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Weird billing mystery
Old 09-30-2015, 12:00 PM   #1
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Weird billing mystery

My husband is guardian of his mother, who is now in a memory care home.
He has been dealing with all of her medical billings following a hospitalization, then nursing home, then finally, the memory unit.

Without exception, they have all failed to bill the secondary insurance - and he's had to follow up (sometimes several times) to give them the secondary insurance information. Most of the bills eventually get resolved with little to nothing due after the secondary insurance is finally billed.

This obviously involves calling and giving them the secondary insurance info (sometimes more than once.) He obviously doesn't want to pay first if it hasn't been through both medicare and the secondary insurance.

We've got a bill with NO phone number of any kind on it.
It's a small one - but there is nothing other than a PO Box to remit payments to. No phone number of any kind. Like all medical bills it's cryptic in the services being billed and it appears it went through one insurance because there is an adjusted amount.

When I google the company name I see a variant of it looking to hire nurses and home health aides... but nothing about billing offices, etc.

Has anyone heard of MedOptions PAE?
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Old 09-30-2015, 12:43 PM   #2
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Surely the facility taking care of her should be able to identify it. Is there a date of service shown?
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Old 09-30-2015, 12:45 PM   #3
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Just guessing...

Might it be some part of MedOptions? MedOptions Facility Services

PAE - pro-active eldercare?

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Old 09-30-2015, 12:49 PM   #4
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If I get a bill and I cannot figure out who and what I owe, and there is no phone number I ignore it...

It happens every once in awhile, but not often... so far I have never had any problems...

One went to a collection agency and they sent a bill with a phone number... I called and they were able to give me enough info to show that I actually did owe the money and I paid it right then... all others have not done anything...
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Old 09-30-2015, 01:03 PM   #5
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Originally Posted by omni550 View Post
Just guessing...

Might it be some part of MedOptions? MedOptions Facility Services

PAE - pro-active eldercare?

omni
I saw that - but there were no matches on the address. There are dates associated with the billing - and she was in a skilled nursing home for the 2 dates.

My husband will call the nursing home to see if they worked with med options, and if they have a phone number if the answer is yes.

He still won't pay it till he finds out if both insurance companies have been billed. He can't find that out till he can talk to them about the bill.
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Old 09-30-2015, 01:08 PM   #6
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Quote:
Originally Posted by rodi View Post
My husband is guardian of his mother, who is now in a memory care home.
He has been dealing with all of her medical billings following a hospitalization, then nursing home, then finally, the memory unit.

Without exception, they have all failed to bill the secondary insurance - and he's had to follow up (sometimes several times) to give them the secondary insurance information. Most of the bills eventually get resolved with little to nothing due after the secondary insurance is finally billed.

This obviously involves calling and giving them the secondary insurance info (sometimes more than once.) He obviously doesn't want to pay first if it hasn't been through both medicare and the secondary insurance.

We've got a bill with NO phone number of any kind on it.
It's a small one - but there is nothing other than a PO Box to remit payments to. No phone number of any kind. Like all medical bills it's cryptic in the services being billed and it appears it went through one insurance because there is an adjusted amount.

When I google the company name I see a variant of it looking to hire nurses and home health aides... but nothing about billing offices, etc.

Has anyone heard of MedOptions PAE?
I'm having a similar situation with my mother's billing. Since she moved into an ALF there have been lots of billed services, and I don't recognize many of the billing agent names.

One thing you can do is look at the date of service, then look at her Medicare / primary insurance statement to see what other service was billed on that same date. Another is to call the facility, ask what service was provided on that day, then who provides the service. What I am finding in our case is lots of ancillary activities are coordinated by the ALF but done by independent contractors, the invoices and insurance claims are, like the one you are dealing with, strange names and confusing references.
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Old 09-30-2015, 01:41 PM   #7
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Update:
My husband called the nursing home, they say MedOptions is legit - and referred him to Medicare. He called Medicare and they stated they'd paid some to medoptions. He was able to get a phone number for MedOptions!!!! He's on the phone with them now - and sure enough - they never billed the secondary insurance.

When he asked why they didn't have the phone number she said they had a new billing company and there were issues that needed straightening out.

Um, yeah... like getting a contact number so you don't have to make several calls to find out how to reach them to tell them to bill the secondary insurance.
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Old 09-30-2015, 02:25 PM   #8
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Quote:
Originally Posted by MichaelB View Post
I'm having a similar situation with my mother's billing. Since she moved into an ALF there have been lots of billed services, and I don't recognize many of the billing agent names.

