Before you pay a medical bill, check the claim, how the insurance company paid

[question everything]

In the past several months we had three cases where we were asked for copays when the insurance said none, or asking for twice the copay amount.

Calling the providers billing offices cleared two cases. The third came from an outsourced office so the person who answered said they would send it back.

Two different insurance companies, three different providers, three different procedures.

Even if you paid at the office, check it once the claim was paid. The provider many have coded it differently.

[Bernardo de La Paz]

1. Come to Canada. You don't see medical bills and per capita cost is half the US rate. . . nt

[lark]

4. We tried when drumpf stole the office.

Canada said no, we were too old. I was 64 and hubby was 57. I would love to live in British Columbia - it's so beautiful there.

[Bernardo de La Paz]

5. I'm sorry about that. Canada is actively seeking desirable young immigrants. . . . nt

[lark]

6. YOUNG being the operative word.

I was employed, managing 3 departments and 35 people. Husband was a district manger with 15 shops in No. FL. It was 100% our age.

[lark]

2. Good advice, highly recommend.

I worked for a large physician billing office and I can tell you both insurance companies and providers make mistakes - when we did QC checks, we found about 30% had errors - which we promptly fixed.

3 times when I had physical therapy I got wrongfully billed. The first 2 times were payments misapplied and the 3rd time the insurance co. processed it wrong and fixed it.

Oh yeah, ALWAYS save your receipts!

[ret5hd]

7. A "mistake" would tend to be 50/50...

in favor of the patient.

I’ve never been charged too little.

[lark]

8. You really don't know if you have been short charged.

We saw many bills where the office w/o things they shouldn't or where there was a system problem and copays were being wiped out in error.

Of course, there were the issues where the insurance co. refused to honor their policy and over-charged. We got involved with helping with those and those were really difficult and tedious to fix. Luckily, we were a major practice so did usually manage to resolve things, but not always. There were several times we told the patients they needed to file suit against the insurance co. One woman was being OVERBILLED over $100,000 between the hospital and the physicians due to the insurance error.

[SheltieLover]

3. I keep getting a lab bill for an incorrectly coded bill

I've tried calling provider's office, main hospital billing, resorted to calling numerous board members.

Still not resolved. Ridiculous!

[PoindexterOglethorpe]

9. I keep on getting refunds, apparently for co-pays

I wasn't really required to pay.

And it's not as though I have huge medical costs every year, and so go into and out of the donut hole. Not sure why, but I don't look a gift horse in the mouth.

[walkingman]

10. I am on Medicare Advantage (PPO) and have several providers that ask for my 20% (specialists)

upfront. Usually they charge me a few dollars more that Medicare pays. If it's just a couple of bucks I don't bother saying anything after the fact. However, I much prefer the providers that wait until Medicare pays and then bill you.

If you have a chronic condition where you have do go regually the "few dollars more" can add up over time, especially if you are being actively treated (weekly) for a condition. In my case I keep up with it on a spreadsheet and once it accumulates over a few months I send it to the billing group of that org and they give me credit.

Our healthcare in America is a clusterfuck. They intentionally make the billing complicated in order to deceive (my opinion). If we could go to a NHS system (single payer) all of this mess would go away but then they would more than likely take a cut in pay and so the AMA and other medical PACs have lobbied against it forever.