Tag Archives: Medical Bills

Don’t Pay Those Medical Bills…..Part Deux

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I’m back…..and boy do I have a story for you!

I try so hard to let you all know the important things going on in caregiving both legally and practically. It’s so difficult for us to stay abreast of all this crazy, complex information. And yet, I too, fall prey to the insidious actions of those who would undermine all of us.

I did the one thing, the one thing I tell all of you not to do.  Okay, I didn’t actually do it, but I sat side-by-side with my husband and watched him do the ONE THING I TELL ALL OF YOU NOT TO DO.

Here’s the tale:

My husband was having a routine colonoscopy. He hates that I share personal information, but in this case, it’s critical that you know exactly that. For your protection, he’s allowing me to reveal he has routine medical care. Yes, he’s that great.

The day before the procedure, my husband gets a call from the hospital. They tell him that they have called our insurance and he will have to pay a  $1,190 co-pay. Yes, that is One Thousand One hundred Ninety Dollars.

This seemed really odd to me. Routine care is always covered. But I will admit that even with relatively good health insurance, we have been paying larger and larger sums every year for co-pays, deductibles, and God-forbid, out-of-network costs.

Since the hospital said they checked with our insurance and this would be our co-pay, we took the checkbook to the hospital.

Now, I bitched about this to anyone who would listen.

“Can you believe this? Almost $1200 for a CO-PAY for a ROUTINE COLONOSCOPY? No wonder people get cancer! No wonder they won’t get routine tests! That’s a mortgage payment for lots of people! That’s a car payment! Hell, that’s a mortgage payment AND a car payment for most people!

I was hopping mad. We are fortunate that we could pay, but it’s not without a big “OUCH.” I also know that there are many, many people who absolutely cannot afford $1200 out of nowhere for a ROUTINE PREVENTATIVE MEDICAL PROCEDURE. Yes, I’m yelling. Yes, I’m using exclamation points. I was pissed.

When we got to the hospital, the clerk asked how much did we want to put down on our colonoscopy. Like it was a car, a house, or some nice furniture.  Because they were not taking him back there for those great drugs until we made some kind of a downpayment. For God’s sake.  We just don’t want cancer….which clearly we probably wouldn’t be able to pay for either.

But I sat there, speechless, as my husband wrote a check for $1,190.

And then I got the EOB. That ‘s the Explanation of Benefits. I read every one, just to make sure our medical bills were processed and to see how much of a bill I can expect.

Guess what? The EOB for my husband’s colonoscopy showed that it was a routine procedure and we did not owe anything. Not because we owed a co-pay or a deductible that we paid in advance…but because WE DIDN’T OWE ANYTHING.

Yep. We called the hospital and the billing department said: “Oh, that’s just an estimate that they give you, they don’t really know what you will owe.  We will return all your money. But you need to wait at least two weeks.”

My husband is the calm one in this house. Thank God, because they would only discuss this with him. If I had a crowbar, a siren, or a hammer that phone call would have gone so very differently.

P.S. My husband would not have checked the EOB….and I feel very certain that $1190 would have disappeared forever.

Soooooooooooooo……DO NOT PAY THOSE MEDICAL BILLS…………….JUST WAIT. I wrote the book on it and still had to be reminded the hard way.

“You Just have to Laugh……..and take your own advice……”

©2018 Cathy Sikorski

Sometimes You Just Need a Lion on Your Side…….

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I called the hospital today. Well, more accurately, I called the hospital billing department. The billing department is no longer in the hospital. The hospital is in Pennsylvania, where I live, and where my loved ones go to the hospital when they have a problem, medically.

The billing department is in Tennessee, where nobody, who goes to my hospital, lives or goes to if they have a problem medically or otherwise. Okay, maybe that ‘s not true, maybe some people go to Tennessee if they have a problem with say, country music, and want to see if it’s them or the music.

By putting the ‘billing department’ in Tennessee, it prevents all of us in Pennsylvania from actually going to the billing department to talk about a problem. That way no one has to discuss these problems face-to-face. So much easier, said no one, ever.

I called Tennessee today, and although the gentlemen was very nice, the problem was apparently unsolvable.

“I want to know if this bill, which started out at $4500 and is now magically down to $500 has been paid? ” I queried, for the third time in three months.

