and some Senators and Congressmen do care about seniors.

            There are problems with Medicare, the VA Clinics, and Medicaid.  There are problems with other health care segments, too.  But, no one can fix a problem by not listening to reasonable, responsible people who have experience in the field.

            That is what I am accusing the President and some Senators and Congressmen of doing - not listening.  The Democratic leaders and many Democratic members of the Senate and the House fashioned "their" health care reform bill without listening to the concerns of many respected people. 

            Rather than bringing people together to reach a consensus, the President and his allies have done exactly the opposite.  No proposal by a Republican or a moderate Democrat was considered.  The legitimate concerns of the dissenters were not reviewed to allow compromises to correct problems in the bill.  The President and/or his allies called opponents of "their" health care reform bill "Nazis" and "racists" instead of listening to legitimate concerns about the bill.  The President and/or his Democrat allies called health insurance company executives and employees "greedy" and "special interests" instead of listening to the legitimate objections of those people.

            Citizens who read the health care reform bill (H.R. 3200) online and attended town hall meetings with their congressional representatives were shocked, insulted, and angered to realize that many of their congressional representatives never read the proposed law and just parroted some false talking points written by the supporters.

            Presidential candidate Barack Obama promised to bring people together.  But, he and his Democrat allies in Congress have used arrogance, smugness, rudeness, insults, and disinformation to alienate many people in the country including other Democrats.

            The President and his Democrat allies in Congress should stop the rudeness, listen to the legitimate concerns of those who object to problems in the current bill, and change the proposed law to get rid of the legitimate objections.  No one can get other people's cooperation by refusing to listen and casting insults.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For articles and videos by Woodrow Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

SAVED CLIENT FROM PAY DEMAND LETTER

By Woodrow Wilcox

            I just finished saving a client from paying $1,017.46.

            The client is a senior citizen woman from Schererville, Indiana.  She is one of many clients of this insurance agency whom I help with medical bill problems that relate to Medicare.

            I am writing this article on October 8, 2009.  The woman phoned me today to tell me that she got a letter from a hospital that demanded that she pay a bill in seven days or the account would be given to a collection agency.  She cares about her credit and was in a panic.

            On July 23, 2009, I had written a letter to the hospital which explained that Medicare did not send the claim to the client's Medicare supplement insurance company.  I requested that essential information about the unpaid claims be forwarded to the insurance company for processing.

            Our client told me that she had phoned the hospital and was told that the hospital doesn't do that sort of thing.  But, I knew better because that hospital had done the same for other clients when I requested that be done.  So, I phoned the hospital, spoke to a person with whom I had dealt in the past, and got the threat of a collection agency cancelled.  The hospital was happy to send the vital information to the correct insurance company.  Apparently, the hospital and Medicare had incorrect information about our client's current Medicare supplement insurance company.  I worked with the hospital representative to correct that.

            This sort of problems happens all the time.  Our agency helps our clients with such medical billing problems at no charge.

            But, if a national system of health care is established, millions more Americans will experience similar problems with medical bills and government bureaucracy.  You can count on it.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For more articles or videos by him, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

HAMMOND SENIOR HIT WITH $1836 BILL

By Woodrow Wilcox

            An elderly woman who is a client of the insurance agency where I work sent a bill to me and asked for my help.  The client is from the central part of Hammond, Indiana.

            The balance of the bill was for $1836.  I reviewed the bill and phoned our client's insurance company to learn what they knew of the bill.

            The client has a Medicare supplement insurance policy with United World Life Insurance Company.  That firm is part of the group of Mutual of Omaha companies.  Both firms have a very good reputation at our insurance agency for helping us to treat our clients well.

            The representative advised me that the insurance company's claims department NEVER GOT $1,800 OF THE CHARGES FROM MEDICARE.

            Other charges on the bill had been received from Medicare and the insurance company paid on all the reported charges.  But, Medicare failed to report a charge for $1000 and a charge for $800.  The other $36 was a finance charge for not paying the balance right away.

            For our client, I wrote to the medical service provider and explained that Medicare never sent a report about the unpaid charges.  I asked the firm to send the necessary information about the charges to the client's insurance company so that the claim could be processed.  Also, I asked the firm to remove the $36 finance charge.  After all, it is not the patient's fault if Medicare fails to report a claim to the insurance company in a timely manner.

            So, today, I corrected a medical bill problem that was caused by a mistake at Medicare and saved a client over $1,800.  In the past six plus years, I have saved clients of this insurance agency over $600,000 in similar cases.

            How could Medicare make a mistake?  How could Medicare report some but not all the charges on a bill?  It is easy to explain.  Medicare relies on satellite telephonic communications for receiving and sending information about claims.  When there is a sun spot, a storm, lightning, or something else that interferes with the data in the satellite or telephonic signal, data is distorted or lost.

            There are big government industry contractors that make millions of dollars from the federal government for providing computers, satellite communications, telephonic communications, and other services to the federal government to run Medicare, Medicaid, and the VA health care system. 

            A larger national health care system would put more millions of dollars into the treasuries of these special government industry contractors.  That would mean that everyone in the country would start to experience the medical billing problems that senior citizens have experienced for years.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For more articles by Wilcox, visit www.medicareproblems.net and www.woodrowwilcox.com.

MEDICARE DISALLOWED $150 OF MEDICAL SERVICE

By Woodrow Wilcox

            A client of this office sent a medical bill to our office for review and assistance.  The client is a senior citizen on Medicare who bought a Medicare supplement policy through this insurance agency.  The client is from Schererville, Indiana.

            I reviewed the papers and phoned the client's insurance company.  The insurance company representative informed me that Medicare disallowed a claim for medical services which had a charge of $150.  The charge was for a laboratory test.

            If Medicare disallows a claim, then the Medicare supplement insurance policy will not pay the charge either.  Medicare supplement insurance policies pay only after Medicare has reviewed and approved the claim.  The insurance company relies on Medicare to determine the legitimacy of the claim.

            Generally, Medicare will not pay for routine check-up charges or the tests associated with that.  But, generally, Medicare will pay for tests which are ordered by a doctor for diagnosis and/or treatment.

            On the client's bill, I noticed that another charge for a slightly different test was approved by Medicare.  So, I wrote the doctor to ask that he review the information that was sent to Medicare for the denied charge.  If the information did not make it clear that the test was for diagnosis/treatment, then the doctor could augment the notes to make that clear and resubmit the claim to Medicare.

            If Medicare gets the augmented claim and approves it, then our client will not have to pay the $150 surprise bill.  If Medicare still denies the claim, then the client will be stuck with the $150 bill.  I and this insurance agency provide this level of service to our clients AT NO CHARGE TO THE CLIENT.  Does your insurance agent or agency give the same level of service?

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For other articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

SPECIAL INTEREST GROUPS THAT WANT OBAMACARE

By Woodrow Wilcox

            Barack Obama claims that special interest groups oppose his health care reform plan.  Maybe lots of people don't like the details of his plan.  But, one thing is for sure.  There is an array of special interest groups that want "Obamacare".  Here is a list of some of those special interest groups.

            (1) Labor unions that have contracts with the federal government or government industry contractors in the fields that now run the Medicare, Medicaid, and Veterans health clinics.  These unions would expand their membership and increase their union dues and other revenues under "Obamacare".  Also, these unions would increase their political power.

            (2) Government industry contractors which sell or lease computer equipment, computer services, and satellite telephonic equipment or services to the federal government.  It is computers and satellite telephonic equipment and services which are the backbone of the Medicare, Medicaid, and VA health clinic system.

            Government contractors like General Electric, Westinghouse, and a few other companies are the main sources of computers and satellite telephonic equipment and services.

            For your information, General Electric owns or controls the NBC, CNBC, MSNBC, and other media companies.  So, when MSNBC announcers like Chris Matthews and Keith Olbermann attack those who oppose "Obamacare", they are really working to help "Obamacare" become law because their employer General Electric and other government industry contractors stand to gain billions of dollars in new government contracts and billions of dollars in new profit.

            A few years ago, Westinghouse owned CBS.  But, then, Westinghouse pealed away CBS and helped to create Viacom.  There is still an "old boy" network of friendships and financial interests between Westinghouse and Viacom.  Viacom owns or controls CBS, MTV, MTV2, VH1, BET, BET J, Nick At Night, TV LAND, Comedy Central, CMT, Spike TV, and other media properties.

            General Electric and Westinghouse operate businesses in medical equipment and medical services.  Westinghouse operates hospital services, too.

            The main source of my information on these government industry contractors and their media interests is the "WHO OWNS WHAT" report at Columbia Journalism Review (www.cjr.org).

            Big government industry contractors like big government because that is THE CUSTOMER of big government industry contractors.  Big government industry contractors stand to gain billions of dollars if "Obamacare" becomes law.

            (3) Homosexuals are a special interest group that supports "Obamacare".  Homosexual and promiscuous lifestyles often lead to "AIDS" and/or other sexually transmitted diseases.  Treating these diseases is often expensive.  Many insurance companies refuse to sell health insurance to those with the pre-existing condition of "AIDS" or other sexually transmitted diseases.  "Obamacare" would shift costs of the expensive treatments for these diseases onto the general population - the taxpayers and the private insurance companies.  Many people who have an insurance policy now may see their insurance premiums rise substantially once "Obamacare" forces everyone else to help pay for treatment of "AIDS" and other diseases for those who follow homosexual and/or promiscuous lifestyles.  Homosexuals  and homosexual interest groups contributed enormous amounts of money to the Obama presidential campaign.

            (4) Illegal aliens are a special interest group that wants "Obamacare".  Many illegal aliens use other people's social security number in their jobs.  It gets messy when a medical service provider or health insurance company starts asking for verification of the identity of the patient because the social security number seems to indicate a different person.  It's not just the illegal aliens who are in the U.S. now who want "Obamacare".  If "Obamacare" passes, millions of really sick people and their families from other countries will flood the U.S. to get some free or cheap "Obamacare".  That just might break America's health care system.

            (5) Democrats who control local governments throughout the nation are a special interest group that wants "Obamacare".  In many places where Democrats control local government or state government, millions or billions of dollars are spent for medical care for the poor.  In a recent news report, one county commissioner of my home county said that Lake County, Indiana - the county that borders Chicago - spends over one hundred million dollars per year on health care for the poor.  "Obamacare" would shift most or all of these expenses onto the federal government.  Millions or billions of dollars would become available to state or local governments that are controlled by Democrats.  Those Democrats want to spend that money on other things.  

            There are other SPECIAL INTEREST GROUPS that support "Obamacare".  But, this is a good list of the major ones.

NOTE: For other articles by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

OBAMA IS VERY IGNORANT OF MEDICARE!

By Woodrow Wilcox

            In his September 9 speech to Congress, Obama criticized private insurance companies for not covering certain things.  Obama is ignorant of the fact that the federal Medicare system won't cover certain things.

            For example, a client of the insurance agency where I work just discovered that Medicare won't pay anything on his ambulance bill.  He is a diabetic senior citizen and veteran from the Miller section of Gary, Indiana.  Recently, his daughter phoned an ambulance for help.  The ambulance people gave him emergency services for being a diabetic, but did not transport him.  The treatment may have saved his life, but Medicare won't pay for any first responder services.  The client is stuck with a $250 bill.

            Recently, three of our senior citizen clients were shocked to learn that Medicare refused to pay for their pelvic and breast examinations and pap smears.  Two of the ladies are from Munster, Indiana and one is from Hammond, Indiana.

            Medicare regularly refuses to pay for routine medical treatment, tests, and services if the items are done outside the time frames allowed by the rules of Medicare.  Also, Medicare does not help pay for hearing tests or hearing aides, eye tests or eye glasses, or non-emergency dental services.

            There are many problems with the federally run Medicare system.  I have written over 100 articles about such problems and many of the articles are at www.medicareproblems.net.  I have helped senior citizen clients to cancel over $600,000 in wrongful medical bills that were caused by mistakes at Medicare.  There are problems with the federal Medicaid and the federal Veterans Administration medical clinics, too.

            Obama and his allies in Congress want to impose a national health care system that is modeled on Medicare.  That idea is based on the false belief that Medicare works great.  It does not.  If Obama does not understand this, then why shouldn't citizens and Congressmen question his understanding and proposals for change of the health care system?  That doesn't mean that the current system is perfect.  It just means that Obama and his allies have made up their minds without even listening to reason or considering the facts.

Note: Woodrow Wilcox is the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest.  For more articles or videos by him, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

HOW MEDICARE DOES NOT WORK

By Woodrow Wilcox

            When one of the clients of this insurance agency has a problem with a Medicare related bill, it usually comes to me.  I am the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest.

            This agency does not charge our senior citizen clients to help them with Medicare medical bill problems.  It costs the agency money, but we do it without charge to be helpful and demonstrate our concern for our clients.  In the last six years, I have saved clients of this insurance agency over $600,000 by canceling wrongful bills that were caused by Medicare mistakes.

            Whether the problem involves a few dollars or thousands of dollars, errors caused by Medicare can cost senior citizens time, money, and stress.

            If Obama and his allies in Congress succeed in forcing a national health care system modeled after Medicare, then everyone will start to experience the same medical bill problems caused by errors at government agencies which senior citizens have had with Medicare for years.

            The errors caused by Medicare are caused by errors or problems with systems, mechanics, or personnel (human errors).  The errors cost time and effort to the insurance agency, insurance company, and medical office personnel who must work to fix a problem caused by Medicare.

            Today, I had to investigate and write two letters for one of our clients to get her medical bills corrected and paid properly.  Medicare never sent the claim to the client's insurance company.  That happens quite often. 

            It costs time, money, and effort to correct medical bill problems that are caused by Medicare.  It is a drag on the national economy.  If a national health care system that is modeled on Medicare is imposed, the problems that it creates will be a much bigger drag on the national economy.

Note: For other Medicare related articles by Woodrow Wilcox, visit www.medicareproblems.net and www.woodrowwilcox.com.

Purdue University students and graduates are known for their talent for logical and rational thinking.  A Purdue graduate knows that if you build a small machine which does not work, it is silly to believe that if you build the same machine in a larger version the larger machine will work.

Obama and his allies propose a national health care system which is modeled on the federal Medicare and Veterans Administration systems.  That idea is based on the false assumption that these systems work well.  They do not.

For over six years, I have helped senior citizens with Medicare and VA medical billing problems.  I have saved senior citizens over $600,000 of wrongful charges that were caused by mistakes and errors caused of these federal systems.

Over six years ago, I started writing about such problems.  Many of the over 100 articles that I wrote are at www.medicareproblems.net.

Obama and his allies in Congress are ignoring the shortcomings of the present systems and they are ignoring the legitimate objections to the health care reform bill (H.R. 3200).  Citizens who read the bill online and went to town hall meetings were angry that their representatives had not bothered to read the bill and that their representatives gave really stupid "talking point" answers which were written by Obama propagandists and which were totally untrue.

If you don't have time to read the over 1,000 pages of H.R. 3200, then read some of the articles at www.medicareproblems.net which specifically talk about problems with the current federal health care systems and the specific objections which credible people have against Obama's health care reform bill.

Note: For other articles by the author, visit www.woodrowwilcox.com and www.woodrowwilcox.tv.

HELPED WIDOW GET MONEY

By Woodrow Wilcox

            The widow of a deceased client came to our office with some papers and asked for help.  I helped her.

            Since her husband had died, insurance companies were still taking money from her bank checking account for premium payments for policies that covered her husband.

            One insurance policy was for Medicare supplement insurance for her husband.  I contacted the insurance company and forwarded a copy of the death certificate by fax.  I requested that the refund of unearned premiums by check be made to the widow to which the insurance company agreed.  The widow will get over $170 back from that insurance company.

            Two insurance companies were taking money from the bank account for premiums for life insurance policies for the deceased husband.  In each case, I faxed a copy of the death certificate to the respective insurance companies with a request that the check(s) for refund of unearned premium be made to the widow.

            Also, I mailed original copies of the death certificate to the insurance companies, with the respective life policy numbers, and requested that they correspond directly to the widow from that point forward.  I just "got the ball rolling" for the widow.

            This kind of assistance to senior citizen clients is provided free of charge to the clients of this insurance agency.  Does your insurance agent or agency provide the same level of service?

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For other articles by Wilcox, visit www.medicareproblems.net and www.woodrowwilcox.com.

OBAMA IS IGNORANT ABOUT MEDICARE

By Woodrow Wilcox

            In his address to Congress on September 9, Obama insisted that insurance companies pay for routine tests.  Apparently, he is ignorant of the fact that MEDICARE will not pay for routine tests.

            Medicare regularly denies coverage for routine medical services, for medical services that are outside the time frame rules of Medicare, for hearing tests, for eye examinations, for dental services, and other medical services. 

            On the day of his speech, I helped a woman from Schererville who was billed $150 because Medicare refused to pay for a routine test.  Recently, two of our senior citizen clients, one from Hammond and the other from Munster, were surprised when Medicare refused to approve and pay for pelvic and breast exams and pap smears for them.

            Here is my point.  Obama criticizes private insurance companies for not covering some routine medical tests when the federal government run Medicare system regularly denies coverage for many routine tests and many other medical services.  If Obama is ignorant of that, don't voters and members of Congress have a right to question his understanding of health care reform legislation?

            One Indiana citizen who read the entire health care reform bill is Dr. Stephen Fraser.  Dr. Fraser wrote a long letter to Senator Evan Bayh in which he cited the section, paragraph, sentence, and page number of everything in H.R. 3200 (the health care reform bill) which Dr. Fraser disliked.

            You can read Dr. Fraser's letter to Senator Bayh and watch video interviews of Dr. Fraser at www.medicareproblems.net.

            Two of Dr. Fraser's objections are of special interest to senior citizens.  Dr. Fraser objects to the idea of allowing a government approved person who is not a medical doctor to sign a DEATH ORDER for a patient.  Dr. Fraser does not like the idea of Dr. Ezekiel Emmanuel, brother of White House Chief of Staff Rahm Emmanuel, being a key person in the writing of regulations under a health care reform bill.  In one of the interviews on the website www.medicareproblems.net, Dr. Fraser cites articles in American and European publications which detail Dr. Ezekiel Emmanuel's support of euthanasia and refusing medical services to young and old patients.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For other articles or videos by Wilcox, visit www.woodrowwilcox.com and www.woodrowwilcox.tv.

GARY WOMAN GOT BIG BILL

By Woodrow Wilcox

                A client of this insurance agency sent a bill to our office and asked why the bill was not paid.  The client is an elderly woman from Gary, Indiana.

                I examined the bill and noticed something unusual about it.  The bill was prepared in June 2009 for services rendered in September and October of 2008.  But, there were no payments or adjustments from Medicare shown on the bill.

                I checked with the client's insurance company.  It never got any claim from Medicare for the charges on the bill.  You can't blame an insurance company for not paying a bill that it never got.

                So, I phoned the medical office which was billing our client and asked if that firm was contracted to send claims to Medicare.  The representative reported that indeed it was.

                Somewhere between the medical provider and Medicare or between Medicare and the insurance company THE CLAIM WAS LOST.  If no one did anything regarding this bill, our senior citizen client would have had to pay $763.56.

                But, I wrote a letter to the medical provider that sent a bill to our client.  I explained what I had discovered and asked for their help to get the claim directed to the client's insurance company for processing.  This should solve the problem for our client and get Medicare and the insurance company to pay on the claim.

                If the client had no one to spot the problem with the bill and help to get things corrected, the client would have owed the $763.56 charge.  Our insurance agency provides this kind of medical bill problem solving service AT NO CHARGE TO OUR CLIENTS.

                This kind of problem with Medicare medical bills happens all the time.  In other articles, I have stated my reasons for believing that mistakes of the Medicare system cost senior citizens throughout our country OVER ONE BILLION DOLLARS IN WRONGFUL CHARGES PER YEAR.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That firm is the largest senior citizen oriented insurance agency in the Midwest.  For more articles by Woodrow Wilcox, visit www.medicareproblems.net and www.woodrowwilcox.com.

MEDICARE DID NOT APPROVE $855

By Woodrow Wilcox

            A client of this insurance agency brought some bills and other papers to our office.  She wanted to know why her Medicare supplement insurance policy had not paid on some bills.  The woman is from Hobart, Indiana.

            I reviewed the papers and saw the problem right away.

            Medicare did not approve $855 of charges from her doctor's office.  If Medicare does not approve charges, then the Medicare supplement insurance policy will not pay anything.  Medicare must approve and rule on a claim before the Medicare supplement insurance company will pay anything.

            To learn why Medicare did not approve the claims, I need to review the MEDICARE SUMMARY NOTICE form(s) that pertain to the claims.

            If a senior citizen can not find the MEDICARE SUMMARY NOTICE form(s) that pertain to questioned medical bill(s), the senior citizen can phone Medicare to request duplicate copies.  The phone number to call is different for different parts of the country.  For Indiana, the phone number is 1-800-633-4227.

            Keep a copy of this article.  This information will be useful to anyone who wants to help a senior citizen with a problem with Medicare.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  To find other articles or videos by Woodrow Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

MEDICARE DISALLOWED $150 OF MEDICAL SERVICE

By Woodrow Wilcox

            A client of this office sent a medical bill to our office for review and assistance.  The client is a senior citizen on Medicare who bought a Medicare supplement policy through this insurance agency.  The client is from Schererville, Indiana.

            I reviewed the papers and phoned the client's insurance company.  The insurance company representative informed me that Medicare disallowed a claim for medical services which had a charge of $150.  The charge was for a laboratory test.

            If Medicare disallows a claim, then the Medicare supplement insurance policy will not pay the charge either.  Medicare supplement insurance policies pay only after Medicare has reviewed and approved the claim.  The insurance company relies on Medicare to determine the legitimacy of the claim.

            Generally, Medicare will not pay for routine check-up charges or the tests associated with that.  But, generally, Medicare will pay for tests which are ordered by a doctor for diagnosis and/or treatment.

            On the client's bill, I noticed that another charge for a slightly different test was approved by Medicare.  So, I wrote the doctor to ask that he review the information that was sent to Medicare for the denied charge.  If the information did not make it clear that the test was for diagnosis/treatment, then the doctor could augment the notes to make that clear and resubmit the claim to Medicare.

            If Medicare gets the augmented claim and approves it, then our client will not have to pay the $150 surprise bill.  If Medicare still denies the claim, then the client will be stuck with the $150 bill.  I and this insurance agency provide this level of service to our clients AT NO CHARGE TO THE CLIENT.  Does your insurance agent or agency give the same level of service?

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For other articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

MEDICARE MISREPORTED BILL

By Woodrow Wilcox

            A senior citizen who is a client of this insurance agency asked for help on a medical bill.  Because he is a client of this agency, we assisted him to resolve the medical bill matter at no charge.  The client is from Saint John, Indiana.

            I checked and learned that Medicare was not reporting the charges with the same figures to both the hospital and the insurance company.  For example, for medical services rendered on 06/11/09, the hospital charged $525 but Medicare reported only $176 of charges to the insurance company.

The insurance company paid its share of the bill according to the information that it received from Medicare.  But, the hospital wanted more money.

To fix the problem for the client, I wrote a letter to the hospital asking them to forward some key information to the insurance company so that it could compare the claim information which Medicare sent to the hospital with the claim information that Medicare sent to the insurance company.

With such billing problems, resolution will take some time and effort.  This sort of problem happens frequently with Medicare.  This agency assists clients with such billing problems at no charge.  Does your agency give the same measure of service?

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For other Medicare articles or videos by him, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

SAVED CLIENT FROM BIG MEDICAL BILLS

By Woodrow Wilcox

            One of the clients of this insurance agency got two bills from a local hospital with unpaid balances totaling $1,017.46.  The client is from Schererville, Indiana.  She wanted to know why the bills never got paid by her insurance company.

            I checked with the insurance company.  Medicare never sent the claims to the client's insurance company.  The insurance company paid no money because it got no claim to process from Medicare.

            To correct this, I wrote to the hospital and explained this.  I requested that the hospital send the original billing information with the Medicare explanation of benefits that it received to the insurance company.

            This should correct the problem and get the bills paid.

            This kind of problem with Medicare happens all the time.  In other articles, I have explained my calculations for believing that Medicare mistakes cost senior citizens over a billion dollars per year in wrongful charges.  Unfortunately, many senior citizens pay the wrongful charges that are caused by Medicare mistakes because they don't know how to spot and respond to wrongful charges that Medicare caused.

            This insurance agency provides this type of service to our clients AT NO CHARGE.  In the last six years, I have saved our clients over $600,000 in wrongful charges that were caused by mistakes made by Medicare or VA health clinics.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For more Medicare articles by Woodrow Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

SAVED SENIOR $267.31

By Woodrow Wilcox

            A client of this insurance agency was being billed $267.31 from a medical laboratory.  She wanted to know why her insurance policy did not cover and pay for the medical services.  The client is from Highland, Indiana.

            I checked on the matter for our client.  I learned that the client's insurance company DID PAY THE BILL ALREADY.  But, the laboratory was still sending bills to the client and demanding payment or else.

            I got a copy of the cancelled check from the insurance company and contacted the laboratory firm's headquarters.  I explained the problem and asked that they check their records regarding the bill, the check, and their endorsement of the check.

            A few days later, a representative of the laboratory told me what happened.  The insurance company sent the check to an office in Chicago.  The check was supposed to go to an office in Denver.  But, our client was getting a bill from an office in Baltimore.

            If our office had not helped the client, she may have been hounded for payment or sued for the $267.31 that her insurance company had already paid.  Our firm gives this kind of assistance to our clients AT NO CHARGE.  Does your insurance agency give the same measure of service?

            In this case, I believe that Medicare gave the Chicago address to the insurance company for sending payment.  Either Medicare misdirected the insurance company or the laboratory company had not updated their payment information with Medicare.

            Problems like this happen all the time with the Medicare system.  In other articles, I have given my calculations for my belief that medical bill mistakes by Medicare cost America's senior citizens over one billion dollars per year in wrongful charges.  Many senior citizens pay the wrongful charges because they have no one to help them to spot and fix the problems.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For other articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

STRANGE RULES AT MEDICARE

By Woodrow Wilcox

            I just learned something about Medicare rules that seems strange to me.

            A senior citizen can go to a hospital, stay overnight, but not be considered an "in-patient" of the hospital.  Doesn't that seem strange?  It did to me.

            A very pleasant person who works at the Medicare regional office in Chicago told me about this rule.  It applied to the case of one of our clients who is from Portage, Indiana.

            The client went to a hospital in Indiana and stayed overnight.  Medicare ruled that the stay was an in-patient hospital visit.  Medicare and the client's insurance company paid according to that ruling.  The client that I am helping is from Portage, Indiana.

            Then, the client went to Florida.  She entered a hospital there and spent several days.  But, her two hospital visits were within 61 days.  There are special rules at Medicare that cause multiple hospital stays within 61 days to count as one hospital stay for purposes of computing any Medicare Part A deductible that may apply.

            After Medicare ruled that the first hospital stay in Indiana was an "in-patient" stay, Medicare changed the ruling to make the first hospital stay an "out-patient" stay.  Why?  Because, the client had been in the hospital for less than 24 hours.

            This change in ruling will force the first hospital to return $1068 to the insurance company so that the insurance company can pay the $1068 to the second hospital in Florida.

            Helping senior citizens with medical bill problems that are caused by Medicare is so much fun.  More people should try it.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  To find other articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

CHRIS MATTHEWS: HARDBALL GUY PLAYS HARD TO GET

            More than two weeks ago, Chris Matthews of the MSNBC program HARDBALL, said that he did not know of any senior citizen who had a complaint about Medicare.

            When I learned that, I phoned and emailed the show repeatedly to give the message that Chris Matthews should visit my website www.medicareproblems.net and invite me to be a guest on HARDBALL to talk about the many flaws of Medicare and how Medicare harms senior citizens.

            I called and emailed the show repeatedly.  I spoke to two different producers.  I phoned some days.  I emailed some days.  I phoned and emailed some days.  Now, more than two weeks later, no one from HARDBALL wants to talk to me about MEDICARE PROBLEMS.  I must assume that Chris Matthews has visited www.medicareproblems.net and is afraid of me.  Why?  Because I know a lot about how the federal government's current ventures into health care - Medicare, Medicaid, and the VA clinic system - are failing.

            If the federal government can't manage these small health care systems properly, why would any reasonable person believe that the federal government could manage a universal health care system? 

            On HARDBALL, I could talk about my helping senior citizens to cancel over $600,000 of wrongful medical bills that were caused by mistakes at Medicare.  I could talk about how I have helped senior citizen veterans in their billing problems with the VA and Medicare.  I could talk a bit about the failings of Medicaid, too.

            Now, since Chris Matthews is afraid of me and will never invite me to be on his show, I can tell you that I would discuss why I don't trust MSNBC.

            I believe that Chris Matthews and most of the other announcers on MSNBC programs are just puppets on strings.  They say what their puppet masters want them to say.  They do what their puppet masters want them to do.  In your mind's eye, envision Chris and other MSNBC program hosts as having a black line going straight down from each corner of their mouths.  Do you have that picture in your mind?  Don't they look like puppets on a string?  Of course, they do.  But, who are their puppet masters?

            Most people don't know that the federally run Medicare, Medicaid, and VA health systems rely on bureaucrats with computers and satellite-telephonic systems.  Big government contractors sell these computers, software, and satellite-telephonic systems to the government.  Governments spend billions of dollars for these things.  Big government contractors love big government.

            And who owns or controls MSNBC?  General Electric.  General Electric owns or controls enterprises in satellite communications, computers, and medical equipment and systems.

            According to "WHO OWNS WHAT?" at Columbia Journalism Review (www.cjr.org), General Electric owns many other media firms including NBC television stations, Telemundo television stations, NBC Universal Television Studio, NBC Universal Television Distribution, and the CNBC, MSNBC, Bravo, Mun2TV, Sci-Fi, USA, Sleuth, and Oxygen channels.

