Hey all.

Have a very strange situation on my hands and wondering what you would recommend.

About a year ago, my wife had a very bad wrist break. She had to have surgery and we've mostly paid all the bills.

Today, I received a bill from a hospital in El Paso (we're in Dallas) saying that we have a bill that is very overdue. They're threatening to send to collections in 10 days if unpaid....it's only $100, so not a big deal, but...

1) No indication is given what the bill is for...no service date, location, etc.
2) We've paid everything we've previously received and certainly would have paid one this small (comparatively) immediately
3) They won't answer the phone. I've called about 5 times today - the first time it went to voicemail, which is full and won't let me leave a message, and then a receptionist who told me their billing dept. wasn't open yet. Since then, the billing dept still won't answer and now, when it rolls to the receptionist (after saying the voice mailbox is full), they don't answer either.

From reading reviews online, this place seems to be almost impossible to get in contact with.

So that leaves me with a few options as far as I can tell....

1) I don't do anything and end up having to hassle with collections over $100 charge which is a headache...especially since I have ZERO problem paying if it is really for the services rendered to my wife last fall.
2) I pay online, and assume it is legit
3) I send in a check, and assume it is legit

If I knew it was a valid charge AND I knew that #2 or #3 would take care of it, I'd do it immediately.

My concern is if I pay $100 and they just send another letter or hand it over. If they can't manage to handle phone calls, I have suspicions about their handling of online/mailed bill pays.

Any thoughts? I left a note in their online "contact us" portal, but *surprise* I haven't heard back yet.

I finally had somebody answer and take my information - they said they sent out a bunch of erroneous bills and they're working to correct it. They're supposed to call me on Monday...we'll see.

Sounds shady af. Did you compare it against your insurance explanation of benefits to see if there's a corresponding amount?

Bogus. Don't pay a dime.

Okay - it wasn't from her surgery, but I did find it...from last October, looks like it was labwork.

I guess it is legit, so we'll see.

2wealfth Man said:

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There is literally no accountability in the healthcare system from a patient's perspective anymore. Example, how are you supposed to know if a doc/practice group in the hospital you are in is not on your insurance plan even thought the hospital may be. Seen some pretty significant uncovered expenses this way. Also, the whole emergency clinic system is wacky; they say they charge-in network but in reality it may still not be covered if they are not a part of your plan.

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Don't get me started.

We had a high deductible plan and ended up paying WELL over our out of pocket max because of folks coming into our IN-NETWORK hospital to "assist" our IN-NETWORK doc who aren't in any networks. It could have been much worse, but insurance covered some of it for us.

They must bill you within 11 months of the date of service or else they are barred from collections.

See Texas CPRC 146.002

The Wonderer said:

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They must bill you within 11 months of the date of service or else they are barred from collections.

See Texas CPRC 146.002

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Does that hold up if they make claims about having the wrong address on file? I'm assuming that is what they'll say.

I'll dig into the code though - THANK YOU!

JDCAG (NOT Colin) said:

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The Wonderer said:

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They must bill you within 11 months of the date of service or else they are barred from collections.

See Texas CPRC 146.002

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Does that hold up if they make claims about having the wrong address on file? I'm assuming that is what they'll say.

I'll dig into the code though - THANK YOU!

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See CRPC 146.002(d)

Quote:

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For purposes of this section, the date of billing is the date on which the health care service provider's bill is:
(1) mailed to the patient or responsible person, postage prepaid, at the address of the patient or responsible person as shown on the health care service provider's records; or
(2) mailed or otherwise submitted to the issuer of the health benefit plan or third party payor as required by the health benefit plan or third party payor.

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I got a bill from one of those urgent care centers a few months ago. I had paid up front and signed something at the time saying the max charge was what I paid. When I called to ask how to read the bill that didn't even foot and for an explanation of what I was being charged, they said it was an erroneous bill and not to worry about it. How many people pay those? Maybe I'm just a cynic, but I am almost certain the business model includes getting paid for things on these bogus bills they send out.

