Social Security & Medicare Questions

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Social Security & Medicare Questions

Q: My mother was diagnosed as terminally ill, and hospice care started. Despite the doctor’s prognosis, my mother rallied. I took my mother out of hospice care and started providing home care myself, for 4 months until she was admitted to a nursing home. During this time my mother’s Medicare Summary Notice indicated that the hospice care agency continued to bill Medicare, both while she was in my care and even after she entered the nursing home. What should I do?

A: If you believe that Medicare was improperly billed for your mother’s care, call or write the Medicare company that paid the claim. The name, address, and telephone number are on the Medicare explanation of benefits. Have the following facts ready:

The name of the hospice care agency and any identifying number you may have.
The services you are questioning.
The date on which the services were supposedly furnished.
The amount approved and paid by Medicare.
The date of the explanation of benefits.
The name and Medicare number of your mother. The dates you or the nursing homes provided care.
Any other information you may have showing that the claim for service should not have been paid for by Medicare, such as statements from her doctor attesting that she was under your care or that of the nursing home.

If you prefer to use the Medicare Fraud Hotline call (800) 447-8477.

This article first appeared in Volume 5, Issue 6 of "The Social Security and Medicare Advisor" newsletter (May/2000). To receive future editions of "The Advisor" in its special, free e-mail version, please click here.