Medical bill question......Is this normal??

[Kitty 34]

I spent 5 days in the hospital in November with a very bad case of pneumonia. My DH took me to the ER and I was admitted a couple of hours later. Every day there I was seen by the "hospital" doctor who came in each morning and IMHO took very good care of me during my stay.

Soooooo........a month later I'm starting to acquire all the bills. Got the mega hospital bill plus many many test and radiologist bills which of course I expected.

But there was one bill that totally confused me which I received just today. It was from my doctor's office charging me $318 each day I was in the hospital???? What I thought odd is my doctor's office and all of the doctors in that office were never in contact with the hospital doctor about any of my care and treatment. I know this because the day I was released the hospital doctor said he would make sure my doctor's office would get any and all information from my 5 day stay so if I were to make a follow up appt they would know what was going on.

So is this normal.....to be charged by my regular doctor even though he or she had nothing to do with my admittance and treatment??

 

[sonnyjane]

You'll have to call your doctor and have them explain the charges. I can't imagine why they'd be involved at all, but I'm sure they have some complex explanation that I can't give.

 

[missbrooke06]

I've not seen that before. I have had it where I get a hospital bill (with a line for medical services) and then a separate bill from the ER physician. The bill is clearly from your GP?

 

[scrapquitler]

I spent 5 days in the hospital in November with a very bad case of pneumonia. My DH took me to the ER and I was admitted a couple of hours later. Every day there I was seen by the "hospital" doctor who came in each morning and IMHO took very good care of me during my stay.

Soooooo........a month later I'm starting to acquire all the bills. Got the mega hospital bill plus many many test and radiologist bills which of course I expected.

But there was one bill that totally confused me which I received just today. It was from my doctor's office charging me $318 each day I was in the hospital???? What I thought odd is my doctor's office and all of the doctors in that office were never in contact with the hospital doctor about any of my care and treatment. I know this because the day I was released the hospital doctor said he would make sure my doctor's office would get any and all information from my 5 day stay so if I were to make a follow up appt they would know what was going on.

So is this normal.....to be charged by my regular doctor even though he or she had nothing to do with my admittance and treatment??

I would certainly be calling and demanding a good explanation for that.

 

[mefordis]

Do you think the hospital dr. called your dr to update him every day, and your dr charged you that much for each daily phone call? Just speculating. It looks like it may be an hourly rate for a phone call. Of course you would have to ask your dr.

 

[Poohlove]

Is there anything normal with medical bills That is an odd charge, I would definitely be on the phone with the office to try and get an explanation. There probably a very bad, unreasonable explanation to go along with it

I am glad that you are feeling better!!!

 

[Kitty 34]

Thanks for the replies.

I went to my doctor two weeks later and she didn't know anything about my stay until she was literally reading some of the info sent while I was sitting there in front of her.

I will definitely be calling my doctor's office but just thought I'd check with you guys on maybe it's a new protocol or something?? I know, it certainly didn't make sense to me or my DH to be charged for that.

 

[YoYoAurora]

When you call the doctor's office, ask for details on the services provided on each day. Make notes. If it doesn't pass the smell test, contact your health insurance company.

If your personal physician did not know anything about your hospitalization until you went for an appointment, something isn't right. I haven't heard of a personal physician charging when their patient was under the care of a hospital-based physician. It could be an error on the part of your physician's office.

 

[ols386]

When you call the doctor's office, ask for details on the services provided on each day. Make notes. If it doesn't pass the smell test, contact your health insurance company.

If your personal physician did not know anything about your hospitalization until you went for an appointment, something isn't right. I haven't heard of a personal physician charging when their patient was under the care of a hospital-based physician. It could be an error on the part of your physician's office.

That's what I'm thinking, an error on the part of your physician's office.

I was in the hospital just for overnight, about 4 years ago, and my PCP (family doc) didn't even know I was in the hospital.

I'd definitely be asking your PCP about this.

 

[Kitty 34]

When you call the doctor's office, ask for details on the services provided on each day. Make notes. If it doesn't pass the smell test, contact your health insurance company.

If your personal physician did not know anything about your hospitalization until you went for an appointment, something isn't right. I haven't heard of a personal physician charging when their patient was under the care of a hospital-based physician. It could be an error on the part of your physician's office.

After reading comments here and just our gut feelings about this whole thing, I will definitely be calling my health insurance people. My personal physician with whom I have gone to for years and years is not involved with any billing (that I'm aware of). Maybe I should go the billing dept first before I go straight to my insurance. I'm not one to make a stink about something but as you said it just doesn't seem to be passing the "smell" test.

 

[Micca]

I don't like the sound of it either. I'll be interested to know what you find out. I will say that it seems the hospital would contact your regular doctor to at least let the doctor know that you're hospitalized, and I can see why your regular doc might want updates and to consult with the doc at the hospital, but it sounds like that didn't happen.

 

[SMD]

Sometimes your doctor will send someone on their service to look at the patient. When my relative was in an induced coma for more than a week their cardiologist had an intern or maybe a resident, sometimes 2 together come in every day, look at the chart, read the monitors. And they were a cancer survivor, so the oncologist came by to check everything as well. They can be in and out in minutes while you're asleep and you'd never know it.

