I just received a statement from my medicare supplement policy and on it was a claim which they paid from a DR office in Colorado. I haven't been in Colorado in 20 years. Called that DR office but they said they will get back to me in 24 hours (or maybe never). Looked into the process of challenging the claim through Medicare. First have to wait until the Medicare statement shows up then pay them $25 to even start the process. Then get a PIN number. Who knows what next. I will suffer through that when I get my Medicare statement. Why can't the government make life simple for us old people?
Government red tape
- Thread starter grover99
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Can't you contact the provider who issued your supplemental policy?
You should be able to ask for the Medicare fraud office and be connected to the folks that challenge claims. If you're looking at a charge to your supplemental policy wouldn't it have had to been reviewed by medicare first as the primary?
I've had two cases where Medicare paid about $15k for the two situations. In both cases the medical devices ordered by "doctors" in states in which we don't live were not needed and not requested. In one case nothing was delivered, in the other only probable junk, which the Medicare fraud folks told me to toss in the trash. I called back months later to follow up on both but all they could tell me was that they were not sending more checks to those "doctors."
I've had two cases where Medicare paid about $15k for the two situations. In both cases the medical devices ordered by "doctors" in states in which we don't live were not needed and not requested. In one case nothing was delivered, in the other only probable junk, which the Medicare fraud folks told me to toss in the trash. I called back months later to follow up on both but all they could tell me was that they were not sending more checks to those "doctors."
OP
I have done that and they were very helpful and would start an investigation on their end and also gave me a number to call at the Fed level to start from that end. I called that number and was given a hold time of 24 minutes. Got other things to do today so I am setting an hour or two to follow up on this Monday
LVSteve
Member
Late wife#1 told me that one doctor she worked for asked her to do something very sketchy with some Medicare billing. She found another job, pronto.
Jon651
Member
If you've had any tests (lab work, CAT scan, x-rays, etc.) done recently, the doctor reading the results may not be anyone local, so seeing a claim from out-of-state would not be unusual. I've known a few medical practices that never see a patient in real life, just provide services like those described - usually done completely online. This is more common in rural areas where there might not be a specialist anywhere nearby to interpret the test results.
OP
Thought of that and Checked with my regular Dr and they knew nothing about them and was only Dr that has ordered any scans this year.
I had the same thing happen to me for about the same amount for "medical supplies" of every nature. Sunshine Senior Solutions? Fort Lauderdale? The "requesting doctor" was some Doc up in the panhandle. Like you, I reported it and never heard a word from Medicare. I find it difficult to believe these folks can't be rounded up in under a week.
DOGE testified before congress / senate that they estimate around 2.7 trillion in healthcare waste, fraud, and abuse. Approx 40 % of all social security direct deposits were absolute fraud.
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