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Crap. . . medical bills. . . crap

episodic

episodic

Lifer
This system we have is crap.

My son goes for a tonsilectomy. I get at the hospital and they tell me the portion I'm responsible for (after insurance is $312). This is 'before' the surgery. I pay that that day - along with $200 to the doctor.


Fast forward to today, and I get a bill from the hospital for $1300. I asked the lady straight up was the $312 all I'd owe. That was what they said was it.

So I'm out $512 dollars so far and they want another $1300 dollars. That is $1800 dollars. They billed almost $7500 dollars to my insurance for this. A tonsillectomy. . . It was outpatient even - in a bed for 5 hours - maybe.

Crap.


I'll go there Monday and argue. Probably won't do any good.

If it costs this much for something minor - I hope nothing major ever happens. Wonder how many people 'with' health insurance have to file bankruptcy.


 
That seems odd to me. My health insurance covers 100% for all visits( Anthem of California EPO), but even when I had an 80/20 PPO it was never that much.
 
Just under 2 hours or surgery, 5 hours total - $15,500+

And insurance has only paid 2 of the 5 claims at 14 weeks later. People who think that this system is OK are full of shit.

I had to pay $1100+ (like you, that was supposed to be IT) up front and from the looks of the first few claims, looks like I might end up maxing out my out of pocket at $3,000! :|


As for your bankruptcy question, just think....the government (or certain parts of it) wanted us to use Health Savings Accounts for those that didn't have insurance. I couldn't imagine trying to get by on one of those...
 
You're covering the money they loss from treating dead beats w/o insurance going through their emergency service.
 
Well my credit is crap anyway. I'm probably going to pay what the lady told me I owed, and pay off the rest when/if I can. I was very careful to ask how much everything was going to cost, and that is the money I 'put back' and worked extra for.

 
one thing not to do is pay the hospital until you get an explanation of benefits from the insurance. Often a provider will bill both the insurance and the recipient of care. I had to deal with this a lot when I worked for Regence Blue Cross.

 
Originally posted by: Engineer
Just under 2 hours or surgery, 5 hours total - $15,500+

And insurance has only paid 2 of the 5 claims at 14 weeks later. People who think that this system is OK are full of shit.

I had to pay $1100+ (like you, that was supposed to be IT) up front and from the looks of the first few claims, looks like I might end up maxing out my out of pocket at $3,000! :|


As for your bankruptcy question, just think....the government (or certain parts of it) wanted us to use Health Savings Accounts for those that didn't have insurance. I couldn't imagine trying to get by on one of those...
Click to expand...

at least you have insurance. jesus, a trip to the emergency room and a CT scan cost me $4K that im still working on (and, as a student, will be for a while)
 
Originally posted by: mugs
It's called balance billing. You're likely not obligated to pay it, and it may also be illegal depending on the state you live in.

http://www.businessweek.com/ma..._36/b4098040915634.htm
Click to expand...

I'm going to call my health insurance Monday. Hopefully, it is a mistake.

I was under the impression that there was a 'certain precontracted rate' for different procedures that was discounted because it was in network. I understood that I only had to pay 20% of that discounted rate.

 
Originally posted by: xSauronx
Originally posted by: Engineer
Just under 2 hours or surgery, 5 hours total - $15,500+

And insurance has only paid 2 of the 5 claims at 14 weeks later. People who think that this system is OK are full of shit.

I had to pay $1100+ (like you, that was supposed to be IT) up front and from the looks of the first few claims, looks like I might end up maxing out my out of pocket at $3,000! :|


As for your bankruptcy question, just think....the government (or certain parts of it) wanted us to use Health Savings Accounts for those that didn't have insurance. I couldn't imagine trying to get by on one of those...
Click to expand...

at least you have insurance. jesus, a trip to the emergency room and a CT scan cost me $4K that im still working on (and, as a student, will be for a while)
Click to expand...

and that's part of the problem in this country, whether people want to admit it or not. As for your insurance comment, what good is it when I have to fight them from top to bottom to get them to pay, "if" they ever do (denied two of the 5 claims so far).
 
Yeah, it is really effed up...

I'm not in a bad of boat as you, but I had some eye work done last month. Got a bill for $68 to pay out of my pocket, after deductions. Sweet!!!...

