Hospital billing question

[tileman]

It's been a while since anyone in the family has been to the hospital but this seems a bit out of the ordinary to me. Hopefully some of you have some insight into this situation.

Last Wednsday my wife cut her hand and she ended up at the emergency room. When we were leaving the hospital we were directed to the billing department, as expected. The guy at the desk was unable to give us a bill of any kind and asked that we leave a deposit in any amount that we could afford. He stated that they would work up a bill for us in 5 - 10 days. We gave him a check for 250.00. Tonight I get a call from the billing dept at the hospital (same guy we saw at the hospital) he wants to give us an update on the bill although it is not a final bill. At this time the bill is 247.00 so I have a credit (yes I was confused. But he reminded me that this is not a final bill). He also asked if I had applied for the "Blue Card". I do not know what a Blue Card is and I did not apply for it. A little background, we do not have insurance and I am willing to pay my bill, if they will tell me what it is.

About an hour later (it is now 7pm) he calls back to let me know that there are more adjustments to the bill. Now the bill is 497.47 - 30% - 250 (deposit) = 98.23 (due) not final yet. He is able to take another 20% off the total bill if I give him another 28.++ over the phone with a debit or credit card. This is still not my final bill and I may owe more or I might have a credit. If I do not give him the 28.++ tonight over the phone I will loose the option of the additional 20% discount.

This sounds bizarre to me. Is this how medical billing is done now?

ron

 

[ntsammy5]

Good grief! This is just wrong!

 

[Frankiesmom]

yes, it sounds weird. I would say no more $$$ from me til I had an actual bill in hand. Take his name while you're at it-just sounds weird to me.

 

[wvdisluv2]

Could just be me....but sounds hinky I don't trust er's though. I would wait for a final bill before I paid anything else. (I've never heard of hospitals giving discounts for paying NOW over the phone) Ask for a DETAILED/ITEMIZED bill.

I have insurance and spent more time with the billing dept. than I did with the Dr. (scratched cornea a week before Christmas) and they "claim" not to have my insurance info? I emailed my insurance info AGAIN and requested a detailed/itemized bill. I emphasized that I "fully intend to pay this bill".

Hope that your wife is recovering well!

 

[Kathi OD]

NEVER, EVER give your credit card number unless YOU initiate the call. I'd ask for the name of this guy's supervisor and contact them.

 

[tileman]

Yeah, kinda what I thought. Funny thing is he gave me his business card so I have his contact information. I'm going to hold on to it for awhile.

wvdisluv2, she's doing well. Thanks for asking. Strange how they "loose" everything. I would be willing to bet that they had ALL of your insurance information prior to treating you.

 

[clh2]

Just so you know...this may not be the "final" bill. It may be the "final" bill from the hospital. The Dr. bill will most likely come separately. Sorry to be the downer here...just want you to know there may be more coming...

 

[tileman]

She went to the hospital several years ago and she ended up with atleast 4 bills.

1. hospital bill
2. (ER) doctors bill
3. consulted doctors bill ( ER DR. consulted with DR. #2)
4. Orthopedic Dr. bill ( ER DR. and DR. #2 didn't have an answer had to refer)


There may have been others. Can't quite recall it was back on 2004.

ron

 

[PrincessSuzanne]

Not surprising to me at all. I don't get their practices, calling like that is a little weird, but I guess that is the way their hospital is set up. I work for a Medical Assistance Program through a local hospital and we call pt's that are deemed "sefl pay" and try to see if we can get them qualified for any sate or county assistance to hrelp pay for their bill and if we can't, then the account goes back to the hospital billing office to be assessed for the Charity or Unidured Programs, but our Financial Counselors never call someone after leaving to ask for the balance. They may do this for uninsured that are having outpatient procedures, but not after leaving the ER.

This is the new way to get people to pay their ER bills. The hospital bill is the first one to go in the trash and hospital are working to try to get at least some of their money and not have to write off as much debt. Some of the hospitals in our area will asses to see if the pt has a real emergency and if they do, they are seen no questions asked, but if they are here for non-emergent visits, they are assessed and asked for a certain amount of money before treatment is rendered and if the fee isn't paid, they are referred to a local clinic and sent on their way. A huge majority of people in this area use the ER as their family physician and this is one way they are trying to stop that so that people with real emergencies can get the care and attention they need.

I certainly wouldn't pay more until I got the final bill.

Suzanne

 

[delilah]

My hospital gives a discount if you pay your portion of the bill in a timely manner (within 30 days). When I had my surgery in June, my portion of the bill would have been about $400 or so. I paid no interest if I would pay up front, or I could have financing (a service charge for not paying in full) through the hospital. It sounds like the hospital was being kind to the OP by giving a discount if he paid up front, because he had no insurance. I had a dentist who would discount the total for a procedure, like a crown, if one paid in advance. Sometimes breaks are given if the amount owed is large, or the patient doesn't have insurance. It is better for the hospital to write off 20% rather than needing to write off 100% later on.

 

[snarlingcoyote]

I've had hospitals give a huge discount - pay X today and we'll take whatever your insurance pays us, no questions asked. They made more money, long haul on this method, than on dunning and sending people to Loan Collection.

