Disputing a Medicare Claim

Answer:

Medicare is a federal program that provides medical benefits to either a class of people who have been determined to be disabled or to people who reach a certain age limit. Under our laws, if an individual is either on Medicare or if they’re anticipated to become Medicare eligible, we’re required to place Medicare on notice when an individual is involved in some type of accident. When that happens, Medicare provides us with indications and letters of liens that will indicate what they believe they’re owed in a case.

Many attorneys will take those numbers, provide them to the insurance companies, and then pay Medicare the lien that they’re alleging. Our office is a bit different. We’ve hired an individual who’s been trained solely with respect to handling Medicare claims, and at our firm we dispute each and every claim. The reason is that sometimes Medicare gets it wrong and the amount that they’re claiming as a lien against your file may be inaccurate. By disputing, we make Medicare prove that the amount that they’re claiming is an actual amount related to your accident. This comes across a lot of times in situations where there are overlapping injuries, like a preexisting shoulder condition that is once again injured in a slip and fall accident.

At the end of the case, Medicare must be satisfied and we get what’s called the final settlement detail document from them. After we’ve disputed the claim and come to a number that we’re comfortable with, it’s only then that we pay Medicare. We can assure that there’s no interference with your benefits.