Conditional Payment Information - Centers for Medicare & Medicaid Services this is a link to the conditional pay law under Medicare. No place does it say ones doctor, lab, hospital is to pay back any money.
But if its not clear who is to pay first, etc, then the medical biller is to label the claim as a conditional payment and that gets its sent top the recovery unit which is to recover the money from the primary payer. (the health plan or insurer which is to pay first.)
THERE HAS BEEN NO GOVT RUN HEALTH PLANS FOR AT LEAST 15 YEARS. AND NO ENFORCEMENT O THE LAWS SINCE 1994. So patients and doctors were getting overpaid and all were being lied to by the govt conductors in charges are they have been and still are hacking in to the privately owned COMMON WORKING FILE that all use to verify insurance, employment status of the patients and which pays first, etc. or if there is a possible primary payer in the future as a car accident or job injury that has not been decided yet what or which will pay the bills.
WHAT IS CRUCIAL ON THIS IS THAT IF THE CLAIM IS PAID AS A CONDITIONAL PAY, THEN NEITHER THE PATIENT NOR THE MEDICAL PROVIDER OR SUPPLIER IS OVER PAID AT ALL. And since 1/11/13, its now the responsibility of the government, again,to collect the money back to the govt FROM THE PRIMARY PAYER, NOT FROM ANY ONES DOCTOR, LAB, ETC. as few have intentionally done anything wrong as those who act for the government, have been lying to them for years and how can they do anything when the ones paying the claims say its okay.?
If one reads any of the instructions or press releases from CMS it seems very clear as to what each biller must do. BUT THEY ARE STILL GETTING LIED TO BY ACS ET AL UNDER PRESIDENT LYNN BLODGETT, who is ignoring the laws and rules and even judges in our cases. SECRET DEALS OVER RIDE.
Since 1999, all of out medical records are privately owned by Group Health, now Emblem health International and they are not under the HIPPAA law so once they go in with any kind of claim for pay, there is NO PROTECTING OF THEM and no way to correct errors and too many deadly outcomes over this. Plus the Medicare data is also owned by them and their contract forbids any alteration of the info re insurance or employment statues or which pays, first, etc. when the info COMES DIRECT ROM ONES EMPLOYER. as ours posts direct from the US Department of Labor since the Federal Workers Compensation law overrides all other laws on me and those on my Employer Group health plan who also have a Medicare card.
NO ONE IN THE GOVT CONTRACTORS HAVE ANY KNOWLEDGE OF WHAT THE LAW IS AND THEY ARE BEING ORDERED TO USE THE HACKED COMMON WORKING FILE AS THE 'GOSPEL TRUTH' even though its only accurate a couple of hours every two weeks. THEN ITS HACKED INTO TO ALTER THE POSTING FROM ONES EMPLOYER. every source they contact is under PRESIDENT BLODGETT 'S COMPANIES AND ITS A REAL VIOLATION OF THE ANTI TRUST LAWS OF WHAT HAS BEEN ALLOWED TO BE CREATED JUST IN HEALTH CARE.
This has been going on with an illegal software programs since 4/09 and before that claims payers were faxing in requests to delete ones primary plans and flip it to a secondary plan and often even changed the plan from an employer gourp health plan to a medgap policy Its been a STEAL MEDICARE FREE FOR ALL BY MANY.. NO ONE IS GIVEN ANY DUE PROCESS NOTICE THAT THERE HEALTH INSURANCE HAS BEEN 'CANCELLED' ( DELETED) NOR THAT THEY HAVE BEEN 'RETIRED" BY THE MEDICARE CONTRACTOR. every other Tuesdays AM Even though ones employer or jurisdictional agency, has not made any changes in ones status.
How can this gross violation of ones rights be going on? BECAUSE: for at least 15 years there has been no budget form congress for any internal oversight nor even criminal investigations or prosecutions THERE IS NO POLICE OVER THE TRILLIONS OF DOLLARS FLOWING THROUGH OUR HEALTH CARE SYSTEMS THAT ALL ARE NOW UNDER, NOT JUST THOSE WITH MEDICARE and states are complaining over what this international cabal under President Blodgett is doing with the state Medicaid funds.
So the fight over the Speakership of the House of Representatives has more to do with stopping the robbing of the public treasury than anything else?. And its not just health care, but the entire govt at every level is now contracted out and NO POLICE over it to take action when needed, and NO ONE KNOWS WHAT IS GOING ON as there are no internal audit controls. Congress ma Kevin Brady is over the House subcommittee on Medicare and his aides have tried to do things and have not been able to as CONGRESS IS AWARE AND FEW SEEM TO WISH TO DO ANYTHING ABOUT IT?. Why should out elected leaders wish to have us robbed daily and our very lives an livelihoods at risk every day?
