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Get my pies
outta the oven!

Picture of PASig
posted
WTAF is this absolute bullshit? Mad

8 months ago our little girl fell down some stairs and got a buckle fracture on her arm. We received numerous bills which we promptly paid as we received them and thought this matter was over, in fact the last bill I paid I asked if we were all settled up and the woman said “yes“. We have a shitty Aetna HDHP with HSA from my employer and it’s been horrible. Thanks Obama, for what you did and making everyone rush into a HDHP, you piece of shit.

So yesterday a bill arrives in the mail from this hospital for $3200 friggen dollars they say we owe them.

Nope. I’m not paying another goddamn cent to you, you can’t keep “finding” shit to bill people for.

I’ll spend $3200 on a lawyer to fight this just out of principle before I give them another dime.

Our medical/insurance/billing is so fucking broken. Mad


 
Posts: 30250 | Location: Pennsylvania | Registered: November 12, 2007Reply With QuoteReport This Post
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posted Hide Post
Same thing happened to me! Got a bill just over a year after treatment. And my insurance wouldn't pay it, because they cut off reimbursement at a year. I raised hell but no joy. The usual excuses were trotted out:
COVID slowed billing.
Understaffed.
Providers were slow to provide info for billing. All BS! Mad


End of Earth: 2 Miles
Upper Peninsula: 4 Miles
 
Posts: 13703 | Location: Marquette MI | Registered: July 08, 2014Reply With QuoteReport This Post
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posted Hide Post
I received the Covid Antibody infusion in Oct 21
said it was govt paid if I had no insurance, since I have health insurance, the approx. $2500 charge will need to be paid by me, my deductible is $5000 so I know I am on the hook to pay for it. 8 months later I still have not received a bill for it.
I am not going to call and say send me the bill and the longer it takes the less I want to pay it.
 
Posts: 236 | Location: Kansas | Registered: August 28, 2020Reply With QuoteReport This Post
Gone but Together Again.
Dad & Uncle
Picture of h2oys
posted Hide Post
PASig, was the hospital considered "in-network" by your medical carrier Aetna?

If yes, you should have; 1) balance billing protection, 2) network discount, 3) network contractual protection, 4) pre-cert protection.

The 3rd point is in-network providers only have a certain timeframe to file a claim. If the provider does not file in time, the provider has to eat the bill and can't balance bill you.

Naturally they can send you a bill to try to collect but you wouldn't be under any obligation to pay it.

Call your carrier and ask about the above.
 
Posts: 3163 | Location: St. Louis, MO | Registered: November 24, 2009Reply With QuoteReport This Post
Get my pies
outta the oven!

Picture of PASig
posted Hide Post
quote:
Originally posted by h2oys:
PASig, was the hospital considered "in-network" by your medical carrier Aetna?

If yes, you should have; 1) balance billing protection, 2) network discount, 3) network contractual protection, 4) pre-cert protection.

The 3rd point is in-network providers only have a certain timeframe to file a claim. If the provider does not file in time, the provider has to eat the bill and can't balance bill you.

Naturally they can send you a bill to try to collect but you wouldn't be under any obligation to pay it.

Call your carrier and ask about the above.


Yes, in-network

And I suspect this hospital is trying to pull a fast one so I can help pay for the numerous illegals who come there for free, the area it's located is near a large community of them.


 
Posts: 30250 | Location: Pennsylvania | Registered: November 12, 2007Reply With QuoteReport This Post
Gone but Together Again.
Dad & Uncle
Picture of h2oys
posted Hide Post
^^^ That and possibly trying to get you to pay the bill after they "screwed up" and couldn't collect payment from Aetna.
 
Posts: 3163 | Location: St. Louis, MO | Registered: November 24, 2009Reply With QuoteReport This Post
Eye on the
Silver Lining
posted Hide Post
Where is ZSMichael? This is his jam. They do it to me ALL.THE.TIME.
I also call and complain to BOTH the billing facility AND my insurance company. There is something called timely filing and believe me you insurance companies make providers toe that line.
6 months is the most for private ins, usually more like 3-4 months, and Medicaid and Medicare still give a year, at least in my state. Call and check the timely filing limit for your ins for your state.
If they re-processed due to billing error there may be some grace but eight months is pushing it.


