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Message
re: Medical Billing has gone mad
Posted on 5/17/19 at 11:43 pm to LSUFanHouston
Posted on 5/17/19 at 11:43 pm to LSUFanHouston
quote:
The bill shows that insurance company paid whatever and my co-pay which is due is $25. I call LCMC's financial line, wait 20 min on hold, and finally get a clueless woman who basically says it's not their fault, they submitted the claim "correctly". They say to call Blue Cross. I call Blue Cross, wait 15 min on hold, and get a lady that basically tells me that LCMC submitted the claim but didn't use the "wellness visit" code, and that I can certainly contact LCMC and ask them to resubmit. Having wasted enough time, I say F it, it's $25, I'll just pay it.
Posted on 5/18/19 at 4:52 am to pngtiger
quote:
Then to add to it, everything at the hospital is supposed to be 100% covered.
You must have went to the ER that is at the hospital, but not run by the hospital and outsourced to a 3rd party. The notice in fine print on the wall should have told you.
That is another complaint about medical billing. There is no limit on who is billing who. Once a patient comes in everybody is getting a piece of the action and you could expect a bill from anyone.
XYZ hospital charging its facility fees
ABC Doctor Group who manages the ER Doctors charges their fees
123 Lab Services charges your blood tests
Local Imaging Group charges for XRays and other imaging
Pharmacy charges for Medicine
Anesthesiologists charging for their services
Specialist on call gets a charge
And a few others.
What sucks is some doctors offices are switching to the same model, where they have multiple businesses with to the same location so it can be all billed separately from different entities. So that a lab test or imaging request that could have been coded under one doctor’s visit is now billed out by 3 or 4 providers meaning you are no longer getting services under your single copay. Now you are paying out of pocket towards your annual deductible.
Posted on 5/18/19 at 7:38 am to LSUFanHouston
quote:
Government involvement in providing medical care would make the care worse. However, single-payer means I (as the customer) wouldn't have to deal with these payment / billing issues.
That is not what it means. It means there is only one insurance company. If you think all co-pays and deductibles and premiums are going away with single payer I have a desert in Venice to sell you.
Posted on 5/18/19 at 8:41 am to go ta hell ole miss
quote:
My local doesn’t even ask for an ID when I make a withdrawal. Perhaps you should shop around.
What’s your bank? Also can I get your name? You know uh just in case they ask who sent me
Posted on 8/7/21 at 10:34 am to LSUFanHouston
Bumping this to complain about recent medical situation/bill from LCMC for a 4 day hospital stay for my 2 week old who had RSV. We go to pediatrician at ochsner (we have the BCBS Blue Connect insurance plan) and they check her O2 levels and tell us she needs to be rushed into the ER. We get over to ER and are turned away because of capacity issues and are put in an ambulance to Children’s hospital instead.
Of course I’m worried sick about my 2-week old daughter but then also worried about the bill since we are out of network aside from ochsner facilities - but I’m told “don’t worry it’s ER so it will be handled as in-network even if you get admitted.”
Long story short, get to ER, they get my daughter stabilized, get admitted on Thursday, I guess the entire doc team checks out and takes the weekend off so we receive very little care or direction from anyone there and just sit in a room for 3 days wondering what the hell is going on and what the plan is. I asked for someone to speak to about what to expect billing-wise and was told that that department only takes phone calls and is unavailable on the weekend. Finally on day 4 a doctor shows back up and says we can go home.
Get home and receive a nice $9,000 bill. BCBS says “providers are considered in-network if admitted via ER, but facility charges, laboratory, etc are out-of-network.” Call LCMC to complain about being ghosted for 3 days and stretching our stay unnecessarily and they offer to set up a payment plan.
Of course I’m worried sick about my 2-week old daughter but then also worried about the bill since we are out of network aside from ochsner facilities - but I’m told “don’t worry it’s ER so it will be handled as in-network even if you get admitted.”
Long story short, get to ER, they get my daughter stabilized, get admitted on Thursday, I guess the entire doc team checks out and takes the weekend off so we receive very little care or direction from anyone there and just sit in a room for 3 days wondering what the hell is going on and what the plan is. I asked for someone to speak to about what to expect billing-wise and was told that that department only takes phone calls and is unavailable on the weekend. Finally on day 4 a doctor shows back up and says we can go home.