Changing health plans, etc will not solve anything if NO ONE IS IN CHARGE OF THE GOVT. or new plan passed.
Few patients know that they are being overpaid and OWE THE MONEY BACK TO THE GOVT. on this. when it happens to them. I knew, as having been on the inside of these programs inside the government since 6/68 and judges affirmed it and patients were responsible to stop the crooks until 1/1//13 with passage and signing of HR 1063. And SSA refuses to process one waiver requests as they agreed to do in 2005/ where one gives no personal financial info as its one "against equity and good conscience" on form SSA 632.
Also , I have even conducted Medicare fraud investigations. And what is going on now is a monster compared to what used to occur and we were able to get it stopped early . First of all we listened to patients and others reporting things that did not seem right and often were not. But few press releases get conducted in the media when thefts get stopped at a few thousand dollars. When the press release speaks about 100 million by a few scam artists medical providers now and proves inside 'collusion' for this to ever get that high., GOVERNMENT OFFICIALS ARE BOASTING ABOUT THEIR INCOMPETENCE to ever have let it get that much. And it occurred because of no over sight of the contractors who did not have the needed security protocols in place to even catch that kind of thefts. I have never had any medical doctor, etc., I thought was intentionally stealing. but many of them have had their billing services and clearinghouses etc. do so and some of them have hired President Blodgett's companies to take are of business for them or those they hired then hired his companies are were forced to hire them. Too many of these have gone along to get along and most of all of this should not even be needed with the newer systems.
Most of our good doctors and other health sources are really struggling to take care of us when they are lied to , and set up to be fined and penalized etc by President Blodgett and his companies and partners. most who work for them JUST DO NOT KNOW THE LAWS. And CMS keeps sending out the info and they never are given it to follow.
In order to access the COMMON WORKING FILE they are paying huge sums to a clearing house in order to even send in a claim. And why in an error we have crated huge layers of red tape, that are more skims and scams and higher costs for health care that should be being reduced in stead.
Even what are called appeals are not that at all. As they are being done by govt contractors which do not have the legal authority to really make decisions and get the money back from their 'partners who are doing the stealing with SECRET DEALS among themselves. JUDGES rulings do no good as these secret deals over ride all. I reread one decision we had a few years ago that is now pending for a hearing. THEY LOOKED AT THE COMMON WORKING FILE AND THOUGHT EVERYTHING WAS OKAY. They saw no Fed blues deleted and said Medicare could be stolen and system illegally hacked is what they were really saying. But Saturday one of Doyle's doctors is being told there is another insurer on the system. and too late to file. NO ITS NOT TOO LATE AND AN APPEAL HAS BEEN PENDING EVEN THOUGH THE GOVT CONTRACTOR DISAPPEARED IT. And the letter was sent to me as if I was the patients, and the professing form both Blues and Medicare was on him . SO WHAT ALL IS BEING HACKED AT NOVATIS ON THIS?
These appeals are often done by President Blodgett's companies, too. So this is pure harassment for this to go on and horrific treatment of good doctors whom we all need to care for us .\Is this RETALIATION against anyone who questions the thefts going on? Are members of Congress being blackmailed by President Blodgett's snoopers who contract to snoop for NSA on all of us? ITS A MOCKERY OF JUSTICE. I am well aware of the horrific coercion against many of our fine medical providers already to go along with what they are told to do by this cabal Its what the US attorneys' called the biggest RICCO case in the history of the USA. (organized crime)
We have had to appeal every single payment illegally made by Medicare as the medical billing people can get no info as to how to do a conditional pay as those they call have no info to give them on a law that has been in place since 1980. Then ALL, EVEN THE RECONSIDERATION CONTRACTORS ARE TOLD THEY MUST USE ONLY THE HACKED SYSTEM AND IGNORE THE JUDGES, OR ANY OTHER INFO . So huge monies get spent for a mockery of justice as there are NO APPEALS.
HR 1063 does no make any immune on this. So the govt contractors can be fined and penalized also. But they are oblivious to this even though it been an enforceable law again for over two years. DID I MENTION THAT THE FACILITATOR OF THE THEFT IS NOW THE ENFORCER OF THE LAW? And President Blodgett is their 'gospel" not the law or US Constitution? Something that always used to have a review by the OIG ( law enforcement) to see if this is a criminal matter to look into. And since there is recovery of over payments, there is funding to pay the law enforcers. but that is now a subsidiary of GOLDMAN- SACHS OVER AT HHS. they also do the intake and screening for whistle blower complaints and all are treated as ETHICS violations and the offender gets notified as to who is complaining so NO PROTECTION FOR WITNESSES ??.
