(WSVN) - He got a bill from Medicare saying they were paying $17,000 for a terrible wound. One problem, he never had a wound. Did the company get away with it? Let’s bring in Help Me Howard with Patrick Fraser.
If you grew up in South Florida, odds are you love the water.
Henry did and does
Henry: “I’ve always been into the ocean skiing, diving, fishing, hang gliding, you name it.”
One more water adventure; Henry is a treasure hunter.
Henry: “This is a piece of Kangxi China from the Ming Dynasty from the 1500s.”
A fun rewarding hobby.
Henry: “It’s opened a lot of doors for me, giving away treasure and exchanging treasure.”
You never know what surprise the ocean will reveal and in Henry’s case what surprise the mail will deliver.
Henry: “And the bill was in the amount of $17,000.”
It was from Medicare saying they had approved and paid a $17,237 payment to a medical supply company.
Henry had a co-payment…
Henry: “Saying that I was about to owe Medicare, close to $3,500.”
Now it gets weird…
Henry: “I found that I was being billed for a process that I had never had done, at a place that I had never been to before, by people I had never heard of before.”
The company billing Henry and Medicare is Max Care Solution, which said they had provided thousands and thousands of dollars worth of gauze and dressings for Henry’s 48-inch wound.
Henry: “And last time I checked, I don’t have any wounds that are 48 square inches.”
The bill said the supplies were ordered by a Dr. Martinez.
Henry: “Don’t know who she is. Never heard of her. Never met her.”
Henry tried calling the company billing Medicare.
They wouldn’t answer.
He then called Medicare.
Henry: “And got in touch with the fraud department and I told them there was no way, ever, that I would ever pay a nickel towards this bill.”
Won’t pay the bill and doesn’t want Medicare to use your tax money to pay the $17,000 for gauze either.
Henry: “So I’m frustrated, and angry and determined.”
Henry is being billed for Medicare services he didn’t get but how can he get out of paying, Howard?
Howard Finkelstein, 7News legal expert: “It’s simple, if you did not get the services, you don’t have to pay for them. The more complicated part sometimes is proving you did not get them. But the good news, after you file a complaint with Medicare, it’s their responsibility to straighten it out.”
Max Care Solutions wouldn’t answer our calls. No one was in their office near Pinecrest on the days we went there.
The doctor who Max Care claimed ordered the gazes wrote us “I have not written for these supplies. I suspect this is fraudulent activity and I will investigate what is happening with my credentials.”
We then contacted Medicare.
They moved quickly, telling us just because something is marked payable, does not mean funds will be paid.
They told us they were now investigating Max Care Solutions and then did what Henry wanted.
Henry: “They denied payment to the Max Care Solutions and also released me from any obligation to pay my Medicare fee.”
His problem was solved after Henry dove in with Help Me Howard.
Henry: “I’m very glad that I contacted Help Me Howard. It was your correspondence, also with Medicare, that helped bring this to a satisfactory conclusion.”
Glad we could help Henry and nice to see Medicare move so quickly.
Now, whether you are on Medicare or private insurance, it’s good to check your explanation of benefit form, which tells you what services you got and how much was paid.
And if you see something that doesn’t look right, call the number on your insurance card.
Feel like someone is trying to rip you off? Don’t want a band-aid solution? Let us ensure you get some help ’cause we have a prescription for your problem, we hope
With this Help Me Howard, I’m Patrick Fraser, 7News.
More Information:
Medicare Fraud
For a private health insurance company, call the number on the back of your insurance card.
CONTACT HELP ME HOWARD:
Email: helpmehoward@wsvn.com
Reporter: Patrick Fraser at pfraser@wsvn.com
Miami-Dade: 305-953-WSVN
Broward: 954-761-WSVN
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