ULPT Request; Hospital trying to make me pay thousands despite not quoting me for a procedure after I asked and sending it to Debtors
Posted by MinimalThinkingToday@reddit | UnethicalLifeProTips | View on Reddit | 57 comments
How do I get out of this? I asked for a quote prior to the appointment and never received one, nor had paperwork given to me prior to my appointment and then I got a bill for almost 3k that they ran through my insurance that happened to be on file from a previous ER visit.
MamaSucculent@reddit
Threaten them with the No Surprises Act -- if they didn't provide a Good Faith Estimate prior to the service, they've violated federal law, and if they did provide one but the bill is $400 or more higher than the estimate, it's contestable under that same law.
MinimalThinkingToday@reddit (OP)
Thank you. I’ve been looking into also getting some sort of lawyer consultation. Everything I’ve been able to find so far says that this is for people without insurance, not necessarily people with insurance, is that true?
Terangela@reddit
No, it should cover you too. Source
deathbychips2@reddit
Your source says it's only for insurance patients when out of network care. Did a miss where OP said it was out of network?
Terangela@reddit
If it’s $3000 for a neurologist visit then it is very likely out of network.
MinimalThinkingToday@reddit (OP)
It was in network, they did charge my insurance
Terangela@reddit
Ok that changes things. You need to be asking your insurance why it denied coverage. Sorry, that sucks.
MinimalThinkingToday@reddit (OP)
No, they covered most of the procedure. My issue is I was never told they weren’t covering it all despite asking the hospital beforehand and then getting surprised with a bill of almost 3k. I was never advised the cost of procedure and was told not to worry about it upon asking the hospital secretary person and then received a bill months later but I also was never asked or made to sign any paperwork prior to it either
deathbychips2@reddit
Definitely more likely that it's in network and not covered since it is neurological. Bet my life that the insurance company finds it unnecessary.
MinimalThinkingToday@reddit (OP)
Thank you!
deathbychips2@reddit
Yes. It is only for self paid patients. No idea why you are being told otherwise. They had no obligation to give you this since it's almost impossible to 100% know what insurance will cover
MinimalThinkingToday@reddit (OP)
When you request a quote they’re supposed to give you one before the procedures, I know that much at least, and that works in general bc they’re supposed to get approval from the insurance to do the procedure I believe?
deathbychips2@reddit
Isn't this only for self pay patients and insurance patients do not have to be given this?
pittbiomed@reddit
Did you get the procedure and sign anything ?
MinimalThinkingToday@reddit (OP)
I did have the procedure done because when I asked on the appt day about it the guy at the desk told me “don’t worry about it.” I did not sigh any paperwork on the appointment day, and my primary care doctor was the one who sent in the work order.
Veioviz@reddit
If you're in America, you to have to have signed something before a major procedure is done authorizing it. Either on the day of the procedure, or previously. Hospitals and Doctors offices generally do not give out quotes. You're either getting the procedure or you aren't.
The fact is, you had the procedure done, period. As soon as you laid down on the gurney, your final consent for the procedure was implied (on top of whatever releases you signed previously).
It sounds like you just let the bill sit for 3-6months without doing anything to address it. Hospitals only send to collections after a period of time has lapsed. You dropped the ball several times and are now firmly in the 'Live and Learn' category.
There's no way of getting out of the responsibility for the bill. Your best bet is to try to work with the debtors.
OddAdhesiveness8485@reddit
Doctors have the duty of informed consent to the patient. That means holistic full understanding before moving forward. Not your archaic version, where if a patient lays down it means consent.
OP had legal rights to appeal that bill and a right to free attorney in many states. They probably purposely mislead him during his appeal time. Then sent it to collections so now there is nothing he can do.
I am very sorry this happened to you OP. It’s not uncommon. It’s not a lesson that’s needs to be learned because you didn’t make the mistake. You tried to do everything right and many people have walked your path. It’s not you, it’s this beast. The system is designed to make money off of people when they are at there most vulnerable and sometimes in no position to negotiate. Compliance and silence is violence.
MinimalThinkingToday@reddit (OP)
It was not a major procedure, it was a neurologist appointment to see what was wrong with me that lasted 15 minutes. I didn’t think it was necessary to add this to the info at the time since I’m doing this at work, but I called them several times over the past few months, the last time being two weeks ago, and was once again told that they were forwarding this to a supervisor. I did not “let the bill sit for 3-6 months.” I have been actively disputing this since they sent the bill over a month after my appointment.
Combatical@reddit
I'm going through a similar thing. Multiple times I've requested a break down of services charged but they've yet to do so. One of the people I spoke with even went so far as to say "well your insurance didnt pay for those services". I said yes and I would like to know what the services were.
My next step is to write up a request and send it certified to the hospitals administrator. I'll also jump on the phone and tell them I'm recording the conversation for my records. That way I have proof of requesting should I have to take this to the courts. Of which I cant really afford to do but I'm spiteful af, despite my own best interests.