            If a new universal, nationalized health care system is started, that new system will need more and bigger computers, more satellite-telephonic systems time, and more medical equipment and systems.  General Electric might make billions more dollars than what it currently makes.  Could that be enough reason for people over Chris Matthews and other tv announcers to tell them to speak well of Obama's nationalized health care proposal and attack anyone who criticizes Obamacare?  I believe so.

            General Electric is not the only government industry contractor who has major ownership, control, or influence over media.  Westinghouse used to own CBS.  Westinghouse is a major government industry contractor.  Westinghouse is involved in computers, satellite-telephonic systems, hospitals, and medical equipment and devices.  Even though Westinghouse does not directly own or control CBS now, it still has "old boy network" ties to it.  Interlocking membership in boards of directors, some stock ownership, and credit on very favorable terms are just some of the common devices for influencing corporations and their leaders.

            Many government industry contractors have substantial influence in media.  All those who have something to sell the federal government to run a nationalized health care system stand to make a lot of money if they can help to "push and sell" Obama's nationalized, public option, single payer system to the Congress and the voters.

            Almost fifty years ago, my cousin Dwight D. Eisenhower warned America about a military-industrial complex that was willing to put its interests above the interests of the nation and the people.  Now, I am warning America about a government industry contractor "complex" that I believe is promoting Obama's health care reform plan in order to accomplish billions of dollars of profit for those who help to smear and denigrate Americans who oppose Obama's plan to nationalize health care.

            So, when you watch Chris Matthews and other announcers on tv "pushing" Obamacare and slandering the opponents of Obamacare, remember something.  Even if you can not see the puppet strings, the puppet strings are still there.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For more articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.  Also, you can watch videos by him at www.woodrowwilcox.tv.

Written on August 20, 2009 by Woodrow Wilcox;       Copyright 2009 Woodrow Wilcox

BAD AND STUPID GOVERNMENT RAISES HEALTH CARE COSTS!

By Woodrow Wilcox

            President Obama and his allies have been criticizing insurance companies, hospitals, doctors, and others for raising health care costs by being greedy.

            If doctors, hospitals, and insurance companies were as greedy as some politicians, nobody would be able to afford health care.

            If you don't know how the system works, then any criticism might sound smart.  When you know how the system works, Obama and his allies show themselves to be disinformation propagandists.

            The main cause of rising health care costs is BAD AND STUPID GOVERNMENT.  By "government", I mean the politicians, the bureaucrats, the laws, regulations, policy rulings, and court rulings that influence health care systems, resources, and costs.

            Imagine a balloon filled with air.  If you squeeze part of the balloon, don't the other parts expand?  If you squeeze the balloon too much, doesn't it break?  Of course, it does.  But, the place where it expands and breaks is not the place where the pressure was applied.

            The same principle happens when government applies pressure to one area of the health care system.  Other parts of the system are reshaped.

            The biggest influence in the nation's health care system is government and the laws, regulations, policy rulings, and court decisions that government makes.  The other parts of the health care system adjust and change to avoid problems with the government.

            Here is how the balloon principle works in the health care system.

            Medicaid is a joint federal and state run health care system for the poor.  Each state pays a different reduced rate to doctors for seeing poor patients who use Medicaid.  The doctors who do treat Medicaid patients are forced to increase charges to other patients who have insurance or other means to pay.  That raises health care costs for many.

In some states, the Medicaid system does not even pay the doctor enough to cover the cost of treating the patient.  When that happens, fewer and fewer doctors are willing to contract to treat Medicaid patients.  This is especially true of specialists.  When the Medicaid patients can't find primary care with doctors, they go to hospital emergency rooms.

Hospital emergency rooms will treat the Medicaid patients.  But, the cost of treatment for primary care matters at a hospital emergency room is much higher than the cost of primary care at a doctor or clinic's office.  Medicaid won't pay the hospital the fair market value for the emergency room treatment.  So, hospitals must increase charges to patients who have insurance or other means to pay.  That increases health care costs for many.

When doctors and hospitals increase charges to patients who have insurance, insurance companies must pay more.  Do you see how the balloon effect increases charges to insured patients and insurance companies?

Government officials believe that they are doing a great job of getting doctors and hospitals to work for less than fair market value.  But, the bad and stupid government policy is raising health care costs for millions of Americans and putting hospital emergency room personnel under constant stress.  How healthy is that?

So, the Medicaid system harms many poor people, all taxpayers, and many patients and insurance companies.  That's bad and stupid government at work!

Medicare pays medical service providers at a lower than fair market value which is not as steep as the Medicaid system.  So, the balloon effect exists in the Medicare system, too.  But, it is less pronounced.

The federal government taxes doctors, accountants, and lawyers at the highest rate tax brackets.  How stupid is it for a politician to complain about high health care costs but vote to tax to infinity the people who deliver health care?  It is very stupid and very hypocritical!  Doctors use accountants to help them keep their records straight and pay their taxes in a timely manner.  Lawyers help doctors to understand and follow the law and avoid lawsuits or defend against lawsuits.  So, taxing doctors, accountants, and lawyers at the highest rates possible will increase health care costs for everyone.  The doctors, accountants, and lawyers will raise their rates to cover the higher taxes.  The health care customers will have to pay higher bills because of this bad and stupid government tax policy.

These are just a few examples of how bad and stupid government causes health care costs to increase.  Politicians and bureaucrats want to blame private enterprise.  But, it is government enterprise that causes the rise in health care costs.

In my first year of college, I attended a debate in which my science professor argued against the establishment of Medicare.  He said that it would lead to senior citizens losing their privacy because of all the records passing through hands that could not always be trusted.  He said that the federal bureaucracy of Medicare would force doctors, hospitals, and labs to hire more personnel just to communicate with the Medicare bureaucracy and that would increase costs and charges to patients.

I believe that the professor was right.

Written on August 20, 2009 by Woodrow Wilcox.       Copyright 2009 Woodrow Wilcox.

Note: For more articles or videos by Woodrow Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

WHAT'S WRONG WITH A SINGLE PAYER SYSTEM?

By Woodrow Wilcox

            Obama and his supporters want a single payer system.  What's wrong with that?  Nothing - unless you are the ultimate payer.

            Imagine going to a restaurant and that someone has agreed to pay for everything for the dinner party. 

            If you are a dinner guest, will you have a little more than what you really need?

            If you are a dinner guest, will you stay after the dinner to help the host make sure that the bill is accurate and correct?

            If you are the waiter or the restaurant owner, will you be tempted to "pad" the bill a bit?

            Now, imagine that you are the ultimate payer.  You get the bill.  You can't believe how big it is.  Hey, isn't anyone going to stay to help you make sure that everything on the bill is correct?  Where are all the people that you treated to the dinner?  Now, you are left to examine the bill without anyone to help you determine if it is an honest bill.

            The restaurant manager is waiting.  You have no option except to pay a bill that you really want to question.  You have some doubts about what the bill states that you and your guests consumed.  But, you have no means to question the bill effectively.

            In a single payer health care system, first the government will pay, but ultimately, the taxpayers will pay.

            So, why would anyone trust the federal government to operate a single payer system properly?  The federal government can't even operate the currently federally run Medicare, Medicaid, and VA health care systems properly.  And, Obama and his allies want the federal government to take over the entire health care system?  What are they on?

            Medicaid is a budget buster or a real strain for many States.  I just helped with a research project on Medicaid.  Without giving the details that will be in the yet to be published study report, I can tell you that the Medicaid system hurts the poor, hurts the taxpayers, and hurts the health care system.

            For over six years, I have helped senior citizens to cancel wrongful medical charges that are caused by mistakes at Medicare and the VA.  I have saved senior citizens over $600,000.  Based on the work that I've done, I estimate that Medicare Part A and Part B alone cause wrongful charges against senior citizens that are over one billion dollars per year.

            Senior citizen veterans who are clients of the firm where I work come to me for help and I give it.  I've written articles about their problems with the VA.  I've even phoned VA officials in Washington, District of Corruption, to ask why they can't seem to make things work to resolve the veterans' problems with the system.

            If Obama and his political allies start a new nationalized health care system, everyone in the nation will start to experience the problems that Medicare, Medicaid, and the VA systems now generate.

            I don't believe that Obama and his political allies really care about people's health.  I believe that they just want to have a big, ongoing "dinner party" and stick the taxpayers with the bill.

Written on August 20, 2009 by Woodrow Wilcox.       Copyright 2009 Woodrow Wilcox

Note: For other articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

Note: This article was sent as a letter to the editor to the newspaper DC Examiner in the spring of 2009.  I followed their rules for size, etc.  As far as I know, it was never used. -Woodrow Wilcox.

PROBLEMS WITH MEDICARE FOR SENIORS

PREDICT PROBLEMS FOR EVERYONE WITH

OBAMA'S NATIONAL HEALTH CARE PLAN

By Woodrow Wilcox

            Obama and some in Congress are pushing plans for a national health care system.  They believe that the federal government can do a good job of managing health care for everyone.  I DISAGREE.

            For over six years, I have helped senior citizens with Medicare and VA billing problems.  I have written many articles about this.  You can read some of the articles by visiting www.medicareproblems.net or www.woodrowwilcox.com.

            I am the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest.  The office is in a suburb of Chicago.  We have thousands of senior citizen clients.  I have saved our clients hundreds of thousands of dollars.  One widow started getting bills for over $9,000 after her husband's death.  Medicare was messing up the billing process.  I fixed it and the bills disappeared.  That client talks about that problem in a video clip on my website.

            Here is a typical problem that I solved for one client in July 2008.  A hospital in Chicago was demanding about $100 more from the senior citizen.  I reviewed the papers that the client had and phoned the insurance company.

            For one of the dates of service in question, Medicare reported a bill of only $686 to the insurance company when the bill was really $1,187.  I requested that the hospital send the information that it got from Medicare to the insurance company.  That fixed the problem.  Then, I started to wonder how much Medicare Foul-Ups cost senior citizens throughout America.

            On an average day, I handle three serious and multiple minor problems caused by Medicare Foul-Ups.  On July 15, 2008, I handled three serious Medicare Foul-Ups that prompted me to write an article on the subject that day.

            The three serious problems for three different clients on that day were  (1) Medicare failed to send the essential billing information to the correct insurance company for payment; (2) Medicare sent conflicting reports on medical charges to the doctor's office and to the patient's insurance company; (3) the Veterans Administration did not send the necessary information to a client's insurance company for payment processing and VA officials were obstinate and did not want to cooperate with solving the problem.

            If these incidents are statistically average, then the cost of Medicare Foul-Ups to senior citizens can be reasonably estimated.  Here are my calculations.

            If the average Medicare Foul-Up that is not fixed costs a senior citizen an extra $100 in charges that are wrongfully charged to the senior citizen, then the total cost to all senior citizens can be calculated this way.

            Our office handles 3 serious problems per day.  Our agency has about 5% of the senior citizen market in our congressional district.  So, 3 x 20 should equal 100% of average daily serious Medicare Foul-Ups in one congressional district.  There are 435 congressional districts.  So, there should be an average of 26,100 serious Medicare Foul-Ups per day in the U.S.  If each unresolved foul-up costs a senior citizen an average of $100 that the senior citizen would not have to pay if Medicare worked properly, then serious Medicare Foul-Ups are costing America's senior citizens $2,610,000 EVERY SINGLE DAY.  Multiply that figure by 365 and the annual costs to senior citizens for serious Medicare Foul-Ups is $952,650,000.  But, this is only for Medicare Part A and Part B problems.  Medicare Part D (prescription drugs) is another engine of Medicare Foul-Ups.  Also, because Medicare and VA clinics do not communicate well, each senior citizen veteran could be overcharged OVER ONE THOUSAND DOLLARS PER YEAR BECAUSE OF FOUL-UPS ON MEDICARE ANNUAL DEDUCTIBLE CALCULATIONS!

            Many insurance agencies do not have the ability to help their senior citizen clients to save money by correcting serious Medicare Foul-Ups.  So, those senior citizens are badgered with demands for payment of the wrongful bills until they pay them.

            If you believe that having the federal government handle all health care matters will solve problems, you just don't know the facts about how the federal government actually causes many problems that cost citizens and the health care system billions of dollars per year.  If you helped senior citizens with these problems as I do, you would understand what I mean.

Woodrow Wilcox

Northwest Indiana

Note: For other articles or videos by Woodrow Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

Note: This article was researched, written, and sent to newspapers in the fall of 2007.

Dear Editor or Publisher,

Please, publish the following article as a featured commentary in order to help senior citizen veterans in your area.

There is no charge to use this article.

HELPING SENIOR CITIZEN VETERANS

By Woodrow Wilcox

            Many senior citizen veterans are owed some money.  I want to help them get that money.  Are you one of those senior citizen veterans or do you know someone who is?

            Many senior citizen veterans who have a Medicare supplemental insurance policy have had to pay money to doctors and hospitals which they should not have had to pay.  I just learned how those veterans can get their money back.  But, first, I will explain the problem.

            When a veteran with a Medicare supplemental insurance policy uses a VA medical facility, the VA sends information to Medicare, then Medicare tells the VA what to charge and to which insurance company the bill should go.

            The insurance company gets the bill and pays on it.  But, Medicare does not remember the charge from VA.  So, when the veteran goes to a private doctor or hospital later, Medicare's calculations about the annual deductibles for Part A and Part B Medicare are different than the insurance company's calculations.  The difference puts the veteran in a "squeeze" financially. 

            The insurance company won't pay the deductible twice.  Medicare refuses to pay the doctor or hospital because it believes that the annual deductible has not been met yet.

Then, the doctor or hospital threatens to send the veteran's bill to a collection agency or attorney. 

So, the veteran pays the bill to avoid damage to his or her credit.  The veteran should not have to pay anything.  So far, our clients who have paid such amounts have been "out" of the money. 

This can force the veteran to pay the annual deductibles again even though the insurance company already paid the annual deductibles.  For this year, Medicare Part A deductible is $992 and Medicare Part B deductible is $131.  That means that each year, a veteran could be forced to pay up to $1,123 or more as deductibles increase.

            I felt that this was unfair.  So, for over six weeks, I have been calling VA offices to explain the problem and learn if there is a solution.  I got the solution that I am reporting from Barbara Mayerick who is the Director of Business Development of the Veterans Health Administration, Chief Business Office in Washington, D.C.

            Her office has been aware of the problem and has been working on an automated solution.  Until such a solution is in place and functioning properly, she asked me to give the following information to senior citizen veterans who have had to pay medical bills to protect their credit in the scenario that I have described.

            The veteran should take the bills that were paid to the VA medical center business office closest to the veteran.  According to Ms. Mayerick, a process is now in place for such a veteran to get reimbursement.  But, the reimbursement comes in a round about way.  The VA business office will arrange for a refund to the veteran's insurance company so that the insurance company can pay the doctor or hospital that was paid by the veteran.  The veteran should then be reimbursed by the doctor or hospital.

            Ms. Mayerick said that if a veteran tries that approach but does not get the problem resolved, the veteran could contact her office for assistance.  Her address follows below.  Good luck to all veterans who had to pay money to protect their credit.

                                    Ms. Barbara Mayerick

                                    Director of Business Development

                                    Veterans Health Administration

                                    Chief Business Office

                                    Mail Station 161

                                    810 Vermont Street, N.W.

                                    Washington, DC 20420

Note and update: Woodrow Wilcox is the Problem Resolution Officer at the largest senior citizen oriented insurance agency in the Midwest.  For updated articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, www.woodrowwilcox.tv.

MEDICARE DISALLOWED ANOTHER WOMAN'S TESTS

By Woodrow Wilcox

            A client of this insurance agency sent a bill from her doctor's office with a note to our office.  She wanted to know why her doctor's bill was not paid by her insurance.  The woman lives in Schererville, Indiana.

            About a month ago, another client had exactly the same problem.  Medicare disallowed the charges for a breast and pelvic exam and pap test which was ordered by her doctor.

            In each case, Medicare disallowed the claim.  Whenever Medicare disallows a claim, neither Medicare nor the Medicare supplement insurance will pay anything on the claim.  The senior citizen is stuck with the bill for the disallowed claim.

            Here is how I explained this to our client in a letter.

*****

            The bill for $132 was not paid by the insurance company because Medicare disallowed it.  When Medicare denies or disallows a claim, the Medicare supplement insurance policy will not pay on it because it is only a Medicare supplement policy.  Medicare must approve a charge before any Medicare supplement policy will pay.

            Medicare rules are changing.  You had a breast and pelvic exam and pap test which Medicare had approved in the past.  But, under Medicare's rules and regulations, you can get such medical services only within certain time periods.

            Probably, your medical services were performed outside the Medicare allowed time periods.

            In such a case, we want you to understand that neither our agency nor the insurance company had anything to do with this outcome.  The refusal to allow your claim was a decision solely by Medicare.

Note: Woodrow Wilcox is the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest.  For more Medicare related articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

Written on August 19,2009 by Woodrow Wilcox.

SENIOR CITIZEN PAID $400 TO PROTECT CREDIT FROM MEDICARE GOOF

By Woodrow Wilcox

            A client of this insurance agency who purchased a Medicare supplement insurance policy contacted our office for help with a medical bill.  The client is from Crown Point, Indiana.

            The client paid the balance of a bill from a local hospital to protect her credit.  Then, she sent us the bill and a copy of her cashed check showing that the balance was paid.  She wanted to know why Medicare and her Medicare supplement insurance policy had not paid the entire bill.

            I checked with her insurance company.  The claim that Medicare sent the insurance company for the charges at the hospital DID NOT MATCH the bill from the hospital.  The dates and the amounts were different.

            The hospital bill showed dates of service 04/03/09 to 04/04/09.  The claim that the insurance company got from Medicare showed dates of service 04/02/09 to 04/04/09.  The hospital bill showed a total amount of $10,854.70.  The claim that the insurance company got from Medicare showed a total of $10,619.70.  If the hospital filed an amended claim, the insurance company did not get an adjusted Medicare Explanation Of Benefits.

            People who believe that the federal government can run the nation's health care better need to learn that mistakes by Medicare and the federally run VA clinic system cost senior citizens billions of dollars per year in wrongful medical bills. 

            If the federal government takes over all health care, everyone will experience the same kinds of problems that senior citizens now have with federal health care systems.

Note: Woodrow Wilcox is the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest.  For more articles or videos by Wilcox, visit www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

Written on July 29, 2009 by Woodrow Wilcox.

WHY TOWN HALL VOTERS WERE ANGRY

By Woodrow Wilcox

            Obama and his allies criticized citizens who became upset and angry at recent town hall meetings about the health care reform bill.  The promoters of the health care reform bill called the angry voters all kinds of names.

            But, the news media missed the reason for the anger and hostility.  Many voters came to town hall meetings to discuss the health care reform bill with their respective Congressman or Senator.  Many of the citizens came more prepared than the elected representatives.

            At some town hall meetings, it became obvious that the elected official had not done the homework.  Arlen Specter was honest enough to admit that he had not read the bill.  When the elected official would give responses which proved that the elected official was ignorant about what was in the bill, voters became upset.  Participating town hall citizens knew that the elected representative was either ignorant or lying to them.

            How would you react if your elected official tried to tell you that you were wrong and tried to "sell" you some talking points that were false when you had read the bill?  I'll guess that you would be upset.  That is how the voters became upset.  Their elected representatives agitated the voters.

Written on August 19, 2009 by Woodrow Wilcox

Find articles and videos by Woodrow Wilcox at www.medicareproblems.net, www.woodrowwilcox.com, and www.woodrowwilcox.tv.

HEALTH CARE REFORM BILL IS BAD MEDICINE FOR SENIORS

By Woodrow Wilcox

            I got an email about a letter from a doctor in central Indiana to Senator Evan Bayh.  I wanted to make sure that there really is such a doctor and that he really did send a letter to Senator Bayh about the health care reform bill that is being discussed.

            Yes, America, there really is a Stephen E. Fraser, M.D.  He really did read the entire health care reform bill.  He really did write a lengthy and detailed letter to Senator Evan Bayh in which he stated his concerns and objections to the bill.

            I have posted the entire and unedited letter of Doctor Fraser at my website www.medicareproblems.net.  You can read it and compare it to the health care reform bill because his letter gives every citation that you need to check his findings.

            From what I read, the health care reform bill is "heap big bad medicine".  But, it is especially bad medicine for senior citizens, handicapped or disabled people, and political dissidents that a government official might want to label as "crazy" in order to send them to a "funny farm" or "re-education camp".

            Following is just two parts of Dr. Fraser's letter to Senator Bayh which deal with SENIOR CITIZEN ISSUES.

*****

My source for HR3200 is from the energycommerce website.  The link is http://energycommerce.house.gov/Press_111/20090714/aahca.pdf.

Dear Senator Bayh,

As a practicing physician, I have major concerns with the
health care bill (HR 3200) before Congress.  I spent the
last week reading this bill, which at over 1000 pages is
quite difficult to get through.  Have you read it? I'm
shocked by the brazenness of the government's intrusion into
the patient-physician relationship.  I'm especially
concerned about the creation of a central committee to
decide medical coverage decisions.   

*****

SECTION 1233 ADVANCE CARE PLANNING CONSULTATION (pages
424-431)
 
Page 425 Lines 22-25, 426 Lines 1-3: Government provides approved
list of end of life resources.  Government MANDATES program for orders for end of life every 5 years. The Government decides it should be involved in end of life care.
 
Page 428 Lines 17-25: Additional advanced care planning consultations
will be used frequently as patients health deteriorates.
 
Page 429 Lines 1-3: "advanced care consultation" may
include an ORDER for end of life plans.
 
Page 429 Lines 13-25: The Government will specify which Doctors or other individuals can write an end of life order.
 
Page 431-2  The Government mandates that "quality measures on end of life care" be measured and reported. 

*****

            Obama and other promoters of the health care reform bill claim that there is nothing in the bill to cause alarm and that critics of the bill are spreading disinformation.  Really?  Doctor Fraser is citing sections, paragraphs, and sentences of the bill.  Obama is giving "talking points".  Which one is more likely to be spreading disinformation?

            I challenge you to read the bill or at least Doctor Fraser's letter.  Then, decide for yourself.  Do you trust Obama or Doctor Fraser?

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  For more health care articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

MEDICARE DID NOT SEND THE CLAIM

By Woodrow Wilcox

            A client of this insurance agency sent a Medicare Summary Notice to our office.  She wanted to know why her insurance company had not paid on a claim.  The client is from Saint John, Indiana.  I helped her.

            I phoned the insurance company.  Medicare never sent the claim to the insurance company.  The client has an excellent Medicare supplement insurance policy with an excellent insurance company.  But, insurance companies don't pay claims that they never get.  In this case, Medicare failed to send the claim to the insurance company.

            I arranged for the insurance company to get the legally necessary information so that it could process and pay on the claim.  This insurance agency helps senior citizen clients with such problems AT NO CHARGE.  In this case, we saved the client $88.38 and some hassle and stress.

            Medicare makes mistakes like this all the time.  It doesn't send the claim to an insurance company or to the correct insurance company, etc.  If the insurance company does not get the claim from Medicare, it can not and will not pay anything.  When that happens, people at collection departments, collection agencies, and collection attorney offices harass senior citizens for bills that would have been paid by insurance companies if Medicare worked properly. 

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  It has thousands of clients.  Wilcox has saved clients of that firm over $600,000 in wrongful claims that were caused by Medicare mistakes.  To read more articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

MEDICARE CHEATED GARY WOMAN

By Woodrow Wilcox

            An elderly woman who is a client of this insurance agency brought two unpaid bills to our office for our review and help.  The client is from the Miller part of Gary, Indiana.  I helped her.

            After I copied and reviewed the bills, I contacted the client's insurance company.  I learned that Medicare had gummed up the bill processing.

            For one bill from a Chicago hospital, Medicare never sent anything about the claim to our client's insurance company.  For a different bill from a local hospital, Medicare failed to send one of the two key documents that every Medicare supplement insurance company needs to process a claim.

            On behalf of our client, I wrote letters to the two hospitals and requested that each forward to our client's insurance company the documents that it needs to process and pay on the claims.

            This insurance agency provides this kind of medical bill problem solving service to our clients AT NO CHARGE.  Does your insurance agent or agency provide the same level of service?

            Problems like these occur all the time with Medicare.  In past articles, I have estimated that medical bill problems caused by Medicare cost America's senior citizens over one billion dollars per year.  If a national health care system that is modeled on Medicare is started, then everyone will have these kinds of medical bill problems that are caused by federal bureaucracies and systems that don't really work.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  To read more MEDICARE PROBLEMS articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

Letter To Editor

NANCY PELOSI IS REALLY "NAZI" PELOSI

            Speaker of the House Nancy Pelosi is calling opponents of the health care reform bill "Nazis".  She is applying that term to the wrong people.  She needs a history lesson.

            "Nazi" is the German abbreviation for a member of the NATIONAL SOCIALIST GERMAN WORKERS PARTY which was lead by Adolph Hitler.  NATIONAL SOCIALISM was a fundamental belief and principle of Adolph Hitler and the "Nazis".

            The health care reform bill is a NATIONAL SOCIALIST bill.  So, it rightfully can be termed the Nazi health care reform bill.

            Also, an old principle is that if something waddles, quacks, and swims like a duck, it probably is a duck.  That principle can be applied to Nancy Pelosi.

            Earlier this year, Nancy Pelosi ordered all the Democrats in the House of Representatives to vote for the economic stimulus bill without first reading it.  That is very Nazi-like.  Most of the Democrats were obedient to their leader in a goose-stepping, unquestioning, unthinking Nazi-like way.  So, Nancy Pelosi and most Democrats in the House waddle, quack, and swim like Nazis.

            So, Nancy Pelosi now should be called "Nazi" Pelosi.  The term fits her perfectly.

Woodrow Wilcox

Griffith, Indiana

HOW MEDICARE CHEATS SENIOR CITIZENS

By Woodrow Wilcox

            I just helped a couple from Lake Station, Indiana.  Each of them had a medical bill problem caused by Medicare.  The husband was born in 1926 and the wife was born in 1929.

            In the husband's case, the original bill amount from a local hospital was for $$2,643.  But, Medicare reported a total original bill of only $1,610.  The client's insurance company promptly paid the balance of $109.61 on the bill for $1,610.  But, the hospital wanted a balance of $155.84 on an original bill of $2,643.

            The insurance company received no other claims for the same date of service.  So, the most likely thing that happened was that Medicare failed to calculate or send the complete bill with all charges to the insurance company.  This could have been caused by a human error involving a distraction and mistake, or it could have been caused by a loss of data in the sending of electronic data via telephone lines and satellite communications.

            In either case, if the problem with the bill is not fixed, the senior citizen on Medicare gets hounded by collection departments, collection agencies, and collection attorneys until the senior citizen pays a bill that never would have come to the senior citizen if Medicare worked well.

            In the wife's case, Medicare sent the bill to the client's old insurance company instead of to the client's current insurance company.  I guess that the folks at Medicare have some catching up to do.  The client switched insurance companies on October 1, 2008.  The client visited the hospital and incurred the bill on April 29, 2009.  I'm writing a letter to the hospital to help fix the billing problem on August 10, 2009.  Yep.  I'd say that the folks at Medicare are a bit behind on updating their records of which claims go to which insurance companies.

            In past articles, I have given my calculations for my belief that medical bill problems that are caused by mistakes at Medicare cost America's senior citizens over one billion dollars per year in wrongful charges.

            If Obama and his allies in Congress force a new nationwide government health care system on all of us, then all of us will experience the type of medical bill problems which senior citizens have suffered under Medicare for years.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  To read more articles on Medicare Problems by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

FEDERAL MEDICARE BUREUCRATS REFUSED TO PAY BILL

By Woodrow Wilcox

            The federal Medicare system refused to pay for a senior citizen's pelvic and breast exam and pap smear.

            A client of this insurance agency brought this to my attention.  The client is from Munster, Indiana.

            Her doctor wanted her to get these tests done.  But, Medicare rules and regulations dictate when a senior citizen can and can not have these tests and expect Medicare to cover them.

            In the case with our client from Munster, she needed the medical tests at a time that the federal Medicare system would not allow.  So, she must pay the bill for these tests because the federal government's Medicare system won't.

            If Obama and his allies in Congress create a new federal system of health care modeled on the Medicare system, then everyone in America can expect federal rules and regulations to dictate when they can or can not get medical services.

            For over six years, I have helped senior citizens with Medicare problems and have written articles on problems with the Medicare system.  I have saved senior citizens over $600,000 in wrongful charges that were caused by Medicare mistakes.  Many of my articles are posted at www.medicareproblems.net.  I challenge people to visit the website and learn what kind of problems everyone will be facing if Obama and his allies succeed in forcing on everyone a health care system modeled after Medicare.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  To read other articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

SAVED WIDOW ALMOST $400

By Woodrow Wilcox

            A few weeks ago, the widow of one of our recently deceased clients drove fifty miles one way to ask me to help with a bill that was not paid by her late husband's Medicare supplement insurance policy.

            I reviewed the papers that she had and realized that the MEDICARE SUMMARY NOTICE which pertained to the unpaid bill was absent.  She assured me that she had brought all the papers that she had regarding the bills generated during her late husband's last few days alive.

            Here is the problem that I pinpointed.  If the widow did not get the MEDICARE SUMMARY NOTICE from Medicare, then it is very likely that the insurance company that issued a Medicare supplement policy to the widow's late husband DID NOT GET THE MEDICARE "EOB" THAT IT NEEDED TO PAY THE CLAIM.  You can't blame an insurance company for not paying a bill that Medicare failed to send it.

            The hospital was hounding the widow for payment of a balance of $392.45.  The widow was worried.  She was struggling financially after the death of her husband.  She needed help and we helped her.

