Confusion Over Insurance Payments? A Medicare Attorney Can Help

by | Nov 30, 2016 | Lawyers

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Medicare has helped many elderly patients to receive the medical care they need. However, not all procedures and appointments are covered under Medicare, which can leave patients in a confusing place. For example, if an injury or illness results from an auto accident, or working conditions at a current or previous job, typically the required treatment goes to third party insurance carriers for payment. Sometimes, due to complications regarding what individual or institution is responsible for making payments, Medicare makes conditional payments. This can lead to a complicated process of filing claims and making settlements, which can lead to patients footing the bill.

Many patients choose to hire a Medicare Attorney to help them sort out questions and recuperate money spent in their care. The first step to take after hiring an attorney is to contact the Benefits Coordination and Recovery Center of the Medicare office to inform them that a case is being filed. Details of the case and additional information about the attorney must be reported in order for a patient’s attorney to gain access to medical information. Proof of representation must be filed by the attorney.

The results of negotiations occurring between Medicare and other insurance agencies must be reported to the beneficiary, as well as any attorney he or she has hired, and any legal representative that has been assigned. This should not require action on the part of the patient. Information regarding conditional payment amounts can be made available to patients throughout the negotiation process.

Once a decision has been made, a formal letter will be sent to the beneficiary and his or her attorney. It will include a summary of all conditional Medicare payments, the total amount of the demand, and information on appeals. This letter will inform patients of what individuals or entities will be required to reimburse Medicare providers for any and all conditional payments.

The best time to hire a Medicare Attorney is before embarking on this process. Mark Aberasturi is an elder law attorney who can help clients understand these often complicated legal proceedings and recover damages when confusion over payment cause financial distress. Interested parties can visit his Facebook for more information or to get in contact to schedule a meeting.

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