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How to Handle Medicare Billing Errors

Senior

How to Handle Medicare Billing Errors

For seniors and those under the age of 65 with medical conditions in the U.S., Medicare is an exceptionally beneficial program. When seniors have fixed or limited income, paying for healthcare can get tough. That’s when this federal program comes to the rescue.

Medicare billing errors can happen, but they are easy to find & fix. Here are some tips you should follow to make sure that your billing issues are corrected:

It could be an accident

From small to billion-dollar government programs, mishaps happen. These mistakes could be a simple error by a coder who entered the wrong billing code. This can be easily fixed. There are people on all ends of the healthcare industry who can help you correct the billing issues.

Ensure you’re not being conned

An accident can also be disguised as a scam. Instances of fake Medicare activities include someone stealing your identity to use it to file Medicare refund claims or sell you equipment & services that you don’t really require to make some extra money. You can contact the Inspector General’s Office if you suspect a Medicare fraud.

Check with Social Security

Medicare fraud can also be reported to the Social Security Administration. When it comes to auto-debited premiums, you can contact your local Social Security office to ensure that there are no problems that may have led to a missed or incorrect bill.

Fill Out the Right Form

Medicare has several forms that range from proving medical necessities for various apparatuses to approving the beneficiary. While some forms are for you to handle, there are a few for medical providers and hospitals to fill out. Any of the parties involved can make a mistake in the process. That could be filling out the right form incorrectly or filling out the wrong form. Make sure you have filled out all of your forms correctly.

Know Who Is Billing You

If the hospital takes responsibility for the claim, Medicare will pay the provider for 80% of Part B services and the hospital will bill you for the remaining cost. In cases where the hospital does not take the responsibility for the claim, you will have to pay Medicare directly for the services that aren’t covered. You may also have to take responsibility for the whole payment and Medicare will reimburse you. In this case, you may want to make sure all the billing details are correct. If the billing error is made by the hospital or a medical provider, contact them and request to speak with the individual handling insurance. If the error is made by a private insurer, call them on their claims issue hotline number.