$479 For a simple Doctor’s Appointment?

[jyoutz]

Do Not pay that $2,800 bill.
First: Fight the insurance company about the denial! Enlist the written support of the Dr.
After that: Stall...Stall...Stall...,for many months.
Then tell the hospital that you are willing to negotiate,..... and offer a MUCH lower total payment!

They just send the bill to collections after awhile if you don’t pay.

 

[jyoutz]

Yeah like 45 years younger lol. I'm not worried about credit in the least, and I've never heard of a hospital actually going to collections, but we'll see what's going to happen. I'm not just about to hand over the money.

I had a doctors office send a bill to collections last year for $100. Turns out they had the wrong address for me and kept sending out bills monthly, and of course I never received them. But they sent a $100 billing to collections.

 

[coast40]

The new dentist being 6'6" and haveing John Seana hands its much different.

I changed dentists when Herman Munster bought the practice. I'm happier with Steve Martin.

 

[Bmyers]

Law requires U.S. hospitals to post prices. Guess who is footing the bills.

Hospitals must list the cash prices for services like X-rays or medical tests online, according to federal law. A new study finds the rule is largely ignored.

www.nbcnews.com

Above is an article I read yesterday about hospitals not following the Federal Law that requires them to post prices. So, I went online and checked a couple of the local hospitals and the had prices. If you needed hernia surgery, the ranged the price from $21,000-$75,000 and stated with insurance the price may vary.

Just think if your car dealer or your house builder would do the same.

I would like to build a three bedroom, two bath, etc. house and the price?

Builder-it will be between $50,000 and $500,000, once we are done building it we will let you know.

Yes, there are variables in medical procedures, you may suffer a heart attack, etc. yet, the 'normal' procedure doesn't vary that much from person to person that the medical system couldn't be more honest about their pricing.

 

[TheOldHokie]

Law requires U.S. hospitals to post prices. Guess who is footing the bills.

Hospitals must list the cash prices for services like X-rays or medical tests online, according to federal law. A new study finds the rule is largely ignored.

www.nbcnews.com

Above is an article I read yesterday about hospitals not following the Federal Law that requires them to post prices. So, I went online and checked a couple of the local hospitals and the had prices. If you needed hernia surgery, the ranged the price from $21,000-$75,000 and stated with insurance the price may vary.

Just think if your car dealer or your house builder would do the same.

I would like to build a three bedroom, two bath, etc. house and the price?

Builder-it will be between $50,000 and $500,000, once we are done building it we will let you know.

Yes, there are variables in medical procedures, you may suffer a heart attack, etc. yet, the 'normal' procedure doesn't vary that much from person to person that the medical system couldn't be more honest about their pricing.

That is the situation in a nutshell. You basically write the providers a blank check when you authorize treatment. Health insurance limits your exposure a bit by virtue of the fact the insurers have negotiated reimbursement rates for the procedures but you still have no control over what procedures are subsequently performed, billed, and then approved or denied by the insurer(s) after the fact. Its an insane system.

Dan

 

[Henro]

That is the situation in a nutshell. You basically write the providers a blank check when you authorize treatment. Health insurance limits your exposure a bit by virtue of the fact the insurers have negotiated reimbursement rates for the procedures but you still have no control over what procedures are subsequently performed, billed, and then approved or denied by the insurer(s) after the fact. Its an insane system.

Dan

Reaching the age to get medicare is a dividing line.

With Medicare, you know the charge you get for a service will be lower than it would otherwise. Great protection there.

With Medicare, the provider MUST advise you if Medicare is unlikely to, or will not, pay for a service offered. This is done using an ABN form, which is an advanced notification of benefits not likely to be paid for, or something like that. They use different words I am sure.

Bottom line is IF the provider does not get you to sigh an ABN form for a service provided, you are off the hook. The service if denied by Medicare, cannot be charged to you.

Sometimes a service is denied by Medicare, simply because the provider codes it wrong in their submission for payment. I only know this because a few years ago I was talking with a guy, that has a small software company, that provides software to medical organizations related to Medicare billing.

He told me he went for a procedure, and the provider said it was not covered by Medicare. He told them to re code the procedure and submit it again. It was covered.

He also told me about the ABN form, and how important it is to understand what its purpose is. Sigh an ABN and you are on the hook for whatever the provider decides to charge you. Medicare is out of the picture, in so many words.

A couple years ago my wife was having an eye issue and visited a specialist. Afterwards we got a bill for something Medicare would not pay for. Wasn't much, maybe a hundred bucks or so. Anyway, I call about the bill, and talk with the billing department, and get to the point where I mention that we were never given an ABN form to sign, and did not realize the procedure would not be covered by Medicare. Woman said "No ABN?" Never hear anything further from them...

 

[Henro]

One other thing to keep in mind, with Medicare, is if you happen to go to the ER for something, and the doctor offers to keep you for a night for observation, that Medicare DOES NOT pay for observation in the hospital.

You MUST be admitted as a normal patient for treatment. If you are admitted for observation, it is your dime. I would imagine that the hospital gets you to sign an ABN form at that time, and that many people don't realize what they are signing, when it is mixed in with other papers shoved in your face at the same time.

Again with my wife, we had this come up. I discussed it with the doctor in the ER, and since we live 15 minutes from two good hospitals, he saw no problem with me observing the wife at home, and bringing her back if needed. Of course, it was not needed...But had she stayed in the hospital for "observation" we would have had a significant bill to pay.

I have not kept up to date on these things over the last couple years, but imagine nothing has changed, at least not for the better...

 

[Dieseldonato]

One other thing to keep in mind, with Medicare, is if you happen to go to the ER for something, and the doctor offers to keep you for a night for observation, that Medicare DOES NOT pay for observation in the hospital.

You MUST be admitted as a normal patient for treatment. If you are admitted for observation, it is your dime. I would imagine that the hospital gets you to sign an ABN form at that time, and that many people don't realize what they are signing, when it is mixed in with other papers shoved in your face at the same time.

Again with my wife, we had this come up. I discussed it with the doctor in the ER, and since we live 15 minutes from two good hospitals, he saw no problem with me observing the wife at home, and bringing her back if needed. Of course, it was not needed...But had she stayed in the hospital for "observation" we would have had a significant bill to pay.

I have not kept up to date on these things over the last couple years, but imagine nothing has changed, at least not for the better...

Most insurance won't pay for observation if your not admitted properly.