re: Just got a $6,684 bill for a coronary calcium test

Posted by AbitaFan08

Boston, MA

Member since Apr 2008

26555 posts

Posted on 6/6/23 at 9:12 am to Hewonbyalot

quote:
Abita, if offering advice I'd love some too.
Just today I received an EOB for an MRI, facility billed over $11k, Cigna adjusted down to $1,200. That alone is outrageous, but here's what's worse... when Cigna approved the MRI, I phoned them to get the out-of-pocket estimate before procedure. They took two days to consult the facility and get back to me. When they called back their estimate was $525. Fast forward to receipt of EOB today...
After an hour on the phone with Cigna today, they said "well that was just an estimate". $1,200 much different than $525. They are currently reviewing the case to listen to recording of the phone call when I received estimate, but told me they don't promise any recourse.

I'm sorry I missed this yesterday. I have a lot of questions about the details of this, but as someone else noted, on it's face this seems like a viable complaint to CMS through the NSA. If you'd like, feel free to email me and I'll be happy to help you through the process of filing a complaint so you don't get a bunch of RFIs that slow your process down.

abitafan08@gmail.com

Posted by SUB

Member since Jan 2001

Member since Jan 2009

20818 posts

Posted on 6/6/23 at 9:34 am to LSUfan4444

quote:
the absolute first step is to request that they file the claim with your insurance and then wait for the EOP of denial from your insurance company.

This is good advice. Your insurance company may actually work to get the bill cost down. Sometimes they have mediators that negotiate with the provider for uncovered expenses.

Posted by The Torch

DFW The Dub

Member since Aug 2014

19270 posts

Posted on 6/6/23 at 10:19 am to Eli Goldfinger

My PI thought I was having appendicitis and sent me for an MRI, I had not met my deductible so my part was $5,000.

Test was negative

Posted by RockyMtnTigerWDE

War Damn Eagle Dad!

Member since Oct 2010

105404 posts

Posted on 6/6/23 at 10:22 am to Eli Goldfinger

Pay me 5K and I can make them go away.

They may come back later, but I promise I can initially make them go away.

Posted by Eli Goldfinger

Member since Sep 2016

32785 posts

Posted on 6/6/23 at 10:39 am to RockyMtnTigerWDE

To add insult to injury, this pos radiology group (Radiology Alliance) has a local Nashville number for billing, but it immediately routes your call offshore. The offshore folks are useless.

Posted by AbitaFan08

Boston, MA

Member since Apr 2008

26555 posts

Posted on 6/6/23 at 10:52 am to Eli Goldfinger

So radiology alliance is the provider billing. Are they out of network for you? What facility did you actually go to, and are they in network?

Posted by Eli Goldfinger

Member since Sep 2016

32785 posts

Posted on 6/6/23 at 10:59 am to AbitaFan08

They’re in network.
However, insurance DOES NOT cover calcium CT scans.

Radiology Alliance only interpreted the results of the CT.

Posted by kywildcatfanone

Wildcat Country!

Member since Oct 2012

119116 posts

Posted on 6/6/23 at 11:52 am to Eli Goldfinger

quote:
Just got a $6,684 bill for a coronary calcium test

Sounds like the hospital tacked on a couple of Apple headphones.

Posted by AbitaFan08

Boston, MA

Member since Apr 2008

26555 posts

Posted on 6/6/23 at 12:44 pm to Eli Goldfinger

Got it. Well unfortunately if the provider was in network then the protections of the NSA won’t work for a balance billing case. Hopefully it’s a billing error.

Posted by TexasTiger89

Houston, TX

Member since Feb 2005

24274 posts

Posted on 6/6/23 at 1:25 pm to LongueCarabine

quote:
the hospital didn’t even ask for my insurance card, because most insurance companies won’t pay for it. Strictly a cash transaction.

Yes, my doctor's office explained to me no insurance. Made me sign a paper acknowledging this. Guess they had too many complaints from people not paying attention.