No one wishes to be SPEAKER OF THE HOUSE AND BEAR THE WRATH OF THIS CABAL?
Who will have the courage to stand up for the nation and people and the public monies. Reaching out to bring someone back as Speaker of the House of Representatives that helped put this atrocity beast system in charge in real coup of the govt of the USA and its on going around the world in these trade treaties secret provisions., etc. IS NOT GOING TO STOP IT?
So recently we began getting letters from our appeals that MEDICAL PROVIDERS ARE HAVING THEIR BANK ACCOUNTS TAKEN ILLEGALLY BY THIS CABAL. Every appeal is clearly marked that its an HR1063 case. And we are here for any medical provider or suppler to be a witness and offer evidence of the horrific lies that they are actually paying for in order to file a claim to get paid. NO ONE IS TO BE TAKING ANY MONEY BACK FROM A DOCTOR, LAB, HOSPITAL, ETC. They are underpaid as the primary pays better. All of this is coming out of PRESIDENT LYNN BLODGETT OF XEROX MANAGEMENT SERVICES WHO CONTROLS EVERY CONFLICTING PHASE OF HEALTH CARE. ( I name him as high level government officials have named him as the only source of info as they do not have access to their own agency's records any more. WHO DOES HE WORK FOR?) As well as other government programs. and ones own employer may have been forced to hire them to mange their companies and one may not know who is a co worker and who is one of 'them.' as its all done in secret. etc.
WE HAVE ARRIVED AT SEEMINGLY BIBLICAL TIMES where one cannot buy or sell until they go through them, a real beast of a system that has no rule of law, or due process in it. yet our very neighbors and other good people work for them, and seem oblivious that they are violating rights of all. of us and even themselves.
Appealing the over payments to the medical providers is not going to help much as THEY MUST USE THE HACKED IN COMMON WORKING FILE. And Congress has denied access to the government systems people to even check out the systems for security.
AND ALL BILLS ON ME BACK TO 8/1/00 ARE UNDER APPEAL AND THERE IS NO ISSUE OF TIMELY FILING DO TO THAT. And for those on my Federal Blues Policy that have a Medicare card, their claims are protected also for any filing dates. WORKERS COMP LAWS WILL NOT LET ONE CHOOSE TO RETIRE UNLESS THEY PAY BACK ALL PAID OUT AND PAY FOR ALL FUTURE MEDICAL CARE. AND PRESIDENT BLODGETT WILL NOT POST MY FILE SO IT CAN BE WORKED AND IN DEFIANCE OF 38 FED JUDGES PRESENTLY. to get things done. Permanent disability by workers comp has to be done. and it means he has to make records available to the agency official to do this. Apparently there are 85,000 injured feds and family members who are missing from roles and we did not get our OPM hack letters in the first round of them and WE HAVE HAD THE WORSE HACKING DONE TO US? And three of us in my household still have current federal Blue Cross Blue Shield as a primary according to the official Us Dept of Labor info, But why the local officials cannot access that is beyond me. They have to get their info from President Blodgett after it gets altered and hacked into and not posted, etc. The same thing is going on at OPM. the top officials have the official records on me and their contractors do not but have as President Blodgett as their (MISINFORMATION) info entity. and he misinformed SSA, my employer pretending to be quoting the official US Dept of Labor records and it was a lie as proven bi weekly. and I have spoken to the IT Dept there several years ago and they are proud of the security of the system to protect we injured feds rights., but does little good when there is no longer any government in charge of much of anything, anymore.
So one letter we got was to inform us that one Doctor had the money taken back , with no due process rights, and then told it was too late to refile it. THAT IS A LIE.
Just because they threw away appeals, and filings and hacked into system does not mean its not legally pending and open. and several of these PARTNERS OF MEDICARE ARE THE ONES THAT SHOULD BE GETTING FINED AND PENALIZED? HR 1063 DOES NOT GIVE ANY IMMUNITY FROM CONGRESS ON THIS. to any source so the one who did this in the name of NOVATIS is legally wrong. ALL need to start overseeing what this cabal is doing in your names also.