One thing you can do is look at the date of service, then look at her Medicare / primary insurance statement to see what other service was billed on that same date. Another is to call the facility, ask what service was provided on that day, then who provides the service. What I am finding in our case is lots of ancillary activities are coordinated by the ALF but done by independent contractors, the invoices and insurance claims are, like the one you are dealing with, strange names and confusing references.
This was my experience too, when my mom was in a memory care facility. Mostly local folks who actually provided a service, but trying to figure out the details from the cryptic statements I received was quite a slog.
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Old 09-30-2015, 06:51 PM   #9
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Quote:
Originally Posted by rodi View Post
Update:
My husband called the nursing home, they say MedOptions is legit - and referred him to Medicare. He called Medicare and they stated they'd paid some to medoptions. He was able to get a phone number for MedOptions!!!! He's on the phone with them now - and sure enough - they never billed the secondary insurance.
By the way, Medicare sends out statements showing a summary of what it paid (I think this is quarterly maybe). You can also download it online to get the info more quickly.
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Old 09-30-2015, 08:37 PM   #10
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That's awful that they didn't even put a phone number on the bill. I am thinking of how difficult this could be, for those elderly who are not doing well and don't have kids or anybody to chase down phone numbers and such. Or maybe they all have arranged for someone to do this, before they get to that stage in life.
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Old 09-30-2015, 09:15 PM   #11
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"When he asked why they didn't have the phone number she said they had a new billing company and there were issues that needed straightening out.

Um, yeah... like getting a contact number so you don't have to make several calls to find out how to reach them to tell them to bill the secondary insurance."


My uninformed opinion is the lack of contact info is deliberate by the rat bastard billing company.

The new ( Read cheaper) billing company cannot afford to deal with pesky questions. This is the kind of stuff that makes my blood boil, and should be illegal. I am sure those in the medical field have seen shenanigans like this. In cases like this I go out of my way to find a responsible manager or owner from the provider that hired the billing company, and start a very pointy uncomfortable conversation about going too far on cost cutting.

Just my 2 cents worth
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Old 09-30-2015, 11:20 PM   #12
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OH... BTW, just because you have a number does not mean much...

A testing company did blood work and tests on my mom.... the Dr office gave them her old insurance info which of course was rejected... the bill went from a few dollars to over $1,000 since there was no insurance...

I called and let them know they had the wrong insurance, but they did not want to put down the correct insurance... they got it from the doc... called the doc and they said they gave the correct info... tried 3 times with each unsuccessfully... my last time I told the testing company that they would not get a check from my mom as insurance would cover it 100%....

After a year they finally put it to the correct insurance and got paid....


Yep, if they make it hard for me to fix the problem, I have no incentive to pay them at all....
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Old 10-01-2015, 03:26 PM   #13
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This is a nice article that specifically identifies what needs to occur in order for the secondary policy to be billed. The paragraph "Carrier Filing of Medigap" claims is pertinent to the issue you describe. You should not have to do any claim filing if the Medicare file is set up correctly.

http://www.ec-online.net/knowledge/a.../medigap1.html

Additionally, Medicare should have current information on the secondary policy. Information can be updated by calling Benefits Coordination and Recovery Center at 855-798-2667.

Of course, make sure any providers have the secondary policy information.

Hope this helps.


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Old 10-01-2015, 03:49 PM   #14
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That's awful that they didn't even put a phone number on the bill. I am thinking of how difficult this could be, for those elderly who are not doing well and don't have kids or anybody to chase down phone numbers and such. Or maybe they all have arranged for someone to do this, before they get to that stage in life.
Of course one could do things the old fashioned way and send a certified mail letter to the po box asking for more information. Yes its a couple of dollars in postage but, that is the way the law is written, that phone calls don't really count in a legal sense but letters do. (As suggested by this website: Mail Letters to Creditors Certified - Document Credit Disputes) It notes that this route does give you traceability. As the website says if it is not it writing it does not exist.
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Old 10-01-2015, 05:59 PM   #15
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This is a nice article that specifically identifies what needs to occur in order for the secondary policy to be billed. The paragraph "Carrier Filing of Medigap" claims is pertinent to the issue you describe. You should not have to do any claim filing if the Medicare file is set up correctly.

http://www.ec-online.net/knowledge/a.../medigap1.html

Additionally, Medicare should have current information on the secondary policy. Information can be updated by calling Benefits Coordination and Recovery Center at 855-798-2667.

Of course, make sure any providers have the secondary policy information.

Hope this helps.

^^This.


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