__________________________

"Trust, but verify."
 
Posts: 4692 | Registered: October 24, 2005Reply With QuoteReport This Post
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posted Hide Post
Timely filing is typically one year from date of service. After that you better have a good excuse.
The hospital must provide a detailed explanation of the charges.
 
Posts: 13129 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
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More details would help. Sometimes the ER is contracted out to another corporation like TeamHealth who are almost always out of network. There has also been some recent legislation regarding surprise billing. You can look up the particulars.

On a recent ER visit I was billed for a self administered medication. It was 40 dollars. It would have been covered if a nurse administered it. It was for 800mg Ibuprofen. They took it off.
 
Posts: 13129 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
His Royal Hiney
Picture of Rey HRH
posted Hide Post
That sucks big time.

Even though I started a practice of downloading EOB’s from my insurance company, it’s a bear to match it with the invoice when you get several invoices and EOBs on the same service date. And I don’t put it past the billing department to send you an invoice for something you don’t have to pay.



"It did not really matter what we expected from life, but rather what life expected from us. We needed to stop asking about the meaning of life, and instead to think of ourselves as those who were being questioned by life – daily and hourly. Our answer must consist not in talk and meditation, but in right action and in right conduct. Life ultimately means taking the responsibility to find the right answer to its problems and to fulfill the tasks which it constantly sets for each individual." Viktor Frankl, Man's Search for Meaning, 1946.
 
Posts: 17708 | Location: The Free State of Arizona - Ditat Deus | Registered: March 24, 2011Reply With QuoteReport This Post
Drill Here, Drill Now
Picture of tatortodd
posted Hide Post
quote:
Originally posted by h2oys:
^^^ That and possibly trying to get you to pay the bill after they "screwed up" and couldn't collect payment from Aetna.
^^ THIS ^^

I think the OP should call Aetna and find out the exact time limit for his coverage.

I have Aetna and about 18 months ago somebody decided to bill me 7 or 8 months after the date of service. Like the OP, it was an ER visit and everybody is an independent contractor (a separate rant) so many, many bills were sent within a couple weeks. I was pretty surprised since I had paid everything a long time ago. I made 2 calls:
  • Aetna to find out their contract length. I can't remember the exact answer but the provider was too late.
  • The provider. They fessed up that billing me was a last ditch effort to not eat their screw up.



    Ego is the anesthesia that deadens the pain of stupidity

    DISCLAIMER: These are the author's own personal views and do not represent the views of the author's employer.
  •  
    Posts: 20974 | Location: N. Houston, TX | Registered: November 14, 2005Reply With QuoteReport This Post
    Member
    posted Hide Post
    Guess PAsig solved the problem.
     
    Posts: 13129 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
    Member
    Picture of rtquig
    posted Hide Post
    Two years ago I received a bill from the hospital for my then 20 year old daughter. The charge they were trying to collect happened when she was 8 years old. When she was that age both my wife and I had very good medical policies. What one plan didn't pay the other one payed the deduct.
    The bill went right into the garbage. Didn't call them, never heard again from them.


    Living the Dream
     
    Posts: 3826 | Location: New Jersey | Registered: December 06, 2010Reply With QuoteReport This Post
    Get my pies
    outta the oven!

    Picture of PASig
    posted Hide Post
    quote:
    Originally posted by ZSMICHAEL:
    Guess PAsig solved the problem.


    I'm still trying to resolve it.

    Got on a chat with Aetna who contacted the hospital, sounds like they screwed up and want me to eat their screwup. NOPE. I still think they saw that we paid all the claims prior and are trying to get more $$$ out of us. Screw YOU, Grand View Hospital! Roll Eyes

    This was Aetna:

    (the accident happened on 9/26/21)

    quote:

    I spoke to Barb in the billing department. She confirmed the initial claim submitted was in the amount of $5,556. Your patient responsibility was $644.25, which is the amount applied to your deductible.