To solve this problem, I had the widow sign a letter to Medicare which I typed for her.  The letter advised Medicare that she had not received a Medicare Summary Notice regarding the DATES OF SERVICE given on the hospital bill.  The letter requested a duplicate copy of any "M.S.N." form for those dates.

The letter worked.  Medicare sent the Medicare Summary Notice to the widow and the Medicare "EOB" to the insurance company.  The insurance company promptly paid the bill once it received the information that it needed to legally pay the claim.

This service saved the widow almost $400 and a lot of stress.  This insurance agency provides this kind of help to our senior citizen clients at no charge.

This sort of problem is common with Medicare.  Many senior citizens throughout the country need this kind of help.  When they don't get it, they end up paying bills that they don't really owe.  That is one of the problems with Medicare.  In other articles, I have estimated that Medicare's shortcomings cost senior citizens several billion dollars per year in "wrongful charges".  By "wrongful charges", I mean bills that would not come to seniors if Medicare worked well.  To read other articles about Medicare, visit www.medicareproblems.net.

Note: Woodrow Wilcox is the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest located in Merrillville, Indiana.

Written on May 27, 2009.

GOVERNMENT HEALTH CARE PROMOTES FRAUD

By Woodrow Wilcox

            On Wednesday, August 5, 2009, I got a phone call from a very upset senior citizen who is a client of our insurance agency.  He wanted to know how to report MEDICARE FRAUD by a local medical service provider.  The client is from Munster, Indiana.

            The client's wife dropped something on her foot.  He took her to a local medical service provider.  An x-ray of the wife's foot revealed that nothing was broken.

            A few days later, the client and his wife got a bill from the medical service provider which included a charge for a chest x-ray.  The client and his wife contacted the medical service provider to ask about the charge for the chest x-ray.

The medical service provider's representative insisted that a chest x-ray was ordered and done and that the couple owed for it.  The couple asked which doctor ordered the chest x-ray.  They got no response.  The couple refused to pay for the chest x-ray.  The medical service provider's representative threatened to sue the couple to force payment for the chest x-ray.

A few weeks later, the couple got a MEDICARE SUMMARY NOTICE which showed that the medical service provider had submitted the chest x-ray charge to Medicare and that Medicare had paid for the false charge.

Because I write a column about Medicare and VA clinic billing problems, I get tips from around the country.  One tip came from a computer expert in California who worked for a company that did billing services for medical service providers who bill California's MEDICAL system. 

He noticed a pattern of questionable or clearly fraudulent charges.  He developed a program to spot such charges.  In one seven month period that he tested, he found over TWO MILLION DOLLARS of questionable or fraudulent charges.  Probably, there are a few thousand billing services in California like the one where the computer expert works.  If California is paying about FOUR MILLION DOLLARS per year times 3,000 such billing services, then California taxpayers are paying TWELVE BILLION DOLLARS PER YEAR IN FRAUDULENT MEDICAL CLAIMS.

            Aren't government run health care programs wonderful and sensible?  (Of course, this is a sarcastic comment!)

SAVED CLIENT $1,068

By Woodrow Wilcox

            One of the senior citizen clients of this insurance agency got a "FINAL DEMAND" letter for $1,068 from a local hospital.  The client sent the letter to me and asked for help.  The client is a woman who lives in Cedar Lake, Indiana.

            I checked with the client's insurance company.  Medicare never sent the claim to the insurance company.  You can't blame an insurance company for not paying a bill that Medicare never sent to it.

            This sort of thing happens all the time.  It does not happen just to senior citizens in this area.  It happens to senior citizens all over the nation.  If no one helps the senior citizens who get these demand letters, then errors and mistakes caused by government employees at the federally run Medicare and VA health systems result in senior citizens around our country being cheated of billions of dollars.

            In past articles, I have estimated that medical bill errors related to Medicare Part A and Part B and caused by Medicare goofs cost senior citizens over a billion dollars per year.  More billions of dollars of errors are caused by other parts of Medicare and VA clinics.  Read my articles and check my calculations at www.medicareproblems.net.

            To correct this problem, I sent a letter to the patient accounts department of the hospital with the following basic language.  Of course, I checked with the client's insurance company before sending such a letter.

Dear Patient Accounts Staff,

            This letter concerns a "Final Demand" letter from your firm dated July 5, 2009 regarding DATE OF SERVICE 02/11/2009 with a balance of $1068.

            Our client's insurance company never received this claim from Medicare.  The insurance company did receive a different claim for $300 with the same date of service and paid that claim promptly.  But, the claim that you cite was not forwarded by Medicare.  The balance appears to be the Medicare Part A deductible.  Our client's policy with the insurance company does pay the Medicare Part A deductible.

            To correct this error caused by Medicare, please, send the original billing information and the Medicare EOB that you have regarding this claim to our client's insurance company for processing.  Here is the contact information.

            After giving the contact information, I thanked the hospital personnel for their cooperation to fix the problem.

            My work took a little time.  And it saved our client $1,068 and much stress and worry.  This insurance agency never charges clients for helping with this service.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  To read other articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

MEDICARE DIDN'T FORWARD BILLS TO INSURANCE COMPANY - AGAIN

By Woodrow Wilcox

            A senior citizen client of this insurance agency sent bills to our office and asked that we check on why his Medicare supplement insurance policy had not paid on the bills.  The client is from Lake Station, Indiana.

            I checked on the matter for our client.  It was the usual problem.  The insurance company never paid the claims because Medicare never sent the claims to the insurance company.  You can't blame an insurance company for not paying claims that it never got from Medicare.

            How much were those claims?  Well, two claims were from a hospital and one claim was from an x-ray service.  The three claims had total original charges of $5,283.

            Medicare paid its share of these claims, but never forwarded the claim information to the client's insurance company so that it could pay its share of the bill.

            That's why the hospital and the x-ray service sent bills to our client.  Medicare never forwarded the claims to the insurance company.  So, the insurance company never paid the claims that it never got.  So, the hospital and the x-ray service wanted our senior citizen client to pay the portion that his insurance company should have paid.

            This sort of problem happens often all over the nation.  If a senior citizen gets such a "false" or "wrongful" bill and does not get help from anyone to fix the problem, then the senior citizen gets "stuck" with the wrongful bill because someone working for Medicare messed up.

            In past articles, I have given my calculations for why I believe that the "false" and "wrongful" bills caused by Medicare's mistakes are costing senior citizens billions of dollars per year.  Read the articles at www.medicareproblems.net and check my calculations.

            I sent letters to the hospital and the x-ray service which requested that each send certain information to the insurance company to get the claims paid for our client.  My service to our client was free.  This insurance agency never charges clients for such assistance.

Note: Woodrow Wilcox is the senior medical bill problem solver with Senior Care Insurance Services which is in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  To read more articles by Wilcox, visit www.medicareproblems.net and www.woodrowwilcox.com.

MEDICARE GOOFED AGAIN!

By Woodrow Wilcox

            A client of this insurance agency sent a bill to our office and asked why his insurance company had not paid the bill.  The client is from Cedar Lake, Indiana.

            I reviewed the bill from a local hospital and contacted the insurance company.  Of the eight charges and dates on the bill, Medicare sent only one charge and date to the insurance company.  The insurance company paid on the claim that it got and did not pay on claims that it did not get from Medicare.  You can't blame an insurance company for not paying on a bill that Medicare never sent to it.

            So, for the client, I wrote a letter that explained this.  I requested that the hospital send the information needed to the insurance company so that the claims could be processed.  The seven charges on seven dates of service totaled $1,149.  That is what our client would have had to pay if neither Medicare nor the Medicare supplement insurance company had paid on the bill for these seven charges.

            This sort of problem happens regularly with Medicare.  Medicare is not a perfectly run federal government program.  It has many problems.  If the federal government starts a new health care system modeled on Medicare, millions of Americans will start to experience the problems which senior citizens and veterans now have with Medicare and the VA health system.

            In some of the articles that I wrote in the past, I gave my calculations for estimating that senior citizens are cheated by over one billion dollars per year because of medical bill problems caused by just Medicare Part A and Part B alone.  More problems caused by Medicare Part C, Medicare Part D, and the Medicare - VA combination cost senior citizens billions more dollars in wrongful charges.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  To read more articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

MEDICARE OVER A YEAR BEHIND

By Woodrow Wilcox

            A senior citizen client of this insurance agency sent the papers that she had and asked why her Medicare supplement insurance company was not paying the bills.  The client lives in Lowell, Indiana.

            I reviewed the papers and realized that Medicare caused the problem by being over a year behind in its record keeping.  Our client's insurance company did not pay a bill because Medicare was still sending bills to an old insurance company that the client had not used for over a year.

            Our client's new Medicare supplement insurance became effective on February 1, 2008.  On May 19, 2009, Medicare printed and sent a Medicare Summary Notice to our client which stated that the claim information was sent to the old insurance company as though it were her current insurance company.

            You can't blame the new insurance company for not paying a bill that Medicare never forwarded to it.  Using the papers that our client presented, I typed a letter for the client to sign for forwarding the necessary documents to the correct insurance company. 

            This sort of mistake is very typical of Medicare.  For over six years, I have helped senior citizens to fix such problems and cancel over $600,000 of "wrongful" charges that were caused by mistakes and errors of the federally run Medicare and VA health systems.

            If the federal government creates a new national health care system that is modeled on Medicare, many more people will suffer financial harm due to poorly organized and managed federal agency bureaucrats and systems.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  To read other articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

MEDICARE REFUSED TO PAY BILL

By Woodrow Wilcox

            A client sent an unpaid bill to this insurance agency and asked us to check why the bill had not been paid by the client's insurance company.  The client is from Munster, Indiana.

            I checked with the client's insurance company and learned that MEDICARE DID NOT APPROVE THE BILL.  So, the insurance company did not pay anything because the policy sold to the client is a MEDICARE SUPPLEMENT INSURANCE POLICY.  Medicare must process and approve charges before the insurance company is obligated to pay anything.

            Why would Medicare not approve charges for medical laboratory tests for a senior citizen on Medicare?  There are several possible reasons.

            The doctor who requested the laboratory tests for the patient or the laboratory may have made a mistake in the notes or not given enough information  in notes to explain a medical need for the tests.  There may be other possible reasons, too.

            I wrote to our client to explain that I need a copy of the MEDICARE SUMMARY NOTICE which pertains to the unpaid bill.  Medicare is supposed to send a MEDICARE SUMMARY NOTICE to a patient to explain how Medicare treated the charges.

            If Medicare does not approve a charge, neither Medicare nor a Medicare supplement insurance policy will pay on such charges.

            So, every senior citizen on Medicare should save every bill and every Medicare Summary Notice at least long enough to make sure that the bills are paid.  Our client from Munster did not send to me a Medicare Summary Notice with the unpaid bill.  Until I get that and review it, I can't help the client further with the unpaid bill.

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services, Inc. in Merrillville, Indiana.  That is the largest senior citizen oriented insurance agency in the Midwest.  To read more Medicare articles by Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

ASKING MEDICARE A QUESTION CAN BE AN ORDEAL

By Woodrow Wilcox

            I was helping a widow when I had a question for Medicare.  Getting an answer was an adventure.  Here is my adventure.

            The widow's husband was transported by an ambulance service from a hospital in Indiana to a hospice in Indiana before he passed away.

            The widow got a bill for this service.  I checked and learned ...

HELPED VALPO CLIENT WITH BILLS

By Woodrow Wilcox

            A senior citizen client of this insurance agency had a problem with three bills that he said his insurance company was not paying.  His agent delivered some papers to me and asked me to check on it.  I did.

            One of the bills was five years old.  I wasn't sure that the man was our client at that time.  So, I wrote to the agent and the man to determine that.  If he was not our client at the time the bill was generated, I can't help him on that bill.

            But, I did work on the other bills for the man.  I checked with his insurance company and got a surprise.

            One bill had not been received from Medicare at all.  So, I contacted the hospital which sent that bill and asked their staff to send certain critical information to the client's insurance company so that the claim could be processed.

            The other bill had the surprise.  Medicare reported the claim with the same date, same original charges, and the exact same medical services except for one thing.  The medical service provider was different.

            That meant one of two things: either (1) the man got the same services on the same day at a different place, or (2) Medicare reported the claim incorrectly to the man's insurance company.

            The insurance company had already paid the claim to the medical service provider that Medicare listed on the claim which it sent to the insurance company.

            To get this problem fixed, I requested the billing medical service provider to send some critical information that it had on this claim to our client's insurance company.  Once that information is shared with the insurance company's claims department, the problem should be spotted and fixed.

            Helping senior citizen clients of this insurance agency with Medicare and VA medical billing problems is something that this agency does without charge.  Does your insurance agent provide this kind of service at no charge?

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  To read more articles by Woodrow Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

Written on May 29, 2009.

HELPING CLIENT WITH UNEXPECTED $966.66 BILL

By Woodrow Wilcox

            A client of this insurance agency got an unexpected bill for $966.66 and came to me for help.  Of course, I helped him.

            The client had gone to a local hospital.  He was treated in the emergency room (ER) for four hours and then admitted to the hospital for three days.

            But, the recording of the admittance was not done properly and the coding of the services was incorrect because of that.  The result was that a claim with incorrect information was submitted by the hospital to Medicare.  That caused the client to get a $966.66 bill that never should have been sent to the client.

            Medicare relies on doctors and hospitals for accurate information.  When inaccurate or incomplete information is submitted to Medicare, all the calculations are skewed.  In this case, there was a big difference between getting medications while under observation in the emergency room and getting medications as a patient admitted to the hospital.

            Medicare does not cover everything.  Whether a medical service is or is not covered is a matter of the facts and the policies and regulations of Medicare.  In this case, there is a difference between medicines received as an "in patient" or an "out patient".  Here is another critical question.  Is a medical service or device provided under Medicare Part A, Medicare Part B, or Medicare Part D?  The federal government has different rules and regulations in each case.

            To help the client, I wrote a polite letter to the doctor and hospital.  In the letter, I explained the situation and asked for their cooperation to correct the records, recode the services, and resubmit the claim to Medicare for a new calculation of Medicare benefits.

            This insurance agency assists senior citizen clients with medical bill problems like this at no charge.  Does your insurance agent give the same level of service?

Note: Woodrow Wilcox is the senior medical bill problem solver at Senior Care Insurance Services in Merrillville, Indiana.  That agency is the largest senior citizen oriented insurance agency in the Midwest.  To read more Medicare articles by Woodrow Wilcox, visit www.medicareproblems.net or www.woodrowwilcox.com.

Written on June 11, 2009

Protecting a Client from a Big Bill

By Woodrow Wilcox

            Medicare changed its mind on a claim.  I'm fighting to fix the Medicare mess up to save our client $1,068.

            On November 13/14, 2008, a client of this insurance agency stayed overnight in a hospital in Lake County, Indiana.  Medicare ruled that it was an overnight hospital stay covered by Medicare Part A.  Medicare advised our client's insurance company of the claim and the insurance company paid the claim accordingly.

            Then, while visiting Florida during the winter, the client stayed in a hospital from January 5 to January 13, 2009.  Medicare ruled that this was an overnight hospital stay covered by Medicare Part A.

            Then, Medicare changed its mind about the "overnight" stay at a hospital in Indiana.  Medicare reconsidered and revised its ruling so that the "overnight" stay at a hospital in Indiana was no longer an "overnight" stay covered by Medicare Part A.

            There are special rules governing the coverage and calculations when a Medicare enrolled patient has two hospital stays within a 60 day period.  The revised ruling of Medicare really gummed up the works for our client, the client's insurance company, a hospital in Indiana, a hospital in Florida, this insurance agency, and ESPECIALLY ME because I have really had to work at fixing this MEDICARE MESS-UP.  This Medicare Mess-Up could cost the client $1,068.

            This is one of the more complicated Medicare Mess-Ups that I have had to work to solve.  A senior citizen who can't read or hear as well as in the past would have a very difficult time trying to fix this Medicare Mess-Up.  Because the client uses this insurance agency, we provide help with this at no charge.  There is a real need to help senior citizens to fix Medicare Mess-Ups.

            In past articles, I have calculated that Medicare Mess-Ups on Medicare Part A and Part B cost America's senior citizens over ONE BILLION DOLLARS PER YEAR in "wrongful charges".  By "wrongful charges", I mean medical bills that would never be sent to the senior citizens if Medicare worked properly.  Medicare Part C, Medicare Part D, and Medicare-VA claims cause more "wrongful charges" to go to seniors.

            Wouldn't it be nice if the Medicare and VA medical systems were fixed and senior citizens saved a few billion dollars that they could spend on things that they need?

Note: Woodrow Wilcox is the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest.  To read more Medicare articles by him, visit www.medicareproblems.net.

PROBLEMS WITH MEDICARE FOR SENIORS

PREDICT PROBLEMS FOR EVERYONE WITH

OBAMA'S NATIONAL HEALTH CARE PLAN

By Woodrow Wilcox

            Obama and some in Congress are pushing plans for a national health care system.  They believe that the federal government can do a good job of managing health care for everyone.  I DISAGREE.

            For over six years, I have helped senior citizens with Medicare and VA billing problems.  I have written many articles about this.  You can read some of the articles by visiting www.medicareproblems.net or www.woodrowwilcox.com.

            I am the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest.  The office is in a suburb of Chicago.  We have thousands of senior citizen clients.  I have saved our clients hundreds of thousands of dollars.  One widow started getting bills for over $9,000 after her husband's death.  Medicare was messing up the billing process.  I fixed it and the bills disappeared.  That client talks about that problem in a video clip on my website.

            Here is a typical problem that I solved for one client in July 2008.  A hospital in Chicago was demanding about $100 more from the senior citizen.  I reviewed the papers that the client had and phoned the insurance company.

            For one of the dates of service in question, Medicare reported a bill of only $686 to the insurance company when the bill was really $1,187.  I requested that the hospital send the information that it got from Medicare to the insurance company.  That fixed the problem.  Then, I started to wonder how much Medicare Foul-Ups cost senior citizens throughout America.

            On an average day, I handle three serious and multiple minor problems caused by Medicare Foul-Ups.  On July 15, 2008, I handled three serious Medicare Foul-Ups that prompted me to write an article on the subject that day.

            The three serious problems for three different clients on that day were  (1) Medicare failed to send the essential billing information to the correct insurance company for payment; (2) Medicare sent conflicting reports on medical charges to the doctor's office and to the patient's insurance company; (3) the Veterans Administration did not send the necessary information to a client's insurance company for payment processing and VA officials were obstinate and did not want to cooperate with solving the problem.

            If these incidents are statistically average, then the cost of Medicare Foul-Ups to senior citizens can be reasonably estimated.  Here are my calculations.

            If the average Medicare Foul-Up that is not fixed costs a senior citizen an extra $100 in charges that are wrongfully charged to the senior citizen, then the total cost to all senior citizens can be calculated this way.

            Our office handles 3 serious problems per day.  Our agency has about 5% of the senior citizen market in our congressional district.  So, 3 x 20 should equal 100% of average daily serious Medicare Foul-Ups in one congressional district.  There are 435 congressional districts.  So, there should be an average of 26,100 serious Medicare Foul-Ups per day in the U.S.  If each unresolved foul-up costs a senior citizen an average of $100 that the senior citizen would not have to pay if Medicare worked properly, then serious Medicare Foul-Ups are costing America's senior citizens $2,610,000 EVERY SINGLE DAY.  Multiply that figure by 365 and the annual costs to senior citizens for serious Medicare Foul-Ups is $952,650,000.  But, this is only for Medicare Part A and Part B problems.  Medicare Part D (prescription drugs) is another engine of Medicare Foul-Ups.  Also, because Medicare and VA clinics do not communicate well, each senior citizen veteran could be overcharged OVER ONE THOUSAND DOLLARS PER YEAR BECAUSE OF FOUL-UPS ON MEDICARE ANNUAL DEDUCTIBLE CALCULATIONS!

            Many insurance agencies do not have the ability to help their senior citizen clients to save money by correcting serious Medicare Foul-Ups.  So, those senior citizens are badgered with demands for payment of the wrongful bills until they pay them.

            If you believe that having the federal government handle all health care matters will solve problems, you just don't know the facts about how the federal government actually causes many problems that cost citizens and the health care system billions of dollars per year.  If you helped senior citizens with these problems as I do, you would understand what I mean.

NEWS RELEASE:  FOR IMMEDIATE USE

Re: SENIOR CITIZENS, VETERANS, U.S. SENATORS, MEDICARE, VA

Recently, I sent the following letter to every current U.S. Senator. 

Visit www.medicareproblems.net to understand this issue.

Dear Senator,                                                             

I'm sure that you care about senior citizens and veterans of your state.  Right?

I'm sure that if you knew that senior citizens and veterans had a problem, you'd want to help to solve it.  Right?

Well, senior citizens and veterans are being harmed by the federal government through the Medicare system and the VA health system.

I estimate that the harm is costing senior citizens and veterans billions of dollars.

Why do I say that?

For over six years, I have helped senior citizens and veterans with Medicare and VA medical bill problems. 

For over six years, I have written articles on my time and at my expense to help as many senior citizens and veterans as I could.

Bureaucrats and lobbyists in Washington may have told you that everything is fine with Medicare and the VA health systems.  That's just not true.

I challenge you to open your mind and learn about these systems where "the rubber meets the road".

That's where I work.  I am the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest.  Almost 100 of the articles that I have written on Medicare and VA medical bill problems are posted at my blog website www.medicareproblems.net.

These articles are among those that I have sent to newspapers and publications for over six years.  I challenge everyone who is debating nationalized health care to read the articles at www.medicareproblems.net.

We should not be considering an expansion of the federal government's responsibility in health care until we fix the problems that have been created by the federal government's poor performance and lack of responsibility toward our senior citizens and veterans.

Senior citizens and veterans are now suffering billions of dollars in wrongful charges because the federal government can't run these systems well.  Don't you want to help the senior citizens and veterans of your state and all over our nation?

NEW WEBSITE www.medicareproblems.net HONORS AND HELPS SENIORS

By Woodrow Wilcox

            For over six years, I have helped senior citizens with Medicare and VA billing problems.  That was part of my job.  I am the senior medical bill problem solver at the largest senior citizen oriented insurance agency in the Midwest. 

            But, on my own time, I started writing articles about Medicare and VA billing problems which I hoped would build awareness of the problems that are costing senior citizens BILLIONS OF DOLLARS EVERY YEAR IN "WRONGFUL CHARGES".

            By "wrongful charges", I mean medical bills that would never be sent to a senior citizen if Medicare and VA billing systems really worked well.

            Here is an excerpt from an email that I got from a senior citizen veteran who is a client of the insurance agency and contacted me for help:

            "I am contacting you with regard to my co-insurer Mutual of Omaha and the Veterans Administration billing department.  Essentially, for the longest time (perhaps years) the VA failed to bill my co-insurer.  Their record keeping system must be a mess because time after time I provided them information which apparently they did not document.  The result was that I paid the charges."

            A conversation with Star Parker prompted me to consider writing an article on Medicare and VA medical billing problems that would be especially helpful to African Americans.  Star Parker is the President of the Coalition for Urban Renewal & Education - "C.U.R.E." (www.urbancure.org).  The article "HELPING AFRICAN AMERICANS WITH MEDICARE AND VA BILLING PROBLEMS" is at www.medicareproblems.net.

            Recently, I was a guest on the "Chicago Overnight Show with Geoff Pinkus" on AM 560 WIND in Chicago (www.geoffpinkus.com).  On the program, I said that I could teach what I do to others who want to help senior citizens to save money by getting Medicare and VA billing problems corrected.  You won't get rich from it, but you'll meet and help some great people in the process.  I urged unemployed journalists, unemployed new college graduates, worship leaders, insurance agents or administrators, and others to learn how to help senior citizens in this important matter. 

            I challenge everyone who is concerned about health care and medical billing problems to visit www.medicareproblems.net and learn about the problems and decide if this is work that you would like to do.  Who knows - helping the senior citizens in your community to save money may just help you, your community, and your future opportunities.

NATIONALIZED HEALTH CARE WOULD BE A DISASTER - JUST LOOK AT HOW THE FEDERAL GOVERNMENT HARMS SENIORS AND VETERANS!

By Woodrow Wilcox

            For years I have written articles that warned people about the dangers of having the federal government run the nation's health care system.  If that happens, the federal government will treat everyone as badly as the federal government has treated senior citizens and veterans for years.

            For years, I have told people about the mistakes, the frauds, and the breakdowns of the health care systems that are run by the federal government - Medicare and the VA medical service.

            For years, I have told people about the communication errors between Medicare and the VA, and between Medicare and insurance companies and medical service providers which cost senior citizens lots of money.  In past articles I have explained my calculations which lead to estimates of loss to our senior citizens in the BILLIONS OF DOLLARS PER YEAR.

            Today, (May 19, 2009), I got an email from a veteran which highlights one of the many problems in federal healthcare systems that are run by federal bureaucrats.  In this man's case, the billing system of the VA failed to advise Medicare and the man's Medicare supplement insurance company of charges for services to the veteran.  Claims must be filed within 15 months to Medicare.  When the claims are not filed properly and in a timely manner, neither Medicare nor the Medicare supplement insurance company will pay.  That leaves the veteran paying bills that the veteran should not have to pay.

            In past articles, I have warned that this failure of the Medicare - VA system has the potential to cost every senior citizen veteran over one thousand dollars per year.  Below this paragraph, without identification of the author, is an excerpt from the email that I got from a senior citizen veteran who has been cheated by the federal government.  Why does this happen?  Because federal government employees don't have any "skin in the game"!  Most of the time, it is much easier for me to work with private insurance company employees to solve an insured client's problems.  Why?  Because, the private insurance companies have "skin in the game".  To read more articles about this and other Medicare problems, visit www.medicareproblems.net or www.woodrowwilcox.com.  Now, here is the excerpt from the email from the frustrated veteran.

            "I am contacting you with regard to my co-insurer, Mutual of Omaha and the Veterans Administration billing department.  Essentially, for the longest time (perhaps years) the VA failed to bill my co-insurer.  Their record keeping system must be a mess because time after time I provided them information which apparently they did not document.  The result was that I paid the charges."

Written on May 19, 2009.

OUTLINE OF TALK BY WOODROW WILCOX

AT KNIGHTS OF COLUMBUS

IN MERRILLVILLE INDIANA

November 25, 2008

1. Medicare is a human designed and managed system.  Like all other such systems, it fails sometimes.

1. (a) Process:  Medical service provider (doctor, hospital, lab, etc.) provides service and reports the service and proposed charges to Medicare.  Medicare reviews and rules on the charges.  Medicare pays what it owes (if anything).  Medicare reports its ruling to the Medicare supplement insurance company so that the insurance company knows how to handle the charges reported.

1. (b) Much of the information is sent via electronic communication.  Communication satellites usually are involved because the federal government and telephone companies rely on them.  If the satellite communication malfunctions, Medicare information can be jumbled or lost.  Have you ever tried to watch a satellite tv channel during a thunderstorm?  Bad weather and sunspots sometimes affect Medicare data communications.

2. Medicare does not pay for everything and not all medical service providers honor Medicare.

            a. Recently a client used a doctor who does not honor Medicare.  So, the client

            got stuck with a big bill.  Medicare won't pay anything and neither will his

            insurance company.

            b. A Medicare supplement insurance policy SUPPLEMENTS the coverage of

            Medicare.  The policy will not pay anything until Medicare reviews and rules

            on the charges.

3. Watch out for ADVANCE BENEFICIARY NOTICES.  If a medical service provider believes that Medicare probably will not pay for certain charges for services, someone at the office of the medical service provider will ask the patient to sign an ADVANCE BENEFICIARY NOTICE without explaining that it obligates the patient to PAY WHATEVER MEDICARE WILL NOT HONOR OR PAY.

Recently, one client asked for help on a bill.  When I checked, I learned that the client had signed an ADVANCE BENEFICIARY NOTICE.  So, I could not help the client/patient.  The bill was a few hundred dollars.

4. Medicare and VA do not have a good communication system for sharing claims information.  This can result in a senior citizen veteran paying OVER ONE THOUSAND DOLLARS MORE than if the veteran never used VA medical services.  To avoid this problem, go to a private doctor or hospital in the first part of the calendar year to use up the annual Medicare deductibles.  After the deductibles are met, the system works better.

For more Medicare problem articles, visit www.woodrowwilcox.com

ADVICE TO SENIOR CITIZEN VETERANS

By Woodrow Wilcox

            Recently, two senior citizens had the same problem and came to me for help.

            In each case, the senior citizen was a veteran who used VA medical services in the first two months of the year.  Each of them had the same problem.

            The VA medical services were billed.  Medicare did not pay anything, but the private Medicare supplemental insurance paid on the charges.

            The Medicare offices that deal with the VA and the Medicare offices that deal with the general public must be in different places and must not communicate well.  I state this because subsequently, Medicare did not have a clear idea of when each insured client had met the annual Medicare Part B deductible.

            Medicare continued to refer to charges as part of the annual deductible when in fact the client had met the deductible.  This messed up the processing and payments from the Medicare supplemental insurance company.  The insurance company would send an EXPLANATION OF BENEFITS which stated that the insured had exceeded the benefit.

            What this mean is that if an insured bought a Medicare supplemental insurance policy that paid the Medicare Part B annual deductible (which is now $131), then the insurance company will pay that deductible only once - not twice.

            The problem is that Medicare is sending notices of deductibles which total more than the $131 Medicare Part B deductible.  The source of this confusion is the lack of accurate communication between the VA and Medicare.

            To avoid this problem, a senior citizen veteran should avoid using VA medical services in January or February.  Use private medical services so that the annual deductible is accurately totaled.  Then, start using VA medical benefits because the processing of claims will run more smoothly.

