Hospital billing question

[ameraumi]

I have never heard of a hospital asking for a payment before you leave the ER. That right there sends up red flags to me. And I will not pay on a bill until I see a list of charges.

 

[tileman]

I really appreciate all the insight. Everyone backs up what I was thinking so I am just going to wait until I can get an itemized bill and then settle up with the hospital. If they feel like giving me a discount that's fine but if not I'm ok with that too.

thanks
ron

 

[PrincessSuzanne]

I have never heard of a hospital asking for a payment before you leave the ER. That right there sends up red flags to me. And I will not pay on a bill until I see a list of charges.

It is very common practic now, with so many people that have no insurance, they have to take what they can get. Now, it can't be asked for up front, but it can be asked for after the pt has been assessed by a PA or MD and before treatment is rendered. That is the practice most hospitals are going to now, because they were losing so much money.

Suzanne

 

[bumbershoot]

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.

FWIW, sometimes when the insurance company sends a check, there is absolutely NO explanation for it. It's mystifying. We had two checks like that back after DS's arrival. No explanation, not even codes. I was out of commission and hubby doesn't know how to talk to insurance poeple, he just doesn't understand it AT ALL. By the time I could have spoken to insurance about it, we had totally forgotten it, literally forgotten..it was erased from my brain, and hubby forgets things like that easily.

I don't even know how long after...I think it was 2 years...we got a call about paying the ob on call. HUh? Thought you were paid. After all...NO BILLS FOR TWO YEARS does kinda say that nothing is owed. Anyway, turned out those checks that we finally remembered were partial payment, but you would absolutely be hard-pressed to know what they were for if you saw the paperwork that accompanied them.


So try to keep that in mind...sometimes it's just mystifying, and for people who don't understand insurance (like my hubby) it can be impossible to figure out what to ask to find out what you want to know. Or to even figure out what it is you want to know.

 

[EthansMom]

I've run into this kind of thing twice in recent weeks. First, my usual doctor's office got a little aggressive in "recommending" a payment up-front for the doctor's visit since my insurance has a deductible (which is pre-paid through a combination of a health fund and flexible spending account). Second one, was DH had to have major surgery last week at a hospital. The hospital billing office called a few days before the surgery and wanted us to pay an amount equal to the entire deductible up front on the day of the surgery... firstly, the surgeon's and anesthesiologist's bills would likely process through our insurance before the hospital bill and therefore, would dramatically reduce the remaining deductible amount. Secondly, we had fully funded the flexible spending account to the amount of our deductible so we would have been out the deductible amount to our insurance company AND the hospitale and would likely have had to try to get any prepayment back from the hospital (we're talking thousands of dollars, not hundreds).

In the case of the doctor's office, I had to sign a paper saying that I would pay an $8 fee if the office had to bill me for my visit. And, in the case of the hospital, I had to make several calls to the insurance company and hospital finance to assure the hospital representative that we had the money set aside to pay the bill and that we fully intend to pay the bill.

It's pretty obvious, though, that health care providers are being hit hard by the recession.

 

[maddhatir]

FWIW, sometimes when the insurance company sends a check, there is absolutely NO explanation for it. It's mystifying. We had two checks like that back after DS's arrival. No explanation, not even codes. I was out of commission and hubby doesn't know how to talk to insurance poeple, he just doesn't understand it AT ALL. By the time I could have spoken to insurance about it, we had totally forgotten it, literally forgotten..it was erased from my brain, and hubby forgets things like that easily.

I don't even know how long after...I think it was 2 years...we got a call about paying the ob on call. HUh? Thought you were paid. After all...NO BILLS FOR TWO YEARS does kinda say that nothing is owed. Anyway, turned out those checks that we finally remembered were partial payment, but you would absolutely be hard-pressed to know what they were for if you saw the paperwork that accompanied them.


So try to keep that in mind...sometimes it's just mystifying, and for people who don't understand insurance (like my hubby) it can be impossible to figure out what to ask to find out what you want to know. Or to even figure out what it is you want to know.

We understand that people forget and just deposit the check (we have had a few people do that and call to apologize)- but I am talking about the people that we send statement after statement (or phone call) telling them the pmt was for the services rendered at our facility and they choose to ignore us (one woman said she put a deck on her house with the money )

 

[maddhatir]

I've run into this kind of thing twice in recent weeks. First, my usual doctor's office got a little aggressive in "recommending" a payment up-front for the doctor's visit since my insurance has a deductible (which is pre-paid through a combination of a health fund and flexible spending account).

We have a "health savings account" also. Our deductible is 5000.00, after that, insurance kicks in and we only have small copays.

One day I went to my primary and of course, as soon as you walk in the door they want your copay. I said- I do not have one (I did not mention by deductible was not met- I just told them I had no copay)

I sat down and was reading a mag and the front desk girl calls me up to the window and she has a paper in her hand. She went on the insurance website to check my coverage and printed it out. She said in a condescending tone, "YOU have a 30.00" copay". So I got a little stern with her and said- "NO! *I* have a copay after my deductible is met!" and pointed to the paper where it says that. I went on to say " YOU bill my insurance company and *I* will pay you want they allow!" and I went and sat down. I am sure I would have said it differently if she would have been a little nicer about it.

