WTAF is this absolute bullshit?

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.

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!

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.

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.

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.

^^^ That and possibly trying to get you to pay the bill after they "screwed up" and couldn't collect payment from Aetna.

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.

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.

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.

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.

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.

Guess PAsig solved the problem.

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.

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!

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.

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

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.

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!

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.

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.

^^^^^^^^^^^^^^
But the letter was signed Juan pay my bill.

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

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.