Playing bill collector

[dmccarty]

We have had many health care billing issues over the years. I can only think of ONE problem we had with the insurance company while we have had many, many problems with the service provider. The wife had a contact with the insurance company that help us over and over and over, even though the problem was NOT the insurance company, but the service provider.

We pretty much stopped going to one service provider because of billing issues. The problem was he was a small office and just could not afford the staff to properly bill and keep up with government regulations. Good health care but the billing messes were just too much for us to handle.

We have had to deal with collection agencies as well because of bills we NEVER, EVER received. I swear the service providers make this stuff up. My wife's identity was stollen at one point which cost a use almost $1,000, but could have have been much, much worse. It was obvious that the staff at a health care provider had stolen the information. They had gone through old records for people who were no long clients and stole names, address, and social security numbers to open up a credit card.

It is ironically "funny" that the number of hospital providers is declining in my area. Increased regulation drives the need for more administrative staff, which increases costs, that in turn drives the consolidation of the hospitals to spread out the administrative costs. We used to have five hospital providers but it is now down to two or three. The physical hospitals are still in place, just the number of companies has gone down. Politicians are now complaining about the lack of competition but they are the ones that made this mess.

If we need scans, they have usually been a non emergency situation so we shop to find the best price. The best price is usually at a provider that only does scans. Getting the scan done at the hospital can be many multiples of the cost of the scanning provider.....

 

[dougtrr2]

This is another rant, which I will delete tomorrow night. Right now am just trying to form a plan of action...

After months of unanswered phone calls I finally paid it to keep from screwing up my credit. A few months later I finally talked to a live person who said he would look into it. A few days later he called me back and said that I was right, and my account would be credited the next time I had a bill with them.

To me this is the fishiest part of the whole deal. It sounds like a lazy person hoping it would just go away. Or by doing it this way, it wouldn't highlight that the billing department made a mistakes.

Doug in SW IA

 

[kenmac]

I keep reading all these ''out of network'' comments and ''needing approval'' for a test.
I have Medicare and a supplement (NOT AN ADVANTAGE PLAN) If my Dr. says its necessary, and it's approved by Medicare, my supplement pays the rest. If the Doc, or hospital accepts Medicare, they are required to accept my supplement. I have no ''out of network''. or approval for any test, or procedure

 

[Michiganguy]

My wife had a major stroke a few years back. After leaving the hospital she was transferred to an inpatient therapy hospital for 6 weeks. Before she left the inpatient facility they set her up with home therapy. Once the home therapist thought the wife was able to progress to outpatient therapy they filled out and submitted the paperwork for her to switch over to outpatient therapy. Inpatient, home and outpatient services were all affiliated but separate entities.
Before she started outpatient therapy they checked with insurance to see how many visits she was covered for and was told 50 visits and her cost was a $20 copay per visit with the insurance covering all other costs.
The outpatient therapist office set up a schedule for 50 appointments going forward.
About 5 months after she had completed her 50 scheduled visits we got a bill for $135,000. I called the billing office for the outpatient therapy and they said it was the balance owed after insurance.
I told them her only responsibility was the $20 copay which we paid at each visit. They said to contact the insurance company. So I called the insurance company and they said they paid for all 50 visits she was approved for and all we were responsible for was the $20 copay.
After many phone calls and lots of frustration it turned out that the insurance covers 50 visits total between home therapy and outpatient. When outpatient contacted the insurance company about how many visits were covered, the insurance company had not gotten a bill yet for the in home therapy so they showed she had 50 visits available when in reality she had already used half that amount for in home therapy.
At first outpatient therapy said it wasn’t their problem and we owed the $135,000. It took months but after lots of arguing and pointing out that home and outpatient services are both affiliated and home therapy was the one to fill out the referral for outpatient that they’ve should have communicated between each better.
In the end the outcome was they wrote off the $135,000 charge.

 

[MAX-24-Dean]

Pretty much everyone I personally know working in healthcare today says, its about the dollars not about healthcare.
When I was growing up it was the other way around.

 

[ultrarunner]

A few have had success going the route of your local consumer reporter or even contacting elected representatives… especially seniors.

Pete Stark was one such here and he wrote laws that regulated hospitals and just mentioning congressman Stark in a certified letter at the time resolved his issue.

Everyday I receive patient calls regarding billing and policy is to provide the toll free number to the enterprise wide billing office in a different part of the state.

If a patient says they are not getting anywhere I take their information and give them mine and expedite it in house…

Often it is a not understanding on the patient part because it’s confusing… other times it’s a real problem that needs resolution…

Annual Deductible resets, copays and multiple entities billing are the most common.

With the new year we are having a few patients walk out… especially when 6 weeks ago they paid less for eye procedure and now back to do the other and it’s thousands more… as the full deductible is due and the price of the lens increased and the copay is now hire.

A few are angry when they realize if they had the second eye done a few weeks ago they would have as much as 2k more in their pocket.

I use eyes because it’s easy to compare and often occurs a few weeks apart.

With centralized billing we only have one person that can look at a patient bill with all the particulars and full access remaining onsite… at least there is still one where a patient can come in and have a sit down.

 

[Jstpssng]

I didn't delete this the way that I said I was going to. The day after starting the thread I called the billing department, and was told "Oh, you have a credit! We'll get that applied to your current bill." It was like deja' vu all over again.
Yesterday I recieved a "Past Due Notice" on my outstanding balance. They owe me the same amount I owe them. It's been a year, and since then I've sent them more than 175 bucks as my PCP is through them.
I am filing in small claims court next week. Hopefully when they recieve the summons it will wake somebody up to the fact that this needs to be taken care of.

 

[ponytug]

@Jstpssng Good luck!

All the best,

Peter

 

[Yander]

My former dentist tried to pull one over on me and my wife being a medical billing follow-up specialist made them look stupid. Long story short, they always collect payment up front for procedures and they did that but then didn't bother to submit the proper paperwork to the insurance company on my procedure to get it paid. They then made the mistake of trying to get me to pay more.

My wife actually called the insurance company and got the truth, about the forms not being submitted and then we called my dentist's office with that information. Needless to say, the threat to send us to bill collection went away. I told the dentist office they were messing with the wrong two people and that my wife does this for a living. I think they realized that in short order. The unfortunate part is there are so many people who do not know any better and just pay the bill.

Between the terrible office practice with Dr. offices and the crooked insurance companies, there is really an opportunity for a business of people to take their medical grievances to. My wife could do this all by herself but figuring out how to make any money from the service would be difficult. Her phone would be ringing off the hook, so to speak.

 

[caver]

I cancelled Charter internet this summer when the local coop installed fiber and it was 5-10$ cheaper. The kid at the local store said you are paid up until such date bring your equipment end on or before that date. I did. I should have gotten it in writing. That was June. I made sure and got a receipt for the modem they owned. October I get a letter from a collections agency saying I owe them money. I make two trips to the local store only to get jerked around and get even more mad. They say I owed them for another month. She showed where billing cycle is two weeks behind your service cycle. Yeah doesn't make sense to me either. I had been with them for probably 20 years (internet). I never got a warning I was overdue. they never tried to charge my card as my former service was on autopay. What company would say hey we will let you have two weeks of service for free right out the gate. Generally they want their money up front. After a couple days I called a charter rep said if I paid it would be taken off the credit reporting. I was not about to pay a collections agency. I saw it as sneaky BS to get more money out of you. So I paid what I call the extortion fee and got a letter confirming that from the collections folks afterwards.