 

[mikehn]

The phone calls are a little weird, but the billing sounds about right. It takes a awhile for the all the charges from everyone that touches you to come trickling in. They do give you a discount if you pay up front, versus waiting for the 'final' bill. Some providers may even offer you a flat fee, which could be significantly less than an itemized bill, but only if you pay up front.

 

[DisneyBamaFan]

I never pay a bill without a written bill in hand. I would not have even given the initial $250...

 

[bumbershoot]

http://www.bcbs.com/coverage/bluecard/ blue card???



I would wait for an itemized bill. And might as well request her complete records as well. Compare and contrast, to make sure they've billed correctly.

And after you have the full, itemized bill, then make arrangements.

 

[C.Ann]

Whole thing sounds odd to me.. Did you get a receipt for the initial $250 you paid? I think I would be very reluctant to pay anything more until I had the full/final bill in my hand..

 

[maddhatir]

I've had hospitals give a huge discount - pay X today and we'll take whatever your insurance pays us, no questions asked. They made more money, long haul on this method, than on dunning and sending people to Loan Collection.

They took money from you even though you are insured!?

Unless it is an upfront copay- do not give your doc, testing facility, hospital anything until you see what your insurance company "allows" for the services.

Let's say the provider bill was 200.00. They submit that bill to your insurance company, they, in return, reduce the bill per their "allowed" amount for each service and that is what they pay your doc. He has to take this payment as payment in full (less and patient copay and deductible)

It is so sad that so many people do not understand this.

If you do not have insurance, you can call the provider and ask them if they will cut their bill. Most of the time, they will.

I knew someone who did not have insurance and they started receiving bills. They went on our state's Medicare site to see what Medicare allowed for each service billed. That gave him some idea of how low he could possibly get the bill down to.

 

[Pin Wizard]

That's unreal. I'd be talking to the supervisor in the billing office.

 

[Traveliz]

I had surgery in September - the weekend before the surgery I got a letter from the hospital stating what they estimated my portion would be and I was to pay that prior to the surgery on Monday so I don't think the different practices we are reading about are unheard of.

Liz

 

[CajunDixie]

You should have paid $10 and told the guy you'd pay more once you receive a complete itemized invoice. Go over that itemized bill very carefully!! It's common for charges to be on there for items you didn't receive.

They took money from you even though you are insured!?

Unless it is an upfront copay- do not give your doc, testing facility, hospital anything until you see what your insurance company "allows" for the services.

Let's say the provider bill was 200.00. They submit that bill to your insurance company, they, in return, reduce the bill per their "allowed" amount for each service and that is what they pay your doc. He has to take this payment as payment in full (less and patient copay and deductible)

It is so sad that so many people do not understand this.

If you do not have insurance, you can call the provider and ask them if they will cut their bill. Most of the time, they will.

I knew someone who did not have insurance and they started receiving bills. They went on our state's Medicare site to see what Medicare allowed for each service billed. That gave him some idea of how low he could possibly get the bill down to.

Slight correction....they only have to take the "allowed" amount IF they are a participating member of a network. When someone offers me the Medicare rate I I'll take small payments and not charge interest but unless you are having financial difficulties (I work in government assistance so if they were having problems they can apply for help in my office too) then you're going to pay our bill in full. I once had Anthem Blue Cross/Blue Shield mistakenly send me 30% of a patients bill and told me it was paid in full. Yet the patients ambulance coverage was 100%. 30% was less than even Medicare would pay! When these insurance companies insist on being a network they are just screwin with the providers and trying to strong arm them into getting less money, even though our patients have paid in thousands to these companies. Insurance is a business and they will use whatever tactics they can to profit.

 

[maddhatir]

Slight correction....they only have to take the "allowed" amount IF they are a participating member of a network. When someone offers me the Medicare rate I I'll take small payments and not charge interest but unless you are having financial difficulties (I work in government assistance so if they were having problems they can apply for help in my office too) then you're going to pay our bill in full. I once had Anthem Blue Cross/Blue Shield mistakenly send me 30% of a patients bill and told me it was paid in full. Yet the patients ambulance coverage was 100%. 30% was less than even Medicare would pay! When these insurance companies insist on being a network they are just screwin with the providers and trying to strong arm them into getting less money, even though our patients have paid in thousands to these companies. Insurance is a business and they will use whatever tactics they can to profit.

Yes- I am sorry I left that little tidbit out of my post And, if the insurance company pays lower than the contract amount- we will certainly go after them for the rest.

I work in a provider's office and if a patient calls and asks for a break- most of the time we give it to them. We NEVER charge interest.

I have had elderly patient's call and tell me they are living on SSI etc etc and I will give them a break or even write off their small balance. My heart breaks when they call. It is not often patient's call to ask for a break.

(I guess I would not make a good Government worker ................... )

But- this one guy, ugh, he called me up about a copay bill. He insisted he did not owe it and basically said we were trying to scam him! He said his referring doc said he would not have to pay us anything. I said, your referring doc knows NOTHING about our billing practices! This patient was a real jerk. Guess what- his balance did not get written off, as a matter of fact, my boss said if he does not pay, send him to our collection agency!

You know what gets me? When the insurance pays the patient directly and they conveniently "forget" they owe us the money! No breaks for those people either.