Are Health Care Providers Scamming Medicare Patients?
If you've reached the age of Medicare and find that the bills never stop coming, your health care providers may be double-billing your copay. I'll explain.
My father is retired, and while he stays pretty active during the warm weather months in Oklahoma, his winters are generally spent sitting around the house trying to stay warm.
Because nobody likes to be bored all the time, he does whatever he can to find activities. I've never met someone so elated to hear the words "tax season." Not only does do the taxes for most of the family, but the meticulous nature of it also soothes his soul.
Since taxes came and went in February this year and because winter lasted much longer than normal, he was forced to find some new busy work to pass the time. Since it's so complicated and tedious, he opted to audit his own Medicare billing for the year and what he found was pure shenanigans.
According to Medicare, some providers... doctor's offices and hospitals... can access a patient's Medicare pay records and charge an upfront co-pay. To anyone in America, this seems totally normal. He didn't think twice about it either unit the bill from Medicare came in requesting he pay his co-pay to them. After comparing the paperwork from Medicare to the paperwork from the hospital, they were identical bills.
It appeared he was being billed his co-pay twice, but that's not the whole story.
After spending a bulk of his time on the phone with Medicare, they explained that while it's normal for some medical providers to look up and charge your co-pay upfront, the bill they send on to Medicare either won't be itemized denouncing that, or the itemized bill won't be sent within the Medicare billing period.
What does that mean? It means that some doctor's offices and hospitals in America are double-billing patients and the government.
When he and the Medicare professional on the phone figured all of this out, he asked "So what do I do? I've already paid the co-pay Medicare is billing me for..." to which the representative on the phone replied, "You'll need to pay us what we've billed." When he stated that he's already paid the co-pay bill they said "You'll have to get a refund from the hospital."
Shenanigans. Government running at peak efficiency.
It seems that health care providers have found a way to lawfully scam the government with their slow billing process the same way people used to float checks through the mail. Worse, most people probably don't pay enough attention to their bills to catch them doing this.
Whether you're on Medicare or not, always keep your records and compare everything to your insurance company statements that usually arrive weeks after service. It could save you hundreds or thousands each year.