Sep 6, 2024

A 73% Error Rate?

    From Follow-up on the Accuracy of the Social Security Administration’s Manual Billing Process to Collect Medicare Premiums, a report by Social Security's Office of Inspector General:

...  When a Medicare Part B recipient receives a monthly Social Security benefit, SSA deducts the monthly Medicare premium from the benefit. Some individuals’ monthly Social Security benefit is lower than the monthly Medicare premium. SSA bills these individuals for the balance of the premium. Each year, SSA uses its Benefit Rate Increase (BRI) program to generate an alert for individuals whose Social Security benefit is lower than their monthly Medicare premium. SSA considers this alert to be a high priority because SSA must bill beneficiaries the remaining Medicare premium as soon as possible and timely issue benefit statements.

In a 2016 report on the Accuracy of the Social Security Administration’s Manual Billing Process to Collect Medicare Premiums, we concluded SSA incorrectly calculated the Medicare premium owed for 48 percent of the sampled beneficiaries we reviewed. For this audit, we reviewed a random sample of 100 beneficiaries from a population of 111,976 beneficiaries SSA’s BRI program identified in November 2022.

SSA timely processed the cases in our sample; however, it incorrectly processed or calculated the Medicare premium owed for 73 of the 100 beneficiaries we reviewed where their Medicare premium was higher than their SSA benefit payments. This included approximately $147,000 in processing errors where employees did not correctly credit monthly benefits to Medicare billing information and $102,000 in payment errors where beneficiaries were not correctly billed for Medicare premiums, which led to overages and arrearages.

Based on the results for our sample, we project SSA did not correctly update records or calculate Medicare premiums owed for approximately 82,000 beneficiaries, which resulted in approximately $76 million in billing errors and $91 million in processing errors. ...

7 comments:

Anonymous said...

Hands on training has been lacking at SSA for years. Everything is done through videos and that doesn’t get the job done.

Anonymous said...

None of this is good, and an error rate of ear 0% should be the expectation. But to put it into perspective, this affects an estimated 82,000 beneficiaries out of 54, 000,000 or 0.15%. The average billing error amount per beneficiary is $927.

Anonymous said...

I'm one of those people, and I'm not sure I like being considered expendable, as I'm a human who paid my taxes and would gladly pay my premium out of pocket but the law won't let me. I keep a spreadsheet of what my premium is, what my offsetting SSA benefit is and calculate the shortage. Takes SSA until August to figure it out for the closed year. Plus the 1099 is usually inaccurate, but try and tell them that. There isn't a way. I've been using my spreadsheet values instead of the 1099 with the IRS. Being stuck in this manual handling situation in the PSC is almost a guarantee of non-quality service. Again, I'd pay the difference monthly or do about anything to get out of this but the law says no can do.

Anonymous said...

@ 12:52 - you’ve “paid your taxes” but you don’t even have a SS benefit more than the premium? How lol

Anonymous said...

Hey 5:45, your lol is disrespectful and I hope you aren't an employee with that dismissive attitude towards a beneficiary. If you are one, that goes a long way to explain the error rate.

Anonymous said...

This category of error-prones includes CSRS retirees, who have had their SS reduced by the windfall revisions. And lol don't make enough to pay the Medicare: My SS was reduced from $500 something when I retired to $200 something; depending on income level Medicare Part B premium runs as high, more or less, as $500, as does mine, so my SS no longer pays part B.
I pay, together with my wife, about $12K a year for Part B, and I resent it.

Anonymous said...

LESSDO beneficiaries should be recoded to appear as not on benefits to the CMS systems. CMS should bill them for Medicare, and SSA should issue them their payment. The way it's done now is insane. CMS handles billing for everyone who isn't on monthly benefits, they're is no reason they can't handle premium billing for a few more.