            If a senior citizen already has a problem like this, I suggest doing the following.  Phone the VA at 1-866-260-2614 and Medicare at 1-800-633-4227.  Request copies of any documents that relate to charges that have a date of service in the first few months of the year.  Then, take these documents to your insurance agent for help with correcting

any problems.

Note: This article was written on July 17, 2007 and syndicated to newspapers.

Letter To The Editor

WHY DON'T THE PRESIDENTIAL CANDIDATES TALK

ABOUT THE FACT THAT MEDICARE MESS UPS

ARE CHEATING SENIOR CITIZENS

OF BILLIONS OF DOLLARS EVERY YEAR?

            For over five years I have assisted senior citizens with Medicare and Medicare-VA medical billing foul-ups.  I work for the largest senior citizen oriented insurance agency in the Midwest.

            Because this agency is large and has about five percent of the senior citizen market in our congressional district, I was able to extrapolate estimates of how much Medicare Foul-Ups cost senior citizens in the U.S.

            I believe that Medicare Foul-Ups concerning Medicare Part A and Part B cost senior citizens about ONE BILLION DOLLARS per year in charges that senior citizens would never have to pay if Medicare worked properly.

            I believe that Medicare-VA Foul-Ups are costing senior citizen veterans over ONE THOUSAND DOLLARS EACH ON AVERAGE.  If there are one million veterans age 65 or older, then the cost is over ONE BILLION DOLLARS PER YEAR of wrongful charges to these veterans.

            For over five years, I have written articles on these problems.  I am posting the articles at www.woodrowwilcox.com.  There is no charge to read or copy the articles.  I am not selling anything at the website. 

            I invite you and your readers to visit www.woodrowwilcox.com and read about Medicare Foul-Ups and how the problem hurts senior citizens.  Maybe Congress will act to fix the problem if enough people complain.

Best personal regards,

Woodrow Wilcox

Note: This letter to the Editor was sent to newspapers during the presidential campaign in 2008.

WHERE YOU LIVE AFFECTS YOUR MEDICARE INSURANCE PREMIUM

By Woodrow Wilcox

            Where a person lives is important for insurance purposes.  Insurance companies rate the possibility of claims on several criteria and residence location is a key factor.  This is especially true for senior citizens who buy Medicare supplemental insurance policies.

            The Medicare supplemental insurance policy helps the senior citizen to pay the 20% of approved medical service charges and the deductible which Medicare does not pay.  Where a senior citizen lives affects the rates for service paid because every area of the country has different rates for medical services. 

            For example, in Indiana, some insurance companies that sell Medicare supplemental insurance rate northwest Indiana and parts of Saint Joseph County as having the highest charges by hospitals and doctors of any areas of Indiana.  For this reason, a senior citizen who lives in Lake County, Porter County, or Saint Joseph County will pay a higher monthly premium for Medicare supplemental insurance than a similar senior citizen who lives in Lafayette, Kokomo, or Seymour.

            Moving from one state to another affects the monthly premium for Medicare supplemental insurance, too.  For example, a senior citizen who moves from Indiana to Florida will usually experience about a 50% increase in monthly premiums for Medicare supplemental insurance even though the policy benefits are the same.  But, moving to another state might reduce the senior citizen's premium for Medicare supplement insurance.

            For example, this agency had clients who moved from Crown Point to the Chattanooga Tennessee area.  The senior citizen couple experienced a savings of almost $400 per month on their Medicare supplemental insurance premiums even though they kept the same benefits.  Another couple from Hebron who moved to Columbia, Tennessee experienced a similar reduction.  Both couples were surprised to find that their other insurance costs, their utility costs, and their property taxes dropped significantly, too.

            I suggest to senior citizens who want to move to a different area of the state or the country that they call insurance agents in the new location to check on insurance costs before they make a move.  Don't just check on insurance either.  Check on utility costs, property taxes, crime rates, and other key factors that are important to every senior citizen who plans to live on a fixed income.

Note: This article was written on August 3, 2006 and syndicated to newspapers.

What do Medicare Foul-Ups cost senior citizens?

By Woodrow Wilcox

            I just handled another serious Medicare Foul-Up bill for a senior citizen client.  A hospital in Chicago was demanding about $100 more from the senior citizen.  I reviewed the papers that the client had and phoned the insurance company.

            For one of the dates in service in question, Medicare reported a bill of only $686 to the insurance company when the bill was really $1,187.  I requested that the hospital send the information that it got from Medicare to the insurance company.  That should fix the problem.  While working on this problem, I started to wonder how Medicare Foul-Ups costs senior citizens throughout America.

            On an average day, I handle three serious and multiple minor problems caused by Medicare Foul-Ups.  On July 15, I handled three serious Medicare Foul-Ups that prompted me to write an article on the subject that day.

            The three serious problems for three different clients on that day were  (1) Medicare failed to send the essential billing information to the correct insurance company for payment; (2) Medicare sent conflicting reports on medical charges to the doctor's office and to the patient's insurance company; (3) the Veterans Administration did not send the necessary information to a client's insurance company for payment processing and VA officials were obstinate and did not want to cooperate with solving the problem.

            If these incidents are statistically average, then the cost of Medicare Foul-Ups to senior citizens can be reasonably estimated.  Here are my calculations.

            If the average Medicare Foul-Up that is not fixed costs a senior citizen on Medicare an extra $100 in charges that are wrongfully charged to the senior citizen, then the total cost to all senior citizens can be calculated this way.

            Our office handles 3 serious problems per day.  Our agency has about 5% of the senior citizen market in our congressional district.  So, 3 x 20 should equal 100% of average daily serious Medicare Foul-Ups in one congressional district.  There are 435 congressional districts.  So, there should be an average of 26,100 serious Medicare Foul-Ups per day in the U.S.  If each unresolved foul-up costs a senior citizen $100 that the senior citizen should not have to pay, then serious Medicare Foul-Ups are costing America's senior citizens $2,610,000 EVERY SINGLE DAY.  Multiply that figure by 365 and the annual costs to senior citizens for serious Medicare Foul-Ups is $952,650,000.  But, this is only for Medicare Part A and Part B problems.  Medicare Part D (prescription drugs) is another engine of Medicare Foul-Ups.  Also, because Medicare and VA clinics do not communicate well, each senior citizen veteran could be overcharged OVER ONE THOUSAND DOLLARS PER YEAR BECAUSE OF FOUL-UPS ON MEDICARE ANNUAL DEDUCTIBLE CALCULATIONS!

            Many insurance agencies do not have the ability to help their senior citizen clients to save money by correcting serious Medicare Foul-Ups.  So, those senior citizens are badgered with demands for payment of the wrongful bills until they pay them.

            If you believe that having the federal government handle all healthcare matters will solve problems, you just don't know the facts about how the federal government actually causes many problems that cost citizens and the healthcare system billions of dollars a year.  If you helped senior citizens with these problems as I do, you would understand what I mean.

Warning: Avoid ADVANCE BENFICIARY NOTICE

By Woodrow Wilcox THE HOSPITAL LIED

By Woodrow Wilcox

            The hospital lied.  It lied in a letter to a client.  That happens quite often.

            In a letter demanding payment from a senior citizen client of this insurance agency, the hospital lied.

            The lying part of the letter stated, "Your insurance company has notified us that they have paid their portion of your claim.  Payment of any remaining balance is your responsibility."

            But, that was a lie. 

            The insurance company did not notify the hospital of any such thing.  The insurance company NEVER GOT THE CLAIM.

            Why would people at the hospital send such a lying and deceitful letter?  The reason is simple: they want the money and they want it now.  They don't want to bother with playing by the rules.  They will say or write anything to get more money faster even if it means that they don't follow the rules.

            On behalf of our client, I wrote to the hospital about the false statement in the demand for payment letter.  I told the hospital that our client's insurance company never got any claim from Medicare for the charges billed.  Since the insurance company never got the claim, it could not have informed the hospital that it had paid its portion of the bill.  I demanded that the hospital produce evidence to support the claim and forward that evidence to the insurance company.

            Our client was covered by Medicare and a good Medicare supplemental insurance policy at the time.  Our client should not have had to pay anything to the hospital for the services billed because of this coverage.  But, some people at the hospital or at Medicare DID NOT DO THEIR JOBS AND MESSED UP THE PAPERWORK.  Instead of working to fix that, the hospital personnel chose the quick, easy, and false way to handle the problem: they just billed the patient for an amount that was not owed by the patient.

            If the client had not asked our agency to review the bill, our client probably would have paid the hospital a bill that she did not owe.  Our service to this client was without charge.  That is the kind of service that we give our clients.  I hope that every other insurance agent and agency that helps senior citizens gives the same standard of service.

Note: This article was written on April 9, 2008 and syndicated to newspapers.

THE HOSPITAL LIED

By Woodrow Wilcox

            The hospital lied.  It lied in a letter to a client.  That happens quite often.

            In a letter demanding payment from a senior citizen client of this insurance agency, the hospital lied.

            The lying part of the letter stated, "Your insurance company has notified us that they have paid their portion of your claim.  Payment of any remaining balance is your responsibility."

            But, that was a lie. 

            The insurance company did not notify the hospital of any such thing.  The insurance company NEVER GOT THE CLAIM.

            Why would people at the hospital send such a lying and deceitful letter?  The reason is simple: they want the money and they want it now.  They don't want to bother with playing by the rules.  They will say or write anything to get more money faster even if it means that they don't follow the rules.

            On behalf of our client, I wrote to the hospital about the false statement in the demand for payment letter.  I told the hospital that our client's insurance company never got any claim from Medicare for the charges billed.  Since the insurance company never got the claim, it could not have informed the hospital that it had paid its portion of the bill.  I demanded that the hospital produce evidence to support the claim and forward that evidence to the insurance company.

            Our client was covered by Medicare and a good Medicare supplemental insurance policy at the time.  Our client should not have had to pay anything to the hospital for the services billed because of this coverage.  But, some people at the hospital or at Medicare DID NOT DO THEIR JOBS AND MESSED UP THE PAPERWORK.  Instead of working to fix that, the hospital personnel chose the quick, easy, and false way to handle the problem: they just billed the patient for an amount that was not owed by the patient.

            If the client had not asked our agency to review the bill, our client probably would have paid the hospital a bill that she did not owe.  Our service to this client was without charge.  That is the kind of service that we give our clients.  I hope that every other insurance agent and agency that helps senior citizens gives the same standard of service.

Note: This article was written on April 9, 2008 and syndicated to newspapers.

Technical Medicare Matters

By Woodrow Wilcox

            Six months before an American citizen or resident alien reaches age 65, it is time to begin the process of enrolling in Medicare and selecting a Medicare supplement insurance company and plan.

            A senior citizen reaching the age of 65 needs to complete two sets of paperwork to enroll in Medicare Part A and Medicare Part B.  Medicare Part A deals with hospital related charges.  Medicare Part B deals with doctor related charges. 

            When a person who has Medicare Part A and Medicare Part B gets medical services, the medical service provider gets the Medicare identification information of the patient and reports the medical services provided and the related charges to Medicare.  Medicare reviews the information to determine whether the medical service was in fact medically necessary and what amount Medicare will approve for charges.  Then, Medicare pays 80% of the approved charges.

            The other 20% of approved charges is the responsibility of the patient.  But, if the patient has a Medicare supplement insurance policy, then the Medicare supplement insurance company will pay on the other 20% of the Medicare approved charges.  Medicare must get and process the bill before the Medicare supplement insurance company will pay on the bill.  The Medicare supplement insurance company relies on the judgment of the Medicare officer for a determination of medical necessity.

            Exactly how much the Medicare supplement insurance company will pay on the bill is determined by the coverage of the policy that the senior citizen bought.  The federal government has standardized the various Medicare supplement insurance "PLANS" so that there is less confusion to senior citizens about what is and what is not covered.  So, a "PLAN A" sold by one insurance company will cover exactly the same expenses that a "PLAN A" from another insurance company will cover.  This helps senior citizens and the people who care for them to really compare "apples to apples and oranges to oranges" when selecting a Medicare supplement insurance plan.

            But, as I have warned in my previous columns, Medicare DOES NOT COVER EVERYTHING.  If a senior citizen gets medical service that Medicare determines is not medically necessary, neither Medicare nor the Medicare supplement insurance company will pay anything on the medical service.  A good example of this is plastic surgery to enhance a senior citizen's looks and ego.  But, other things are not covered, too.  A regular eye examination and service in selecting eyeglasses or service in obtaining a hearing aide are not covered.  Prescription medicines were not covered by Medicare.  Presently, that is in a state of transition.  Officially, Medicare will not cover prescriptions until next year because of the new Medicare laws passed by Congress and signed by President Bush.  There are now Medicare approved prescription discount cards and Non-Medicare approved prescription discount cards.  Check with your insurance company to determine which kind you or your senior citizen friend might have.

            Before the change in the law, insurance companies created prescription discount cards and programs to help their clients to buy prescription drugs at a discount.  These various prescription discount programs are in a state of transition as we move toward Medicare coverage of prescription medicines.

            The various "PLANS" for Medicare supplement insurance have different types of coverage for people of different lifestyles.  Some people want in home nurse coverage, and some people don't.  Some people want to travel in foreign countries, and some don't.

            If you travel in a foreign country, realize that the Medicare coverage changes some.  There is a larger deductible when traveling in a foreign country.  Also, due to language differences, money and banking differences, medical billing practice differences, or other problems, you may need to pay the bill in full before you leave the country.  Then, you would ask Medicare to reimburse you later.  So, travel with access to additional funds, keep receipts and notes about medical services or medicines obtained, and call Medicare and your Medicare supplement insurance agent when you return for instructions on how to get started with processing the information through Medicare.  Remember that your Medicare supplement insurance company will not pay anything until Medicare reviews and pays on your claim.  To make life easier, it is probably smart to buy a traveler's medical insurance policy which pertains to the country or region where you will travel.  If you need medical service, the traveler insurance company can help you to obtain the paperwork necessary to process your claim for reimbursement from Medicare and your Medicare supplement insurance company after you return home.

Note: This article was written on February 16, 2005 and syndicated to newspapers.

Switching Insurance Companies Confused Medicare

By Woodrow Wilcox

            A client from Schererville, Indiana visited our office with a fairly common problem.  I helped him and want to describe the problem and the solution for you.

            The client switched Medicare supplemental insurance policies from one insurance company to another to save some money by lowering his monthly premium.  This was done in advance so that the switch dates would match.  In this case, the old insurance policy ended at midnight on April 30, 2008 and the new insurance policy started one second later on May 1, 2008.

            The client went to a hospital for tests and treatment on April 30 and May 1, 2008.  Medicare sent all the bills to the old insurance company, but did not send anything to the new insurance company.  Insurance companies notify Medicare by electronic filings about Medicare policies and clients so that Medicare can send claims information to the correct insurance companies.

            Apparently, receiving claims information from a medical service provider which must be divided between two insurance companies is a bit too complicated for some people who work at Medicare.  For almost three weeks after the policy switch was made, Medicare was still sending claims information to the old insurance company rather than the new one.

            When the client can give me the addresses of any unpaid medical service providers, I write directly to them for the client to explain the situation and what can be done to help them get paid as quickly as possible.

            But, in this case, because the client did not have the addresses of unpaid medical service providers, I typed a letter of explanation and gave him copies to send or deliver to unpaid medical service providers.  The letter explained the situation and gave the policy numbers and claims department addresses for both insurance companies.  If the unpaid medical service providers follow the instructions in the letter, they will get paid faster than if we must contact Medicare to reprocess claims.

Note: This article was written in the summer of 2008 and syndicated to newspapers.

Switching Medicare Supplement Policies Takes Time

By Woodrow Wilcox

            In the last few days, I noticed that several people who visited were a bit confused about Medicare, Medicare supplement insurance policies, insurance companies, insurance agents, and the amount of time needed to process applications, claims, and problem solving.

            One woman thought that when she gave a check to an insurance agent on one day, she would be covered by the Medicare supplement insurance company the very next day.  That might be the way it is in automobile insurance transactions, but that is not the way it is in Medicare supplement insurance matters. 

            A man who had helped his mother to purchase Medicare supplement insurance thought that when he gave a check to the agent on August 29, his mother's coverage would start on September 1, just two days later.  Again, Medicare supplement insurance is different from property insurance policies.  But, Medicare supplement insurance is similar to regular health insurance in the amount of time needed for any processing.

            In dealing with Medicare or Medicare supplement insurance changes of any kind, one must remember that both a government bureaucracy and a business bureaucracy must change their records.  That takes time. Medicare supplement insurance companies usually want thirty days notice to cancel or change a policy.  Whenever someone switches from one Medicare supplement insurance company to another, the new company usually wants at least thirty days to review the application and accept the client.

            Don't cancel a current Medicare supplement insurance policy without first being accepted by the new Medicare supplement insurance company.  Make sure that you have coverage.  Your insurance agent may ask you to write or sign a letter to request cancellation of the old policy, but that letter should not be sent until the new policy with the new company is approved.

            Some people don't understand that the insurance agent has no control over whether an application is accepted and a policy issued.  That determination is made by an insurance underwriter at the insurance company.  The underwriter reviews the application, the medical history, and other factors to determine if the insurance company should issue an insurance policy.

            The insurance underwriter relies on what is on the application.  But, the insurance company wants to make sure that what is on the application is accurate.  Most insurance companies have another employee telephone the applicant to ask some of the same questions that are on the application.  The interviewer will check to make sure that the applicant's name is spelled correctly, that the address is correct, that the Medicare ID number is accurate, and that the medical history is accurate.

            Sometimes, an applicant is rejected for a Medicare supplement insurance policy.  But, in my experience, I believe that usually this is caused by a misunderstanding or by a faulty memory.  In such cases, some clarification can correct the matter and the applicant can be accepted for a policy.

            Let me clarify this for you.  Sometimes, if an applicant has trouble seeing or reading, an agent will ask the client a question as it is on the application.  The agent will write the answer given.  Later, during the telephone interview, the applicant might answer the same or similar question differently and cause the insurance company to wonder if the application was taken correctly.  Because the applicant answered the same or almost the same question differently on two different occasions, the insurance company, often, will decide to protect itself by rejecting the application.

            If this happens, contact your insurance agent.  Sometimes, the different responses can be explained by clarification of the medical matter or history which is the subject of the question.  Sometimes, the applicant did not correctly hear or understand the question over the telephone.  Some senior citizens have an easier time hearing and understanding an agent who is with them rather than a person on the other side of a telephone conversation.

            In any case, be honest about your answers.  Being honest about the answers helps you not have to remember too much.  Also, it protects you, too.  Most insurance companies have clauses in their contracts that state that the insurance company is relying on the honesty of the applicant's answers, but that if the answers are later discovered to be false, the insurance company does not have to honor the insurance contract.

Note: This was one of the first Medicare articles by Woodrow Wilcox.

It was written sometime in 2003 and syndicated to newspapers.

SENIOR HURT BY SLOW RECORD UPDATING BY MEDICARE

By Woodrow Wilcox

            A senior citizen client of this insurance agency came to our office with unpaid bills and paperwork and asked for help.  I helped him.

            The man had worked at the Union Tank Car Company in East Chicago, Indiana.  When he retired, the former employer paid for three months of insurance coverage.  After that, the retiree was on his own.  He acted responsibly.  He obtained a Medicare supplement insurance policy to cover whatever Medicare would not cover.

            But, Medicare did not update his records well.  Medicare should have changed its records so that the client had Medicare as a primary insurer as of September 1, 2008.  But, over six months later, Medicare had not updated the records.  Medicare still thought that the retiree had primary insurance from the former employer and that Medicare was only the secondary insurer.

            Because Medicare did not update the senior's records in a timely manner, the senior's medical claims were being denied by Medicare.  The senior citizen had medical bill collectors after him for amounts that should have been paid by Medicare or his insurance company.  But, Medicare's goof on his records was causing a big financial burden and a lot of stress for the senior citizen and his family.

            I helped the client by typing a letter to Medicare and having him sign it.  In the letter, I explained the problem and requested a quick resolution by updating the records and reprocessing all medical claims that Medicare had received for dates of service from September 1, 2008.  I copied and attached supporting documents to the letter.  This letter should solve the problem for our client when Medicare gets around to acting on it.

            This is typical of the kinds of Medicare mess ups that cost senior citizens across America OVER ONE BILLION DOLLARS PER YEAR IN FALSE CHARGES.  By "false" charges, I mean charges that would not be billed to the senior citizens on Medicare if Medicare worked properly.

            The help that I gave to the client was free of charge.  This agency gives this kind of help and support to our senior citizen clients at no charge because we are committed to giving good service.  Does your insurance agent or agency give this kind of service at no charge?

To read more Medicare articles by Woodrow Wilcox, visit www.woodrowwilcox.com.

Note: This article was written on March 25, 2009 and syndicated to newspapers.

SAVE THE PAPERWORK!

By Woodrow Wilcox

            Saving paperwork might annoy some people that you know.  But, if you must deal with insurance companies, Medicare personnel, and people who work at hospitals, laboratories, and doctor offices, saving paperwork can be a blessing.

            Recently, I helped a client who lives in Cedar Lake, Indiana, but spends the winters in Haines City, Florida, near Walt Disney World.

            While in Florida, he got sick and got treatment.

            His insurance company had some questions about the claims and tried to write to all the medical service providers in Florida that the client used.

            But, a clerical error at the insurance company caused a problem for our client.  The bills were not getting paid.  The client came to me for help.

            It took some phone calls, some letters, and some time.  I had to find the source of the problem.  The client gave me some paperwork, but not everything that I wanted to make my job a bit easier.

            Finally, I learned that the insurance company would not pay claims until their questions were answered and that a clerk at the insurance company had been sending the insurance company's questions to two doctors using the wrong addresses.

            I solved the problem by getting the correct addresses for the doctors to the insurance company and alerting them that the delay was because of a clerical error at their firm.  These things will happen.  People get distracted or tired and make honest mistakes.  So, I was not upset about the mistake.  I was frustrated that it took so much of my time and effort to get things corrected so that our client's claims would be paid.

            Just in case you need to ask someone for help in straightening a medical billing mess, save the paperwork!

Note: This article was written on August 5, 2008 and syndicated to newspapers.

SAVED WHITING WOMAN $66

By Woodrow Wilcox

            An elderly woman from Whiting Indiana sent a bill to me and asked me to check it.  She is one of our thousands of senior citizen clients for Medicare policies.  I had helped her with some bills in the past.  So, she sent the bill directly to me.

            It was especially nice that she added other information that I needed.  She knew from the help that I had given to her in the past that anyone who helps a senior citizen with a Medicare related bill needs to know the senior citizen's insurance company and policy number at the time the medical charges were made.

            Our client suspected that she did not owe the $66 bill.  She was right.  She didn't. 

            I checked with the client's Medicare supplement insurance company.  It never got the claim details from Medicare.  It got the bill information but not the Medicare review determination.

            So, I wrote a letter to the medical service provider in Merrillville Indiana to explain why the bill had not been paid and to request that the firm send the needed information to the insurance company.  Once that is done, the claim can be processed and paid by our client's insurance company.

            This problem of insurance companies not receiving the needed information from Medicare happens all the time.  In other articles that I have written, I have estimated that the communication problem between Medicare and insurance companies has resulted in senior citizens throughout the USA paying over ONE BILLION DOLLARS per year in medical bills that they really do not owe.  But, with thousands of Medicare processing mistakes every day, senior citizens will keep overpaying ONE BILLION DOLLARS per year until the system is fixed.

            Unfortunately, so far, presidential candidates and other Washington politicians have ignored this problem.  To read some of my past articles on this, visit my website www.woodrowwilcox.com.

Note: This article was written on October 17, 2008 and syndicated to newspapers.

SAVED LOWELL CLIENT OVER $1000

By Woodrow Wilcox

            A client of this insurance agency from Lowell, Indiana got a balance due bill from a hospital with a balance of $1,023.49.  The client contacted our office and sent the bill and other information that I requested so that I could check on the bill for the client.

            I reviewed the information and the bill.  Then, I contacted the client's insurance company.  What I suspected had happened was true.  Medicare never sent the claim information to the client's Medicare supplement insurance company.

            So, I wrote to the hospital for our client and requested that the hospital send certain information to the claims department of the client's insurance company.  This should result in the bill being paid by the insurance company.

            This agency provides this kind of service to our senior citizen clients who obtain Medicare supplement insurance policies through this agency.  In this case, we saved the client over $1,000.

            In previous articles, I have estimated that errors in the Medicare system cost senior citizens about ONE BILLION DOLLARS PER YEAR.  This agency tries to resolve every Medicare billing problem of our clients in order to save them money.

            Most problems are rather easy to resolve.  But, the problems that are caused by a government agency or employee of the Medicare system are more difficult or impossible to resolve because the government employees don't like to admit a mistake and work quickly to correct it.

Note: This article was written on February 4, 2009 and syndicated to newspapers.  To read more articles by Woodrow Wilcox, visit www.woodrowwilcox.com.

SAVED CLIENT $176.10

By Woodrow Wilcox

            One of the clients of this insurance agency phoned me about a bill that was not paid by his Medicare supplement insurance company.  I asked him to bring the bill to our office.  He did and I went to work on it.

            When I saw the bill and talked to our client, I suspected that his insurance company never got the claim from Medicare so that it could pay the balance of the bill.  I was right.  I phoned the client's insurance company and was told that it never got the claim from Medicare.

            So, I contacted the hospital in Lake County, Indiana and told them that the insurance company never got the claim from Medicare.  I asked them to send certain information to the insurance company so that the claim could be processed and paid according to the policy.

            When the hospital does what I requested, I am confident that the bill will be paid.  When that happens, it will mean that I saved our client $176.10.  This kind of service is free to the clients of this insurance agency.

Note: This article was written on October 13, 2008 and syndicated to newspapers.

REFILED AND REVISED CLAIM NOT PAID

By Woodrow Wilcox

            A client from Crown Point with a Medicare supplement policy through this insurance agency asked for our help on a claim that was not paid.  I helped him.

            The original problem was caused by the doctor not providing adequate notes to Medicare to demonstrate the medical necessity of the medical treatment.  Medicare normally will not pay for medical services that seem to be "cosmetic" in nature.  This is a long established policy to avoid Medicare getting bills for millions of "face lift" operations.

            But, when otherwise "cosmetic" surgery is part of a needed medical treatment, Medicare usually pays on the service.  For example, if a person's face is seriously injured in a car accident or a fire or a "mugging", the person may need some "cosmetic" surgery as part of the regular medical treatment in order to help the person to have a more normal life.

            In the case of our client from Crown Point, an eye surgery had caused a medical complication for him.  After the eye surgery, his eyelid kept closing involuntarily and blocking his vision with one eye.  To correct this complication from the surgery, his doctor treated his eyelid with botox.  Botox is usually used in cosmetic surgery.

            So, Medicare personnel thought that the botox treatment was a "cosmetic" treatment and denied the claim.  Medicare would pay nothing on the procedure.

            I contacted the doctor to request that he augment his notes to demonstrate the medical necessity of the treatment and re-file the claim with Medicare.  But, the doctor already had figured out the problem and re-filed the claim with the corrections.  Medicare honored the claim and paid on it.

            But, another problem happened for our client.  When his insurance company got the revised claim information from Medicare, the claim was filed as a duplicate claim instead of a revised claim.  So, the insurance company personnel did not realize that the revised claim was one on which the insurance company should pay.

            I contacted the insurance company and asked if it had received the revised claim on which Medicare had paid and on which the insurance company was obligated to pay.  The insurance company representative with whom I spoke reviewed the file, realized that I was right, and apologized for the mistake.  He promised to redirect the claim with notes so that the claim would be paid.

            Our work to help our client will result in our client saving about $100.  Also, we saved our client some hassle and stress by working on the problem free of charge.  We do our best to protect our clients from the financial harm that is caused by Medicare billing mistakes.  In other articles, I have estimated that America's senior citizens on Medicare are being cheated by over one billion dollars per year because of mistakes in the Medicare system.

Note: This article was written on April 8, 2009 and syndicated to newspapers.

Protect Senior Citizens From Shakedowns

By Woodrow Wilcox

            I help senior citizens every day with medical billing problems. 

When medical service providers make mistakes in billing the senior citizens, I don't get upset.  I investigate and explain the facts.  If the medical service provider responds with an apology and correction, I think nothing more of it.

But, when there is a repeating pattern of problems, I go further and dig deeper.  If I suspect a pattern of sloppy bookkeeping or fraudulent activity, I am ready to report the matter.  But, to whom should I report it?  The facts make a difference.  I understand that, but many senior citizens don't understand that.  If the senior citizen is an immigrant, there is both a language and cultural hindrance to finding the appropriate government official to whom the matter should be reported for investigation.

            As a substantial number of people in the United States ages, more of these people will be targeted to become victims of unethical and illegal practices.  Many times, our clients contact us to ask if they should pay a medical bill that has come to them.  Most of the time, the bill is innocently sent before Medicare and the Medicare supplement insurance company have received and processed it.  But, sometimes, bills are sent in violation of Medicare practices. 

            There are some medical labs and some medical service providers operating in this area who do not seem to want to comply with good billing practices.  Senior citizens who own their own home or have good credit and get a "bad" bill often pay the bill to protect their credit.  When I write "bad" bill, I mean a bill that is not really owed by the senior citizen, but which is sent by a medical service provider.

            I suggest that every state and every county that has a substantial senior citizen population have a central office for investigating reports of senior citizen victimization.  On such a team, local business people who are familiar with good practices in a certain business specialty can act as advisors to the investigating team.  For, example, our office could help with determining if medical service providers are billing and processing payments correctly or not.  The local business people can volunteer to assist the investigating team so that it can more easily determine innocent error from illegal activities that need to be prosecuted.  The investigative team can more easily make an impression on out of state medical service providers or billing services that target senior citizens in our state or county.

