Hospital bills

[Chaoster]

Anyone ever haggle over the bill. Long story short, my wife was in the hospital about a month ago. As you know when in the hospital there are many doctors that come to visit. It is hard to keep track if they take our insurance or not. Well we get a bill now from one of the hospital doctor. They are not in our insurance plan and we have to pay out of pocket. I was thinking of calling and complaining that the doctor was not in our plan. Maybe I can get them to lower the charge? It's less than $400. Or should I just pay the bill and get it over with. I'm just dreading getting bills from other doctors who stopped by and now want their cut.

 

[Aimeedyan]

You likely won't get anywhere, I didn't when it happened to me. I actually had 4 doctors assigned to me - each checked in daily for 5 days - and NONE were on my insurance. I appealed to my insurance company for them to pay it and made pleas with each doctor's office. Needless to say, we are still paying them off.

 

[RooRach0906]

At least ask. We had a DD in May and we asked almost all of them including ones on our insurance plan where we still had to pay if they would take any off if we paid in full right then 3 out of the 4 bills gave us a 15% discount. So ask!

 

[bumbershoot]

Might as well slow down, request a detailed billing statement from the hospital, a detailed bill for any random doctor that bills you, and also request her full records from the hospital and any doctors that bill you. Really make sure they are entitled to what they are billing you for (you wouldn't believe the mistakes (and outright lies) in my and my son's records from the local horrid hospital). Then contact your insurance company, make SURE that you have to pay out of network (or entirely out of pocket) for people that you didn't specifically hire while in the hospital. If this was an emergency, make sure it's ALL coded as care for an emergency. Just make sure everything is absolutely positively correct. Get a notebook for this. Take notes with names and dates. Find one spot to put all the bills and explanations of benefits you get (I like binders for this!). Just make sure everything is correct.

And then once you're sure, after keeping everyone in the loop of course so you're not sent to collections, then pay what you have to pay.

Just as an example of a weirdness I found...DS fell and hit his head. We called 911 b/c his behavior changed, and they took him to the hospital (the competent one this time). In my town, we pay for ambulance rides. The ambulance company was the LAST to bill ME. But I found out almost a year later they were the FIRST to bill insurance. So the insurance company, unbeknownst/un-understood to and by me, paid them as out of network, because it wasn't seen as a verified emergency. The ambulance company and I went round and round for months and months over something else (they offered a discount, and then took it back, offered it again, took it back again, etc). Because I kept trying to get a conference call between me, insurance, and ambulance (insurance wanted this but couldn't be on hold as long as ambulance people routinely did), I finally finally finally found out that insurance had paid as though there were NOT an emergency. the rep I was talking to realized that it was emergent care, changed a code, and boom, I got a refund of what I'd already paid (we'd just come under a high deductible plan the day before he fell so this was all coming from US). But it took almost a year for some rep to really listen and really read.

So just make sure! Work quickly, but make sure.

 

[QVCshopper]

I would talk to your insurance/doctor's billing company who sent you the bill. This has happened to me three times b/c our emergency room doctors don't always take our insurance (first time I broke my elbow; other two were b/c my son gets nursemaid's elbow easily). Finally, the doctor's billing company told me exactly what to tell my insurance company so they would pay. It was like some secret code they use to run it as a non-participating emergency room visit. It took lots of calls, but I ultimately paid nothing but my emergency room co-pay.

 

[snowywhite89]

Anyone ever haggle over the bill. Long story short, my wife was in the hospital about a month ago. As you know when in the hospital there are many doctors that come to visit. It is hard to keep track if they take our insurance or not. Well we get a bill now from one of the hospital doctor. They are not in our insurance plan and we have to pay out of pocket. I was thinking of calling and complaining that the doctor was not in our plan. Maybe I can get them to lower the charge? It's less than $400. Or should I just pay the bill and get it over with. I'm just dreading getting bills from other doctors who stopped by and now want their cut.

You need to negotiate while the bills is current (yours is) and pay the negotiated bill in full. Call them and ask if they have a discount if you pay in full. It can's hurt to try and the worst they can say is no. Good luck.

 

[ameraumi]

If she was in-patient then you have no control over who you see. I know when my late DH was in the hospital do to his cancer we had this happen once. The radiologist was not "in network" and we had no clue until the bill came. I was able to talk to the Ins Co about it, explain the situation, and they were able to verify the in patient dates and did pay it as In Network.

