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Medical billing nightmares: anybody want to share stories?

Posted on 5/21/15 at 3:02 pm
Posted by Cole Beer
Baton Rouge
Member since Aug 2008
4588 posts
Posted on 5/21/15 at 3:02 pm
The Agony of Medical Bills

quote:

Even for people with generous insurance plans, a trip to an in-network doctor can result in thousands of dollars in unexpected charges. Can anything be done?


quote:

It shouldn’t take a Harvard expert in health policy to understand a doctor’s bill. But sometimes, it does. In August of last year, Liz was a medical student whose doctor found a lump on her tonsils. Her primary-care physician referred her to an in-network ear-nose-and-throat specialist.


This is a fairly long, interesting read about the sinister operations of medical billing, insurance and collections.

Moral of the story: don't get sick or hurt
This post was edited on 5/21/15 at 3:04 pm
Posted by Golfer
Member since Nov 2005
75052 posts
Posted on 5/21/15 at 3:10 pm to
I've never understood why it's so complicated. It's just retail. List the price with insurance discount and charge the patient that price.

Wife and I have dealt with this now two times in the last 6 months...general confusion because certain things are billed to the doctor, others to the hospital/doctors office/surgery center, and others to a 3rd-party diagnostics.

Normal retail companies just lump all this together and deal with it on the back-end.
This post was edited on 5/21/15 at 3:13 pm
Posted by Salmon
On the trails
Member since Feb 2008
83618 posts
Posted on 5/21/15 at 3:15 pm to
During my wife's pregnancy on one of her check ups, the doctor told us that there was cause for concern with one of my wife's blood samples and that I should get the same test done as well just to be sure because it would be a bigger deal if we both had the same issue. She told us that her office could handle the blood test, so no big deal, I got the blood test and went on with my day.

1 month later we got a bill for $3k for 1 goddamn blood test. The insurance refused to pay any of it because it was out of network for me because we were at a women's hospital.

I fought it for about 6 months but finally just caved and paid the bill when the hospital started threatening to call a collections agency.
Posted by sneakytiger
Member since Oct 2007
2473 posts
Posted on 5/21/15 at 3:21 pm to
Might be the only industry in the world where neither the consumer nor the seller can forecast what they will pay or receive as a result of the transaction
Posted by AdamDeMamp
$900.00
Member since Jul 2013
3276 posts
Posted on 5/21/15 at 3:25 pm to
quote:

I fought it for about 6 months but finally just caved and paid the bill when the hospital started threatening to call a collections agency.


The whole industry feels like such a sham and it feels like you have no other choice than to do what you're told. They can basically add a charge for anything, label it in their internal code, and how can you argue if that service was provided or not?

We had so many instances like this in a 24 month period that I began to fight back a bit. We'd take our child to the doctor regularly because she was quite ill and then one day got a call from a collections agency about 6 months later. Turns out, we were not receiving the bills from the hospital/doctor for whatever reason. We assumed that most of them were being covered by insurance. Once I got the first call, I started calling around to every medical facility I visited and it was such a screwed up web of issues from our insurance company and the facilities that was completely out of my control.

The facilities said they tried calling me and mailing us letters "multiple" times to tell us these bills were past due but I never received a single one. I checked cell phone records, etc. to make sure they weren't calling my wife and nothing. They are very quick to send to collections and my credit is absolutely spotless. I have never avoided paying any bill or even a single day late in my life due to an "OCD" like focus on my finances.

I started telling them to provide me with their records of mailing/calling me or I would look into taking them to court for sending me to collections and potentially having my credit affected. (It never was because I paid everything immediately once I got the first call.)

Now, I literally call my insurance company and then also the facility a week or so after anyone in my family has a medical visit to make sure everything is in the right hands, etc. Even then, how do I know if my insurance company is covering everything it is supposed to cover, etc.??

It's ridiculous.
Posted by The Spleen
Member since Dec 2010
38865 posts
Posted on 5/21/15 at 4:07 pm to
Yes, I went through a horror story about 15 years ago. Broke my arm and didn't have insurance. Broke it on a Sunday afternoon, and knowing I didn't have insurance and wanting to avoid the ER charges, I was going to wait to go to my family doctor the next morning. The pain became unbearable so I broke down around 10 Sunday night and went to the ER. Paid $100, got some x-rays, a couple of vicodin, a splint, and instructions to go see an orthopedist the next day. A week later get a bill for around $5k, just from the ER. The next day get a bill from the ER doctor for another $1k. Long story short, went back and forth with the billing department on why I got 2 separate bills when the ER doctor was an employee of the hospital, and why the bills were so high. 6 months later, and after sending it to collections despite assuring me they wouldn't, they agreed to settle both bills for $2k total.

I know it's a controversial topic, but the saga is why I support some form of a single payer system. Granted, most of the saga was my own fault(not having insurance, engaging in an activity where I could get hurt, etc.) but the mercy your're at when you go get medical care without insurance is frightening and shouldn't happen in a country this advanced.
Posted by Golfer
Member since Nov 2005
75052 posts
Posted on 5/21/15 at 4:38 pm to
I had to get stitches in November. Went to in-network urgent care. Was apparently seen by an out of network physician...which I'm not sure how that's even possible. Ended up with a relatively minor bill...but something I wasn't even aware would happen.

Wife had an MRI earlier this year. Paid $300 at the time of service. Was told they'd bill insurance and we'd find out what the remainder would be. Since then we've received 3 bills:

- One for $85 two weeks after the MRI for the doctor visit.
- One for $590 about 3 months after for the MRI, which when I called to inquire about paying was told insurance covered it.
- One for $215 last week (5 months later) for the "lab"



Posted by foshizzle
Washington DC metro
Member since Mar 2008
40599 posts
Posted on 5/21/15 at 4:43 pm to
quote:

We assumed that most of them were being covered by insurance.


quote:

due to an "OCD" like focus on my finances.