    They found that not all charges were included in the original claim. They added the charges and submitted a corrected claim in the amount of $13,056. Which is the claim that was submitted in May.


     
    Posts: 30250 | Location: Pennsylvania | Registered: November 12, 2007Reply With QuoteReport This Post
    Member
    posted Hide Post
    Just a tip. Keep notes of who you spoke to and what time. The hospital should have sent the charges directly to Aetna and not you. Insurance companies and Hospital systems are slow to work these things out. The adjustments department works only on alternate Tuesdays and is contracted out to the Indian subcontinent. JK
     
    Posts: 13129 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
    Member
    Picture of sourdough44
    posted Hide Post
    We had this years ago. Our newborn spent a few days in the ICU. It was 3 or so days, total bill was $8-10k as I recall.

    A year later we get a bill for at least another grand, from CA. I was pissed & called hospital billing. They said here’s the deal, a 3rd party takes the bill, looks to see where charges can be added, 1/4 hour nurse time here, medical supplies there, & so forth. If the new bill is paid, that 3rd party takes a healthy cut, 1/3 or so. If the bill isn’t paid, it eventually goes away.

    I then called the insurance company & told them to ignore it. It was never paid.
     
    Posts: 5402 | Location: WI | Registered: February 29, 2012Reply With QuoteReport This Post
    Member
    posted Hide Post
    quote:
    Originally posted by PASig:
    quote:
    Originally posted by ZSMICHAEL:
    Guess PAsig solved the problem.


    I'm still trying to resolve it.

    Got on a chat with Aetna who contacted the hospital, sounds like they screwed up and want me to eat their screwup. NOPE. I still think they saw that we paid all the claims prior and are trying to get more $$$ out of us. Screw YOU, Grand View Hospital! Roll Eyes

    This was Aetna:

    (the accident happened on 9/26/21)

    quote:

    I spoke to Barb in the billing department. She confirmed the initial claim submitted was in the amount of $5,556. Your patient responsibility was $644.25, which is the amount applied to your deductible.

    They found that not all charges were included in the original claim. They added the charges and submitted a corrected claim in the amount of $13,056. Which is the claim that was submitted in May.


    Labcorp (Tucson) tried to pull that shit on me.

    Made me sign a paper that would require me to pay for blood work IF they screwed up the paperwork to Insurance carrier, which is what they did, then tried to bill me.

    I told them to eat a bag of dicks, or words to that effect.


    *********
    "We have what it takes to take what you got" - The IRS.
     
    Posts: 8045 | Location: Arizona | Registered: August 17, 2008Reply With QuoteReport This Post
    Little ray
    of sunshine
    Picture of jhe888
    posted Hide Post
    quote:
    Originally posted by PASig:

    And I suspect this hospital is trying to pull a fast one so I can help pay for the numerous illegals who come there for free, the area it's located is near a large community of them.


    It isn't anything more complicated than greed and trying to extract as much money out of you as possible. You do not need to resort to plots about illegal aliens to explain this.

    They would send you this bill if there were no illegal aliens within one thousand miles of you.




    The fish is mute, expressionless. The fish doesn't think because the fish knows everything.
     
    Posts: 51477 | Location: Texas | Registered: February 10, 2004Reply With QuoteReport This Post
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    posted Hide Post
    ^^^^^^^^^^^^^^
    But the letter was signed Juan pay my bill.
     
    Posts: 13129 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
    Get my pies
    outta the oven!

    Picture of PASig
    posted Hide Post
    I filed an appeal.

    The hospital "found" that they "undercharged" us $7,500 in May 2022, 8 months after we thought we were all settled up. I could see maybe a month or two, but 8 months later?

    C'mon now with that BS Roll Eyes

    If I take my car to my mechanic for new brakes in September 2021 and pay him $300, he's not going to try and bill me another $1000 8 months later in June 2022 and get away with it.


     
    Posts: 30250 | Location: Pennsylvania | Registered: November 12, 2007Reply With QuoteReport This Post
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