MinimalThinkingToday@reddit (OP)
i’ll take that into consideration, thank you. I called my insurance last night after I got a message from the debt collectors and they’re trying to set up a three way call between us and the hospital but the whole thing is turning into a waste of time at this point. I’m finally back on my feet after being essentially homeless for almost 2 years only to repeatedly get kicked down by greedy hospitals.
Combatical@reddit
Dude I feel that so hard. As far as I know once its hit collections its out of the hospitals hands since they've sold the debt. I'm not 100% on that though. I'm in the red and about to be there but trying to nip it before it gets there.
MinimalThinkingToday@reddit (OP)
Thank you. I’m really hoping I don’t have to try and deal with that because I’ve told them numerous times about the issue and they keep telling me to just apply to it anyways, etc, but I don’t want to sign something that makes it all my responsibility when it never should have been, especially when I can’t afford to pay it and would’ve just canceled the appointment if I knew how much it would cost.
Combatical@reddit
I got separate bills from the docs I saw and the equipment that was used but I had qualms with the hospital charging me more than all those combined for just being in the building. It doesnt make sense.
pittbiomed@reddit
Normal standard operating procedure to charge a" facility fee" if getting thongs done at a drs office, especially of its a hospital
Combatical@reddit
Oh I'm well aware. Just I dont believe the fee should be 2600 over the services rendered. My hospital is a particularly rare case, its basically going through the process of being bought out because of its unwillingness to work with the local gov and is practically going bankrupt.
pittbiomed@reddit
How do you know the going rate for the services rendered? This is making less sense as it goes along. You got no info on costs for a procedure then say its 2600 more than it should be? Zero sense to me
Combatical@reddit
Friend, these are facility charges, facility charges are separate from the actual (service rendered) medical charge, service, MD review, pharmacy, IVs, medical equipment used (eg: CT scans, CT scan no dye, EKGS etc).
I used to do medical billing so I'm somewhat familiar with the phrase "reasonable and customary". This basically means "we made it up". You know whats interesting about those reasonable and customary charges? They're generally based on what they can get away with and arbitrarily raise those customary prices as time goes on to push squeeze what they can out of insurance. They're also top secret from a facility to facility standpoint and facilities guard those numbers with their life. Insurances will pay out more to certain facilities too.
I mentioned I got separate bills. I'm fine with paying everything that was done but the separate bill from the facility was 2600 over what was charged for what was actually done. A facility charge, 2600 for just walking in the building? Just because they have doctors in the building? I'd like a breakdown of what they're charging me for on that side of things.
Forgive me, perhaps I wasnt being thorough enough or maybe you're mixing my comments up with OP but I was talking to OP and not you.
pittbiomed@reddit
Yes, i know. 35 years in healthcare, thats status quo for facility charge. Know your insurance and what it covers and these issues wont be such a surprise
Combatical@reddit
Oh I heard the bias.. My insurance is quite decent. I'm gonna say a \~$6000 bill for walking into a facility and nothing more is a little absurd.
pittbiomed@reddit
But the issue is that you got a procedure that you decided to get done. Read the small print of your policy. Its amazing how many folks spend 1000s a year for healthcare and truly do not know about their policy.
Combatical@reddit
I think were forgetting I paid for the actual services and the doctors.
Also my case wasnt so much as an elected thing. I had an EKG done at a clinic related to the hopsital (free to me due to my employer) they sent me to the hospital. Hospital does their thing. I pay them because I respect what they do but then I get a bill from the hospital its self. I cant recall the wording on the bill. But it was basically a charge for a hospital visit.
Again and let me be clear, I paid the doctors, I paid the NP, I paid for the devices they used on me, I paid for the pharmacy side. The facility then sends me a bill for X. I ask what its for and I'm in the wrong?
Let me write it out like this..
Actual shit done: $X,XXX Paid in full
Random bill from facilty: $X,XXX
Me: "Whats this for?"
Hospital: Not a peep..
Do you see my quandary?
pittbiomed@reddit
No i do not. I already know im going to be billed for that facility charge since ive read my entire policy and understand what is involved . Good luck to you.
Combatical@reddit
Thanks for your valued input.
MinimalThinkingToday@reddit (OP)
The kicker is, they still couldn’t figure out what’s wrong with me and told me to “come back if it gets worse,” but also not offering any help aside from that and I had to ask around before I got even that as an answer.
Combatical@reddit
Story of every one of my visits. Starting to wonder why I pay for health insurance at all.
Its always, we dont know that'll be $2k
Veioviz@reddit
Depending on what state you live in, collectors generally have 30-60 days to furnish itemized bills upon written request. If they fail to do so, the 'bill' is no longer valid.
Might be something to google
pittbiomed@reddit
Yeah then since you made the appt and checked in then you assume financial responsibility for a office procedure.
Jim-Jones@reddit
First, read this. Library?
Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win by Marshall Allen. Be sure to read this BEFORE going to a hospital.