Posted by Hawkeye95
Member since Dec 2013
20293 posts
Posted on 5/21/15 at 4:43 pm to
I have had a shite ton of medical billing issues. And if the hospital is wrong, good luck getting it cleared.

I had a doctor ask for some tests on a biopsy that I did not request, and were not standard. Cost me like $600 in the end. I was so livid when i got the bill - I didn't get this, but oh yes apparently I did. The insurance company was no help.

I got a bill 5 years after a knee surgery. It was maybe $250, but they called collections on me. I got a laywer friend to write a letter for me, and it stopped it. But annoying as all frick.

What I especially hate is when they say - this is your portion at the office, and then you get a bill later in the mail.
Posted by Dooshay
CEBA
Member since Jun 2011
29879 posts
Posted on 5/21/15 at 4:49 pm to
Hear so many bad stories. Glad Obama implemented the affordable care act to clean up this mess.
Posted by DowntheBayouTiger
Atlanta, GA
Member since Oct 2009
812 posts
Posted on 5/21/15 at 5:18 pm to
The hospital, doctor's office, etc can blabber all they want about how much you will owe because they have checked your insurance and all that crap, but it all comes down to whatever the insurance company spits back after the claim is sent in. I actually do medical billing and the crap still sucks.
Posted by hungryone
river parishes
Member since Sep 2010
11987 posts
Posted on 5/21/15 at 6:37 pm to
Fighting with dental insurance right now....apparently Delta will pay for ONE crown on a tooth, but if it needs to be replaced, you're on your own. WTF? No one breaks a crown by choice.....it's like a car tire, if you have one long enough, it may chip or crack.
Posted by JayDeerTay84
Texas
Member since May 2013
9847 posts
Posted on 5/21/15 at 6:54 pm to
My wife just had our thrid baby. The bill was unreadable. shite all over it.

One charge was $735 "just in case my wife needed blood". Like, wtf.

My wife was there for 1.5 days, $2K room bill.

$548 to test the babies hearing.

Just keep adding it up.

$1.5K for the doctor to literally catch the baby.

The entire medical industry is a sham.



On top of all that, 1 vist to the doctor ='s like 3 bills.


Now when they call me asking to pay and they get pissy I threaten them to send me to collections so I can pay less.

They usually just shut there trap and get paid when I damn well feel like it.
Posted by JayDeerTay84
Texas
Member since May 2013
9847 posts
Posted on 5/21/15 at 6:57 pm to
quote:

Fighting with dental insurance right now....apparently Delta will pay for ONE crown on a tooth, but if it needs to be replaced, you're on your own. WTF? No one breaks a crown by choice.....it's like a car tire, if you have one long enough, it may chip or crack.


So before my wifes pregnancy, they called our insurance company to confirm what was covered.

The lazy bitch called BCB of Texas instead of BCB of Alabama like my card CLEARLY States.

Come to find out they only cover 2 ultra-soudns and they scheduled us for 4.

After the 3rd, BCBS stopped paying. The hospital didn't tell us until after our 4th.

Posted by TigerFanDan
BFE
Member since Jul 2008
883 posts
Posted on 11/10/15 at 7:12 pm to
I hate dealing with medical billing office. My wife sees a doctor who requests some blood work and 2 xrays. My hospitalization policy does not cover this period. I tell the lab and xray business office and they say no problem, we will treat you as a cash customer with no insurance. They charge $362 for lab and $172 for xray. Paid lab on the spot and paid xray when bill was mailed to me, also paid radiology group $75 for reading the film. Everybody gets paid cash and its all good right. Started getting bills for $1247 for lab work only. Requested itemized bill and its the same lab work for nearly 4 times the earlier billing. All because I have a hospitalization policy and they tried to bill insurance company. They can kiss my arse.
Posted by TheChosenOne
Member since Dec 2005
18522 posts
Posted on 11/10/15 at 10:11 pm to
It's not necessarily a nightmare because I came out way ahead, but...My wife was in the hospital for two weeks before my daughter was born and then she was in the NICU for 6 weeks after that. The crazy amount of bullshite that we were billed for was insane. Also, despite the OBGYN and hospital being in-network, the hospital Anistiesiologists were not. So, that was $3,500.

After fighting the first couple bills, I just decided frick it. We were going to hit our out of pocket max no matter how much I fought, so I just paid up to my out of pocket max and left the rest to insurance. All totaled, they were billed over $400k...I paid $12k (the ordeal spanned over two calendar years, so I hit the $6k out of pocket max twice )
Posted by ynlvr
Rocket City
Member since Feb 2009
4596 posts
Posted on 11/11/15 at 6:43 am to
Sounds like a business opportunity in Medical billing. I'll have to look into this.
Posted by The Spleen
Member since Dec 2010
38865 posts
Posted on 11/11/15 at 7:59 am to
.
This post was edited on 11/11/15 at 8:03 am
Posted by yellowfin
Coastal Bar
Member since May 2006
97693 posts
Posted on 11/11/15 at 8:18 am to
Went in for colonoscopy
preapproved
covered 100%
cut out one polyp
changed coding
2k bill
Posted by Pelfan8104
BRLA
Member since Jun 2015
95 posts
Posted on 11/11/15 at 7:48 pm to
there are no good outcomes when it comes to medical bills.
This post was edited on 3/22/16 at 5:25 pm
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