Call the billing dept of the dr/hospital first and let them know the situation and you are not refusing to pay but you are trying to work out the details with the Ins Co. Then call the Ins Co and go thru the details.

Good Luck!

 

[Lucky4me]

After two years of dealing with doctors and hospitals for dh's cancer, I've become an expert.
For a bill that low, I doubt you will get too far, but you can still try to negotiate.
If they won't budge, ask for a payment plan if you'd like to do it that way.

I spend a couple of hours a week talking to people about dh's bills, whether it be insurance company, hospital, or doctors office. At this point, I have go to people at each place. So many billing errors are made every day, it's ridiculous. The ones made in the hospital are almost impossible to fight. They can pretty much do what they want, bill what they want and it's their word against yours.
Most of them are simple coding errors, but they can be difficult to clear up. They also all blame each other for the mistakes. I think my record was talking to the insurance company and hospital five times each in one day to clear something up. It meant $1000 back in our pockets, so was worth the hassle.

 

[malibuconlee]

If she was in-patient then you have no control over who you see. I know when my late DH was in the hospital do to his cancer we had this happen once. The radiologist was not "in network" and we had no clue until the bill came. I was able to talk to the Ins Co about it, explain the situation, and they were able to verify the in patient dates and did pay it as In Network.

Call the billing dept of the dr/hospital first and let them know the situation and you are not refusing to pay but you are trying to work out the details with the Ins Co. Then call the Ins Co and go thru the details.

Good Luck!

Yes, this.

I had a similiar situation when I had my daughter. Only one hospital in town that was in network. Only one anesthesiologist practice which was not in network. Called after receiving the bill/EOB and they processed it as in network since I used an in-network hospital.

 

[ccgirl]

Yes, this.

I had a similiar situation when I had my daughter. Only one hospital in town that was in network. Only one anesthesiologist practice which was not in network. Called after receiving the bill/EOB and they processed it as in network since I used an in-network hospital.

This is great advice. I used to work in a hospital billing dept. Mistakes are made. First question is; who is the bill coming from? Usually the charge is split into a professional component (doctor) and a facility component (hospital). Some hospitals staff their own doctors called Hospitalists. In this case, the physician works for the hospital so you can do a lot of negotiation with the hospital. Regardless if the doctor is a Hospitalist or not, you should not have to pay out of network benefits if you did not make the choice to have them see your wife. I would call the billing company where the bill came from. The hosptial has their hands tied as far as a professional component. Good luck!

 

[wdwmom0f3]

Yes, this.

I had a similiar situation when I had my daughter. Only one hospital in town that was in network. Only one anesthesiologist practice which was not in network. Called after receiving the bill/EOB and they processed it as in network since I used an in-network hospital.

I never knew this. I am still paying for Dd's surgery that she has last year and this is the reason. I may make a phone call today...

 

[Piecey]

Yes, this.

I had a similiar situation when I had my daughter. Only one hospital in town that was in network. Only one anesthesiologist practice which was not in network. Called after receiving the bill/EOB and they processed it as in network since I used an in-network hospital.

This is what my insurance company does.

The radiologist, anesthesiologists, ER doctors, etc. at our hospital of choice are ALL out of network. The hospital is in.
Insurance processes all the claims as in-network, I just have to call and say "This service was provided at an in-network facility" and they re-process.

The only thing that hasn't worked out is that the bill from the anesthesiologists for my c-section was over their "allowable"... so they paid 100% of the allowable and sent the rest back to us.

I've never dealt with the doctors bills while inpatient though. My OB was in-network and when my son was admitted, his pediatrician was the only physician to see him and he is in-network too.

Hope you get some money saving answers, OP!

 

[bettymae1121]

Some docs will give a discount if you pay the bill in full immediately. I had an insurance snafu a few years back where I had to pay a $1000 to my OBGYN. When I called to pay over the phone with a CC, the office assistant said since I was paying "cash" in full she'd give me a discount and knocked the bill down to $800. I didn't even ask, they offered!

So, if you can't get insurance to pay, see if your doc will give a discount to you just for paying in full.

 

[DebMcDonald]

You should absolutely start with the hospital billing office or doctors office, depending on where the bill is coming from. I work at a very large hospital in Boston and all our doctors that are affiliated with our hospital are all credentially for the same insurance company, so no matter who comes into your room it would be covered, unless the hospital itself didn't take that insurance, so my recommendation would be to fight that bill. Also if the attending that ordered that consult (assuming it was a specialist) deemed it necessary to order that consult so it should be covered as medically necessary.

