I know there has been posts on here before about the medical billing industry being all kinds of jacked up so thought I'd share this story. We pre-paid for an $800 procedure recently. Received a bill for $400. Called in to dispute only to find out our "account" is on hold due to a balance of $24,000. Haha...where do they come up with this nonsense?
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The Med - Billing
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Last: 9 yr ago by KidDoc
Most likely because in reality no procedure you have at the hospital is actually $800. Supplies alone for almost anything is more than that. When you pre pay the doctor that is one thing, but you have to consider the actual hospital (building and nurses aren't free), supplies, cost of disposal of waste, other docs (radiology ect seem to be involved in almost everything, if you realize it or not), lab costs just to name a few. Also, I am sure after insurance is processed the bill will be much less than 24k...if that is the cost AFTER insurance how on earth did you think you were going to get it for $800? That is slightly unrealistic...
My uninsured appendectomy (done back in 2011 at the Med, after a trip through their ER) was just over $50,000. The biggest expense by far was the charge for the Operating Room. Crazy expensive.
The Med had some kind of change in their billing. They must have switched to a different billing company. The phone number on their website tells you to call a different number and when I called that number they wanted to know which hospital I was calling about.
I gave the the name and address of The Med along with date of service. I told them that they had billed the wrong insurance for a visit in Jan 2015 because I could see it pending on my old insurance policy website. (I had given them the correct ins info at time of visit). They told me that they would bill the correct insurance. I pulled up the old insurance a few days later and saw that they again billed the wrong insurance.
I made another call and tried to explain that they needed to bill my current insurance but I gave up trying to explain. The customer service person said for me to wait for the claim to get denied and then when they send me a bill to then provide the correct insurance information. Gah!
I'll be dealing with this 2015 claim well in to 2016, I think.
I gave the the name and address of The Med along with date of service. I told them that they had billed the wrong insurance for a visit in Jan 2015 because I could see it pending on my old insurance policy website. (I had given them the correct ins info at time of visit). They told me that they would bill the correct insurance. I pulled up the old insurance a few days later and saw that they again billed the wrong insurance.
I made another call and tried to explain that they needed to bill my current insurance but I gave up trying to explain. The customer service person said for me to wait for the claim to get denied and then when they send me a bill to then provide the correct insurance information. Gah!
I'll be dealing with this 2015 claim well in to 2016, I think.
quote:
if that is the cost AFTER insurance how on earth did you think you were going to get it for $800?
Because that is what we were quoted prior to the procedure and that is what we paid upfront, in full. $24k was never quoted, never mentioned to anyone, never in the picture. I realize there are other costs associated with hospitals such as overhead, supplies, etc. My wife is in the medical industry...it's not new to us. There has clearly been an error on their end.
To add to that...I believe this procedure wasn't covered under our insurance so we paid 'cash' for the procedure. That is why it was paid upfront.
Who did you pay $800 to?
$800 sounds very cheap for any inpatient procedure. Anesthesia alone would be that or more.
I hope you weren't misled on the total cost.
$800 sounds very cheap for any inpatient procedure. Anesthesia alone would be that or more.
I hope you weren't misled on the total cost.
I paid $750.00 for spending one hour and thirty minutes in The Med Emergency Room just so they could monitor my blood pressure. No meds were given. No blood was taken for testing.
We seem to have this same thread over and over just the name changes (joes/med/s&w). We all know medical billing leaves a huge amount to be desired. So far as the ER visit please reference my above post. The doctor has to be paid. The hospital it self must pay nurses, admin, janitors, security guards, lab folks, equipment ( I gurantee you that your ER room had over 50k in equipment) utilities ect AND attempt to make a profit. This is the healthcare system we have, like it or not. It continues to amaze me that people are surprised that it costs money, and lots of it.
cslifer - I didn't even see a doctor and only had one nurse which I only saw 3 times and was attached to a 12 lead and a blood pressure monitor.