Note: This article is undated.  It is an early article written by Woodrow Wilcox on Medicare matters.  Probably, it was written in 2003 or 2004.  It was syndicated to newspapers.

Protecting Senior Citizens from Wrongful Bills When Medicare Makes Mistakes

By Woodrow Wilcox

            A senior citizen client who bought a Medicare supplement insurance policy through this agency sent us a bill from a hospital in northwest Indiana which claimed that our client owed the hospital $135.

            At first, I thought that the client might have purchased a policy which does not cover the Medicare Part B annual deductible which is now $135.  But, I checked with the client's insurance company as I always do.

            I learned that the client had a Standard Plan F policy which does cover the annual Medicare Part B deductible of $135.  That information told me that there was a billing problem somewhere.  So, I continued to question the insurance company representative.

            The insurance company never got a claim from Medicare for a bill with a balance of $135 for the date of service shown on the bill.  But, the insurance company did get a claim from Medicare for the same date of service which showed a balance due of $77.74 which the insurance company had paid.

            Several things might have caused this problem.  The hospital might have added new charges without re-filing with Medicare.  But, the nuances of the case led me to believe that either Medicare sent different information regarding the same claim to the hospital and the insurance company OR Medicare failed to send information on a second or amended claim for the same date of service to the insurance company.  In either of those cases, Medicare MESSED UP. 

            I caught this problem and wrote a letter to the hospital explaining what had happened and requesting that they get some information to the client's insurance company so that the outstanding bill could be processed for payment.

            This sort of thing happens all the time.  But, many senior citizens don't have the help of someone like me to straighten the billing problem and save them money.  In those cases, senior citizens end up paying money that they don't really owe because Medicare MESSED UP the billing information.  I have publicly estimated that Medicare caused MESS UPS cost senior citizens on Medicare about ONE BILLION DOLLARS PER YEAR in wrongful charges. 

Note: This article was written on September 15, 2008 and syndicated to newspapers.

NEW MEDICARE SUPPLEMENT PLANS K AND L

By Woodrow Wilcox

            The beginning of Medicare Part D prescription drug coverage on January 1, 2006 was well publicized.  But, the Medicare Modernization Act of 2003 made some other significant, but less publicized, changes in the law of the land.

            Two new standard Medicare Supplement insurance plans - K and L - were introduced.  But, like the other standard plans under Medicare Part A and Part B, insurance companies are not required to offer these new standard plans.

            Remember that the federal government authorized insurance companies to offer standard plans for supplemental insurance with Medicare Part A and Part B.  This standardization reduces the confusion about different plans so that senior citizens can choose a plan more easily.  Whatever is covered by Standard Plan A with one company will be exactly what is covered by Standard Plan A with another company. 

            Plans K and L offer senior citizens Medicare supplement insurance with a high deductible option.  For those who don't mind high deductibles, higher co-payments, and more out-of-pocket expense, Plans K and L can be purchased for lower premiums.  The main difference between Plans K and L is the amount, percentage, and ceiling on out-of-pocket expenses.

            For some senior citizens, using Plan K or Plan L to reduce monthly premiums for Medicare supplemental insurance makes sense.  They anticipate needing medical services only a few times a year rather than a continuous series of use of medical services.  If you are in very good health for your age, you might be able to save money by switching your Medicare supplemental insurance to a Plan K or L.  If you want to learn more about Standard Plan K and L, talk with your insurance advisor.

Note: This article was written on March 22, 2006 and syndicated to newspapers.

Stop Sharing Our Personal Information with the World

By Woodrow Wilcox

            I help senior citizens with their insurance and financial related problems.  Many times that means holding on the phone while I wait to talk to someone at an insurance company or other firm.

            People from India and the Philippines may be very nice people.  But, they do not speak English with an American accent.   So, it is both difficult and frustrating to speak with them while trying to help senior citizens.  Some American companies have reduced their phone answering costs by hiring firms outside the U.S. to answer their customer service and order phone calls.  I believe that this is wrong.

            Allowing people outside the U.S.A. to have access to our citizens' names, addresses, phone numbers, social security numbers, Medicare ID numbers, credit card numbers, medical histories, and other vital information is inviting the trouble of identity theft.  If a foreigner harvests a computer record bank with all that information and sells it to a criminal enterprise, there is no limit to the amount of trouble, frustration, and financial difficulty that can be forced on America's senior citizens and others.

            I would urge everyone to contact federal officials to persuade them to pass legislation that forbids such personal information to be on the internet or shared in any way with firms or people outside the U.S.A.

Note: This article is undated, bu was syndicated to newspapers.

"On Hold" is Taxing and Should Be Taxed

By Woodrow Wilcox

            Being "ON HOLD" with a telephone call is not my favorite way to spend time.  On my "least favorite things to do" list, it ranks close to visiting a dentist.

            But, I am "ON HOLD" on telephone calls much of the day because I'm helping senior citizens to solve their problems with Medicare, insurance companies, doctors, clinics, hospitals, and collection agencies.  Various companies are always putting me "ON HOLD".  I listen to whatever they believe will keep me calm while I wait.  Sometimes it is "elevator" music.  Sometimes it is a "your call is very important to us" recording.  Sometimes it is a "here is some information for you to hear again and again and again until we take your call" recording.  It is a very frustrating experience for me.  It is even more frustrating for the senior citizens that come to me for help.

            Recently, I got an idea for solving the problem and helping a lot of unemployed people in the process.  The U.S. Constitution allows Congress to impose an excise tax.  That is like a sales tax to the federal government.  So, here is my idea.

            The federal government should impose an "ON HOLD" excise tax on companies based on the number of minutes that they have a client or customer "ON HOLD".  This would be directed at big companies with big call centers.  Little family businesses could be exempt because they don't have a call center.  For the first three minutes that someone is "ON HOLD", don't impose a tax.  Good businesses generally answer the phone to help a client or customer before three minutes is gone.  But, after three minutes, impose a one dollar per minute federal "ON HOLD" excise tax.  I believe that the technology is available to record this information.

            With the possibility of paying one dollar per minute of excess "ON HOLD" time, a company would be faced with the choice of paying $60 per hour to the federal government, or hiring and training more people to answer their phones and help the clients and customers.  Imposing such an "ON HOLD" excise tax would reduce unemployment and increase federal government revenue so that the federal deficit can be reduced. 

            So, with this idea, the clients and customers win, the new people hired to answer the phones win, and the federal government (and the taxpayers) win.  The only ones who might lose are the big companies that presently are putting everyone "ON HOLD".

Note: This article was written in 2003 and syndicated to newspapers.

ONE COUPLE WITH TWO PROBLEMS WITH MEDICARE

By Woodrow Wilcox

            A married couple from Schererville brought bills and papers to our insurance agency office and asked us why some bills were not being paid by the insurance companies with which they had Medicare supplement policies.

            I reviewed the papers and made phone calls to investigate the problems.

            I learned that the husband's problem was caused by a clerk who mistyped the DATES OF SERVICE.  The typing error caused the dates of service to be before the man had his policy with the insurance company.  An insurance company will not pay a claim if you have no policy with it no matter how much the company personnel like you.

            I fixed the husband's Medicare supplement insurance problem by getting the dates of service corrected.  That saved our client $1,024.

            The wife's problem was a bit more difficult.  Medicare sent information twice to two different insurance companies.  Medicare sent correct billing and claim information to the wrong insurance company.  Medicare sent either incomplete or other billing and claim information to the correct insurance company.

            The wrong insurance company refused to pay for any of the claim.  Of course, that was to be expected.  The correct insurance company got information from Medicare for a claim of only $81 when the correct amount of the claim was $287.  The client's insurance company paid on the claim according to the information that it got from Medicare.  But, the hospital demanded payment of the balance.

            To help our client, I wrote to the hospital to request that it send the billing and Medicare claims information that it has on this matter to the claims department of the correct insurance company of the client.  That should solve the problem.

            It is unfortunate that Medicare does not work well enough so that senior citizens are not "hit" with unwarranted bills.

Note: For more Medicare articles by Woodrow Wilcox, visit www.woodrowwilcox.com.

Note: This article was written on October 8, 2008 and syndicated to newspapers.

OLD INSURANCE COMPANY MESSED UP CLIENT'S BILLS

By Woodrow Wilcox

            In early March 2009, a client from Highland, Indiana brought some insurance papers to our office and asked me to check on why the medical bills were not being paid.

            In late 2008, the client notified his insurance company to cancel his policy as of January 1, 2009.  The client bought the same Medicare supplement policy from another company for a lower premium and scheduled an effective date for the new policy on January 1, 2009.

            The client switched Medicare supplement insurance policies from U.T.A. Insurance, based in Austin, Texas, to Shenandoah Life Insurance Company.  U.T.A. Insurance Company did cancel the policy on the correct date, but UTA Insurance personnel forgot to cancel the electronic claims crossover from Medicare as of the same date.

            So, after January 1, 2009, Medicare kept sending the claims to UTA Insurance which promptly denied the claims because the policy with that company was cancelled.  The UTA Insurance Company representative with whom I spoke cancelled that crossover notice to Medicare as I was on the phone with her.

            Because of this error by UTA Insurance, the claims of our client were sent from Medicare to the wrong insurance company from January 1, 2009 to March 3, 2009.  To help the client correct this problem, I typed an explanation letter with instructions that the client could send to every doctor, hospital, or laboratory that had an unpaid claim during the period of bad claims crossover.

            The insurance agency where I work provides this kind of service to our senior citizen clients at no charge.  We do our best to protect our clients from being harmed when a Medicare medical billing problem occurs.  And such problems occur often.

Note: This article was written in the spring of 2009 and syndicated to newspapers.

More Medicare Mess Ups

By Woodrow Wilcox

            My associate Gloria Den Hartog and I were discussing more Medicare problems that our agency's clients were experiencing.

            Gloria was helping a client who had a Medicare Part D problem.  In that case, Social Security had been deducting the Medicare Part D (prescription drugs) policy payments from the senior citizen's Social Security checks.  But, the insurance company that was supposed to be getting the payments from Social Security claimed that it never got the payments.

            Gloria helped the client to request an audit to track the money that was taken from the Social Security checks but not paid to the client's insurance company.  The client's prescription drug coverage is threatened because the government Medicare Part D program DOES NOT WORK WELL.

            I told Gloria that I was helping one of our agency's clients who had a Medicare Part A and Part B supplemental problem with a medical office in Lake County.  Medicare disapproved of a $150 charge because the explanation reported by the medical office did not demonstrate the medical necessity of the service.

            Medicare has become strict in its requirements of documentation.  If the information filed with the claim does not support the claim, Medicare denies it to save the federal government some money.

            To help our client, I sent the medical office a letter that requested that the claim be re-filed with corrected notes to support the medical necessity of the service and claim.  Three weeks later, the firm ignored my letter and sent the same bill to our client.  Now, I'm researching the correct procedure to complain to Medicare about the medical firm and its billing practices.

            Anyone who believes that putting the federal government in charge of all health care in this country would solve our health care problems is sadly mistaken and ignorant of the facts of how the federal government's involvement has increased costs and complicated the providing of medical service.

Note: This article was written in late 2008 or early 2009 and syndicated to newspapers.

Protecting Clients/Patients From Billing Mistakes Or Fraud

By Woodrow Wilcox

            Joyce Brannon was murdered by her doctor.  Joyce Brannon was a disabled person on Medicare.  Joyce Brannon was going to testify to a Federal Grand Jury in a Medicare Fraud case against her doctor.  On May 5, 2005, a federal jury convicted the doctor of murdering Joyce Brannon to keep her from testifying against him regarding Medicare Fraud.  In the same trial, the doctor was convicted of Medicare fraud and Mail fraud (intentionally sending false bills through the mail).

            According to the National Healthcare Anti-Fraud Association, health care fraud might be costing the insurance industry $100 million per day.  Medicare fraud is part of the problem. 

In 1986, Anthem Blue Cross Blue Shield established an anti-fraud unit to help find fraud, gather evidence, and cooperate with law enforcement officials.  Anthem Blue Cross Blue Shield publicizes the numbers in mailings to its clients.  In 2004, the Anthem Blue Cross Blue Shield healthcare fraud hotline got over 1,344 calls from Indiana patients, 1,507 calls from Ohio patients, and 2,293 calls from Kentucky patients.

            Carefully examining bills, crunching numbers, and using software to detect fraud are the usual tools of the insurance industry.  But, in some cases, anti-fraud units of insurance companies are actually watching traffic at medical service providers' offices.

            Although some doctors do participate in Medicare fraud, I believe that the vast majority are honest doctors who want to help people and make a decent living.  The tragedy is that some honest doctors get hurt because one or more staff members who handle billing do something incorrectly.  Most of the time, errors involve honest mistakes.  But, sometimes the pattern of "mistakes" does not seem so honest. 

            When these billing "mistakes" catch the attention of insurance investigators or public officials, it could cost the doctor thousands of dollars and hundreds of hours to prove innocence.  Even if no crime is charged, if mistakes were made, the doctor might have to pay restitution, interest, or civil penalties.

            It is sad to me to think that incorrect billing practices by staff members might cost an honest doctor so much money, time, and trouble.  When I see a bill with innocent errors or mathematical mistakes, I write a nice letter to ask that the problem be resolved.  But, when I see something on a bill that seems to "red flag" a potential billing problem for the doctor, I write an "accurate but stern" letter.  Staff members of medical offices that get one of these letters from me don't like it.  They always want to "look good" to their boss-the doctor.  When a staff member protests profusely, I suspect that the staffer might have already known that there was a problem, but did not want to admit it.  Shakespeare summarized this tendency with the phrase, "Me thinks thou doeth protest too much."

            But, I believe that it is in the best interests of both the patient and the doctor that the billing should be done correctly.  An honest patient and an honest doctor have too much to lose when Medicare billing is not done correctly.  Even an innocent doctor can be hurt financially.  And a patient might feel forced to pay a bill or get a negative item on a credit report when neither is justified.  My "accurate but stern" letters are criticized.   But, I believe that they serve the purpose to alert doctors to potential problems in their billing practice and give evidence that I am a friend to both honest patients and honest doctors.

Note: This article was written on May 12, 2005 and syndicated to newspapers.

Michigan City Couple Harmed By Medicare Mess Ups

By Woodrow Wilcox

            Two clients of this agency were harmed financially by "Medicare Mess-ups".  Here is the story of their plight.

            The husband asked our office to investigate a bill for $2,209.38 with a DATE OF SERVICE of April 9, 2008.  I checked and learned that the client's insurance company never got this claim.  But, the insurance company did get a claim on a bill for $4,173.38 with a DATE OF SERVICE of April 8, 2008.

            But, the client was in the hospital for only one day for tests.  He was not in the hospital for two days - just a few hours on one day.  So, one of the bills must be erroneous.  If the amounts matched but the dates differed, I would suspect that someone simply mistyped a date.

            This is still being investigated.  It should be.  How can a hospital generate two bills with such a wide discrepancy in amounts for service on two days when the patient got service on only one day?  Are you starting to understand why I keep saying and writing that the Medicare system is not working for senior citizens?

            The wife had a different problem.  Her bill was given to a collection agency before the claim was made to Medicare and the Medicare supplemental insurance company.  How could that happen?  Well, in this case the doctors/owners/managers of a medical testing company failed to file National Provider Information (NPI) forms with Medicare properly.  Until Medicare gets those forms, the medical testing company can not file any claim with Medicare.  If a claim is not filed with Medicare, it can never be processed by a Medicare supplemental insurance company.

            The management of the medical testing company sent the woman's bill to a collection agency without ever sending a bill to the woman, Medicare, or the woman's Medicare supplemental insurance company.  I talked with a person at the billing firm who admitted that this was wrong and agreed to recall the bill from the collection agency.

            The billing company is now waiting for the owners/managers of the medical testing company to properly file NPI documents with Medicare before any more attempts to collect on the bill are made.

            In past articles, I have written of many problems with the Medicare system which harm senior citizens.  I have written about the problems of senior citizen veterans and their frustrations with mistakes between Medicare and VA services and charges, too.  If the federal Medicare system is saturated with problems, what will all medical service be like if the federal government takes over all health care?

NOTE:  Woody Wilcox is the senior problem resolution officer at Senior Care Insurance Services in Merrillville, Indiana which is the largest senior citizen oriented insurance agency in the Midwest.

Note: This article was written in the summer of 2008 and syndicated to newspapers.

MEDICARE-VA PROCEDURES CHEAT SENIOR VETERANS

By Woodrow Wilcox

            I have been helping a client who is a senior citizen veteran from Dyer, Indiana.  He is in a typical situation.  Medicare-VA procedures don't work and it is costing him money.  He has a bill of over twelve hundred dollars which would be paid if Medicare and the VA ever fix their billing system.

            Here is the problem.  A senior citizen who enrolls in Medicare shows a Medicare ID card to a medical service provider (i.e., a doctor, hospital, laboratory, etc.).  The Medical service provider bills Medicare.  Medicare determines the charges allowed under the Medicare system and pays 80% of the allowed charges.  Either the patient or the patient's Medicare supplement insurance company pays the annual deductibles and the other 20% of allowable charges.  That is the way the system is supposed to work.

            The problem for senior citizen veterans is that the VA can not bill Medicare because one department of the federal government can not bill another department of the federal government.  So, when someone uses VA medical services, Medicare is not being advised.  If Medicare is not advised and allowed to calculate allowable charges and the annual deductibles, then these figures get skewed and hurt the senior citizen veteran.  When Medicare does not get, calculate, and forward information to the patient's Medicare supplement insurance company, that insurance company does not pay any bills.

            I contacted the Medicare supplement insurance company of our senior veteran client from Dyer.  It never got any claims for the dates of service that are on the bill from the VA clinic.

            Last year, I made many phone calls and climbed up the ladder of VA clinics to discuss this billing problem.  The result was an article that I published last fall to help senior citizen veterans.  At the time, VA officials said that they were working on the problem and they thought that they had a solution.  I had them explain the proposed solution to me.  It was convoluted.  After hearing it, I told them that I was where "the rubber meets the road" and that their proposed solution would not work.

            A few years ago, some people in Washington thought that they could save taxpayers money by letting VA collect money from Medicare supplement insurance companies that were paying on Medicare claims anyway.  But, forbidding the VA to bill Medicare directly causes the system to break down.  The cost to senior veterans is enormous.  There is a high cost of frustration with a system that does not work.  And, each senior citizen veteran who uses VA health services and has Medicare and a Medicare supplement insurance policy could end up paying over TWELVE HUNDRED DOLLARS per year more than a non-veteran on Medicare.  That is because the bad communication between Medicare and VA could force the veteran to pay the annual Medicare deductibles TWICE!  If there are one million senior citizen veterans, then this bad Medicare-VA problem is costing senior citizen veterans OVER A BILLION DOLLARS PER YEAR.

            The squeaky wheel gets the oil.  Please, join me in "squeaking" about this to Congress, the President, the VA, and Medicare so that this injustice to senior citizen veterans ends.

Note: For over five years Woodrow Wilcox has helped senior citizens with their Medicare billing problems and has written and syndicated articles about it.  Written on September 16, 2008 by Woodrow Wilcox.

MEDICARE STATEMENTS DID NOT MATCH

By Woodrow Wilcox

            One of this agency's senior citizen clients sent a bill to our office for our review.

            This insurance agency is not legally obligated to assist clients with customer service problems or claims problems.  Insurance companies have entire departments devoted to those purposes.

            But, many times, a senior citizen on Medicare does not know what to say to a claims or customer service person at an insurance company or at Medicare offices.  Sometimes, something is missing and the senior citizen does not know that.  Medicare procedures can be complicated.  So, our agency tries to help in such matters because we really do care about our clients.

            The bill to the client was for date of service 01/02/2008 and had a balance of $32.65.  I contacted the client's insurance company and learned that the bill from the hospital did not match the information from Medicare that the insurance company received.

            The Medicare information received by the insurance company showed that after Medicare's payment and discount, the balance of the bill was only $11.69 which the insurance company paid.

            So, why did the hospital want the senior citizen to pay an extra $32.65?  I requested that the hospital send a copy of the Medicare information that it received about this bill to the insurance company claims department.

            Since then, the hospital has not tried to get the extra $32.65 from our client.  This sort of thing happens quite often.  We try to help our senior citizen clients by protecting them from wrongful charges due to the errors of others.

Note: This article was written on August 5, 2008 and was syndicated to newspapers.

MEDICARE REPORTS DID NOT MATCH

By Woodrow Wilcox

            A client who lives in Schererville, Indiana brought conflicting paperwork to our office and asked for our help.  I helped her.

            According to the documents, the doctor's office received a partial payment from Medicare with a Medicare EXPLANATION OF BENEFITS.  The statement from the doctor's office showed a Medicare adjustment of the bill, a Medicare payment on the bill, and a balance of 20% of the approved charges for the patient or the patient's insurance company to pay.

            But, Medicare sent a Medicare EXPLANATION OF BENEFITS to the client's insurance company which stated that the bill was not approved by Medicare.  When a bill is not approved by Medicare, neither Medicare nor the Medicare supplemental insurance company will pay on the bill.

            But, the statement from the doctor's office showed that Medicare had approved, adjusted, and paid on the bill.  So, Medicare sent conflicting documents to the doctor's office and the insurance company.

            I wrote to the doctor's office and requested that a copy of the Medicare EXPLANATION OF BENEFITS that the doctor's office received be sent to the claims department of the client's insurance company.  I was hoping that this quick way of getting information to the insurance company would avoid the long and tedious process of getting Medicare to re-examine and correct some records.

            For those who think that allowing the federal government to control and pay for all health care is a solution, you would not think that if you had my job for a few days.  The federal government has done much to mess up the nation's health care system.

Note: This article is undated but was syndicated to newspapers.

MEDICARE AS PRIMARY INSURER VERSUS

MEDICARE AS SECONDARY INSURER

By Woodrow Wilcox

            Over half of every day that I work is spent in fixing Medicare bill payment problems.  There are many ways that Medicare does not work well when it comes to getting bills paid for the senior citizens who rely on Medicare.

            One problem which keeps arising has an easy preventative solution that every senior citizen can pro-actively use.

            When a senior citizen relies on a group health insurance plan as a primary insurer after reaching age 65 and enrolling in Medicare, the termination of the private group health insurance can cause billing problems.

            The senior citizen could be covered by a group insurance plan through work or through the employment of a spouse who is part of a group plan that provides coverage for the Medicare enrollee.

            Often, when the group coverage is terminated, Medicare is not notified.  So, bills go to the wrong place and are not properly paid.  According to Medicare's records, the senior citizen still has coverage from a private group health insurance plan.  So, Medicare believes that Medicare is the secondary insurer.

            When the senior citizen terminates the private insurance coverage, Medicare becomes the primary insurer.  But, often Medicare does not get notified of this.

            If you are enrolled in Medicare and your private group insurance coverage ends, get a letter of termination from the private insurer and send a copy of the letter to Medicare with a note that advises that from the termination date onward, Medicare is your primary insurer.

            In the note, remind Medicare to reprocess any claims that have come to Medicare since the date of termination of the private group insurance coverage.  There are big differences in the calculations and Medicare payments between Medicare as a secondary and Medicare as a primary insurer of a senior citizen.

            Follow this advice, and you can avoid a lot of billing problems.

Note: This article is one of the earliest articles written by Woodrow Wilcox.  It is undated, but it was syndicated to newspapers.

PROBLEMS WITH MEDICARE PART C AND OUT OF STATE INSURANCE AGENTS

By Woodrow Wilcox

            Two clients of this agency have gotten into big financial trouble because they responded to phone calls from out-of-state insurance agents.  Medicare Part C was the problem in each case.

            Medicare Part C is a relatively new choice in Medicare coverage.  Medicare Part C combines Medicare Part A, Part B, and Part D with some restrictions to lower costs.  The restrictions deal mostly with which doctors, hospitals, and laboratories a senior citizen can use. 

            An unfortunate part of the laws and regulations covering Medicare Part C plans is that insurance agents from other states can sell it.  I strongly recommend that a senior citizen always use a local insurance agent.  The local insurance agent is licensed in the state where the senior citizen lives and is very familiar with the hospitals, doctors, and clinics that the local senior citizen might use.  If there is a problem with a bill and the senior citizen needs help to resolve it, the local insurance agent who sold the Medicare supplement policy can help the senior citizen.

            One of our clients who lives in Indiana responded to a phone call from an insurance agent in Illinois.  She agreed to receive information about a Medicare Part C insurance plan that the agent was promoting.  She thought that she signed to just review the information.  After she reviewed the information, she phoned and wrote letters to cancel it.  But, the insurance company would not cancel it and the insurance agent who sold it did not help her to cancel it.  Now, she has a bill for $1,287 for an insurance policy that she never wanted.  It is a Medicare Part C policy that did not suit her needs.  I am working to help her get this bill cancelled.

            One of our clients who is an immigrant from China responded to a similar phone call from an insurance agent in Texas.  The immigrant's understanding of English is good but not great.  The acceptance of information about a Medicare Part C plan from another company has caused enormous hardship on the client and the client's family.

            Medicare calculates what it should pay and what the patient or the patient's insurance company should pay DIFFERENTLY DEPENDING ON WHAT MEDICARE PROGRAM THE PATIENT CHOOSES.  Medicare C pays very differently than the normal combination of Medicare Part A, Part B, and Part D.  Medicare C has more restrictions, too.  Those restrictions can add up to more charges that the senior citizen must pay without the help of Medicare or an insurance company. 

            So, please, always use a local insurance agent to help in selecting the Medicare plan and insurance policy that is best for you.  To learn more about Medicare problems and solutions, visit www.woodrowwilcox.com.

Note: This article was written on September 25, 2008 and syndicated to newspapers.

MEDICARE MISDIRECTED BILLS TO OLD INSURANCE COMPANY

By Woodrow Wilcox

            I have evidence that someone at Medicare needs to catch up on some work.

            Our client from Hobart, Indiana visited California and needed some medical services during her visit.  The medical service providers filed the claims with Medicare.  But, Medicare forwarded the claims information to our client's old insurance company.

            When I say "old" insurance company, I mean that our client had not used the "old" insurance company for two years!  So, someone at Medicare needs to update some information to make claims processing smoother for Medicare patients and their medical service providers.

            The "old" insurance company denied the claims, of course.  Fortunately, the client sent me some paperwork from the "old" insurance company.  I worked on getting the claims redirected to the client's current insurance company for processing and payment.  If this had not been done, our senior citizen client would have started to get bills from medical bill collectors for $1,602 that she would not owe if Medicare had forwarded the claims information to the correct insurance company. 

            So, the free service that I and this insurance agency provided to our client will save her $1,602.

Note: This article was written on September 9, 2008 and syndicated to newspapers.

MEDICARE MESSES MILLER WOMAN'S MEDICAL BILLS

By Woodrow Wilcox

            A woman from the Miller Beach section of Gary, Indiana got a medical billing problem caused by Medicare.  She is a senior citizen client of this insurance agency and I helped her with the medical billing problem without any charge because that is this agency's policy.

            She switched her Medicare supplement insurance policy from one company to another to save money on premium payments.  Medicare was notified in advance of the change from one insurance company to another and informed of the date when the change would occur.

            But, someone at Medicare ignored the information and started sending claims to the new insurance company BEFORE THE CHANGE TO THAT COMPANY HAD OCCURRED. 

            That's right.  Medicare stopped sending the claims information to the correct insurance company and sent the claims information to the future insurance company before the change was scheduled.  So, Medicare stopped sending claims information to the correct company but sent the claims information to the wrong company.

            Because Medicare messed up, the old insurance company did not get the claim information and did not pay the claims.  The new insurance company refused to pay on any claims that happened before the effective date of the policy with the new company.  So, our elderly client was not getting her claims paid for a while.  Bills that she did not expect were coming to her with demands for payment.

            I don't have room here to describe what I did to correct this problem.  But, I did help the woman and the billing information will be sent to the correct insurance companies.  If no one had helped this elderly woman, she would have been hounded by bill collectors to pay bills that she really did not owe.

            In past articles, I have estimated that Medicare billing problems like this cost senior citizens in the U.S. OVER ONE BILLION DOLLARS PER YEAR IN FALSE CHARGES.  I am proud to work at an insurance agency that tries to protect its clients from such false charges caused by Medicare billing mistakes.

Note: This article was written on February 20, 2009 and syndicated to newspapers.

MEDICARE AND MAYO CLINIC HIT MICHIGAN CITY MAN WITH BIG BILL

By Woodrow Wilcox

            One of this insurance agency's clients from Michigan City got an unexpected bill from the Mayo Clinic for $488.44.  The client sent the bill to me and asked me to check on it.

            The client has a very good Medicare supplement policy with Equitable Life & Casualty Insurance Company.  Medicare and the client's policy with Equitable should have paid any bill that the client incurred.  So, the client was surprised by a bill for almost $500.

            I checked on the matter and learned that the client's insurance company never got the claim from Medicare.  The bill had aged over 90 days and could have hurt the client's credit rating.

            When Medicare goofs like this, senior citizens get hurt.  Their credit rating can be hurt.  They can get annoying phone calls and demand letters from collection departments, collections agencies, and collection attorneys.  Many times senior citizens are bullied into paying these bills EVEN THOUGH THEY DON'T REALLY OWE ANYTHING.  All of this happens because the federal government's MEDICARE system is faulty and creates problems for senior citizens.

            I wrote to Mayo Clinic for our client.  I told Mayo Clinic what to send to our client's insurance company so that the claim could be processed and paid.  This insurance agency pays me to help our senior citizen clients with such Medicare bill problems at no charge to our clients.

            In past articles, I have estimated that senior citizens across America are cheated over ONE BILLION DOLLARS PER YEAR because of Medicare billing problems.

Note: This article was written on February 17, 2009 and syndicated to newspapers.

