A cautionary tale about your next hospital visit

[Joe Nation]

I have an upcoming surgery and got a call from the hospital from their financial estimates department to let me know how much I was going to have to pay out-of-pocket before the surgery and they wanted to know if I would like to pay the amount in full now or when I arrived the day of the surgery.

I was shocked to hear that my upfront costs were going to be over $2,100 since my co-pay for any hospital procedure at a Tier I in-network facility was only suppose to be $275. I declined to make any payment at the time of the call and hung up and called my health insurer. Now I have pretty good insurance and after speaking to the customer service people I was told that indeed my co-pay was $275 and they couldn't figure out what the extra $1,800+ charges were for. They did let me know that any over payments would be returned to me eventually. I just had to shell out the 1800 bucks and wait for them to return it at some point.

So, I called the hospital financial estimates office back and asked why my upfront out-of-pockets cost were so high. To my surprise, they said that they were charging a 10% advanced payment for a 23 hour observation period after surgery cost which of course the insurance company would pay for. They quickly removed the additional charge and dropped my out-of-pocket cost to the co-pay amount of $275 that it should have been in the first place.

I have to wonder how many elderly or extremely sick people there are that don't have the ability to figure out what they are being told by these smooth talking liars. I would have had to wait months for the insurance to pay the hospital and then wait even longer for the hospital to refund my $1,800 if they ever did. You are only responsible for your co-pay. You do not have to supplement the insurance payment because the hospital would like you to. They never tell you that. Universal Health Care NOW!

[dalton99a]

1. Kick

[Jerry2144]

2. Another grain of sand

On the beach of reasons why we need to get rid of for-profit health care.

[Diamond_Dog]

3. K&R

[Dustlawyer]

4. Hospital billing is like the Wild West, whatever they think they can get away with.

Unlike other service businesses in the free market, there is no way to shop for competitive pricing. This is why we need universal health care. You have to fight over the bill every time.

[mitch96]

21. "whatever they think they can get away with.".. The finance dept is like used car dealers...

What ever "fees" they can slip in and think you won't notice...fuckers...
m

[Kali]

5. I am in that hell right now

paid 1700 to hospital on day of surgery thinking that would finish up my deductable, but my deductible was instead counted and covered by another bill I hadn't actually received yet. meanwhile insurance hasn't settled with hospital so I can't even begin to try and get that 1700 back. I could sure use it. was told 45 days, nope. been 75 at least now. claim still "pending" with insurance. calling them is a freaking nightmare too. I think they have one employee working from home at the moment and she has barking dogs.

[Nittersing]

7. Any chance local news could help?

Not too long ago, we had a local news guy asking folks to contact him about insurance/hospital payment issues.

[Kali]

9. maybe

currently I am waiting another 72 hours for my latest call to be processed.

[lagomorph777]

6. Been there done that. You have to question everything.

And it can come equally from the hospital or the insurer. You have to play them off each other.

[Ms. Toad]

8. I never pay until the insurance has settled.

I once spent about 200 hours chasing a $100 overcharge. I had paid my out-of-pocket expense, even though the insurance billing was wrong, on the theory that I owed it I ought to pay it. The the hospital mis-credited it when the insurance company withdrew the out-of-network payment, then repaid at the in-network costs.

Never again.

[Orrex]

10. Years back I spend hours on the phone with my insurance company

They were unable to explain my billing to me in a way that accounted for every denial, partial denial, deductible, copay, out-of-pocket and miscellaneous expense.

The only thing they were sure of--and boy were they sure of it--was that I definitely owed every last penny that they claimed I owed.

[Joinfortmill]

11. Unf*ing believable.

[Grokenstein]

12. Dentists pull that sort of stunt, too.

My insurance covers two exams per year, and my dentist sent me a reminder for the second one. When I arrived, they wanted to charge me up front, in CASH, and pointedly stated I would get no receipt. I walked out, went home, filed a complaint with my insurer and changed providers.

If they do that to someone in their 50s, imagine the sort of shit they pull with older folk.

[OMGWTF]

13. Healthcare is one industry where no one really knows the price of their procedure until it's done.

I wish doctors would advertise what their prices are. I've never seen it anywhere and I'm old and thankfully on Medicare.

[FSogol]

15. You've never met my auto mechanic.

[Nululu]

14. 6 months for me to get an overselling refunded

Never pay and hope for a reimbursement, it can take many months.

I paid for at the local in network charge and it took months of my pestering them to get paid. Fortunately I kept good records. The elderly or someone feeling ill might not be able to do that.

[Snackshack]

16. Medical Fraud is so easy to do...

The things my grandmother got charged for by healthcare providers was insane. Towards her final years she was in & out of hospital many times and after every stay we would ask for an itemized bill. Going thru the pages of charges was just mind numbing and every time there were charges that were removed. Charges that shouldn’t have been there but as the OP says charges just left there because people are too ill or don’t understand.

Always ask for an itemized bill.

[calimary]

17. This isn't a thread. This is a PUBLIC SERVICE!

Should be read and noted by all of us.

Definitely one of those “teachable moments” to keep in mind.

[RobinA]

18. I Had A Similar

situation. I was signed up to have a colonoscopy three years after the previous colonoscopy. All per the doctor. Hospital rep called to make sure I knew that this would not be covered, per a call she made to my insurance. I said, BS, I know my insurance and it's covered. She said it wasn't. So I called insurance and told them the hospital was saying it wasn't covered. Insurance said it was covered and that there was no indication anyone from the hospital had called about my policy. She also offered to, while I was on the phone, three-way call with this hospital person to set the matter straight. Which we then did. I don't know what the game was, but you definitely have to stay on top of these people. And know your policy.

[hamsterjill]

19. Great post!

Not only elderly and sick people - but working people who don’t have time nor the means to stay “on hold” for hours arguing.

Universal Healthcare NOW!!!

[Joe Nation]

20. To add one more detail to this story....

I went into MyChart, the patient portal, and the estimate for my less than 48-hour outpatient stay is going to be roughly $131,000. The hospital charges are about $110,000 and the surgeon's charge is over $20,000. I am definitely asking for an itemize bill before I leave the hospital.

[NanananaFatman]

22. Next visit? Lmfao.

That’s rich. Literally from my point of view and the point of view of millions and millions of Americans.

I have no insurance. There isn’t going to be a first one. I’ll eat a bullet first.