Stay on top of those 'already paid cash bills'. The lady on the phone will say, "oops, we made a mistake - you are paid in full. ignore the bill".

But about six months later, that same bill will be turned over to creditors. Hospital just never fixes their mistake. After a certain period, it goes to collection agency. Then you deal with their nonsense. Eventually, you'll deal with the hickey on your credit report.

Paid $289.64 to a hospital for a procedure back in December. Got a refund check a few months later - thought that maybe the insurance had paid some additional in the interim and it was a refund.

I called the hospital and they confirmed I had the correct account number, patient, and date of service. As it turns out, we had been to that hospital with my son a few years ago and they applied the payment from my HSA to the wrong account (a paid in full account for my son). I confirmed the account number again and requested the HSA check again with a brand new payee while I was on the phone with them.

Fast forward a few weeks later and I get yet another refund check and a letter that my account was being sent to collections. They went through the notes and confirmed they had again applied it to the wrong account. I told them I would not cash the check (I'd even return it to them) and they could just transfer the payment to a different account - both of which I was listed as the responsible party. No dice - everywhere I turned "We can't do that" was the standard response.

I ended up having to deposit the second check and pay them over the phone (with a service charge, no less) to get it all settled.

What a mess.

Thriller said:

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Paid $289.64 to a hospital for a procedure back in December. Got a refund check a few months later - thought that maybe the insurance had paid some additional in the interim and it was a refund.

I called the hospital and they confirmed I had the correct account number, patient, and date of service. As it turns out, we had been to that hospital with my son a few years ago and they applied the payment from my HSA to the wrong account (a paid in full account for my son). I confirmed the account number again and requested the HSA check again with a brand new payee while I was on the phone with them.

Fast forward a few weeks later and I get yet another refund check and a letter that my account was being sent to collections. They went through the notes and confirmed they had again applied it to the wrong account. I told them I would not cash the check (I'd even return it to them) and they could just transfer the payment to a different account - both of which I was listed as the responsible party. No dice - everywhere I turned "We can't do that" was the standard response.

I ended up having to deposit the second check and pay them over the phone (with a service charge, no less) to get it all settled.

What a mess.

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most likely dictated by their billing program and not a policy in place.

Probably, but that was just one example of what they could't do throughout the process. Working with hospital billing departments is second only to cable companies in my opinion.

Thriller said:

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Probably, but that was just one example of what they could't do throughout the process. Working with hospital billing departments is second only to cable companies in my opinion.

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One of the downsides of a highly regulated industry.

I've posted a few times on TA...don't pay. Request a full itemized bill. Challenge want you feel is incorrect.
Offer a settlement amount. It is so messed up play the game.

The whole hospital/insurance business seems scammy.

With my first kid's birth, I kept getting bills in the mail and I kept paying them on time. A lot of bills, I didn't know which was which but I kept paying. I felt like I had been taken for a ride by the hospital and the insurance co.

So for Kid No 2, I didn't pay. I got bills, I did not pay. Interestingly the bill amount kept reducing! So if it was $3000, then it became $2000, and became $1000 over time. I just did not pay. A point came when it did not reduce and I got a letter threatening collections, that is when I paid up.

Felt much better that I did not get scammed this time. My feeling is that these hospitals just make a bill and charge the patient and the insurance company at the same time. They get paid by the insurance, and many times by the patient. So they owe the patient a refund but DO NOT DO IT on their own. If you claim it, they would refund and that hardly happens unless you are diligent.

So they play on this and make extra money. If you sue they say it's your fault that you did not claim it.

For this case, why are you not getting the bill from the hospital? Talk to them and ask who these $100 people are.

Thriller said:

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Paid $289.64 to a hospital for a procedure back in December. Got a refund check a few months later - thought that maybe the insurance had paid some additional in the interim and it was a refund.