If you presented in an ER you had to be at seen by an MD, PA, or NP. In the ER setting they can all do very similar things, so unless you signed yourself out, you were seen by more than "one nurse". Additionally, if you were on a 12 lead, one of the above mentioned providers reviewed it, no if ands or buts. The only way that would not be the case is if you signed yourself out before the completed assessment/treatment.
You seem to think you have first hand knowledge of my visit and experience to the emergency room. Please tell me more.
I have no knowledge of it nor do I care to have any more than we have already been burdened with. I understand that folks like to get on the Internet and complain about things with anonymity, myself included, and that is fine. That being said, making things up or not telling the whole story simply to make a person or business look bad is not cool. My guess is that is what happened here. Sorry, not biting on the troll.
No anonymity on my posts. You see that link at the bottom...click on that and you can find out anything you'd ever want to know about me. The purpose of my post was to piggyback on previous threads of similar nature. I am not bashing The Med. 20 months ago The Med was where we welcomed our most precious twins to the world. The Med was awesome. The doctors were great. The nursery was clutch. I don't have anything bad to say about The Med. The billing, however, especially on the above noted issue, is way off. I don't know the ins and outs as my wife was more involved than me. My wife is in the industry. She understands insurance in and out. She had her i's dotted and t's crossed before this procedure went down. Once we get this figured out I will be happy to report back. And if I'm wrong, happy to own up to it.
Sorry for the confusion jmazz, my above post was in no way directed towards you.
A woman brought a very limp duck into a veterinary surgeon. As she laid her pet on the table, the vet pulled out his stethoscope and listened to the bird's chest. After a moment or two, the vet shook his head and sadly said, "I'm sorry, your duck, Cuddles, has passed away."
The distressed woman wailed, "Are you sure?""Yes, I am sure. Your duck is dead," replied the vet. "How can you be so sure?" she protested. "I mean you haven't done any testing on him or anything. He might just be in a coma or something."
The vet rolled his eyes, turned around and left the room. He returned a few minutes later with a black
Labrador Retriever. As the duck's owner looked on in amazement, the dog stood on his hind legs, put his
front paws on the examination table and sniffed the duck from top to bottom. He then looked up at the vet with sad eyes and shook his head.
The vet patted the dog on the head and took it out of the room. A few minutes later he returned with a
cat. The cat jumped on the table and also delicately sniffed the bird from head to foot. The cat sat back on its haunches, shook its head, meowed softly and strolled out of the room.
The vet looked at the woman and said, "I'm sorry, but as I said, this is most definitely, 100% certifiably, a dead duck." The vet turned to his computer terminal, hit a few keys and produced a bill, which he handed to the woman. The duck's owner, still in shock, took the bill. "$150!" she cried, "$150 just to tell me my duck is dead!"
The vet shrugged, "I'm sorry. If you had just taken my word for it, the bill would have been $20, but with the Lab Report and the Cat Scan, it's now $150."
The distressed woman wailed, "Are you sure?""Yes, I am sure. Your duck is dead," replied the vet. "How can you be so sure?" she protested. "I mean you haven't done any testing on him or anything. He might just be in a coma or something."
The vet rolled his eyes, turned around and left the room. He returned a few minutes later with a black
Labrador Retriever. As the duck's owner looked on in amazement, the dog stood on his hind legs, put his
front paws on the examination table and sniffed the duck from top to bottom. He then looked up at the vet with sad eyes and shook his head.
The vet patted the dog on the head and took it out of the room. A few minutes later he returned with a
cat. The cat jumped on the table and also delicately sniffed the bird from head to foot. The cat sat back on its haunches, shook its head, meowed softly and strolled out of the room.
The vet looked at the woman and said, "I'm sorry, but as I said, this is most definitely, 100% certifiably, a dead duck." The vet turned to his computer terminal, hit a few keys and produced a bill, which he handed to the woman. The duck's owner, still in shock, took the bill. "$150!" she cried, "$150 just to tell me my duck is dead!"
The vet shrugged, "I'm sorry. If you had just taken my word for it, the bill would have been $20, but with the Lab Report and the Cat Scan, it's now $150."
quote:
The customer service person said for me to wait for the claim to get denied and then when they send me a bill to then provide the correct insurance information. Gah!