MEDICARE, HOSPITAL, AND DOCTOR

GIVE SENIOR CITIZEN ROTTEN TREATMENT

By Woodrow Wilcox

            A client from Cedar Lake has had really bad luck with Medicare, a hospital, and a doctor.

            On June 1, 2007, the client switched Medicare supplement policies from one insurance company to another insurance company with a lower rate.  That is a normal and smart thing to do to save money. 

            Unfortunately, Medicare personnel did not update her records in a timely manner.  The switch from the old insurance company to the new insurance company was on June 1, 2007.  But, on January 4, 2008, the old insurance company reported that it had received a claim notice from Medicare for a medical service to our client which happened on September 21, 2007.

            Of course, the old insurance company refused to pay the claim because our client did not have a policy with that insurance company on September 21, 2007.  Medicare should have sent the claim to the new insurance company.  But, Medicare did not.  This gummed up the works a bit.  But, the hospital in Lake County, Indiana compounded the problem.

            The hospital started sending bills to our client from various addresses in Illinois, Michigan, and Pennsylvania.  The places that generated the bills were not the place to which the hospital wanted a payment sent.  And the hospital did not want the payment sent to its Lake County, Indiana address where the medical services were performed and the bill was generated.

            To help our client, I wrote a polite letter that explained that Medicare sent the claim to the wrong insurance company and telling the hospital what to send to the correct insurance company so that the claim could be paid.  I sent the letter to the Chicago payment collection address. 

            But, the people at the payment collection address never did anything that I asked.  They never contacted the hospital personnel with the medical service and billing records to tell them about my letter.  When I discovered this, I phoned the hospital and requested the fax number to the patient billing department.  I used that fax number to send a cover fax and a copy of my previous correspondence to the patient billing department.  But, that fax was ignored by hospital personnel.

            When I discovered that, I made multiple calls to the hospital and was told to fax the same information to a different fax number.  I did so.  But, then, our client's account was given to a collection agency in Pennsylvania.

            The hospital in Lake County, Indiana has treated our client very badly.  How many other senior citizens are being harmed financially by this hospital's terrible business practices?  As bad as this is, I know of a doctor in Merrillville, Indiana who treat's senior citizens with even worse business practices.

            I am still helping this client.  My assistance is free because she is a client of this insurance agency.  How much are bad business practices by Medicare and medical service providers costing senior citizens who are badgered until they pay bills that they should not have to pay?  I estimate that these practices cost senior citizens on Medicare about ONE BILLION DOLLARS PER YEAR.  Someday, I hope to testify to Congress on this.  When I do, I will name the rotten hospital and the rotten doctor.

Note: Written on September 19, 2008 and syndicated to newspapers.

MEDICARE GOOFED AGAIN!

By Woodrow Wilcox

            One of the clients for this insurance agency sent a bill to me from The University of Chicago Medical Center and asked me why his insurance company had not paid the bill.  This agency helps our senior citizen clients with such billing problems free of charge.  Our agency is the largest senior citizen oriented insurance agency in the Midwest.

            I checked with the client's insurance company.  This was another case of Medicare goofing up in a way that costs millions of senior citizens millions of dollars per year.  In other articles, I have estimated that Medicare goofs cost senior citizens about ONE BILLION DOLLARS per year in false charges for medical services.  To read some of the articles that I have written over the past five years, visit www.woodrowwilcox.com.  To watch my videos about senior citizen issues, visit www.woodrowwilcox.tv or www.woodrowwilcox.com.

            The bills that the hospital reported to Medicare were for original amounts of $3,072.00, $1,187.00, and $3,321.09.  Medicare reported the original amounts of the bills to the client's insurance company as $275, $686, and $1,120.  The client's insurance company paid the claims based on the information sent to it by Medicare. 

            Medicare caused a problem that could have cost our client hundreds of dollars in "false charges".  By "false charges" I mean that the senior citizen on Medicare is getting billed an amount which would not be billed if Medicare (or someone involved in the Medicare process) had done the job correctly.  Senior citizens who are on fixed incomes are getting cheated by millions of dollars per year because of Medicare goofs.

            I helped our client to avoid hundreds of dollars of "false charges" by contacting the hospital, explaining the situation, and requesting that the hospital send certain information to the client's insurance company so that the claim could be processed and paid properly. 

            I am glad that I was able to help our client.  But, I worry about other senior citizens on fixed incomes with Medicare who don't have anyone to help them avoid the "false charges" that happen when Medicare goofs.

Note: This article was written on October 3, 2008 and syndicated to newspapers.

Medicare Foul-Ups Cost Senior Citizens Millions of Dollars per Year!

By Woodrow Wilcox

            On an average day, I handle three serious and multiple minor problems caused by Medicare Foul-Ups.  On July 15, I handled three serious Medicare Foul-Ups that prompted me to write an article on the subject that day.  Then, I wondered about how much do these Medicare Foul-Ups cost senior citizens every year.

            The three serious problems for three different clients on that day were  (1) Medicare failed to send the essential billing information to the correct insurance company for payment; (2) Medicare sent conflicting reports on medical charges to the doctor's office and to the patient's insurance company; (3) the Veterans Administration did not send the necessary information to a client's insurance company for payment processing and VA officials were obstinate and did not want to cooperate with solving the problem.

            If these incidents are statistically average, then the cost of Medicare Foul-Ups to senior citizens can be reasonably estimated.  Here are my calculations.

            If the average Medicare Foul-Up that is not fixed costs a senior citizen on Medicare an extra $100 in charges that are wrongfully charged to the senior citizen, then the total cost to all senior citizens can be calculated this way.

            Our office handles 3 serious problems per day.  Our agency has about 5% of the senior citizen market in our congressional district.  So, 3 x 20 should equal 100% of average daily serious Medicare Foul-Ups in one congressional district.  There are 435 congressional districts.  So, there should be an average of 26,100 serious Medicare Foul-Ups per day in the U.S.  If each unresolved foul-up costs a senior citizen $100 that the senior citizen should not have to pay, then serious Medicare Foul-Ups are costing America's senior citizens $2,610,000 EVERY SINGLE DAY.  Multiply that figure by 365 and the annual costs to senior citizens for serious Medicare Foul-Ups is $952,650,000.  But, this is only for Medicare Part A and Part B problems.  Medicare Part D (prescription drugs) is another engine of Medicare Foul-Ups.

            Many insurance agencies do not have the ability to help their senior citizen clients to save money by correcting serious Medicare Foul-Ups.  So, those senior citizens are badgered with demands for payment of the wrongful bills until they pay the wrongful bills.

            If you believe that having the federal government handle all health care matters will solve problems, you just don't know the facts about how the federal government actually causes many problems that cost citizens and the health care system billions of dollars a year.  If you helped senior citizens with these problems as I do, you would understand what I mean.

Note: This article was written on July 28, 2008 and syndicated to newspapers.

MEDICARE PART D CHANGE TIME IS HERE

By Woodrow Wilcox

            Senior citizens who want to change their Medicare Part D insurance policy need to do that before December 31.

            By law, the time for changing Medicare Part D coverage is from November 15 to December 31.  The Medicare Part D coverage is kept on an annual basis because of the "donut hole" calculation.  The "donut hole" is figured on an annual basis from January 1 to December 31.  The "donut hole" is that part of the Medicare Part D program which forces the senior citizen to pay full price for all prescriptions.

            Some companies are now taking the "hard line" that if you don't get the cancellation letter or fax to them by December 31, you must remain that company's premium paying client for another full year.

            So, any senior citizen with a Medicare Part D policy who thinks that a change in policies or insurance companies might be in order should meet with an insurance agent right away to explore the options.  Don't wait until the last day or minute because that might be too late.

Note: This article was written in November 2006 and syndicated to newspapers.

Medicare Doesn't Cover Everything

By Woodrow Wilcox

            Medicare does not cover everything.  Be aware of that.

            Recently, an elderly woman asked me to review a bill that she got from her doctor.  It was for over $250.  Most of the bill was for tests that the doctor ordered. 

            But, Medicare did not approve the charges.  Because Medicare did not approve the charges, the Medicare supplement insurance company would not pay on the charges either.  So, at least for now, the senior citizen is "stuck" with the big bill.

            Here are some insights to help all senior citizens who rely on Medicare:

1. Realize that Medicare does not pay for any and all medical procedures or services.  Long ago, a system was established in which Medicare could review procedures and services.  If the procedure or service seemed medically necessary, it would be approved.  If it was not medically necessary, it would be disapproved.  If it is approved, Medicare will pay on it.  If it is not approved, Medicare will not pay on it.
2. If Medicare will not approve and pay on a medical service or procedure, then the Medicare supplement insurance company will not pay on it either.  This type of insurance is a supplement insurance.  But, the supplement insurance company relies on the judgment of the Medicare officials. 
3. There are many, many procedures and services that Medicare will not pay for a Medicare client.  For example, eye glasses are not covered by Medicare, Routine dental services and procedures are not covered by Medicare.  For some procedures or services, Medicare will pay for only a limited number of times per year, depending on the exact treatment or service.
4. Medicare routinely refuses to pay when the doctor or service provider does not write notes which clearly demonstrate the medical necessity of a service or procedure.  So, if you have a problem like the one I discussed above here, first contact the medical service provider to ask that the notes be augmented to clearly show the medical necessity of the service or procedure, and then that the claim be resubmitted to Medicare.  I have used this method to help many senior citizens reduce their bills.
5. Realize that the Congress and President can change the deductible as they did at the beginning of 2004.  When that happens, realize that your Medicare supplement insurance company will not make up the difference.  You will.
6. Have extra cash in reserve, or extra insurance, to help cover dental, eye glass, or other medical services that Medicare will not cover.
7. If money is a problem, tell the doctor or other medical service provider that.  Ask that they check whether the medical service or procedure will be covered by Medicare.  If it won't be covered, ask that an alternative procedure or service that Medicare will cover be used to achieve the same results.  Ask that the notes given to Medicare make it clear that there is a medical necessity for the procedure or services.  As long as Medicare will pay, your Medicare supplement insurance company will pay.  That will reduce the chances of an expensive surprise for you.

Note: This was one of the first articles about Medicare written by Woodrow Wilcox in 2003 and syndicated to publications in northwest Indiana and the south part of Chicago and suburbs in Illinois.

Medicare Part D Needs To Be Fixed

By Woodrow Wilcox

            January 1, 2006 marked the start of Medicare Part D prescription drug benefits.  The new Medicare coverage has many problems.

            A big problem is that it is not standardized.  With Medicare Part A and Part B, the federal government standardized the plans for Medicare supplement insurance coverage.  In that way, the Plan A of one company covered exactly the same things as the Plan A of another insurance company for Medicare supplement coverage.  This reduced the chances for confusion of senior citizens while still allowing them to have choices.

            With Medicare Part D, the federal government did not standardize the plans that could be offered by insurance companies.  Instead, the federal government set a minimum standard of benefits and then let insurance companies get creative with their coverage plans.  There are over 500 insurance companies that offer Medicare D insurance plans and most of them have four different plans.  So, there are about 2,000 different plans that senior citizens and insurance agents could study and consider.  That has overwhelmed many senior citizens and their insurance agents.

            The federal law that created Medicare Part D created a "donut hole" of coverage in all plans that will force the average senior citizen to pay $3,600 per year in medicine costs before the 95% cost coverage assistance starts.  In addition to the $3,600 that a senior citizen would pay for medicine, the senior citizen now must pay a new insurance premium for a Medicare D plan directly from the Social Security monthly check that the senior citizen would otherwise receive.  So, the Medicare D program reduces senior citizens' Social Security checks.

            In my opinion, the new law is too complicated and does not offer any real relief for most senior citizens.  Complicated laws are difficult for anyone, but especially for senior citizens and the relatives, friends, and insurance agents who try to help them.  Also, the Medicare Part D program does not offer any real financial relief to the average senior citizen.  The law just complicates the lives of senior citizens even more than what existed before Medicare Part D.

            I believe that Congress would serve senior citizens and our country better by passing laws to regulate the price of drugs so that pharmaceutical companies make a reasonable profit, but not astronomical profits by setting the prices at whatever level the executives of those companies want.  Billions of dollars in tax breaks and grants are already given by our government for research and development.  If our tax dollars help to pay to develop and test drugs, then we should have a say in what will be the price of those drugs. 

Note: This article was written in early 2006 and syndicated to newspapers.

Medicare Needs Reforming

By Woodrow Wilcox

            President Lyndon Johnson proposed the Medicare program to help the image of his political party and his presidency during the Vietnam War. 

            The program was put together rather quickly and with input from limited sources.  The main parties consulted were leaders in the government industry (bureaucrats and politicians), the insurance industry, and the medical industry.  Not much thought was given to how this would affect the average person who had to use the system or work in the system.

            For example, dental and vision care for senior citizens was not seriously considered.  To this day, Medicare will not pay for most dental or vision related health problems for senior citizens.  Another example is the lack of consideration for the privacy of senior citizen's personal information such as age, date of birth, social security number, address, telephone number, and other personal data.  Only last year did the federal government start requiring more stringent protection of and accountability for such personal information.  Also, Medicare lacked any prescription medicine benefits until President Bush signed into law a new, phased-in benefit which will start rather soon.

            The arithmetic for supporting the Medicare system has changed, too.  It used to be paid from general revenue of the U.S. government.  Now, a special tax is imposed on every paycheck of every worker in America to help fund Medicare.

            In my first year of college, my science professor engaged in debates about the Medicare system.  In those debates, he predicted that the Medicare system would drive up the prices charged for medical services because more money would be needed to support the bureaucracies of the federal government, the state governments, insurance companies, and medical service providers who would need extra personnel to deal with the other bureaucracies.

            In my first job after college, I learned about more problems with the Medicare system while working at Blue Cross Blue Shield of Indiana.  That company was contracted by the State of Indiana to help administer Medicare and Medicaid in Indiana.

            I work with Medicare related problems of senior citizens almost every day.  I believe that there is enormous room for improvement.  It is my hope that a careful discussion of reforming the entire system will occur in the near future.   I hope that both the politicians and the public will request and consider suggestions from people who actually work in the system.  In my opinion, many of the problems can be corrected by some changes in the system.  People who have special interests to keep the Medicare system as it is, in order to keep money coming to them and to their friends, will offer many arguments and inaccuracies in order to confuse and scare the public.  I challenge everyone to keep an open mind about all suggestions for change.  Think of solving the Medicare system problems like you might solve a jigsaw puzzle: never reject any piece until you are absolutely sure that it is not part of the puzzle.

Note: This article was written on December 1, 2004 and syndicated to newspapers.

Medicare's Many Changes, Many Deadlines, and Much Confusion

By Woodrow Wilcox

            The combination of the start of Medicare Part D and the end of healthcare coverage for almost 3,000 Inland-Ispat-Mittal Steel retirees or their surviving spouses has created confusion for many area senior citizens. 

            First of all, let me suggest that if you have an insurance agent who has studied Medicare Part D and is willing to explain it to you, appreciate that agent as a real friend.  Insurance agents are not getting much of a commission for explaining and enrolling for Medicare Part D.  I have heard some insurance agents complain that taking time to explain Medicare Part D and enroll people in it is costing them time and money without providing enough money to cover their expenses for doing it.  So, if you have an insurance agent who is trying to help you with Medicare Part D, realize that your insurance agent is acting as a friend to you, also.

            November 15, 2005 was the first day that senior citizens could enroll in the new Medicare Part D coverage plans.  But, the Medicare Part D coverage will not start until January 1, 2006.  People who already have Medicare Part A and Medicare Part B are eligible to enroll in Medicare Part D.  The open enrollment period for people who already have Medicare Part A and Part B is from November 15, 2005 to May 15, 2006.  After that open enrollment period ends, if someone who was eligible enrolls, there will be a financial penalty for enrolling after the open enrollment period.  The penalty is usually one percent per month of tardiness.  If you need further explanation, ask your insurance agent.

            Also, November 15, 2005 was a deadline for almost 3,000 retirees and surviving spouses of Inland-Ispat-Mittal Steel Company to enroll in the Medicare supplement insurance program offered through NEBCO in Rhode Island.  Mittal Steel decided to drop the health insurance coverage for company retirees and surviving spouses to save $2.5 million per year.  Mittal invited NEBCO to offer Medicare supplement insurance to the affected people at group rates.  NEBCO set a deadline for enrollment of November 15, 2005, but promised the retirees that they could withdraw their application before January 1, 2006 and receive a full refund.  The NEBCO plan included a provision to enroll in Medicare Part D and a Medicare Part D insurance plan for prescription drug coverage.

            The Inland-Ispat-Mittal Steel retirees affected by the cutoff of healthcare coverage will lose all their retirement healthcare benefits from Mittal Steel as of January 1, 2006.  Under federal law, these affected senior citizens will have just over two months to enroll in some other Medicare supplement insurance plan and be guaranteed acceptance.  When they apply with another insurance company, they will have to furnish a letter of prior coverage from the insurance company that covered them up to January 1, 2006.  But, these affected senior citizens should try to apply for a Medicare supplement insurance policy that would start on January 1, 2006 so that there is no gap in their policy coverage.

            One of the main differences between Medicare Part A and Part B and the new Medicare Part D is the lack of standardization of plans.  For Medicare Part A and Part B, the federal government standardized the plans so that there is less confusion to senior citizens.  A Plan A Medicare supplement policy from one insurance company would cover exactly the same services as a Plan A Medicare supplement policy from another insurance company.  The federal government did not standardize Medicare Part D in the same way.  Instead, the federal government required insurance companies to provide certain minimum coverage in any plan.  After that, insurance companies were free to be creative in their policy designs.  Over 500 insurance companies were approved to sell Medicare Part D policies.  Most of those companies have four or more coverage plans.  So, that means that senior citizens and their insurance agents have over 2,000 choices for Medicare Plan D coverage.  Both insurance agents and senior citizens are being overwhelmed by the variations.

            But, wait!  There's more confusion on the horizon!  Several states are challenging the constitutionality of the new Medicare Part D law.  The states are not upset about the idea of helping senior citizens.  The states are upset that the federal government wrote the Medicare Part D law in such a way as to really "stick" most of the costs to the states.  Texas and New Hampshire seem to be leading the way with resolutions, budgeting cuts, and lawsuits to get the federal government to change Medicare Part D so that it won't bankrupt the states.

Note: This article was written in the fall of 2005 and syndicated to newspapers.

Medicare Bureaucracy Assists Medicare Fraud

By Woodrow Wilcox

            In March, a client of this insurance agency showed me paperwork about a bill which was filed under her identification information, but which was not her bill.

            Someone had received services from a local hospital under our client's name and identification.  The bill was filed with our client's insurance company.  The insurance company sent an EXPLANATION OF BENEFITS to the client.  That was when she first learned of the bill.  The portion of the bill which the insurance company would not pay was $912.

            I helped the client to contact both the hospital and her insurance company to advise them that she was not in the hospital on the dates of service shown in the bill and the explanation of benefits.  I thought that this was just an innocent error, so I did not pursue further work or investigation of the matter.

            In late May, the same client visited the office with two new bills that were made with her identification information, but without her.  Someone made a bill under our client's name with a nursing home for $3,213.  Also, someone made a bill under our client's name with a hospital in Fort Wayne, Indiana for $31,173.75.

            I helped the client to write letters to these facilities to advise them that she never used their services.  Also, I contacted her insurance company and learned that they were already making inquiries about the legitimacy of the bills.

            But, I was very surprised when I tried to contact an appropriate officer of Medicare to report possible fraud which needed to be investigated.  I got switched around to different people.  Finally, I talked to a Medicare supervisor named Dawn Madison.  She said that she could not give me an address or a fax number to send a letter and documentation about possible Medicare Fraud because there was no address or fax number that was dedicated to such a purpose.

            With all the publicity about identity theft and the victimization of senior citizens in such matters, why doesn't Medicare have a specific office, address, phone, and fax that are dedicated to receiving information about possible Medicare fraud and directing the information received to the appropriate office for investigation and/or prosecution?  Why doesn't anyone in the federal government think about practical things like that?

Note: This article was written on May 30, 2006 and syndicated to newspapers.

MEDICARE BILLING PROBLEMS HURT SENIOR CITIZENS

By Woodrow Wilcox

            In previous articles, I have estimated that Medicare billing problems cost senior citizens across America about ONE BILLION DOLLARS PER YEAR in charges that would not come to them if the Medicare system worked properly.

            There are various reasons which cause the variety of problems.  But, all the problems with the Medicare billing system cost money to senior citizens on Medicare if the problem is not spotted and steps are taken to correct the billing errors.

            For over six years, I have helped to correct the Medicare billing problems of the clients of the largest senior citizen oriented insurance agency in the Midwest.  That has been one of my duties at the insurance agency where I work in Merrillville, Indiana.

            This agency has thousands of senior citizen clients.  Handling Medicare billing problems for our clients allowed me to see patterns of problems with Medicare billing that repeatedly hurt senior citizens.  So, after I help the insurance agency's clients, I stay after work and write articles about Medicare billing problems in order to help senior citizens across America by alerting them to possible problems and the work that I have done to resolve the Medicare billing problems for our clients.  I have written and distributed the articles without charging publications for using the articles. 

Many of the articles that I have written are posted at www.woodrowwilcox.com.

I would like to tell Congress about the Medicare billing problems that are costing senior citizens about ONE BILLION DOLLARS PER YEAR.  Until the problems are corrected, senior citizens will continue to be harassed and bullied by collection agencies and attorneys for medical bills that the senior citizens would not be asked to pay if Medicare worked properly. 

I need your help.  Please, contact your representatives in the Congress and the U.S. Senate.  Encourage them to read the Medicare articles at www.woodrowwilcox.com.  And, encourage your friends to read the Medicare articles at www.woodrowwilcox.com and to contact their representatives in the Congress and the U.S. Senate to get them to pay attention to this important issue.

Note: This article was written on February 11, 2009 and syndicated to newspapers.

Note: Now, you can refer others to the website www.medicareproblems.net, also.

Medicare and Social Security Foul Ups

By Woodrow Wilcox

            Some people ask me why I don't want a government health care system for everyone.

            One of the reasons is contained in a file that is on my desk as I write this.

            With the consent of our clients, I have a copy of their official records with Medicare and Social Security.  The record shows that both the husband and the wife were enrolled in a Medicare Part C plan and a Medicare Part D plan starting on January 1, 2007.

            What's wrong with that?  You can't be enrolled in a Medicare Part C plan and a Medicare Part D plan AT THE SAME TIME.  THOSE PLANS ARE MUTUALLY EXCLUSIVE.  But, Medicare and Social Security records claim that the elderly couple has both plans at the same time.

            The problem is that this is "screwing up" the couple's medical and prescription bills.  The medical service providers and the prescription drug providers can't get the billing straight because Medicare and Social Security do not have the record straight.

            When Medicare Part D started, the federal government plan was that Social Security would deduct Medicare Part D plan premiums from the retirees' Social Security checks and send the money to the proper various insurance companies.  That proved to be too complicated for Social Security to handle, so Social Security stopped withholding payments for the insurance companies.  Then, millions of senior citizens got bills from their Medicare Part D plan insurance companies for several months of unpaid premiums for their Medicare Part D plans.

            Under President Lyndon Johnson, Medicare was enacted by a Democrat controlled Congress to help President Johnson and Democrats win support among senior citizens to offset the unpopular Vietnam War. 

            Under President George W. Bush, Medicare Part D prescription programs were enacted by a Republican controlled Congress to help President Bush and Republicans win support among senior citizens to offset the unpopular War in Iraq.

            In both cases, I believe that the laws enacted were poorly designed, poorly written, poorly planned, and poorly implemented.  The purpose of these laws was to please certain political special interests and certain financial interests rather than design and implement a program that really would benefit senior citizens.

Note: This article was written on June 11, 2007 and syndicated to newspapers.

Medicare Part D: Prescription for Drugs and Court Battles

By Woodrow Wilcox

            Medicare Part D assistance for prescription drugs is scheduled to start in January 2006.  But, don't call your insurance agent yet to get the details.  There are some problems that might postpone the start of Medicare Part D.

            There is an old saying that "The Devil is in the details."  That seems to be the case for Medicare Part D.  To finance the purchase of drugs for senior citizens, the federal law required the states to send money to the federal government to help pay for this new service.  Leaders of state governments are challenging the requirement as unconstitutional. 

            New Hampshire passed a law that no money would go to the federal government for this program unless and until a court of competent jurisdiction decided that the requirement to send money to the federal government to support Medicare Part D is constitutional.   Rick Perry, the Governor of Texas, vetoed a bill to spend $444 million to cover the bill that the federal government is expected to send Texas.

            The problem that is pushing the federal government and the state governments into conflict is paying for Medicaid, the federal/state program to pay for healthcare for those who can not afford it otherwise.  The costs of paying for Medicaid have been growing about ten percent per year since 1999.

            A court battle between various states and the federal government might force a postponement of the start of Medicare Part D prescription drug benefit.  Or, the threat of a postponement might force Congress and the President to pass a modification that would change Medicare Part D substantially in order to avoid a financial crisis and conflict for the states and the federal government.  So, keep your private prescription drug discount card to use until we learn what Medicare Part D really will and will not cover.

Note: This article was written on July 11, 2005 and syndicated to newspapers.

Medicare Part D: Complications Abound

By Woodrow Wilcox

            An elderly couple visited our office recently to seek our help.  Social Security had deducted five payments for Medicare Part D to an insurance company from each Social Security check of the elderly couple.  Instead of their Social Security checks missing $140 for Medicare Part D payments, their social security checks were missing $700.  The elderly woman asked me, "How are we going to eat this month?  Now, we have no money for food!"

            Unfortunately, there was little that this or any other insurance agency could do in such a case.  We helped the couple to contact Social Security from our office to get some money back.  But, insurance agents don't have any leverage with Social Security.

            In previous articles, I reported that several states are suing the federal government over the Medicare Part D program because the law that created the program shifted much of the costs for Medicare Part D onto the States.  That legal challenge is still making its way through the courts.

            Medicare Part D did not do much to reduce the costs of prescription medicines.  It simply changed the payment methods by adding federal bureaucracy and insurance company bureaucracy to the process.

            To me, the better solution would be to establish state and federal laws with review boards for regulating what pharmaceutical companies can charge for medicines.  The pharmaceutical companies are not the only ones that help to develop new medicines.  Taxes subsidize basic and contributing research at universities and research institutions.  Tax exemption helps support research at hospitals and clinics.  So, really, the tax paying public helped to pay for the development of every medicine that is developed in the U.S.  Therefore, the public should have a right to regulate what pharmaceutical companies charge for prescription medicines.

            The pharmaceutical companies could have the patents to prevent others from making the same drugs for a limited time.  But, there should be no right to unlimited profits.  The time, money and energy needed to accomplish this method of cost control would be far less than the present Medicare Part D system which does little or nothing to control the costs of medicine for our senior citizens.

Note: This article was written in 2006 and syndicated to newspapers.

MEDICARE MESSED MUNSTER MAN'S MEDICAL$

By Woodrow Wilcox

            A few times this year, the same client from Munster has needed the free bill resolving service that this agency offers to clients.

            Earlier this year, Medicare sent claims information to the wrong insurance company regarding bills totaling $7,580.09. Of course, the other insurance company rejected the claims.  I tracked down the problem and got the claims information to the correct insurance company.  That saved our client a lot of money and hassle.

            A similar problem happened this year with a smaller claim and I handled it in a similar way.  So, more money was saved for the client.

            But, an unusual, old claim needed work, too.  It seems that Medicare sent reports on only two of four claims to the client's insurance company three years ago.  The unpaid balance was $145 and the doctor's office wanted to be paid.

            The insurance company can not pay a claim that it never gets from Medicare.  Because the claim is over fifteen months old there are some problems with the claim. 

            Did the doctor's office actually file the other two claims with Medicare?  Did Medicare receive the claims or was there a problem with the electronic information transmission?  Did Medicare get and process the claims, but accidentally not send them to the insurance company?  Or, did the electronic information transmission from Medicare to the insurance company get jumbled so that the claims information never got to the insurance company?

            All of these things could have happened.  There are many steps in the process at which points the system can fail.

            Often, when the system fails, the senior citizen is harassed for payment of amounts that never should be billed to the senior citizen.  I work for an insurance agency that cares enough about senior citizen clients to have me help them with billing problems at no charge.

Note: For other Medicare articles by Woodrow Wilcox, visit www.woodrowwilcox.com.

Note: This article was written on November 6, 2008 and syndicated to newspapers.

Match and Check the Bill with the Medicare Summary Notice

By Woodrow Wilcox

            "The Devil is in the details" is an old saying.  It seems to be very true of medical bills to senior citizens.  This is an article which every senior citizen and everyone who helps a senior citizen should read.  So, make copies of this article and give the copies to everyone whom you know that fits the description.

            Some medical service providers make mistakes and accidentally overcharge senior citizens.  Some medical service providers are dishonest and attempt to "shakedown" senior citizens with overcharges.  When I deal with medical service providers for the clients of our firm, I approach the matter by giving the benefit of the doubt and assuming that the overcharge is just the result of a mistake-an innocent error.  Everybody makes mistakes on occasions.  Distractions and stress are often the cause.

            But, if there is a repeating pattern of overcharges, then, I start to get suspicious.  Even then, I try to kindly direct attention to the repeating problem of overcharges and ask what is being done to eliminate the problem.  It is rare that I really get tough and take more drastic action.

            Recently, I was a guest on the public access television show "Chatting With Chester" on Comcast Cable TV in Hammond, East Chicago, and Whiting, Indiana.  The show is hosted by Chester Lobodzinski.  That morning, before going to the television studio for the show video taping, I had helped a client by writing a letter to a medical service provider to state that the bill to our client for over $300 was wrong and that our client owed them NOTHING.  I then explained how and why I knew that.  I cited references to Medicare documents and regulations.