I called the hospital and they confirmed I had the correct account number, patient, and date of service. As it turns out, we had been to that hospital with my son a few years ago and they applied the payment from my HSA to the wrong account (a paid in full account for my son). I confirmed the account number again and requested the HSA check again with a brand new payee while I was on the phone with them.

Fast forward a few weeks later and I get yet another refund check and a letter that my account was being sent to collections. They went through the notes and confirmed they had again applied it to the wrong account. I told them I would not cash the check (I'd even return it to them) and they could just transfer the payment to a different account - both of which I was listed as the responsible party. No dice - everywhere I turned "We can't do that" was the standard response.

I ended up having to deposit the second check and pay them over the phone (with a service charge, no less) to get it all settled.

What a mess.

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Shocking that this happens in America. This is usually a 3rd world problem

BombayAg said:

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The whole hospital/insurance business seems scammy.

With my first kid's birth, I kept getting bills in the mail and I kept paying them on time. A lot of bills, I didn't know which was which but I kept paying. I felt like I had been taken for a ride by the hospital and the insurance co.

So for Kid No 2, I didn't pay. I got bills, I did not pay. Interestingly the bill amount kept reducing! So if it was $3000, then it became $2000, and became $1000 over time. I just did not pay. A point came when it did not reduce and I got a letter threatening collections, that is when I paid up.

Felt much better that I did not get scammed this time. My feeling is that these hospitals just make a bill and charge the patient and the insurance company at the same time. They get paid by the insurance, and many times by the patient. So they owe the patient a refund but DO NOT DO IT on their own. If you claim it, they would refund and that hardly happens unless you are diligent.

So they play on this and make extra money. If you sue they say it's your fault that you did not claim it.

For this case, why are you not getting the bill from the hospital? Talk to them and ask who these $100 people are.

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This is illegal. Typically the following occurs for patients with insurance:

• Bill utilizing CPT codes is generated from the chargemaster and submitted to insurance company
• Copy of bill sent to patient
• EOB for patient sent to patient by insurance company showing what they are covering
• Payment sent by insurance company to hospital for contractual rates
• Payments applied and posted
• New bill reflecting payments generated and sent to patient (if hospital practices balance billing)
• Patient pays remainder of bill or negotiates a payment with hospital
• Payment made

Hate to say it, but it is not just the system but the people working for these places as well. Dated a girl that worked in a doctors office and got told numerous horror stories about her fellow coworkers that are making $10 - 15 an hour that have little to no care for patients and the system. They're just there to collect a paycheck. If they mess up your account, do not send out referrals, forget to tell you the patient that your insurance is not accepted by the doc until after your visit and you get a nice bill in the mail, etc., it doesn't matter to them. The system is bad but so are most of the underlings who are doing the day to day. It's not like that everywhere of course but it makes me hesitant to ever set foot in a doctors office unfortunately.

This exact same thing happened to me about a year or two ago after I had my annual physical. They sent me a bill for $100 for lab work even though my PPO covers a physical every year. It was discovered, after numerous calls between me and the lab, that they inputted it into their system and subsequently sent the bill to the carrier with the wrong diagnosis code. Rather than submitting it as a physical, they submitted it as tests for legionaries disease.

Their customer service guy that I spoke with asked me to help HIM file the damn claim properly. I ended up telling him to figure it out and that I'm not paying for their ineptitude. I never heard from them again.

We were away from home when by daughter developed some abscess on her cheek. They did a CAT scan, which showed it wasn't something more serious and gave us some antibiotics that seemed to help. Get a bill in the mail from the hospital for over $6000. I check market rates for this and their price was ridiculous, but I was still willing to pay 3 or 4 times what the market rate was. However, when I called to negotiate a more reasonable fee, they said it is there policy that they do not negotiate. I said well then that's my policy too and hung up. Haven't heard anything back from them in about a year.