I'll be dealing with this 2015 claim well in to 2016, I think.
The provider has a deadline to file the claim. I would recommend you call again until they get your insurance billed correctly. I know it's a hassle and shouldn't be this way but they might say you provided the incorrect insurance and try to bill you in the end. If they file to the correct insurance after the deadline they do not get paid unless you pay them.
Good for you for being on top of it and checking the status online.
A lot of people were discussing a certain OBGYN at Advanced OBGYN and his history of "poor" work relationships.
Well, this thread and those concerns regarding the billing and management branch of The Med is why he left and why he was so upset.
This isn't shocking to me in the least because we had some issues when we had our first child there two years ago. Took almost a year and a half of haggling over what we payed and us telling them they were wrong. 1 1/2 years later we received a refund check from them stating they had done an audit and we were owed some money. Well, yeah we knew we did and it took you that long to figure it out. Not run very well at all in the billing department.
Well, this thread and those concerns regarding the billing and management branch of The Med is why he left and why he was so upset.
This isn't shocking to me in the least because we had some issues when we had our first child there two years ago. Took almost a year and a half of haggling over what we payed and us telling them they were wrong. 1 1/2 years later we received a refund check from them stating they had done an audit and we were owed some money. Well, yeah we knew we did and it took you that long to figure it out. Not run very well at all in the billing department.
I went to the MED ER back in October. Bill was just under $1400 (about $700 each for DR and facility bills) for blood sugar to be checked and EKG. Spent about 15 minutes there. When I had a little accident and sliced my finger open, I was headed to an ER but before I got there, the bleeding was under control and I decided I couldn't afford the cost right now, turned around, and called a physician I know and asked if they could come over and give me their opinion as to whether I needed stitches. I find it incredibly sad that I pay $608/month for insurance but when I think I'm having an emergency, I have to rethink my decision to seek medical care because I can't afford the cost.
The cost for me to have a baby delivered at the MED and St. Joes was about the same...the only difference is I had twins at the MED and there is a 4 year gap in services. My insurance is a little better than it was when I had my singleton.
The cost for me to have a baby delivered at the MED and St. Joes was about the same...the only difference is I had twins at the MED and there is a 4 year gap in services. My insurance is a little better than it was when I had my singleton.
The rates hospitals bill is what is absurd. Three years ago my wife was bit by a Copperhead. Minor bite, the hit and run defensive mechanism they employ. Anyway we raced to the Med ER where she was admitted initially for monitoring before eventually being given one treatment of anti-venom. She was there about 36 hours total.
The total bill was $63K. The anti-venom was $44K. The insurance adjustments brought it down to $2800 overall and $2200 for the anti-venom. We'd already met her deductible that year so we paid $58. It's really quite ridiculous for the insured price to be <5% of the total bill. That tells me that in medical language the word "bill" is short for bull feces. What really ticked me off is the realization that sans insurance I would have tried to negotiate and might have been happy to pay "only" $28,000 when the going rate was actually $2800. That told me the system is broken beyond repair.
To be clear I don't have a solution though I'm 100% confident it can be found with more government. They fix everything. Sorry, wrong forum.
The total bill was $63K. The anti-venom was $44K. The insurance adjustments brought it down to $2800 overall and $2200 for the anti-venom. We'd already met her deductible that year so we paid $58. It's really quite ridiculous for the insured price to be <5% of the total bill. That tells me that in medical language the word "bill" is short for bull feces. What really ticked me off is the realization that sans insurance I would have tried to negotiate and might have been happy to pay "only" $28,000 when the going rate was actually $2800. That told me the system is broken beyond repair.
To be clear I don't have a solution though I'm 100% confident it can be found with more government. They fix everything. Sorry, wrong forum.
HAH lab test ! cat scan ! love it ! love it !
Update on my original post. Total pre-paid amount on our end was $2,200...which was split 3 ways between The Med (facilities), Surgeon and Anesthesiologist. The Med's cut was $800 which they somehow managed to balloon to $24k. As of this morning they have corrected the error on their end and our account balance is zero.