            As I have stated in other articles of this column, keep and match the bills with the Medicare Summary Notice and the insurance company's Explanation Of Benefits according to the date(s) of service.  That is the key to discovering billing errors.

            Today, I helped another senior citizen client.  For your benefit, below is an abbreviated excerpt of what I wrote to the medical service provider that was attempting to collect from our Medicare supplement insurance policy client.  Learn from this example.

Dear Account Representative,

            Our client brought papers to our office for our review.  The papers relate to a certain bill to her from your firm.

            Our opinion after reviewing the matter is that your firm is billing our client ILLEGALLY.  Attached are copies of pertinent papers with the matters regarding the illegal billing highlighted for your consideration.  The Medicare Summary Notice advises our client that your firm can NOT bill her for the amount that your bill demands.

            Of course, if you believe that our opinion is mistaken, please, let us know that.  We would be willing to help to contact Medicare officials for a full review of the matter.

                                                            Cordially yours,  Woodrow Wilcox

            This kind of assistance to our senior citizen clients is without charge.  I am amazed that more insurance agencies don't provide the same support services for their Medicare supplement insurance policy clients.  I have suggested to our firm that we sponsor a free seminar on how to read the items mentioned in this article.  I believe that such a seminar would be helpful to many people and good public relations for our insurance agency.

Note: Written by Woodrow Wilcox.  Syndicated by the author.  No charge to publish.

Many Problems With Medicare Part D

By Woodrow Wilcox

            There are many problems with Medicare Part D.  Many senior citizens are frustrated because they have enrolled in a Medicare Part D plan, but have not received the policy or identification card that they expected.

            Medicare Part D has been frustrating for insurance agents and insurance agencies, also.  In my opinion, the entire Medicare Part D law was poorly written and poorly planned.  Congress may have consulted pharmaceutical companies, insurance companies, and various lobbyists when it wrote this "bad" law.  But, I don't believe that Congress or the President consulted any insurance agents who actually work with senior citizens.

            The law is very complicated.  The Medicare Part D plans are not standardized as the plans are standardized for Medicare Part A and Medicare Part B.  Instead, there is a minimum level of requirements for any Medicare Part D plan.  Then, insurance companies can be creative.  As a result, over 500 insurance companies offer Medicare Part D plans.  The number of possible plans is over 3,000 in the U.S. and over 200 in the State of Indiana.  With so many variations, it is difficult for insurance agents and their senior citizen clients to compare "apples" to "apples" and "pears" to "pears".

            Another problem is that some insurance companies simply did not prepare to serve the enormous numbers of enrollees for Medicare Part D plans.  One client reported being on the phone for three hours before she could talk to a Medicare Part D representative to correct a matter.  Things got so bad for the agency with which I work that we had to send a letter to a major insurance company to try to jolt the company into providing better service to insurance agents and their senior citizen clients.  Here are some excerpts from the letter that I sent that will enlighten you to the problems that many insurance agents are having when they try to help senior citizens with Medicare Part D.

"Dear Supervisor,

            "We are quite disappointed with the service from your department.

            "Our staff members have informed me of several negative incidents concerning our attempts to get information about the status of applications that our agency sent to (your insurance company) - to your department.  Yesterday, one member of our staff was instructed that we are no longer to call or fax anything to your department to get information unless it is a life threatening emergency.  When our clients can't get the medicines that they need because (your insurance company) is not processing their enrollment into Medicare D plans in a timely manner, we consider that to be life threatening.

            "Our staff was told to use the customer service phone number to make inquiries.  When our staff members use that phone number, they get a recording that there will be a fifteen minute wait or a disconnection.  Then, there is a disconnection.  This is extremely poor customer service.

            "This agency is the largest insurance agency in the entire State of Indiana for serving the needs of senior citizens.  Our clients are our relatives, our friends, our neighbors, and their relatives, friends, and neighbors.  We care about every client.  If you don't care as much about our clients as we do, then maybe we should help our clients to do business with other insurance companies.

            "There must be an immediate improvement in our agency's ability to get information on the status of our clients' applications for (your insurance company's) Part D plans, or this matter will be taken to more executive officers of (your insurance company)."

Note: This article was written on February 3, 2006 and syndicated to newspapers.

MAKE SURE OLD INSURANCE COMPANY GOT CANCELLATION LETTER

By Woodrow Wilcox

            One of the clients of this insurance agency switched insurance companies to lower his Medicare supplement insurance policy monthly premiums from $134.45 to $99.  But, he did not check to make sure that the old insurance company got the cancellation letter and cancelled the policy.

            After a few months, the client realized that two insurance companies were getting a monthly premium from him for exactly the same policy from each insurance company.  A senior citizen who has Medicare is supposed to have only one Medicare supplemental insurance policy. 

            The problem was given to me to fix.  I am the senior problem resolution officer at the largest senior citizen oriented insurance agency in the Midwest.  I was able to fix the problem.  Here is how I did it.

            I contacted both insurance companies, got the client's policy information from each company, and learned what each company's records showed about this matter.  The old insurance company never got the letter of cancellation.  Maybe it was lost in the mail.  Maybe the client miswrote the address to the insurance company.  Who knows what happened?  I explained the problem to each insurance company and asked for possible solutions to end the double coverage.  I had several possible solutions in mind, but I invited suggestions first.

            The old insurance company's representative said that it would accept the new insurance company's new policy coverage overview page as proof to substantiate the client's intention to end the old policy when the new one began.  Our client will get a refund for the months of premium that the old insurance company took while the new insurance policy was in place.

            This was a happy ending for our client.  I was glad to be of service.

Note: For more Medicare articles by Woodrow Wilcox, visit www.woodrowwilcox.com.

This was written on September 3, 2008 and syndicated to newspapers.

MEDICARE SYSTEM IS CONFUSING FOR MANY

By Woodrow Wilcox

            I just talked with a nice office worker named Lynne at a medical firm just west of Chicago. 

            A few days ago, I wrote to her firm to help get a Medicare bill problem resolved.  After we talked, Lynne said something which I want to pass along to you.

            "I feel so sorry for so many senior citizens on Medicare.  The system is confusing and complex.  I'm trained in the system but even I have problems with it sometimes," Lynne said.

            This is another problem of the Medicare system.  In past articles, I have written my estimate that the current Medicare system creates billing problems which result in senior citizens being swindled of more than ONE BILLION DOLLARS PER YEAR in medical charges that they do not owe.

            In my six years of dealing with Medicare bill problems, I have written about one hundred articles to inform the public and help some senior citizens to avoid problems and swindles.  You can read many of the articles at www.woodrowwilcox.com.

Written on February 5, 2009 and syndicated to newspapers.

ANYONE WHO WANTS NATIONALIZED HEALTH CARE HAS NOT DEALT MUCH WITH THE FEDERAL GOVERNMENT'S MEDICARE SYSTEM

By Woodrow Wilcox

            Do you really want the federal government to take over the health care system?

            If you answer "Yes", then I know that you have not dealt with the federal government's Medicare system very much.

            For five years, I have been helping senior citizens with Medicare problems.  For five years, I have been writing about senior citizen problems with Medicare.

            From the thousands of problems that I have worked to resolve, I can say with some authority that the federal government's Medicare system DOES NOT WORK WELL.

            Just recently, I had to send a letter to Medicare for a client.  The letter illustrates a few of the problems that Medicare has internally.  Following here is the letter that I sent for our client.

Dear Medicare Representative,

            Attached is the first page of a letter to our client from your office.

            Your letter states that Medicare made a mistake and overpaid on a Part B claim.

            Your letter states that you want the client to repay "$?A907xxxxx."  Neither our client nor anyone in our office knows what "$?A907xxxxx" is.

            Also, your letter states, "Please see the enclosed attachment for a description of the overpaid accounts.  Please include a copy with your payment."  BUT, THERE WAS NO EXPLANATORY ATTACHMENT WITH THE LETTER.

            There is a limited time for appealing an adverse decision.  Your letter is unfair to our client because it did not state an intelligible amount and it did not provide an attachment with a description of the problem.

            Please, correct and resend whatever message you intended to send and allow the full appeal time period to run from the time our client receives the complete and intelligible letter.

Note: Woody Wilcox is the senior problem resolution officer at Senior Care Insurance Services in Merrillville, Indiana which is the largest senior citizen oriented insurance agency in the Midwest.

Note: This article was written in 2008 and syndicated to newspapers.

LETTER TO THE EDITOR

FEDERAL GOVERNMENT IS TOO INCOMPETENT TO HANDLE HEALTH CARE

            As the senior problem resolution officer at the largest senior citizen oriented insurance agency in the Midwest, I help many senior citizens to resolve Medicare and Veterans Administration medical billing problems.

            My opinion is based on over five years of experience as the senior problem resolution officer here.  In my opinion, the federal government is too incompetent to take over the nation's healthcare system.

            On the day that I am writing this, I have handled three serious problems so far.  In one case, Medicare failed to send the essential billing information to the correct insurance company for payment processing.  In another case, Medicare sent conflicting reports on medical charges to the doctor's office and to the patient's insurance company.  In another case, the Veterans Administration did not send the necessary information to a client's insurance company for payment processing.  The VA officials were obstinate about insisting that something that needed to be done had already been done and they were reluctant to cooperate and resend the information.

            It took me half the workday to work on these problems for our senior citizen clients because the federal government is so incompetent and inefficient in its present involvement with the nation's healthcare system.  I hate to imagine the terrible results if the federal government takes over all healthcare matters.

            This is not to suggest that the current system is perfect.  Far from it.  But, Congress and the President should consult people like me who are where the "rubber meets the road" in the healthcare system before they "push" changes that lobbyists who make big political donations will love and the average citizen will hate.

Woodrow Wilcox

Note: Written in 2008 and sent to newspapers.

LETTER TO CONGRESS AND THE PRESIDENT

MEDICARE IS NOT WORKING WELL

By Woodrow Wilcox

            I am the senior problem solver at the largest senior citizen oriented insurance agency in the Midwest.  In the five years that I have been here, we have always had between 4,000 and 7,500 clients.  Every day, Medicare problems come to us to solve for our clients because the system is so complicated and fouled that the average senior citizen has difficulty with it.

            Recently, with the help of tv program producer Gordon Bloyer, our office used the internet to get the attention of Medicare to help one of our clients who was facing a life threatening situation.  You can watch our appeal by visiting http://www.youtube.com/watch?v=XUs-O1Ilhl0 , or visit www.gordonbloyershow.com, click "See Gordon Bloyer's videos on youtube", and look for the video picture of Gloria Den Hartog who worked with me to solve the client's problem..

            I have many complaints about the Medicare system.  Here are just a few.

1.  On a regular basis, information sent electronically from the medical service provider, to Medicare, to the Medicare supplemental insurance company IS LOST WHEN SATELLITES ARE USED IN THE COMMUNICATION.   This gums up the works constantly and causes the bills not to be paid.

When the bills don't get paid, medical service providers, collection agencies, and collection attorneys go after the senior citizens.  Most senior citizens don't know how to collect and coordinate the paperwork, call the right people, and fax copies to the correct parties in order to fix the problem.  If insurance agents and agencies don't intervene to help the senior citizen clients, the senior citizen clients become victims of the system that is supposed to benefit them.  By this I mean that senior citizens are forced to pay bills that they should not have to pay.

2.  Medicare Part D for prescription drugs is absolutely horrible in its design.  It forces perfectly healthy people who don't need drugs to pay money to insurance companies.  It does not really control the price of medicines.  It created a system for enriching big insurance companies and big drug manufacturers.  It restricted what could be paid to insurance agents but loaded the agents with the work of looking up medicines and explaining the complicated policies to senior citizen clients.  It restricted the window of time for switching from one company to another to the month and a half of November 15 to December 31 when many senior citizens and insurance agents are busy with the holidays and have difficulty finding time to meet to discuss and accomplish a policy change.

3.  In an effort to reduce government costs, Medicare has been writing regulations that shove more and more of the costs of healthcare back onto senior citizens.  For example, if a senior citizen is well enough to take a pill during an emergency room visit, the cost of the pill is the patient's responsibility - not Medicare's.

4.  Medicare does not help senior citizens with the costs of regular eye exams or eyeglasses.  Nor does Medicare help with the costs for hearing tests and hearing aids.  These are essential for senior citizens.

5.  Insurance companies are allowed to hire people and firms in foreign countries to manage customer services aspects of Medicare supplemental policies.  So, people in foreign countries are handling the identity information of senior citizens in the U.S.  Is it any wonder that senior citizens are often the victims of identity theft when people is foreign countries have access to their identity information?  I'm not attacking foreigners.  I'm attacking the stupidity of our government for not restricting access to the identity information so that it can easily prosecute anyone who steals the information.

Note: Written in 2007, syndicated to newspapers, and distributed in Washington DC at both CPAC and FRC Value Voters Summit.

Letter To The Editor

MEDICARE MESS UPS ARE CHEATING SENIOR CITIZENS OF BILLIONS OF $

            For over five years I have assisted senior citizens with Medicare and Medicare-VA medical billing foul-ups.  I work for the largest senior citizen oriented insurance agency in the Midwest.

            Because this agency is large and has about five percent of the senior citizen market in our congressional district, I was able to extrapolate estimates of how much Medicare Foul-Ups cost senior citizens in the U.S.

            I believe that Medicare Foul-Ups concerning Medicare Part A and Part B cost senior citizens about ONE BILLION DOLLARS per year in charges that senior citizens would never have to pay if Medicare worked properly.

            I believe that Medicare-VA Foul-Ups are costing senior citizen veterans over ONE THOUSAND DOLLARS EACH ON AVERAGE.  If there are one million veterans age 65 or older, then the cost is over ONE BILLION DOLLARS PER YEAR of wrongful charges to these veterans.

            For over five years, I have written articles on these problems.  I am posting the articles at www.woodrowwilcox.com.  There is no charge to read or copy the articles.  I am not selling anything at the website. 

            I invite you and your readers to visit www.woodrowwilcox.com and read about Medicare Foul-Ups and how the problem hurts senior citizens.  Maybe Congress will act to fix the problem if enough people complain.

Best personal regards,

Woodrow Wilcox

LET'S REGULATE INSURANCE COMPANIES MORE

TO PROTECT SENIOR CITIZENS ON MEDICARE

By Woodrow Wilcox

            Most of the time, I write about problems of senior citizens on Medicare which are created by Medicare or VA bureaucrats, or medical service providers.  But, this time, I'm zeroing in on some insurance companies that have what I consider to be some very bad practices that hurt senior citizens.

            In one case, an insurance company based in Georgia rescinded the Medicare supplement policies of two senior citizens after the senior citizens had been paying for the policies and using the policies for months.  This caused a problem for the senior citizens because they cancelled their old Medicare supplement insurance policies after the insurance company in Georgia approved their applications.

            Rescinding the policies made the senior citizens responsible for their annual Medicare deductibles and the 20% co-pay that their policies with the Georgia insurance firm would have paid.

            The Georgia insurance firm claimed that the senior citizens did not answer the health questions on the application honestly.  The Georgia firm said that it had the right to rescind the insurance contract at any time within two years of the application.

            This should not be allowed.  Senior citizens don't remember everything.  It is easy for insurance companies to get and check medical records.  That is what insurance underwriters are supposed to do.  If the senior citizen makes a mistake or forgets to tell about a health issue, the underwriting department can either reject the application or have the senior citizen sign an AMENDMENT TO APPLICATION and approve the policy.  It is done all the time.

            The problem is compounded when a senior citizen is an immigrant and American English is not the first language of the Medicare age person.  There must be a legally rebutable presumption that the senior citizen who answers the questions on an application for Medicare supplement insurance - or any other insurance - is doing the best job possible of answering the questions honestly and that any error made is innocent error.

            Another insurance company in Texas sued an insurance agent in Indiana for telling his clients about less expensive insurance with other insurance companies.  The insurance company lulled the insurance agent into signing a contract with the Texas insurance company.  Then, after the agent had sold policies from that insurance company to his clients, the Texas insurance company raised the rates on the clients without prior notice to the clients or the agent.  When the agent tried to help his clients switch to less expensive policies with other insurance companies, the Texas insurance company sued the Indiana insurance agent in a Texas court.  The Texas court ruled that the Indiana agent could not tell his clients about less expensive insurance with other companies.  What a ridiculous situation! 

In my opinion, the policies and contract clauses of these insurance companies should be outlawed because of all the financial harm that these companies have caused to senior citizens and agents who honestly serve the senior citizens well.

Note: Written on September 16, 2008 and syndicated to newspapers.

LEARN AND FOLLOW MEDICARE RULES TO SAVE MONEY

By Woodrow Wilcox

            One of our clients sent a copy of a bill that was not paid by the Medicare supplemental insurance company.  The client wanted to know why the insurance company did not pay the bill.  I investigated the matter. 

            Unfortunately, I had to write a letter to the client to explain why Medicare and the insurance company refused to pay on the claim.  The case is another example of why it is so important for senior citizens and the friends and loved ones who help senior citizens to learn and follow the rules of Medicare. 

            People who learn and follow the rules of Medicare can save lots of money.  People who do not learn and follow the rules of Medicare can lose lots of money.  In which category of people do you want to be?

            Below here is part of the letter that I sent to the client.  Read and learn so that you can avoid the same mistake.

Recently, you sent a bill to our office for review.  That bill is being returned to you with this letter.

The bill is for a balance of $99 for a routine physical examination.  Medicare denied this charge.  By law and by your insurance contract, the insurance company can not pay on a claim that Medicare denied.

Medicare denied the charge because routine physical examinations are never covered and never have been covered by Medicare.

If this was not a routine physical examination, your physician should have written notes to indicate that the examination or tests were for diagnosis.  Examinations and tests for diagnosis and treatment are generally payable by Medicare and the Medicare supplemental insurance.  If this was not a routine examination, ask the doctor to augment the notes and resubmit the claim to Medicare for consideration of payment.  If Medicare changes its position and pays on the claim, then your insurance company will honor that and pay on the claim according to the policy.

Because your doctor or clerk at the doctor's office advised Medicare that this was a routine physical, Medicare and the Medicare supplemental insurance will not pay on this bill.  So, unless Medicare changes its position because of new information from your doctor, this bill is your bill and you should pay it.

To avoid this problem in the future, always ask your physician to be sure to write notes that indicate the medical necessity of an examination or other medical service.

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

Note: written on September 21, 2006 and syndicated to newspapers.

I PROPOSE A NEW LAW

By Woodrow Wilcox

            I'm frustrated on Fridays. 

I try to use my time wisely to help resolve the Medicare bill problems of this insurance agency's senior citizen clients.  But, Fridays are frustrating.

Here is why.  Many insurance companies with which we deal give their customer service employees half a day off on Friday afternoons.  This is especially popular at insurance companies which have customer service centers in Florida. 

Most of the insurance companies which do this are in the Eastern Time zone.  Because this agency is in the Central Time zone, the customer service departments at several important insurance companies are closed on Fridays at 11 a.m. where I am.

            So, I propose a new law in Indiana (and in other states).  If an insurance company wants to do business in Indiana, its customer service department must have people available during all times that are convenient business hours for people and insurance agencies in Indiana.  I would like every insurance company to be required to staff its customer service department from 8 a.m. to 6 p.m. according to Indiana time for both Eastern and Central Time zones during every business day.  If an insurance company doesn't do that, then that company's license to sell insurance in Indiana should be suspended or cancelled until it complies with the new law.

            That will get some people's attention.

            If you like this idea, please, contact your state representative and state senator to tell them that you support this idea.

Note: Written on March 20, 2009 and syndicated to newspapers.

INDIANA HOSPITAL CHEATED LYNWOOD WOMAN

By Woodrow Wilcox

            An elderly woman from Lynwood, Illinois used a hospital in Indiana.

            Medicare messed up the bill which caused an unpaid balance to the hospital.  I wrote to the hospital and coached their representative on what to do to get the bill problem corrected and the balance paid.

            But, the hospital cheated the woman by not even bothering to do what I instructed.  Instead, the hospital sent the balance to an attorney for collection.

            I wrote to the collection attorney and explained that it was his client - THE HOSPITAL IN INDIANA - that was responsible for not getting paid.  If the hospital had done what I advised, the hospital would already have the money.

            Several things went wrong with this bill balance of less than $40.  First, Medicare sent the information to only one insurance company instead of two.  Prior to going to the hospital, the client decided to switch insurance companies to save money with a lower premium.  The "switch date" occurred while the client was in the hospital.  Medicare sent claim information to the old insurance company, but not the new one.  Medicare got notification of the change several weeks before the change, but had not entered the information into the Medicare computer system.

            But, after that, when the hospital in Indiana was advised of the Medicare billing problem and was told what to do to solve it and get paid, the hospital ignored the matter and sent the elderly lady's bill to a collection attorney.  To me, that is cheating a patient of reasonable and professional services.  Would you want a hospital to treat you or an elderly relative in such a manner?

Note: Written on April 2, 2009 and syndicated to newspapers.

How to Use Insurance Agencies and Insurance Companies Better

By Woodrow Wilcox

            Every day, I work with many people on insurance related problems.

            I am surprised by the number of people that I meet who do not know the difference between an insurance agency and an insurance company.  Also, many people do not know how to use insurance agencies and insurance companies better.

            An insurance agent or agency sells insurance from an insurance company to a client.  The insurance agents sell insurance to their relatives, friends, neighbors, and then to the relatives, friends, and neighbors of their clients.

 There are two kinds of insurance agents.  Independent insurance agents are licensed to sell for one or more companies, but the agent is not an employee of any insurance company.  So, the agent can use independent judgment to help clients select an insurance policy with an insurance company.  Other agents are actually employees of an insurance company.  They get a base salary and commission from the insurance company that they represent.  They are expected to sell that insurance company's policies.  Some of these employee agents can sell insurance from other companies if the insurance company that employs them does not have the type of insurance desired by the client.

Insurance agents do not make any money by helping a client with a customer service problem.  If they help with such a problem, it is because they want their clients to know that they care about their clients.  They want a good reputation which will bring more clients to them.

But, many insurance agents never get training in customer service matters.  Often, it is faster, and more fair to the insurance agent, to use the insurance company's customer service department.  Some companies call this department the "policy holder services" department, or a similar name.

For senior citizens on Medicare, calling the insurance company about a problem is a rather simple matter.  On every identification card for Medicare supplement insurance, there is identification information for the client and an address and phone number of the insurance company.

Most of the problems that might occur for a senior citizen with Medicare and a Medicare supplement insurance policy are simple ones.  A quick phone call to the insurance company will take care of many problems.  But, sometimes, a problem can't be solved easily.  Some things are just difficult to explain over the phone to someone who can't read the same document that you might have.  In those cases, call your insurance agent for help.  Insurance agents have access to faxes and other ways to get the customer service department to understand the problem.  Sometimes, agents can explain a problem more clearly to the customer service department at an insurance company.

This agency helps our clients in such matters without charge.  We really care about our clients.  I'm sure that other agents and agencies care about their clients.  In complex problem matters, every good agent wants to help the client.  But, for simple problem matters, I'm sure that every agent would appreciate a client for calling the customer service department of the insurance company first.  If the problem can be solved with a simple phone call by the client directly to the insurance company, the insurance agent's time is saved for other business matters.

Note: Written on April 19, 2006.

How Doctors and Hospitals Can Really Mess Up Medicare Bills

By Woodrow Wilcox

            When a senior citizen who has Medicare and a Medicare supplemental insurance policy visits a hospital or a doctor's office, a lot can go wrong and often does.  Straightening out the messes that doctors, clinics, hospitals, laboratories, and Medicare create is a key function of my job.  It is a full time job and then some.

            Medical service providers have up to 15 months to submit a claim for payment.  That means that the billing department of a medical service provider can "dilly-dally" for a year and almost three months before submitting a claim to Medicare.  Many medical service providers submit the claim within three months.  That is a much more reasonable and workable time period.

            Recently, a medical office in Munster, Indiana submitted claims to Medicare ONE YEAR after the medical services were provided.  In that one year period, the senior citizen had changed from one insurance company to another for her Medicare supplemental insurance policy to reduce her monthly premium payments.

            Medicare got the claims over a year after the medical services were provided and mistakenly forwarded the claim information to the new insurance company instead of to the insurance company that the patient had at the time of services a year earlier.  The new insurance company refused to pay on bills that were created before the client bought her policy with the new insurance company.

            The client sent a copy of the unpaid bill to our office for our review.  I caught the problem, reviewed the facts with both insurance companies, and wrote to the doctor's office to tell them what information to send to each insurance company so that the claims could be processed and paid.

            If you are a senior citizen who has a problem with a medical bill that has been unpaid by Medicare and/or your Medicare supplemental insurance company for more than three months, contact your insurance agent for assistance to check and correct whatever problem is preventing the processing and payment on the bill.  The more you delay, the more difficult it will be to fix the problem.  If you wait too long, you may pay dearly for procrastinating.

HOSPITAL WAS REALLY MEAN TO SENIOR CITIZEN

By Woodrow Wilcox

            I was stunned by the pure meanness of a hospital in Indiana toward one of our senior citizen clients on Medicare.  Here is the story.

            On October 28, 2008, I wrote a letter to the hospital on behalf of our client who lives in Lowell, Indiana. 

            The letter politely described problems with the bill that the hospital sent to our client.  Here is part of what I wrote to the hospital.

            "Your bill states that the original charge was $3,709.49.  The bill that Medicare forwarded to the insurance company, for the exact same dates of service, had a total of $3,609.49.  The insurance company paid its part of the claim as determined by Medicare.  The amount of $105.76 was paid to your firm by check number XXX.  That check cleared.  To help resolve the problem, please, send the billing information and the Medicare EOB information that your firm has regarding this claim to the insurance company."  Then, I gave the contact information.

            Obviously, there were differences between what the hospital claimed the bill was and what Medicare reported to the insurance company what the claim was.  The insurance company paid the claim according to the information that it received from Medicare.

            This mistake, and many other kinds of mistakes, in the Medicare system cost senior citizens OVER ONE BILLION DOLLARS A YEAR in charges that should never be billed to senior citizens.  This insurance agency helps our clients to correct Medicare billing errors so that our clients don't get hurt by Medicare billing mess ups.

            In response to my letter, the hospital in Indiana gave the bill to a collection agency which demanded our senior citizen client pay $2,643.01 immediately.

            I wrote to the collection agency to explain why the bill should be returned to the hospital so that the hospital can file correctly with Medicare and the client's insurance company.  Also, I wrote a letter of complaint about the hospital and its billing practices to federal Medicare officials.  I rarely do that.  But, in this case, the hospital was so mean to our client that I believed it was totally justified.

HOSPITAL IGNORED LETTER FROM INSURANCE COMPANY

By Woodrow Wilcox

            A client of this insurance agency with a Medicare supplement policy was treated at a hospital in Lake County, Indiana on July 30, 2008.  The client brought an unpaid bill to our office for our review on March 16, 2009.  I investigated the matter.

            Our client's insurance company informed me that it had sent a notice to the hospital that it had received nothing concerning the claim from Medicare.  On August 20, 2008, the insurance company asked the hospital to send both the original billing information and the MEDICARE EXPLANATION OF BENEFITS which the hospital had regarding the claim.  The hospital in Lake County, Indiana never responded with the requested information.

            The insurance company could not process or pay the claim without that information.  On March 3, 2009, the hospital sent a bill to our senior citizen client demanding payment of the $241 bill.  If our client had not given our office the bill and asked for our help, then she would have been stuck with a $241 bill.

            This sort of Medicare billing error happens all the time.  It is Medicare foul-ups like this which cost senior citizens throughout the nation with OVER ONE BILLION DOLLARS in "false" bills every year.  By "false" bills, I mean bills that would never be sent to senior citizens if the Medicare system worked properly.

            This insurance agency helps senior citizen clients with these Medicare billing problems at no charge to the client senior citizen.  Does your insurance agency provide the same services at no charge?  In this case, we saved our client $241 and a lot of stress.

Note: Written on March 17, 2009 and syndicated to newspapers.

HOSPITAL GETS PAID BUT BILLS AGAIN AND AGAIN

By Woodrow Wilcox

            A senior citizen client from Crown Point, Indiana visited our office with her granddaughter.  The client brought a payment demand letter from a hospital in Lake County, Indiana that she had received.  I copied the letter and investigated the bill for our client.

            I checked with our client's insurance company about the bill.  The insurance company had already paid the bill - almost a year ago.  And, the hospital had cashed the check almost a year ago.

            So, I sent a letter to the hospital citing the facts regarding the check, the number of the check, the amount of the check, and the fact that the hospital cashed the check.  This should fix our client's bill problem.

            The amount of the wrongful bill was just under $100.  That may not be much to some people, but it is often a significant amount to a senior citizen on a fixed income who has Medicare and has bought a Medicare supplement insurance policy.  Also, the wrongful bill caused stress to our senior citizen client.  She did not deserve that.  My work on the wrongful bill got rid of the bill and relieved the client of some stress.

            This insurance agency helps clients with such problems at no charge to the client. 

Note: Written on March 6, 2009 and syndicated to newspapers.

HOSPITAL DOUBLE BILLED WIDOW AND INSURANCE COMPANY

By Woodrow Wilcox

            The widow of one of our clients from Dyer, Indiana brought a bill and other papers to our office.  I helped her.

            A hospital in Lake County, Indiana sent her a bill for $232.11.  She wanted to know why she was being billed when her deceased husband had insurance.

            I contacted the insurance company and learned that it had already paid the $232.11 balance over two months before the widow came to our office for help.

            To correct the matter, I sent a polite letter to the patient accounts department of the hospital.  I cited the date of the check, the type of check, and the number of the check that the hospital had received in payment of the $232.11 balance of the client's bill.