 

[Gumbo4x4]

On some of my freight bills to difficult locations (like NYC) the freight companies tack on an "arbitrary" charge. No seriously, that's what they actually call it!! I'm waiting for the day medical billing becomes that honest.

 

[lsyorke]

Call your doctor before you call the insurance company. Give them the opportunity to fix what appears to be an error. IF they do claim that it's legitimate ask what the code is they billed. An E&M(evaluation and management) has certain requirements be met within the medical record to get paid. Hard to meet those requirements if they weren't there. Call them first.

 

[karensi]

I'm curious too as to what your doctor could possibly be charging you that much money for.
Would you mind coming back here and letting us know what happens when you speak with your MD?

 

[manning]

I had an echo test scheduled a week later. On way home got a call to come back for it.

Then I get billed twice for it. Someone there forgot to cancel the later procedure.

 

[Tasha228]

Call your dr's office and ask for billing. Explain it to them first. They may be able to take care of it on their end without ever having to go thru the hassle of calling insurance companies. They can refile and void charges as needed if it's on their end. If it isn't, they should be able to tell you that. Then the insurance company will be your next step, unless they say otherwise.

 

[wilkeliza]

I would go first to your PCP since you like them and speak with their billing. Give them the opportunity to fix the situation. I believe if you do go straight to insurance they could make a case for insurance fraud which would then create an issue with your PCP and you so it should be a last step. Now if you go to your PCP and they have no good excuse for the charge but don't want to fix it then go to your insurance and let the cards fall where they may.

 

[Poohlove]

It doesn't even sound like the doctor's office had a reason to even bill the insurance company to begin with, I am curious to see why they did.

 

[Pea-n-Me]

I would start by calling the hospital and asking about the charge first, since they seem to be the ones who charged it, unless I am misreading it. I would also see what the insurance company has to say, as well as touch base with the doctor's office billing to see if they know anything about it, but I think your best info will come from the hospital itself.

We had it happen last year when DH was in the hospital. Turns out the extra billing was for a "consult". Things can get so confusing in a hospital (and I work in one) so it wouldn't surprise me if someone from the primary care group actually did consult but word never got back to the primary care physician. Do you know if the hospital and the doctor's office use software that "communicate" with eachother? Some systems don't, so they rely, still, on things like faxed information and that sort of thing, which can fall through the cracks. These are the things I'd be looking for.

I've also posted before that in the past several years I've had to sort through numerous issues like this - when you get multiple separate bills for hospital stays. (We had a $35 bill for an EKG after DH's stay, as well, which seems absolutely crazy since he had multiple EKGs during his stay and we were only "charged" for one! My guess is that somehow the person doing the EKG didn't "transmit" the information electronically properly and it somehow didn't get to the right place for billing. But I digress...)

The latest fiasco I had to deal with - since this past September - was finally resolved in our favor. But it took months, and I actually got a call from a collection agency while this was going on, which infuriated me since I'd been working on it and supposedly it'd all been resolved. But what happened was DD had to see a consulting doctor, separate from the surgeon, before a surgery she had scheduled. We were approved for that visit from our PCP's office. Well something came up and we had to change the consult appointment time, and the only time they had available was with a different doctor in the same group, so we took it, not realizing, or being informed from anyone, that it would apparently require a whole new authorization. So since we hadn't gotten a second authorization, we were charged almost $1000 for the visit. Each of the parties involved - the hospital, the insurance company, and the PCP's office all had a different take on it. It was super frustrating having to go back and forth repeatedly with all of them, making sure things were done, and done correctly.

We basically resolved it by the PCP's office confirming that the visit was authorized, and they were able to provide the original authorization number from June (which I know doesn't make complete sense, ie why didn't it work for both doctors then if it did now, who knows) to both the hospital and the insurance company by faxing it over to them. (Ha! The FAX issue again! Turns out the insurance company will only accept info by FAX if you can believe that. This receiving dept will also NOT take phone calls from customers, only from doctor's offices or hospitals. I spent an inordinate amount of time trying to get someone on the phone, but ultimately I was only able to "speak" to a general customer service rep! ) Anyway, somehow, the hospital followed through with contacting the insurance company confirming the authorization, and the insurance company received the authorization also, but - and here's the zinger, and what caused them to put is in collections - they don't automatically re-submit authorization corrections! So although they had it, technically, it wasn't "re-submitted". So it took numerous phone calls AGAIN after I got the calls from collections to straighten it all out once and for all. Sorry so long, but just trying to illustrate how nuts these things can get, and how frustrating it can be trying to resolve them. The lady in the hospital billing dept assured me she'd call me if there were problems, and she never did, so I *think* on their side they also thought things were all set. The biggest problem was the insurance company.

I will say from being a long term hospital employee from the days when most things were on paper, to now, where much is electronic, it's been a cluster, in large part because some of the systems don't "talk" to eachother yet, and this creates a lot of problems. I think things are headed in that direction, but not everyone's there yet. We once had a presentation from the head of my hospital's computer systems and it was really interesting what he had to say about this. New systems had to be incorporated into old ones - without their ever shutting down (and thereby disrupting hospital operations; unable to do for even a day. Lots easier to put in a new system than to try to add to old ones, often multiple old ones in many cases). Even though we've made progress, there's still a lot of older systems out there trying to combine with newer ones.