Also read up on RIP Medical Debt. They buy medical bills and cancel them for 1% of the total. Not a mistype, the real number. That's how little they will settle for!
hoefort0es@reddit
As a brit I don't think I can offer much other than trying a piss disk. For maximum effect, aparagus drink lots of beer and hardly any water the day prior.
MinimalThinkingToday@reddit (OP)
..what? Are you referring to a drug test? Because I’m a little confused and I am not being drug tested.
CatsAndBongs420@reddit
It's a running joke in this subreddit to use a piss disc which is a frozen piece of urine 😩 it's the solution to all the problems. Your fellow redditor was hoping to educate you on the most potent version of the piss. Asparagus is delicious and good for you but it sure makes things a little stinky.
Hope you can get this issue resolved with your bill.
Sheeshka49@reddit
Not everyone has the gene that turns your asparagus pee stinky. AND, there is a separate gene that allows you to smell that stink. Little known fact. Only 40% of people have the gene that allows them to smell it.
hoefort0es@reddit
I didn't know this! Thanks for sharing, will be more mindful for future piss disk operations 🫡
MinimalThinkingToday@reddit (OP)
oh lol, thank you for letting me know!
ImDisposableDan@reddit
Come to Australia. Houses are expensive but we'll help you pay for all your Health and Education stuff.
Probably more an Ethical Life Tip though. Sorry for being off brand for the sub.
MinimalThinkingToday@reddit (OP)
I appreciate the sentiment! If it wasn’t for all the crazy animals I see on the news, and the heat factor, I would probably take you up on that to be honest 😭
ImDisposableDan@reddit
The Animal thing we just say to make the English think they made the right decision to put the convicts here and keep the Queen there.
The heat will probably ruin your day at least a couple times a year though. That is a real thing.
unwittyusername42@reddit
So, has this already been sent to collections? That's makes a major difference. If it is not yet in collections, the other commentor regarding the No Surprises Act is the way to go.
If it's been sent to collections it's a totally different story. I had this happen when a few medical bills were in limbo because my insurer was claiming they were not the primary insurance because a system showed an old insurance plan as active despite it not being active. Medical provider was aware, continually updated about everything going on while I was fighting to get it sorted out and then they just sent it to collections.
Once it hits collections, you no longer can do anything about it with the hospital (unless the collections is really just an outsourced accounts receivable call center disguised as a collections place to get you to pay). Someone has purchased the debt and the hospital no longer owns it. In this case, for under $3k, you do absolutely nothing. You don't take the collections calls, you don't respond to them, you just ignore it. It will be on your credit report but it's not going to have a major effect and as it gets older the impact is smaller. They aren't going to take you to court for under $3k. Mine has a few months before the statute of limitations in in place and it falls completely off. They must have sold it again for a few pennies because I got one call and one letter from some other collections place and nothing else.
MinimalThinkingToday@reddit (OP)
It has been sent to collections. I did call them yesterday to tell them to stop trying to collect it as the hospital messed up and were supposed to be looking into this issue before they sent it to collections, and they did not tell me they were sending it out until I started receiving mail from the collections agency.
Is it too late to ignore the agency if they call me after this if the hospital doesn’t take it back? I plan on moving in a few months anyways and the number I have is originally from out of state.
unwittyusername42@reddit
It's never too late to ignore someone :) The one issue is that by saying that the hospital had been looking into it you have most likely admitted to owing the debt. It's best to not say anything or have any contact.
The hospital can't "take it back". They have sold it to a collections agency - the agency owns your debt now.
I personally would still ignore it. There is a small chance they take you to small claims court and you have to pay the money, court and lawyer fees and penalty interest. Even after admitting to owing the debt to the hospital it's still very unlikely they will actually do that. If they don't you just deal with a small ding on your credit (believe me it's pretty small) for a little and then it goes away. The only other option is to try and negotiate a lower payout to close the debt and include removing it from your credit report as part of that, but depending on the company and what they paid for it, it might be a tiny discount or a big discount.
MinimalThinkingToday@reddit (OP)
If it helps I told them that I did not owe the debt and that the hospital messed up because they didn’t quote me properly and that their supervisors were reviewing the case and it shouldn’t have gone to collections?
I’ll definitely keep this in mind in the future though, tysm! I’m in my early twenties and probably won’t be buying a house or car for a decade so I’m not super worried about the hit on my credit since I’ve still been proven reliable credit score wise lol. Thank you for the tips :)
-professor_plum-@reddit
You could find out who the CEO is….
MinimalThinkingToday@reddit (OP)
I’m not built for prison 💔
Different-Phone-7654@reddit
The gov just layed out how to not get caught by telling everything on how they caught the other guy.
P0tency@reddit
Look up medical debt relief, I don’t think you actually have to pay medical debts and they don’t report to credit
MinimalThinkingToday@reddit (OP)
They report if it’s over 500 and has been in collections for over a year. It was only just sent to them but I called them to make sure it was put on hold while the situation was figured out. I’ve heard that you can dispute medical debts sold somehow bc of smthn or other in regards to hippaa (?) but I’m not sure how that works.
Scottenfreude@reddit
Do you have Luigi's phone number?