I think sometimes they see how far they can push you.

Stay strong everyone OH! and be sure to watch Michael Moore's SICKO!!!!!! That will enlighten everyone!

I think that movie should be mandatory for everyone in the US to see just to open their eyes, if only a little bit.

 

[merryweather20]

Glad I live in Canada. I was at the person who got billed by the hospital and three different Dr's some of whom it appeared didn't even see her.

 

[CajunDixie]

**Snipped**
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.

We took some of those to court. We were told it was insurance fraud. Judges get pretty po'd when you tell them the patient received our payment then lied and said they didn't get it yet we say they got $$$ and cashed the check on 01/12/09. And we send them reminders that their insurance (BTW I hate Anthem) company sends our money to them.

FWIW, sometimes when the insurance company sends a check, there is absolutely NO explanation for it. It's mystifying. We had two checks like that back after DS's arrival. No explanation, not even codes. I was out of commission and hubby doesn't know how to talk to insurance poeple, he just doesn't understand it AT ALL. By the time I could have spoken to insurance about it, we had totally forgotten it, literally forgotten..it was erased from my brain, and hubby forgets things like that easily.

**Snipped**
So try to keep that in mind...sometimes it's just mystifying, and for people who don't understand insurance (like my hubby) it can be impossible to figure out what to ask to find out what you want to know. Or to even figure out what it is you want to know.

But the thing is I've seen the EOBs for these payments for our service and it states XYS company with a date of service of 01/01/09 amount charged $$$$. I know they aren't always that easy to read but we send them an invoice BEFORE they are ever paid saying you'll receive payment for our claim within 6 weeks. Then we bill again a month later to give them another heads up. What makes us angry is not the accidental misunderstanding its when they cash the check and blatantly lie to us and say they never received it, yet their insurance company tells me when they cashed it and how much the check was.

We understand that people forget and just deposit the check (we have had a few people do that and call to apologize)- but I am talking about the people that we send statement after statement (or phone call) telling them the pmt was for the services rendered at our facility and they choose to ignore us (one woman said she put a deck on her house with the money )

I had a father tell me tough ^%$# it's mine now. Bet he didn't say that to the judge as he was ordered to not only pay us but pay court costs and interest too!!! If they don't show for court the judge can put body attachments on them, so if they would get pulled over for something like a speeding ticket, they'd have to pay the total (court costs and interest too) or go to jail. To get out of jail they have to pay us. It's rare we do that!!!!! We try our best to work with people and set up small payment plans but liars get the express trip to court or collections.

 

[ameraumi]

It is very common practic now, with so many people that have no insurance, they have to take what they can get. Now, it can't be asked for up front, but it can be asked for after the pt has been assessed by a PA or MD and before treatment is rendered. That is the practice most hospitals are going to now, because they were losing so much money.

Suzanne

Thank goodness I have not come across this. Even with all of DH's current treatments we have NEVER been asked to pay up front (or right after treatment without a bill). They would get a big fat no from me until I know what my insurance co will pay. And in most cases, my ins pays 100%.

 

[Nancy]

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

It's not unheard of at all. A lot of providers will call and ask what kind of plan a person is on. If they have a deductible they may want it up front. We try very hard to not have the providers bill up front but insurance companies can not tell a doctor/hospital how to run their business even if they are contracted as in network with the company.

All I can say is keep records of everything you pay ahead of time so if there is an overpayment made you can get that money refunded

 

[bumbershoot]

But the thing is I've seen the EOBs for these payments for our service and it states XYS company with a date of service of 01/01/09 amount charged $$$$. I know they aren't always that easy to read but we send them an invoice BEFORE they are ever paid saying you'll receive payment for our claim within 6 weeks. Then we bill again a month later to give them another heads up. What makes us angry is not the accidental misunderstanding its when they cash the check and blatantly lie to us and say they never received it, yet their insurance company tells me when they cashed it and how much the check was.

I'm sure that our current company, and even our last insurance company, would have proper information on the EOBs. But when we were with Great West their EOBs were heinously bad. I mean absolutely bewildering.

I will say, however, they continued to be kind and gracious when I was still trying to figure out who was billing me for what, and why, years after DS's arrival. And it confused matters greatly b/c I was given an on call OB who was a Group Health doctor. And it was NOT a Group Health hospital!!! I was in an in network hospital and everyone else was in network, but the OB was NOT, and then he refused (REFUSED) to bill it as emergent care, despite him saying "emergency emergency" all over the place, so we got to pay out of network fees for something that absolutely should have been IN network. Then it took him nearly 2 years to bill.

I still have the papers that came with the checks somewhere...mind boggling and bewildering.


Glad I'm with Aetna now, they are much less confusing, and no one will get them confused with Group Health b/c of similiarity with the names! (also a problem at the hospital)