I spent time on the phone today and spoke to many through out the process around the USA. the IGNORANCE OF THE LAW BY THOSE INFORMING THE DOCTORS, ETC. is astounding and a mockery of justice in the USA. WE ARE IN AN OVER THROWN GOVT, AND MANY ARE GOING ALONG WITH IT AND HAVE NO SENSE OF CONSTITUTIONAL RIGHTS OF EVEY ONE IN THE MATERS, AT ALL. All think that systems are secure and they were intentionally programmed to not be is obvious as the security protocols are missing to block even the well intentioned from altering data that is not to be changed.
EVEN MORE HORRENDOUS IS THAT THE PATIENT HAS NO RIGHT TO SPEAK TO THE PARTNERS OF MEDICARE AND ARE PUSHED OFF TO 1-800 MEDICARE WHICH HAS NO INFO AND our phone lines have been blocked from calling them since 4/09 when I found out from the Deputy Secretary of HHS that thousands of fraud reports they did fill out were never docketed in in DC and CONGRESS GOT LIED TO BY HHS. and no budget passed, in 2010. to stop the on going thefts before the whole nation got put under the "federal plan" of no rights for any and robbing of the nation of the money needed for direct care.
The simple fact that they were able to created 16 phony Medicare claims numbers on me meant that there was NO SECURITY ON THE MEDICARE SYSTEM AT ALL and that was done as far back as the last programming in 1/06. When the work cannot be checked out, it like one constructing building that falls down as shoddy work and materials were used. and inspectors paid off to over look the dangers. THERE ARE NOT EVEN ANY INSPECTORS ALLOWED TO INSPECT THINGS DO TO NO BUDGET FROM CONGRESS. AND THOSE WHO HAVE WOKE UP TO THE DANGERS NOW, ARE DENIED ACCESS TO INSPECT AND PROTECT THE USA MONIES AND OUR RIGHTS. at SSA, CMS, etc and states are denied access, too.
So , the House of representatives is the ones who passes the budget and just a little money is needed to stop the robbing of the USA and even the members of Congress's own doctors, etc. from being robbed. as THE LAW , HR 1063 SAYS TO COLLECT FROM THE PRIMARY PAYER, NOT THE UNDERPAID MEDICAL TREATER.
Any medical provider or supplier that needs our help, call or contact us. You all have our number, etc.
And I still need statements that none of you got 17 pays per each of my claims from 1/1/06 through 11/20/12 . which the "500" named witnesses documented was debited from the Medicare trust fund and you got paid under one phony number as the system was by passed and the other 16 were paid in your name, but money diverted elsewhere by the FEDERAL RESERVE? Another place where we have no idea what they are doing with out money? As every pay that goes out from the US Treasury is not sent to any one, as the Federal Reserve okays it, and sends it out. And have they diverted monies? But the records also show all of our over 700 medical providers involved with just our family as being the ones who got all the 17 pays. What has been going on is that when we mention any of this, their billing people ( some of them are President Blodgett's companies) and are told to ignore us.
They are paying them to look our for them and they are working for another first, who is involved in theft?.
With the new coding system , there is no reason, we need all these layers of read tape to get a medical bill paid. The only reason to create all of this is having the insecurity of systems to allow massive thefts to go on and is going on . Those good doctors, etc. who take care of us should be paid within minutes of us being treated or seen. But over sight is needed and some experts to audit the whole. Its time for our health care dollars to be used for health care and not all this other that allows a few thieves to enter in and take from us. our precious right to life and health. CONGRESS THESE ARE YOUR OWN DOCTORS, ETC. BEING TREATED SO BADLY BY WHAT YOU HAVE ALLOWED.
SUPPORT YOUR LOCAL DOCTOR! Vote!
My prayers to YAHUSHA whom we Christians call Christ Jesus for our Congress and House of Representatives to act for us and our nation. Those of other faiths or no faith may you add your prayers and or good thoughts for their success as they grapple at the highest levels to take back our shredded Constitution to carry out its mandate of ' for the general welfare of the people and the security of the nation." As long as a few will do harm to us and steal from the people, we do need some able to check things out for us and stop the few thieves among us who have grabbed high power over us in recent decades.. Congress you must stop gagging yourselves over this mess that those created in prior years. but you have yet to stop and should have before the whole nation was put under this cabal. as its does not matter what kind of health plan or government program is set up, if its not over seen, its can go bad very quickly also. EVERY ONE IS UNDER THIS NOW. SO ITS EVERY ONES CONCERN IF LIFE IS PRECIOUS TO EACH AND EVERY ONE. AS IT IS TO ME AND MINE.
Linda Joy Adams 10/16/15
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