            Medicare billing problems happen all the time.  In past articles, I have estimated that Medicare billing problems cost senior citizens around the nation about ONE BILLION DOLLARS PER YEAR in "false" charges.  By "false charges" I mean charges that are billed to the senior citizen when no amount would be owed if Medicare worked properly.

            The insurance agency where I work helps our clients with these Medicare billing problems at no charge.  Does your insurance agent help with these problems at no charge?

HOSPITAL BILLS MEDICARE, INSURANCE COMPANY, AND PATIENT TWICE -

FOR DIFFERENT AMOUNTS!

By Woodrow Wilcox

            A hospital in Lake County, Indiana billed Medicare twice for different amounts.  This caused problems in the Medicare system.  It resulted in a big and unexpected bill for our agency's client who was a senior citizen from Lowell, Indiana.

            At first, the hospital sent a bill to Medicare for $12,497 for dates of service April 2 to April 30 in 2007.  Medicare and the insurance company paid on that claim.  But, later, the hospital sent a bill to Medicare for $21,098 for the same patient/client for dates of service April 1 to April 30, 2007.

            The insurance company never received any claim from Medicare for the $21,098.  Medicare may have considered it a duplicate claim.  So, the insurance company paid nothing on it.

            The hospital has used several addresses in correspondence with the patient/client.  The hospital is in Lake County, Indiana, but has used addresses in Illinois, Tennessee, and Maryland.  The hospital may have used other addresses with Medicare or the insurance company, too.  This did not help to find the party to contact to fix the problem.

            I wrote a letter addressed to the supervisor of patient accounts at the hospital to explain the conflicting bills and request cooperation.  But, no one at the hospital did anything to resolve the problem.  Instead, another letter demanding payment from the patient/client was generated.

            I persisted in phone calls to the hospital's billing department.  I finally found someone who was at another location but claimed to have the authority to resolve the problem.  So, I faxed all the documents about the conflicting bills to this person.  I hope that this will resolve the billing problem for our client.

            Our insurance agency is not legally obligated to help with customer service and billing problems.  We help because we care about our clients and we know that the Medicare system creates many billing problems which often require the assistance of someone to the senior citizen.  For those Medicare enrolled senior citizens who have billing problems and no assistance, the results can be "dings" on credit reports for bills that are not really owed or paying bills that are not really owed.

HERE ARE A FEW SUGGESTIONS

By Woodrow Wilcox

            Recently, I had to help a client who was robbed.

            She needed help with getting new ID cards for her Medicare supplemental insurance and her Medicare Part D prescription plan.

            If you are a senior citizen, or if you help to care for a senior citizen, I suggest photocopying every ID card and credit card of the senior citizen and keeping the copies in a safe and secure place. 

            If the senior citizen's wallet is stolen or lost, having copies of important papers that may have been in the wallet or purse at the time will help to make the process of getting replacement documents easier.

            For those who are not senior citizens, this is a good idea, too.  If you make copies of your driver license, credit cards, and other important items that you carry with you, you will have an easier time getting replacement documents, too.

            I suggest to every driver, senior citizen or not, that a disposable or digital camera be carried when driving.  If an accident happens, take pictures of the scene, the damage, the people, the injuries, the roadway, and other items.  These photos can help to refresh memory before having to testify and the photos are usually accepted as evidence in court.

            Finally, I have another suggestion about Medicare.  When a person reaches age 75, don't require them to carry Medicare supplemental insurance in addition to Medicare.  Instead, have Medicare cover 100% of the Medicare approved charges. 

            In this way, from age 65 to age 75, senior citizens will help to pay for their medical services.  After age 75, many senior citizens have memory problems which can cause the accidental non-payment of a Medicare supplemental policy premium.  When an elderly person forgets to pay a premium, and no payment is made for sixty days, most companies will cancel the policy for non-payment and not allow the senior citizen to renew the policy.  The senior citizen would need to apply for coverage.  At age 75, most senior citizens have serious health problems which would prevent them from qualifying for a new insurance policy.  Thus, the senior citizen is left with no insurance but Medicare.

            Since Medicare pays only 80% of approved charges, the senior citizen on Medicare who has no Medicare supplemental coverage would be responsible for the other 20% of Medicare approved charges.  If one hospital stay results in charges of $100,000 in Medicare approved charges, the senior citizen would be responsible for $20,000 of the bill.  How much would a bill for $20,000 affect the senior citizens that you know?

Note: This was written on December 26, 2006 and syndicated to newspapers.

HELP SENIOR CITIZENS WITH MEDICARE BILLING PROBLEMS

By Woodrow Wilcox

            For almost five years, I have helped senior citizens to fix Medicare related problems.  Believe me, there are many, many problems with the Medicare system.

            Most of the problems are caused by Medicare employees, insurance claims workers, clerical workers at hospitals and doctor offices, and collection agencies or attorneys.  Seldom is a Medicare problem caused by the senior citizen who is on Medicare.  But, when a problem occurs, the senior citizen is expected to fix it by calling, writing, faxing, or visiting various offices.  Few senior citizens can do that effectively.

            The senior citizens whom I serve are the clients of my employer - the largest senior citizen oriented insurance agency in the Midwest.  We have thousands of clients.  I keep dealing with the same problems over and over again but for different clients.  Medicare is far from perfect.

            The owners and managers of this agency provide such help to the clients even though it costs much to do so.  It demonstrates that this insurance agency really cares about the client.  I'm sure that other insurance agents and agencies care about their clients, too.  But, it is difficult for a single agent or a small agency to deal with Medicare problems if no training or little experience is provided.

            So, I have a suggestion for every city, town, county, and parish in the U.S.  Establish a public office and officers to help your community's senior citizens with Medicare related problems.  If the Medicare problem is caused by a hospital, a doctor, the claims department of an insurance company, or some other party, BILL THAT PARTY FOR THE COSTS OF HELPING THE SENIOR CITIZEN.  An insurance agent or agency can not charge the offending party for causing the problem as a government office can.  If the problem was caused by the senior citizen of your community, don't charge anything.  Let it be a great service of your community to the senior citizen.

            All that is needed to help your community's senior citizens with their Medicare related problems is an office with computers, internet, fax machine, telephones, and office supplies.  A few essential forms to allow disclosure and agency are needed, too. 

            Insurance agents and agencies have been providing this help to their clients at significant costs and loss of funds.  A caring insurance agent should not have to lose time and money constantly because other parties are messing up clients' Medicare claims.  The municipality that helps the community's senior citizens has a much better chance of recouping some costs from the offending party.

            When a senior citizen's Medicare claims are not handled properly, it can result in the senior citizen being bombarded with demands for money which are not legitimate.  If money is wrongfully extracted from a senior citizen, that person is harmed and the community where that person does business is harmed because there will be less money in the local economy.  A few years ago, I helped a widow from Cedar Lake, Indiana clear up over $6,000 of bills for which she never should have been billed.  So, it really is in the best interest of every community to help senior citizens with Medicare related problems.

HELPING SENIOR CITIZEN VETERANS

By Woodrow Wilcox

            Many senior citizen veterans are owed some money.  I want to help them get that money.  Are you one of those senior citizen veterans or do you know someone who is?

            Many senior citizen veterans who have a Medicare supplemental insurance policy have had to pay money to doctors and hospitals which they should not have had to pay.  I just learned how those veterans can get their money back.  But, first, I will explain the problem.

            When a veteran with a Medicare supplemental insurance policy uses a VA medical facility, the VA sends information to Medicare, then Medicare tells the VA what to charge and to which insurance company the bill should go.

            The insurance company gets the bill and pays on it.  But, Medicare does not remember the charge from VA.  So, when the veteran goes to a private doctor or hospital later, Medicare's calculations about the annual deductibles for Part A and Part B Medicare are different than the insurance company's calculations.  The difference puts the veteran in a "squeeze" financially. 

            The insurance company won't pay the deductible twice.  Medicare refuses to pay the doctor or hospital because it believes that the annual deductible has not been met yet.

Then, the doctor or hospital threatens to send the veteran's bill to a collection agency or attorney. 

So, the veteran pays the bill to avoid damage to his or her credit.  The veteran should not have to pay anything.  So far, our clients who have paid such amounts have been "out" of the money. 

This can force the veteran to pay the annual deductibles again even though the insurance company already paid the annual deductibles.  For this year, Medicare Part A deductible is $992 and Medicare Part B deductible is $131.  That means that each year, a veteran could be forced to pay up to $1,123 or more as deductibles increase.

            I felt that this was unfair.  So, for over six weeks, I have been calling VA offices to explain the problem and learn if there is a solution.  I got the solution that I am reporting from Barbara Mayerick who is the Director of Business Development of the Veterans Health Administration, Chief Business Office in Washington, D.C.

            Her office has been aware of the problem and has been working on an automated solution.  Until such a solution is in place and functioning properly, she asked me to give the following information to senior citizen veterans who have had to pay medical bills to protect their credit in the scenario that I have described.

            The veteran should take the bills that were paid to the VA medical center business office closest to the veteran.  According to Ms. Mayerick, a process is now in place for such a veteran to get reimbursement.  But, the reimbursement comes in a round about way.  The VA business office will arrange for a refund to the veteran's insurance company so that the insurance company can pay the doctor or hospital that was paid by the veteran.  The veteran should then be reimbursed by the doctor or hospital.

            Ms. Mayerick said that if a veteran tries that approach but does not get the problem resolved, the veteran could contact her office for assistance.  Her address follows below.  Good luck to all veterans who had to pay money to protect their credit.

                                    Ms. Barbara Mayerick

                                    Director of Business Development

                                    Veterans Health Administration

                                    Chief Business Office

                                    Mail Station 161

                                    810 Vermont Street, N.W.

                                    Washington, DC 20420

Note: This article was written a few years ago and syndicated to newspapers.

INTERNET USED TO HELP SAVE SENIOR CITIZEN

By Woodrow Wilcox

                The internet and Gordon Bloyer helped save a senior citizen from a life threatening problem with Medicare Part D - prescription drugs.  It may be the first time ever that was done.

                Gordon Bloyer used to have a public access and a leased access television show in Porter County, Indiana.  But, last year, Indiana laws on pubic access and leased access television shows changed and caused the cancellation of his tv show.

                So, Gordon Bloyer started using the internet.  He became so well known that YOUTUBE.COM flew Gordon Bloyer to Florida to participate in a CNN sponsored presidential candidate debate.

                Then, Gordon started helping businesses to promote and advertise on the internet.  His first client was Drena's Bar and Grill in Porter County just south of Portage, Indiana.  Gordon invited me to meet him at Drena's and watch him at work.  Gordon posts promotional videos on the internet that are linked to Drena's webpage at www.drenasbarandgrill.com.  I talked with the owner, managers, and some of the bands that appear at Drena's.  Everyone was pleased with Gordon's work.  The bands, especially, liked being able to refer booking agents to the video clips that Gordon Bloyer posted.

                When our insurance office had a problem with Medicare and an insurance company that was life threatening for one of our clients, and no one at Medicare or the insurance company seemed to care, I called Gordon and explained the situation.

                Gordon Bloyer jumped at the chance to help and he didn't charge us anything.  He was just as concerned for our client as we were. 

                On Thursday, February 28, Gordon videotaped our appeal to help our client.  Gordon edited and posted the video the same day.  You can watch our appeal by visiting http://www.youtube.com/watch?v=XUs-O1Ilhl0 .

                On Thursday, Friday, and Saturday, I emailed the video clip with a message to Medicare, the insurance company, news media, and talk radio shows.  On Monday morning, March 3, our office got a phone call from a top official at Medicare.  Medicare officials became very cooperative to help us to get our client's Medicare medicine problem fixed.

                I believe that the video that Gordon Bloyer posted for us was the first time that the internet was used to fix a Medicare medicine problem and save a senior citizen from a life threatening situation.  Hooray for Gordon Bloyer!

                To learn more about Gordon Bloyer, visit www.gordonbloyershow.com, or contact him by email at gordonbloyershow@yahoo.com or by phone at 219-762-0720.

GLEN PARK SENIOR CITIZEN GETS BIG BILL

By Woodrow Wilcox

            A senior citizen who lives in the Glen Park (south) part of Gary, Indiana got a bill for Medicare Part D (prescription drugs) for over $1,600.  She is a client of this insurance agency and she came to us for help.  It is this agency's policy to help our senior citizen clients in such matters without charge.

            Over one thousand six hundred dollars may not be much money to a drug company lobbyist in Washington, District of Corruption.  But, it is a big amount to most senior citizens who live in Gary, Indiana.

            Medicare Part D is the prescription drug part of Medicare.  The law requires senior citizens on Medicare Part A and B to pay for Medicare Part D or face penalties later when they do enroll in Medicare Part D.  Even if a senior citizen is healthy and needs no prescription medicine, the law requires the purchase of a Medicare D insurance plan.

            Originally, Social Security was supposed to subtract the Medicare Part D insurance plan premium from each senior citizen's Social Security check and send the money to the appropriate insurance company.  But, that was a bit too complicated for the folks at Social Security.  So, many senior citizens got big Medicare Part D prescription drugs insurance premium bills when they didn't expect it.  In the case of our client from Gary, she got a bill for $1,610.60.

            When Medicare Part D was started, I criticized it for being designed to help drug companies and insurance companies more than senior citizens in the Medicare system.  All my criticism was justified then and it is justified now.

            There are many problems with the Medicare system.  To read many of my articles on the subject, visit www.woodrowwilcox.com.  If the federal government takes over all healthcare, it will surely mess up healthcare for everyone.  Just look at the federal government's terrible record with running Medicare in a way that cheats senior citizens of over a billion dollars per year.

Note: This was written on March 6, 2009 and syndicated to newspapers.

FEDERAL GOVERNMENT SHOULD NOT TAKE OVER HEALTH CARE!

By Woodrow Wilcox

            In this election year, I have heard many people urge that the federal government take over the nation's health care system.  I believe that is a bad idea.

            I'm not suggesting that the present system is perfect.  I want reform, too.  But, I want reform that will bring positive changes.  The federal government is involved with healthcare for senior citizens and veterans and those systems are full of problems.  I know because for over five years I have helped senior citizens with their billing problems with Medicare and VA health matters.

            For over five years, I have written articles about the problems that senior citizens have with Medicare and the VA.  Gradually, I am posting those articles so that anyone can read them at www.woodrowwilcox.com.

            In my opinion, the present federal Medicare system causes senior citizens to be swindled out of one billion dollars per year.  In my opinion, the present Medicare - VA billing system causes senior citizen veterans to be swindled out of one hundred million dollars per year.  If you want to know more about this and check my calculations, visit the website www.woodrowwilcox.com and read the Medicare related articles.  It is free.  There is no charge for this information.

Note: This was written in 2008 and sent to newspapers as a letter to the editor.

DON'T BLAME YOUR INSURANCE AGENT WHEN

YOUR HOSPITAL OR DOCTOR MESSES UP THE BILL!

By Woodrow Wilcox

            When a Medicare covered client has a problem with a bill not getting paid by the Medicare supplemental insurance company, don't blame the insurance agent.

            But, do ask the insurance agent who sold the policy to help with getting the problem resolved.

            A few moments ago, I just finished helping one of this firm's clients from Lowell, Indiana.  She had a bill from a hospital in Chicago which was not paid by the client's Medicare supplemental insurance company.

            I collected the papers that the client had on the matter and called the insurance company to ask why the bill had not been paid.  I learned that the hospital messed up by making two errors.

            First, the hospital sent the bill directly to the insurance company instead of sending the bill to Medicare for processing and then forwarding to the insurance company.  Second, the hospital gave the wrong COORDINATION OF BENEFITS codes on the information sent to the insurance company.  The insurance company had not received the claim from Medicare and did not have the needed information to process the claim correctly and legally.

            After some effort, I obtained a copy of the MEDICARE SUMMARY NOTICE which gives the same essential information as the MEDICARE EXPLANATION OF BENEFITS.  Medicare supplemental insurance companies need the information on one of these Medicare documents in order to process and pay a claim.

            The hospital caused the problems that caused the bill not to be paid promptly.  The same problems happen when doctors and clinics mess up on a bill.

            So, when problems like this happen, don't blame your insurance agent.  Your insurance agent is probably the best person capable of helping you to fix a Medicare related problem when it occurs.

DON'T BLAME INSURANCE AGENT OR COMPANY

WHEN MEDICARE MESSES UP!

By Woodrow Wilcox

            A client of this insurance agency from Lowell, Indiana called me for help with a billing problem.

            She had switched her Medicare supplement policy from one insurance company to another effective October 1, 2008.  But, Medicare continued to send billing information to the old insurance company.  Of course, the old insurance company was refusing to pay anything on any bill that was generated after the policy with our client was cancelled.

            Our client phoned Medicare on November 25.  After a long hold period, she was told that Medicare had no record of her switching from one insurance company to another and that her new insurance company should send a "claims crossover" notice to Medicare.  After that call, our client called our office.

            I checked with the client's new insurance company.  The policy with that company became effective October 1, 2008.  The new insurance company had sent a "claims crossover" notice to Medicare on September 19, 2008.

            Then, the representative helping me told me that Medicare takes from two weeks to forty-five days to update records from crossover notices.  But, our client spoke to a Medicare representative on November 25 which is more than two months after the new insurance company had sent the "claims crossover" notice to Medicare. 

            So, Medicare might claim that it takes two weeks to forty-five days to update its records on "claims crossover" notices, but it can really take much longer.

            Really, it should take much less time because most of the time the information is sent to Medicare electronically.  Medicare does not need to retype everything.

            Here is my point: Medicare is not well run and moves so slowly and badly that it creates problems for senior citizens.  The failure to make the changes needed within a few days of receiving a "claims crossover" notice generates misdirection of bills and a tangled web of paid and unpaid bills between two insurance companies and the medical service providers who serve senior citizens on Medicare.

Written on November 26, 2008 and syndicated to newspapers.

DOCTOR DEMANDS PAYMENT OF $118.46 ON BILL THAT WAS PAID IN FULL

By Woodrow Wilcox

            One of this insurance agency's senior citizen clients got a bill from her doctor's office and brought the bill to our agency for our review.  Both the client and the doctor are from Munster, Indiana.

            I reviewed the bill and phoned the insurance company to learn what records it had on the charges.  There were some major discrepancies.

            The bill said that the original total charges on the date of service were only $335.  But, records that the insurance company had from Medicare showed original total charges on the date of service were $605.  Medicare allowed only $208.66 of charges.  Medicare paid $166.94.  The balance of $41.72 was paid by the insurance company.  I recited these facts and the date and number of the check that the doctor's office received from the insurance company to prove that the bill was paid in full.  Our senior citizen client did not owe the doctor $118.46 on these charges.

            Probably, the people in the doctor's office are busy and have not been properly trained in accounting for Medicare allowable charges, adjustments, and payments.  But, if the doctor's office personnel mess up on other patients' records, how much money is being falsely billed to senior citizen patients?  In other words, how much money is the doctor billing and receiving from his Medicare enrolled patients when the patients really don't owe anything?

            This insurance agency helps senior citizen clients without charge in such matters.

BEWARE OF DIFFERENT RULES FOR DIFFERENT PARTS OF MEDICARE

By Woodrow Wilcox

            Beware of different rules for different parts of Medicare.

            There are four "PARTS" to Medicare.

            Medicare Part A deals with hospital services.

            Medicare Part B deals with visits to doctor's offices and similar services.

            Medicare Part C deals with plans that combine Medicare Parts A, B, and D under one related insurance plan.

            Medicare Part D deals with prescription drug coverage.

            If you are enrolled in a Medicare supplemental insurance plan that covers Medicare Part A and Part B, you can disenroll with one insurance company and enroll with a different company any time of year with reasonable notice.  When you do this, make sure that the new insurance company has accepted your application and given you a new insurance contract before you write a cancellation letter to the old insurance company.

            But, Medicare Part C and Medicare Part D plans allow disenrollment and enrollment only during certain specified times of the year.  Be sure that you know what those times of the year are.  Be prepared to switch within the allowed time period if you do want to switch.  Not switching during the allowed time will lock you into staying with your old insurance company for another year.

            So, if you have a Medicare Part C or a Medicare Part D insurance policy, check with the insurance agent about when you can make a change.  If you try to change such a policy outside the allowed time period, it will cost you time and money to straighten.  And, it might not get "straightened" in the way that you had hoped.

Note: This was written on June 6, 2007 and syndicated to newspapers.

Check Your Medicare Part B Options

By Woody Wilcox

            Medicare Part B covers doctor visits and non-hospital medical treatment.  Within six months of the effective date of a person's Medicare Part B enrollment, the senior citizen has an "open enrollment" period for Medicare supplemental insurance coverage application.  In applying for Medicare supplemental insurance coverage during the "open enrollment" period, the senior citizen does not have to answer any health questions on the insurance company's application form.

            For people who turn 65 but want to continue working and who have health insurance coverage through their employer, this presents a time of decisions.  In some cases, it is better for the senior citizen to enroll in Medicare Part A only and wait until retirement to enroll in Medicare Part B.  The reason is that delaying the effective date of Medicare Part B can save the senior citizen thousands of dollars.

            Each person's situation is different.  And the rules regarding the mix of Medicare, private employer insurance, and Medicare supplemental insurance can change.  So, when a person is 64 years and 6 months old, getting the help of a knowledgeable insurance agent who regularly deals in Medicare supplemental policies is vital. 

            If a person enrolls in Medicare Part B, but does not get a Medicare supplemental insurance policy during the "open enrollment" period, then when the person retires, all insurance companies can ask health related questions.  So, all insurance companies could refuse to issue a Medicare supplemental insurance policy in those circumstances.  It is only during the "open enrollment" period that insurance companies must accept the applicant for coverage.

            Making the right decisions in this matter could save a senior citizen thousands of dollars.  Making the wrong decisions in this matter could cost a senior citizen thousands of dollars.  At age 64 years and 6 months, start checking all the options with the help of an insurance agent who handles Medicare supplemental policies and issues regularly.

Written on August 17, 2005.

Check the Laboratory Bill with the Medicare Summary Notice

By Woodrow Wilcox

            I'm looking for a good lawyer.  But, I'm not looking for me.  I'm looking for our clients.  Our firm has over 7,000 senior citizens as clients.  Every day, I'm helping some of them with problems.

            Sometimes, I discover a pattern of bad billings in which the laboratory or other medical service provider persistently fails to follow the rules about billing people who have Medicare.  So, I'm looking for a lawyer who wants to help senior citizens to enforce their rights, collect damages, and repair their credit by bringing actions against such firms.  I'm so upset with the repeated injustices that senior citizens endure that I'll spoon feed the cases to the attorney.

            I just helped one client who was being billed for $130.55 that he did not owe.  Just because someone sends you a bill, it does not mean that the bill is correct.  In this case, the medical laboratory already had been paid the full amount allowed by Medicare.  But, the laboratory company ignored the federal rules and regulations regarding accepting Medicare payments.  The medical laboratory billed our client for the difference. 

BILLING DISCREPENCY COULD INDICATE "SENIOR SHAKEDOWN" BILL

By Woodrow Wilcox

            An elderly widow from Whiting, Indiana who is a client of this insurance agency sent some bills from some local hospitals for our review.  Each bill had a balance due which should not have happened because of the type of Medicare supplement policy that the widow had.

            In each case, there was a difference between what the hospital reported to the patient as the original billed amount and what Medicare reported to the insurance company as the original billed amount.  In each case, this caused a "balance due" difference which the hospital expected the senior citizen to pay.

            The difference in the original billed amount as reported by the hospital or Medicare could be caused by several problems.  In some cases, Medicare personnel accidentally enter the wrong figures

            But, too often, a hospital files charges with Medicare, and then adds new charges to the bill without re-filing with Medicare.  That is why the original billed amount presented to the patient is higher than the original billed amount reported by Medicare to the Medicare supplement insurance company.  This cheats the senior citizen on Medicare in several ways.

            First, the senior citizen's Medicare supplemental insurance company will never pay on the higher billed amount because the insurance company will never get the claims from Medicare.  Medicare will not pay on the added charges because it never got the claims from the hospital or other medical service provider.  And the hospital or other medical service provider will demand money from the senior citizen under fraudulent circumstances. 

In such cases, the hospital or other medical service provider never has the added charges reviewed by Medicare, adjusted downward by Medicare, or paid by Medicare or the Medicare supplement insurance company.  The medical billing entity MAKES MORE MONEY BY ADDING CHARGES TO THE BILL AFTER SENDING THE FIRST BILL TO MEDICARE.  The extra charges don't get reduced by Medicare and the senior citizen is hit with charges that are wrongfully demanded.

If the senior citizen does not get help to find the problem and confront the hospital or other medical biller on the matter, then the senior citizen will pay the extra charges.  I call these "add on" bills "senior citizen shakedown" bills.  I consider these bills to be a form of larceny against senior citizens by hospitals and other medical service providers.

Note: This article was written on September 16, 2008 and syndicated to newspapers.

Avoiding Insurance Problems After You Quit Working While On Medicare

By Woodrow Wilcox

            One of the clients of this firm came to me for help.  I am in the process of helping him.  I thought that sharing the basic problem and resolution would be helpful to some people who read this column.

            The client enrolled in Medicare at age 65, but continued to work part time because of the excellent and inexpensive insurance that he got through his employer.  Paying the small premium while he worked was cheaper than buying a Medicare supplemental insurance policy.  This made sense.  This was smart thinking by the client.

            But, eventually, the client quit the job and bought a Medicare supplemental insurance policy.  The client experienced problems because Medicare never was notified that the client had quit the job and stopped having the employer subsidized insurance.  So, when the client's medical bills didn't get processed correctly, the client had a problem.

            To correct this problem, I worked with the client to get a letter of insurance termination from the employer's insurance company.  Such a letter was not sent to either the client or Medicare when the client lost the employer provided insurance. 

Once we get a copy of the termination letter to Medicare, we will have the client request a reprocessing of all claims since the date of termination of the previous insurance.  The reprocessing will correct the matter and payments will be made for the client's medical bills.

While the client worked and had insurance, Medicare was the secondary insurance.  After the client quit the job and lost the insurance, Medicare became the primary insurance.  In each case, the claims are processed differently.

Other senior citizens who quit a job and change from an employer provided insurance to a Medicare supplemental policy can avoid this billing problem by being pro-active.  Ask the employer's insurance company to provide a LETTER OF TERMINATION OF COVERAGE.  Then, send a copy of that letter to Medicare promptly.  That will minimize the chances of you having the same problem as our client.

Note: This article was written on September 24, 2007 and syndicated to newspapers.

A $100 DIFFERENCE IN BILL MAKES PROBLEMS FOR SENIOR CITIZEN

By Woodrow Wilcox

            One of this insurance agency's clients from Lowell, Indiana sent a bill to me for review.  The bill balance of $375.35 was not getting paid.

            I reviewed the bill and contacted the client's insurance company to discover what it knew about this bill.

            The hospital in Lake County charged our client an original billed amount of $3,709.49.  But, Medicare reported to the insurance company that the charges from the hospital were $3,609.49.  Medicare calculated the insurance company's portion of the bill and the insurance company paid that.  I got the date of payment and the check number of payment and the fact that the check had cleared.

            A difference between what a hospital reports as the bill to the patient and what Medicare reports to the insurance company is rather common.  Medicare does not work very well in my opinion.  I've been helping senior citizens with Medicare billing problems for over five years.

            I wrote to the hospital to inform it of the discrepancy between the bill to the client and the billing information from Medicare to the insurance company.  I requested that the hospital contact the insurance company to share information that is critical to finding and resolving the problem.

            There may be other problems with the bill, too.  But, first, I want the hospital, Medicare, and the insurance company to agree on what the charges and final bill are.  Then, I can work on the other billing problems for our client.

Mistakes Happen: Give People a Chance to Correct Things

By Woodrow Wilcox

            Recently, a hospital billed a client for $912 that the client did not expect to pay.  I asked the client to bring all the papers that pertained to the bill so that I could review it.

            For minor billing problems or questions, calling the policy holder services department of the insurance company that issued a Medicare supplement insurance policy is the quickest and easiest way to resolve a problem for a senior citizen.  But, sometimes, it is too complicated to talk on the phone and describe the various correspondence from a medical service provider, Medicare administrators, and the insurance company claims department.  Sometimes, it is better to take the papers to your insurance agent's office to ask for a review.  An experienced insurance agent or administrator can review the papers to find the most important parts and help to resolve the problem.

            When I reviewed the client's papers, I discovered what I thought was an error on the part of either the hospital or the insurance company.  I phoned the insurance company and learned that the bill had been paid.  I got the check number and the date of issue.  In a letter to the hospital, I explained all of this and cited the payment information.

            Two weeks later, our client got another letter from the hospital which demanded payment within five days or the matter would be given to a collection agency or attorney.  I phoned the patient accounts department of the hospital.  I asked to speak to the department supervisor.  I asked for the fax number to the department.  My intention was to alert the supervisor that the bill had been paid and then send copies of my previous correspondence.  But, I never got to speak to the supervisor.  The person answering the phone told me to "hold" when I asked for the supervisor and fax number.  I waited and waited.

            Then, I called the hospital and got the name and fax number of the hospital administrator.  I wrote a polite letter that explained that the bill had been paid and that I had tried to discuss it with a supervisor in the patient accounts department, but that I had been put on "hold" and ignored.

            I believe that the hospital administrator will realize that I have been reasonable in my attempts to resolve the problem for our client.  But, if the hospital administrator ignores my attempts to be resolve the problem, then I will bring this billing problem matter to the attention of state and federal officials who regulate hospitals and their Medicare billing practices.

            But, please, notice something.  When there is a problem, I try to be reasonable.  Everyone makes mistakes.  When mistakes do happen, and it affects our clients' in a negative way, I try to collect the facts and then discuss the problem to a resolution.  I do that because if I make a mistake, I want others to treat me in like manner.