Question
I fell and broke my wrist, I went to the hospital, then was referred to a Clinic, where I saw 2 different doctors, and they did surgery on my wrist. It was billed and paid through medicare. A few months later, I thought maybe my auto insurance would cover it, because it happened when I got caught up in my seat belt, and fell out of my car. I called my auto insurance, and they said they would cover it. They got ahold of medicare, and started the process with MSPRC. They called the clinic, and asked for a copy of their billing. They sent them a copy of the billing (not showing that medicare had already paid, or that they were billed). The insurance company (state farm) computer starting sending them checks. The checks totaled my entire entitlement, 10,000.00. MS{RC has now sent a lein letter to my insurance company, but there is no money left. State Farm, MSPRC, and Medicare have said the doctors office needs to return those checks, that they have already been paid in full by medicare. The total that State farm owes MSPRC is about 3200.00. The doctors office won't call MSPRC, they said they would not refund the money until they get it in writing from medicare, and they do not see that MSPRC and medicare and NOT one and the same. HELP!! Thanks
Answer
Hi Kathy
This is really a legal question and outside of my expertise.
BUT, maybe this might work for you. Call 1-800-Medicare..When answered you will be on the press the button section. ASAP say AGENT. You be transferred to the representative talk session. When that is answered request to speak to a claims specialist in reference to a claim that has been paid twice. Do not call on Monday or early in the morning or you will be on the phone all day. Have all the information you have ready when you call. The claims representative is the office that sends out those letters you are looking for.
I am not familiar with the legal actions that might be needed.
Hope this is some help.
John
