Medical Bill help

[1Mouse2RulethemAll]

I received a lovely little budget buster in the mail Friday...a medical bill from more than 4 years ago. The hospital want's more than $1500, yet I was covered under Medicaid at the time.

What do all you budget smart people suggest I should do?

 

[deegack]

call medicaid and the hospital and find out whats up. I know when I had my daughter the hospital had 22 months to bill me for anything.
Worst case, you have to pay but at this point I would only send it what you can easily afford.

 

[lost*in*cyberspace]

What do all you budget smart people suggest I should do?

It depends. Look at the bill carefully. Is it really from the hospital or is it from a debt collection agency (most likely)?

 

[1Mouse2RulethemAll]

It depends. Look at the bill carefully. Is it really from the hospital or is it from a debt collection agency (most likely)?

It's from the hospital. Medicaid should have paid it all at the time and they did pay some. It looks like the hospital is trying to get the balance from me that the insurance did not pay. I thought that was illegal.

 

[mistysue]

If medicaid didn't pay the whole thing (part of it probably wasn't eligable?) then you owe the balance.
That isn't illegal, it's how insurance works and medicaid is like an insurance.

It is strange that they waited 4 years though. I would call and ask what it is because they should NOT be waiting that long to bill you. Unfortunately, there are rules on how long they can take to bill insurance, and it is written right into policies and the doctor's forms that you sign that if they bill late, you are still liable for it. Once I had a pediatrician "forget" to bill for my daughter's visit until after 90 days. Well, insurance only has to accept it up to 90 days after the date of service, so now I was liable for the entire visit. I had paid my copay on the date I was there. Technically, they were legally allowed to come after me for the balance. I acted like I didn't know that, kept complaining and they dropped it.

 

[Pinnie]

I received a lovely little budget buster in the mail Friday...a medical bill from more than 4 years ago. The hospital want's more than $1500, yet I was covered under Medicaid at the time.

What do all you budget smart people suggest I should do?

Looking at your signatures suggests you have the money to pay the bill. Maybe you better rethink the Hawaii trip. Just sayin.....

 

[Lintasare]

If medicaid didn't pay the whole thing (part of it probably wasn't eligable?) then you owe the balance.
That isn't illegal, it's how insurance works and medicaid is like an insurance.

It is strange that they waited 4 years though. I would call and ask what it is because they should NOT be waiting that long to bill you. Unfortunately, there are rules on how long they can take to bill insurance, and it is written right into policies and the doctor's forms that you sign that if they bill late, you are still liable for it. Once I had a pediatrician "forget" to bill for my daughter's visit until after 90 days. Well, insurance only has to accept it up to 90 days after the date of service, so now I was liable for the entire visit. I had paid my copay on the date I was there. Technically, they were legally allowed to come after me for the balance. I acted like I didn't know that, kept complaining and they dropped it.

Medicare and Medicaid have different timely filing limits than regular insurance. I work for a BC/BS plan and we are getting Medicaid claims from 5 years ago and we have to take them and process them.

 

[momto2inKC]

It's from the hospital. Medicaid should have paid it all at the time and they did pay some. It looks like the hospital is trying to get the balance from me that the insurance did not pay. I thought that was illegal.

Just like with any insurance, if there is a balance after the insurance has paid, you are responsible.

 

[Lintasare]

Just like with any insurance, if there is a balance after the insurance has paid, you are responsible.

And I have never known Medicaid to pay 100%.

 

[mrsklamc]

It's from the hospital. Medicaid should have paid it all at the time and they did pay some. It looks like the hospital is trying to get the balance from me that the insurance did not pay. I thought that was illegal.

Insurance? If you had insurance, it should be billed first, THEN medicaid, then you.

 

[mrsklamc]

In fact if you had insurance in addition to the Medicaid, that may be the reason for the delay. Sometimes when there are two payors it takes awhile for them to argue out who pays for what.

 

[maxiesmom]

I suggest you pay the bill asap as you are responsible for it.

I guess I don't understand what kind of advice you are looking for, other than that.

 

[marmalade]

Looking at your signatures suggests you have the money to pay the bill. Maybe you better rethink the Hawaii trip. Just sayin.....

The OP never said anything about not being able to pay the bill. It's from FOUR years ago and this is the first she's heard of it. I would NEVER pay a $1500 bill that just showed up in my mailbox from 4 years ago without investigating it first.