Then today, I get another bill for $166 more showing my 'credit' of $68 on a few of the itemized things. What gives? Why do they bill stuff like this twice?
 
you know one big problem with insurance is the massive amounts of paper work, especially with Medicare. they require a paper claim so everything has to get mailed or faxed then scanned and imaged and a data entry person has to input the claim then a claims processor does his/her thing then finally after roughly 3 weeks the provider gets paid they're cut. Usually by that time the provider has billed the patient and they freak out
 
Originally posted by: Engineer
Just under 2 hours or surgery, 5 hours total - $15,500+

And insurance has only paid 2 of the 5 claims at 14 weeks later. People who think that this system is OK are full of shit.

I had to pay $1100+ (like you, that was supposed to be IT) up front and from the looks of the first few claims, looks like I might end up maxing out my out of pocket at $3,000! :|


As for your bankruptcy question, just think....the government (or certain parts of it) wanted us to use Health Savings Accounts for those that didn't have insurance. I couldn't imagine trying to get by on one of those...
Click to expand...

HSA's have actually worked extremely well for the majority of our staff-level employees. No complaints, only praises.
 
Originally posted by: episodic
This system we have is crap.

My son goes for a tonsilectomy. I get at the hospital and they tell me the portion I'm responsible for (after insurance is $312). This is 'before' the surgery. I pay that that day - along with $200 to the doctor.


Fast forward to today, and I get a bill from the hospital for $1300. I asked the lady straight up was the $312 all I'd owe. That was what they said was it.

So I'm out $512 dollars so far and they want another $1300 dollars. That is $1800 dollars. They billed almost $7500 dollars to my insurance for this. A tonsillectomy. . . It was outpatient even - in a bed for 5 hours - maybe.

Crap.


I'll go there Monday and argue. Probably won't do any good.

If it costs this much for something minor - I hope nothing major ever happens. Wonder how many people 'with' health insurance have to file bankruptcy.
Click to expand...

Could this be your 20% of an 80/20 plan?
 
Originally posted by: SacrosanctFiend
Originally posted by: Engineer
Just under 2 hours or surgery, 5 hours total - $15,500+

And insurance has only paid 2 of the 5 claims at 14 weeks later. People who think that this system is OK are full of shit.

I had to pay $1100+ (like you, that was supposed to be IT) up front and from the looks of the first few claims, looks like I might end up maxing out my out of pocket at $3,000! :|


As for your bankruptcy question, just think....the government (or certain parts of it) wanted us to use Health Savings Accounts for those that didn't have insurance. I couldn't imagine trying to get by on one of those...
Click to expand...

HSA's have actually worked extremely well for the majority of our staff-level employees. No complaints, only praises.
Click to expand...


Then they have not had to go through a major (or semi major) procedure then (and yes, I understand that many HSA's have co-insurance that kicks in after $5,000 (or so) of bills per person in a year - usually at 80/20).


HSA = moving from employer insurance to employee nearly 100% self insured.
 
Originally posted by: episodic
Originally posted by: mugs
It's called balance billing. You're likely not obligated to pay it, and it may also be illegal depending on the state you live in.

http://www.businessweek.com/ma..._36/b4098040915634.htm
Click to expand...

I'm going to call my health insurance Monday. Hopefully, it is a mistake.

I was under the impression that there was a 'certain precontracted rate' for different procedures that was discounted because it was in network. I understood that I only had to pay 20% of that discounted rate.
Click to expand...

If you went to an in-network doctor, then the bill they sent you was almost certainly illegal. It wasn't a mistake, it was a deliberate attempt to take advantages of people's lack of understanding of how these things work.

From the article:
California, New Jersey, and 45 other states ban in-network providers from billing insured patients beyond co-payments or co-insurance required by the plan.
Click to expand...


Edit: There is the possibility that the person who initially told you it would only be $312 was mistaken... you'll want to talk to your insurance company about this. Don't trust the hospital.
 
Originally posted by: jjsole
Originally posted by: episodic
This system we have is crap.

My son goes for a tonsilectomy. I get at the hospital and they tell me the portion I'm responsible for (after insurance is $312). This is 'before' the surgery. I pay that that day - along with $200 to the doctor.


Fast forward to today, and I get a bill from the hospital for $1300. I asked the lady straight up was the $312 all I'd owe. That was what they said was it.

So I'm out $512 dollars so far and they want another $1300 dollars. That is $1800 dollars. They billed almost $7500 dollars to my insurance for this. A tonsillectomy. . . It was outpatient even - in a bed for 5 hours - maybe.