Insurance companies are notorius for not wanting to pay things, so do not pay unless you absolutely have to.

 

[DisneyAndRedSox]

After two years of dealing with doctors and hospitals for dh's cancer, I've become an expert.
For a bill that low, I doubt you will get too far, but you can still try to negotiate.
If they won't budge, ask for a payment plan if you'd like to do it that way.

I spend a couple of hours a week talking to people about dh's bills, whether it be insurance company, hospital, or doctors office. At this point, I have go to people at each place. So many billing errors are made every day, it's ridiculous. The ones made in the hospital are almost impossible to fight. They can pretty much do what they want, bill what they want and it's their word against yours.
Most of them are simple coding errors, but they can be difficult to clear up. They also all blame each other for the mistakes. I think my record was talking to the insurance company and hospital five times each in one day to clear something up. It meant $1000 back in our pockets, so was worth the hassle.

In the last 5 years we have been very lucky, nothing serious and we have caught a bunch of billing mistakes! Mostly lab work that should have been coded as preventitive and was not. The one that takes the cake... I was billed for an epidural when I had DD but I was denied one when in labor. I pushed for 2 hours with nothing except a shot of Demerol (worthless!) When I called the woman said "are you sure you didn't have an epidural?" I can't repeat here what I said back to her!

 

[Karenj2]

We've been fighting with our insurance since June (March, really) about them denying coverage for DD's hearing test at birth. It's PA state law, we had no choice of doctors (or even of declining it - it was mandatory to release her from the hospital), and yet since the hearing company is out of network we're being charged. (Not much, but it bugs the daylights out of us - all this nickel and dimeing!!!)

We also had issues with the same insurance for an ultrasound before I had her - my OBGYN practice is all in-network, and all the doctors within it are in-network, except for (according to the HMO) the doctor that performed the ultrasound... We ended up having to pay that bill because they were going to send us to collections, and I wasn't allowed to have any follow up appointments until the bill was paid. Theoretically, if we "win", we will get our money back, but I'm not holding my breath.

Can I say, I hate the current state of HMOs???

 

[Avonlady1001]

OP, it's worth a try! Same happened to me at the ER this summer. Hospital is in-network, but NONE of the ER doctors are in-network w/ ANY ins co! Can you believe it? Not a one! (I found this out during my fight...had I known before, I would've chosen a diff hospital to go to!) My ins co (BCBS) used to have a "no-choice provider" option for these circumstances, but no longer, so I fought as far up in the ins co as I could & when they washed their hands of me, I moved my fight to the hospital. I spoke to a supervisor in billing, and she brought my bill from $400 down to $147. She adjusted the bill to what it would have been had ins covered as in network & subtracted the portion that the ins did pay. I paid the rest. I was very happy with this.

She also told me that more & more hospitals were hiring doctors in their ERs that are not in network with anyone...wouldn't give me the reasons, but I guess it's the unfortunate wave of the future.

Now DD recently had eye surgery & of course the anesthesiologist isn't in-network (are they ever????) Have to start the fight again...My advice is never to pay a hospital bill without fighting...you may not win, but you have to try. Start w/ the ins co & then the hospital.

Good luck!

 

[Chaoster]

Thanks for all the replies. Will call the hospital and ins. company.

 

[luvmesometigger]

I used to work for a health insurance company years ago. If the facility is in network, the doctors are considered in network for you. There is no way for you to know who is in and out of network if they are coming to to see you. This is called "being held harmless"

Now, if you went to a doctor at first who is out of network and then used an in network facility, you are responsible for the out of network doctor.

 

[vettechick99]

This is my experience with it. If it's a small town hospital, they will usually take a little at a time and not give you a discount to settle up the bill. I am paying monthly on a bill from March from a smaller hospital because they won't offer me a discount.

If it's a larger hospital, they normally will offer a discount, but only after a certain time. I have two outstanding bills right now with a larger hospital. One from May, and one from August. I just settled the May one with a 25% discount. They won't offer me a discount on the August one yet, because it's only a few months out. So I'll pay a little each month until they do.

25% is a nice chunk, even on a small bill like yours. So it can't hurt to ask.