 

[mdsoccermom]

My suggestion is pay and be done with it. In fact, I can't think of any other reasonable solution. Take the money you were going to use for Aulani. You may have to postpone the trip, but that's life.

 

[mdsoccermom]

The OP never said anything about not being able to pay the bill. It's from FOUR years ago and this is the first she's heard of it. I would NEVER pay a $1500 bill that just showed up in my mailbox from 4 years ago without investigating it first.

Well, the fact that she asked "budget smart" people on a budget board what to do suggests she is looking for a financial solution.

 

[dcfromva]

I received a lovely little budget buster in the mail Friday...a medical bill from more than 4 years ago. The hospital want's more than $1500, yet I was covered under Medicaid at the time.

What do all you budget smart people suggest I should do?

I don't know if this would fall under the category of balance billing which in many states is illegal or if you received care for an uncovered expense (or a non-participating provider--though if the medicaid paid something on this they probably are a participating provider. )

Well, anyway, I googled Oklahoma Medicaid and found a link to
http://www.okhca.org/publications/pdflib/SC_handbook.pdfSoonerCare Choice 2011 Member Handbook

This is the advice given from the Handbook:

"Usually, you will not get a bill from a SoonerCare provider. Sometimes, you will get a “statement” from a provider that is not a bill. If you are not sure, call the provider and ask if you have been billed. You may have to pay the charges.
You may have to pay if:
► You got services that were not covered.
► You got covered services from an out-of-state provider not contracted with SoonerCare.
► You got services without the needed referral from your PCP-Medical Home.
► You got services from a provider who does not accept SoonerCare.
You also may be billed for co-payments if you are unable to pay them at the time you received the service.
If you get a bill and do not think that you have to pay for the charges, call OHCA at
1-405-522-7171 or 1-800-522-0310. Give the following information:
► The date of the service.
► The amount being charged.
► Who is billing you.
► Why you are being billed.
It is a good idea to have the bill with you when you call. We will help you understand what was billed to you and whether you may have to pay it."


edited to add this note was also in the handbook:
"SoonerCare cannot repay you for services you have paid for."

 

[marmalade]

Well, the fact that she asked "budget smart" people on a budget board what to do suggests she is looking for a financial solution.

And any budget smart person would not pay a bill for $1500 from 4 years ago without looking into it first.

 

[a1tinkfans]

IF you had other insurance at the time of service, often times co-insurance claims get delayed for a myriad of reasons...But, they/hosp may have waived their right if THEY delayed the billing KNOWING that you had other insurance. That being said, IF they did NOT know you had other insurance because you forgot/etc to notify them, then you will be stuck paying because the "other" carrier will deny due to delay..
I would call if it is the hospital (NOT if its a debt company), ask them for proof they billed, what they got paid and by whom and any all denials. Follow that with a written letter indicating what they TOLD you and that you are awaiting the proof for this long delayed billing.
Then await proof, review to see if in order...perhaps the other company is actually at fault for not paying...you need to review it all and figure out what went wrong, if it did. Then
either process it accordingly and by that I mean, pay it if you can outright...OR ask them for a billing plan if you can not.
Good Luck....perhaps you will learn that something went awry and itll get resolved with minimal payout from you/co pay or deduct??

 

[mdsoccermom]

And any budget smart person would not pay a bill for $1500 from 4 years ago without looking into it first.

That's just common sense. A person should know to do that without asking random strangers on a message board.

 

[Halle]

If medicaid didn't pay the whole thing (part of it probably wasn't eligable?) then you owe the balance.
That isn't illegal, it's how insurance works and medicaid is like an insurance.

It is strange that they waited 4 years though. I would call and ask what it is because they should NOT be waiting that long to bill you. Unfortunately, there are rules on how long they can take to bill insurance, and it is written right into policies and the doctor's forms that you sign that if they bill late, you are still liable for it. Once I had a pediatrician "forget" to bill for my daughter's visit until after 90 days. Well, insurance only has to accept it up to 90 days after the date of service, so now I was liable for the entire visit. I had paid my copay on the date I was there. Technically, they were legally allowed to come after me for the balance. I acted like I didn't know that, kept complaining and they dropped it.

Physicians sign agreements with insurance companies, they are responsible for filing a claim within the time limit. If the claim isn't filed it is not the fault of the patient. Did you check with your insurance company?