Get home and receive a nice $9,000 bill. BCBS says “providers are considered in-network if admitted via ER, but facility charges, laboratory, etc are out-of-network.” Call LCMC to complain about being ghosted for 3 days and stretching our stay unnecessarily and they offer to set up a payment plan.
Posted on 8/7/21 at 10:48 am to LSUFanHouston
quote:
I know HIPPA scares the everliving hell out of medical companies. But there is no way, no how, the intention of HIPPA would be to make it a PITA to make a payment.
Government policies always have unintended consequences
Posted on 8/7/21 at 10:48 am to TFS4E
quote:
Always laugh when people make it hard for you to give them money
I had that problem with Bancorp South. Bunch of frickin' slack-jawed Tupelo hicks at that place.
Posted on 8/7/21 at 11:01 am to Norbert
quote:
Much of this is deemed cosmetic.
Psoriasis that gets so bad it affects my daily life? Cosmetic. Minor psoritic arthritis that means I can't touch my toes but has no other affect, I get the good medication covered.
It's nuts.
Posted on 8/7/21 at 11:15 am to lesgeaux
I had a colonoscopy in December that I’m still fighting with insurance and hospital about. Insurance says I’m too young for preventative procedure, doc says it was medical due to family history and the fact I had one 5 years ago and they had to remove polyps.
I’m pretty much done dealing with it so I’m going to pay the $8k and just go out of the country for procedures in the future
I’m pretty much done dealing with it so I’m going to pay the $8k and just go out of the country for procedures in the future
Posted on 8/7/21 at 11:18 am to lesgeaux
Holy shite that’s ridiculous
I’d be livid
I’d be livid
Posted on 8/7/21 at 11:23 am to LSUFanHouston
I once received a bill from a do for $15. On the bill it said "if less than $25 do not pay". I did not pay it.
To them it was not worth their trouble to handle a $15 check.
For $25, I would have waited until the next time I visited the office if they were going to give me such a hassle.
To them it was not worth their trouble to handle a $15 check.
For $25, I would have waited until the next time I visited the office if they were going to give me such a hassle.
Posted on 8/7/21 at 11:34 am to LSUFanHouston
Doctors and nurses make more here than anywhere else.
Maybe we should cap those greedy fricks salaries.
Especially if they vote democrat.
Maybe we should cap those greedy fricks salaries.
Especially if they vote democrat.
Posted on 8/7/21 at 11:38 am to NewIberiaHaircut
quote:
I got a surprise $460 bill for my son a year and a half after the visit. shite like that should be illegal! Bill me in 90 days or less
Probably because they were fighting with the insurance company to pay it. After a year they do not have to fight anymore, and then it’s your responsibility
Posted on 8/7/21 at 11:39 am to LSUFanHouston
quote:
get a clueless woman who basically says it's not their fault, they submitted the claim "correctly".
No they didn't.
This happens all of the time. I see the wrong codes on claim forms more often than not. There are a lot of clueless woman that work in Doctors offices. No offense to women but it's mostly women that work in admin.
Posted on 8/7/21 at 11:49 am to LSUFanHouston
America’s Medical billing is one of the most dysfunctional systems in American history.
Posted on 8/7/21 at 11:52 am to LSUFanHouston
Pretty soon people are just going to stop paying the doctors.
Posted on 8/7/21 at 11:54 am to LSUFanHouston
I have an amazing story that had made me hate the medical billing and insurance professions forever.
My wife has had bunions and messed up feet for all her life. 3 years ago at 36 yo, we decided to finally fix it. We’re a young healthy family so we have a high deductible $10k plan. Still do to this day. It wasn’t debilitating or anything but just an annoyance when she was working out and playing tennis.
It was 2 different surgeries adding up to $170k. Overpriced and ridiculous but whatever, insurance covers 90%+. remove bunions and put pins in to have her toe bone straightened up to the foot. 2 surgeries, 6 months apart.
We’ve been making steady payments for 3 years on it, never missed a payment.
Last spring she started having some pain and a protrusion. The pin was coming out on her right foot. Go to the Dr. and he says no biggie. Bone has fused back together so you’re all good to get the pin out. Come back this day and we’ll get it out.
She comes back, he cuts and unscrews the pin, sews her back up, they do an X-ray and he says you’re all good. Literally 10 minutes of work. She signs nothing. We have no bill. He said it’s our pin coming out so it’s fine.