Crap.


I'll go there Monday and argue. Probably won't do any good.

If it costs this much for something minor - I hope nothing major ever happens. Wonder how many people 'with' health insurance have to file bankruptcy.
Click to expand...

Could this be your 20% of an 80/20 plan?
Click to expand...


Probably - but they told me up front before the surgery my portion was $312.
 
I got billed $3000 for a broken finger. All they did was inject some saline into my finger and tetanus shot and let me go. (They charged 2500 for ambulance use when I walked in.)

This is why I refuse to visit a doctor until I decide if I am going to purchase a home or not. I am not going to ruin my credit because I refuse to pay for bullshit billing practices.
 
Originally posted by: Engineer
Originally posted by: SacrosanctFiend
Originally posted by: Engineer
Just under 2 hours or surgery, 5 hours total - $15,500+

And insurance has only paid 2 of the 5 claims at 14 weeks later. People who think that this system is OK are full of shit.

I had to pay $1100+ (like you, that was supposed to be IT) up front and from the looks of the first few claims, looks like I might end up maxing out my out of pocket at $3,000! :|


As for your bankruptcy question, just think....the government (or certain parts of it) wanted us to use Health Savings Accounts for those that didn't have insurance. I couldn't imagine trying to get by on one of those...
Click to expand...

HSA's have actually worked extremely well for the majority of our staff-level employees. No complaints, only praises.
Click to expand...


Then they have not had to go through a major (or semi major) procedure then (and yes, I understand that many HSA's have co-insurance that kicks in after $5,000 (or so) of bills per person in a year - usually at 80/20).


HSA = moving from employer insurance to employee nearly 100% self insured.
Click to expand...

In fact, I know of two employees in my dept. who have had procedures exceeding 20K with no complaints. And, yes, it was t 80/20. PPO's, EPO's, and HMO's are fading out. FSA's and HSA's are a way for the employees to take responsibility and keep employer cost low.

 
episodic:

Have you received your EOB yet? You might be able to login online and see it. More than likely they might have fucked up the claim, and it got denied. Definitely talk to your insurance provider first. The EOB they provide should tell you exactly what you owe. After consulting with them, then talk to the hospital about any differences in the amount owed. When you pay with insurance they accept, the insurance company has already agreed to terms with the hospital for you. That's why the hospital quoted you the $312.
 
In the end, we all know a government sponsored plan will only be worse. Anyone who says different needs to take off the
rose.gif
colored goggles...
 
Originally posted by: amdhunter
I got billed $3000 for a broken finger. All they did was inject some saline into my finger and tetanus shot and let me go. (They charged 2500 for ambulance use when I walked in.)

This is why I refuse to visit a doctor until I decide if I am going to purchase a home or not. I am not going to ruin my credit because I refuse to pay for bullshit billing practices.
Click to expand...

Hospitals don't bill for ambulances. The ambulance company should send you a bill separately.
 
Originally posted by: SacrosanctFiend
Originally posted by: Engineer
Originally posted by: SacrosanctFiend
Originally posted by: Engineer
Just under 2 hours or surgery, 5 hours total - $15,500+

And insurance has only paid 2 of the 5 claims at 14 weeks later. People who think that this system is OK are full of shit.

I had to pay $1100+ (like you, that was supposed to be IT) up front and from the looks of the first few claims, looks like I might end up maxing out my out of pocket at $3,000! :|


As for your bankruptcy question, just think....the government (or certain parts of it) wanted us to use Health Savings Accounts for those that didn't have insurance. I couldn't imagine trying to get by on one of those...
Click to expand...

HSA's have actually worked extremely well for the majority of our staff-level employees. No complaints, only praises.
Click to expand...


Then they have not had to go through a major (or semi major) procedure then (and yes, I understand that many HSA's have co-insurance that kicks in after $5,000 (or so) of bills per person in a year - usually at 80/20).


HSA = moving from employer insurance to employee nearly 100% self insured.
Click to expand...

In fact, I know of two employees in my dept. who have had procedures exceeding 20K with no complaints. And, yes, it was t 80/20. PPO's, EPO's, and HMO's are fading out. FSA's and HSA's are a way for the employees to take responsibility and keep employer cost low.
Click to expand...

That "could" possibly be fine "if" the employer would contribute some money to the HSA, but many do not (mine doesn't and in fact, still charges for the catastrophic insurance portion of the HSA).
 
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