That is awesome jmazz. If I give you my patient account number, can you get mine worked out too? I mean, while you are on a roll and all. Ugh. I hate medical billing crap.
^ Sure. But I'll have to charge a 10% negotiation fee.
I'll gladly pay you 10% of my bills as a negotiator fee if you can get them down to $0. I've tried to "settle" but was told they would only take off 10% if I paid in full. So...I have several payment plans with them.
I'm hoping the government will give me my money back next month in the form of a tax return so that I can turn around and pay off the medical bills.
I'm hoping the government will give me my money back next month in the form of a tax return so that I can turn around and pay off the medical bills.
A ponderous question:
The hospitals bill these large amounts. The inscos have a negotiated amount. Do the hospitals and/or inscos then use the difference as a write-off, thereby reducing their tax load?
The hospitals bill these large amounts. The inscos have a negotiated amount. Do the hospitals and/or inscos then use the difference as a write-off, thereby reducing their tax load?
quote:
A ponderous question:
The hospitals bill these large amounts. The inscos have a negotiated amount. Do the hospitals and/or inscos then use the difference as a write-off, thereby reducing their tax load?
No
The hospitals bill large amounts because the insurance companies pay on something called "reasonable and customary" amounts, which is less than what is billed. If the local hospitals all start charging more and more, they can push up the reasonable and customary amount for a particular procedure.
Basically, the hospitals all know that they will only get a percentage of what they bill so they push the billed number up as high as they can --- so they get a percentage of a larger number. If you, your parents or grandparents have medicare, take a look at a couple of their Explanations of Benefits. It is shocking. The bill might be for $150 office visit, for example. Medicare will cut it down to something like $25. I'm not kidding. A hospital stay might be $3,000 and Medicare pays $180. It is crazy. It is all crazy.
Basically, the hospitals all know that they will only get a percentage of what they bill so they push the billed number up as high as they can --- so they get a percentage of a larger number. If you, your parents or grandparents have medicare, take a look at a couple of their Explanations of Benefits. It is shocking. The bill might be for $150 office visit, for example. Medicare will cut it down to something like $25. I'm not kidding. A hospital stay might be $3,000 and Medicare pays $180. It is crazy. It is all crazy.
At least unpaid medical bills don't affect your credit rating as much anymore.
http://www.forbes.com/sites/christinalamontagne/2014/08/26/medical-debts-will-soon-weigh-less-on-your-credit-score-but-theyre-still-a-problem/
http://www.forbes.com/sites/christinalamontagne/2014/08/26/medical-debts-will-soon-weigh-less-on-your-credit-score-but-theyre-still-a-problem/
If you think the Med is bad, try battling out a billing error with Scott and White
quote:Don't be so cheap! I would gladly pay 1000% of zero,
I'll gladly pay you 10% of my bills as a negotiator fee if you can get them down to $0.
The Med will sue you in a heartbeat! I had something done I paid my co-pay and my insurance paid the other $32,000.00. Now they are saying I still owe $1000.00. They took me to court. Lost and they are appealing it.
Was it the med or the collection agency thay went to court? The reason I ask is that in my experience they send it to a collection agency shockingly fast...so fast that I actually got a call from the collections people within a month of being seen. Not a big deal but annoying. I love the medical care they provide, but the billing is sadly the same as every where else
quote:Lol. I am money conscious.quote:Don't be so cheap! I would gladly pay 1000% of zero,
I'll gladly pay you 10% of my bills as a negotiator fee if you can get them down to $0.
My college aged daughter went to the Med ER one night and we got the full bill (not much $2500) despite the fact that she gave them her insurance information. I called and told them to bill the insurance (after she had to call to authorize me to discuss it) and they said ok. Finally got an EOB 2-3 months later-- insurance paid $50 haha.
Talk about a markup.
This was the only medical experience I've ever had that I had to actually tell them to bill the insurance, shouldn't that be step # 1?
Talk about a markup.
This was the only medical experience I've ever had that I had to actually tell them to bill the insurance, shouldn't that be step # 1?
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