2 months later, we get a 7k bill for the pin removal. I ask “politely” WTF? It’s a 10 minute procedure with your equipment at fault. If it were a few hundred dollars I’d think that was ridiculous, but still pay it. $7k is insanity and they know it. There is no justifiable way to charge that. I asked for an itemized bill. They refuse.
I said just put it on the tail end of the other bill and we’ll keep making payments since you’re obviously not going to be reasonable. They say fine.
We see both bills on their app.
Then the next couple of months we get a letter that we’re going into collections. I call again, asking WTF. Slightly less politely this time. They say, you stopped paying your bill from 2017. You’ve made payments on your 2020 bill from a few months ago. I explain what happened and they say “yeah, you’ve always paid on time. We can’t take it back from collections. You should have called in to say you wanted to pay each bill every month. Somebody should have called to explain but we strictly bill via mail and don’t call to explain. Sorry.”
So we just told the hospital and collections agency we were done and haven’t heard from them in a year. I’m sure it will bite me in the arse some day.
My wife has had bunions and messed up feet for all her life. 3 years ago at 36 yo, we decided to finally fix it. We’re a young healthy family so we have a high deductible $10k plan. Still do to this day. It wasn’t debilitating or anything but just an annoyance when she was working out and playing tennis.
It was 2 different surgeries adding up to $170k. Overpriced and ridiculous but whatever, insurance covers 90%+. remove bunions and put pins in to have her toe bone straightened up to the foot. 2 surgeries, 6 months apart.
We’ve been making steady payments for 3 years on it, never missed a payment.
Last spring she started having some pain and a protrusion. The pin was coming out on her right foot. Go to the Dr. and he says no biggie. Bone has fused back together so you’re all good to get the pin out. Come back this day and we’ll get it out.
She comes back, he cuts and unscrews the pin, sews her back up, they do an X-ray and he says you’re all good. Literally 10 minutes of work. She signs nothing. We have no bill. He said it’s our pin coming out so it’s fine.
2 months later, we get a 7k bill for the pin removal. I ask “politely” WTF? It’s a 10 minute procedure with your equipment at fault. If it were a few hundred dollars I’d think that was ridiculous, but still pay it. $7k is insanity and they know it. There is no justifiable way to charge that. I asked for an itemized bill. They refuse.
I said just put it on the tail end of the other bill and we’ll keep making payments since you’re obviously not going to be reasonable. They say fine.
We see both bills on their app.
Then the next couple of months we get a letter that we’re going into collections. I call again, asking WTF. Slightly less politely this time. They say, you stopped paying your bill from 2017. You’ve made payments on your 2020 bill from a few months ago. I explain what happened and they say “yeah, you’ve always paid on time. We can’t take it back from collections. You should have called in to say you wanted to pay each bill every month. Somebody should have called to explain but we strictly bill via mail and don’t call to explain. Sorry.”
So we just told the hospital and collections agency we were done and haven’t heard from them in a year. I’m sure it will bite me in the arse some day.
This post was edited on 8/7/21 at 11:57 am
Posted on 8/7/21 at 11:58 am to yellowfin
quote:
I had a colonoscopy in December that I’m still fighting with insurance and hospital about. Insurance says I’m too young for preventative procedure, doc says it was medical due to family history and the fact I had one 5 years ago and they had to remove polyps.
When ACA was passed it established that there would be no cost sharing for a colonoscopy. The insurance company is billing you because you had polyps even though they shouldn't according to the intention of the law. Below is a link to an article that explains in more detail.
LINK
Posted on 8/7/21 at 12:00 pm to 3nOut
quote:
We see both bills on their app.
Then the next couple of months we get a letter that we’re going into collections. I call again, asking WTF. Slightly less politely this time. They say, you stopped paying your bill from 2017. You’ve made payments on your 2020 bill from a few months ago. I explain what happened and they say “yeah, you’ve always paid on time. We can’t take it back from collections. You should have called in to say you wanted to pay each bill every month. Somebody should have called to explain but we strictly bill via mail and don’t call to explain. Sorry.”
So we just told the hospital and collections agency we were done and haven’t heard from them in a year. I’m sure it will bite me in the arse some day.
Medical collections should be banned from appearing on credit reports.
Posted on 8/7/21 at 12:08 pm to 3nOut
I don’t even want to get into my issues with OLOL. frick that hospital and all their dr groups. I refuse to use them anymore. If my kids need somthing we will go to oschner in Nola. frick OLOL.
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