“Well, ma’am let me see. Now before I answer that question, even though you’ve given me the account number, can you give me the address on the bill, the date of birth of the patient, the date of the bill, the services rendered, the patient’s blood type and the name of their cat?” he asked ever so politely.

Okay, he didn’t ask for the blood type or the cat, but why not? My question is, why in heaven’s name do you put an account number on the bill if it means absolutely nothing in terms of information? Do you make more money by keeping me on the phone? Are you tracing the call just to make sure I’m not in Tennessee, but that I stayed in Pennsylvania where I belong?

We do-si-do all around the information, until we’re both exhausted and wish we had taken more square-dancing lessons, and finally, he says:

“Please ignore that bill ma’am the insurance company has agreed to review it.”

“Okay, but I have an estate to settle, so can I assume that the bill will be no more than the $500 you currently are requesting?”

“No, you cannot.”

Here’s where I want to find a cat, maybe a tiger or a lion, and release it into the wilds of Tennessee with the scent of this insurance company on its nose like a barrel of catnip.

“Um……….why would that be?”

“Well, what if the insurance company decides to take back all the payments they already made? Then the bill would be more.”

“Why would they do that?” I asked, “Medicare paid this over a year ago and this has been your fault for not properly submitting the balance to the other Medigap insurance carrier.”

“Well,” he replied, “we don’t know what they will do.”

‘Cause you don’t know what you’re doing……that’s really what I wanted to say.

But since he told me to ignore the bill, I’m gonna’ do just that. Probably forever.

“You Just have to Laugh…..”

©Cathy Sikorski 2016

 

Um….yeah…..not paying that….

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You think when your caregiving ends….well, your caregiving ends. But not so, intrepid caregivers. I’m now steeped in estate work and it, too has it’s unbelievable encounters. I have to call billing department after billing department to make certain that a bill is legitimate before I concede to pay. And each billing experience makes the last one look like child’s play.

Billing Experience Number One (really probably number 157)

“Hello? I have a billing question. Can you help me with that?”

“Sure.”

“What information do you need?”

” How about do you have a name and birthdate?”

“Why yes, yes I do.” And do I give her all the necessary information to retrieve the bill for my mother-in-law.

“My question is, this bill seems to have been processed by all her insurance carriers, and so there should be no balance due, and I know that she has also met her deductible.”

“Well, there is still a balance due after that.”

“No, I don’t think so. I’m pretty sure that according to the laws in Pennsylvania, if someone is on Medicare and they have a Medigap policy and both insurances have paid AND the patient has met their deductible that you must accept that as payment in full.”

“One moment, please.”

Oh boy, Muzak.

She returns pretty quickly, which in and of itself makes me happy.

“Well, ok, then. There is no balance due, but we didn’t have in our records that she was on Medicare.”

“Really? Because you just asked me to identify her by her birthdate, which is 1916, which makes her 97 years old AND you are showing on your bill that Medicare made a payment, just sayin’…”

“Well……”

And she hung up.

Billing Experience Number 2 (Actually not even 157, more like 210 by now)

“Hello. I have a billing question. Can you help me with that?”

” I will transfer you to billing.”

“Hello, I have a billing question. What information do you need?”

“Sorry ma’am this isn’t billing. Let me transfer you.”

“Hello, I have a billing question. What information do you  need?”

“Can you hold a moment?”

Of course, I don’t get to answer that question. I just get more Motley Crue Muzak.

“How can I help you?”

“I need to know if this bill for Aunt J is final?”

“Well, let me see…..hmmmm…..no, it looks like there is another bill with an additional balance.”

“Well, I’m sorry to tell you that there are no funds to pay this bill or any future bills. There will be no estate and the patient was visiting from Australia.”

“What? Australia? I don’t understand.”

Really? I’m thinking…..what’s not to understand. That seems pretty clear to me, but OK, I’ll just lather, rinse and repeat.

“Well, I’m sorry to tell you that there are no funds to pay this bill or any future bills. There will be no estate and the patient was visiting from Australia.”

“Um…ok…so could you send us a letter to that effect with a death certificate?”

“Sure. I would be delighted to do that.”

So far I’ve had to send that letter and death certificate 11 times. Do you think they would send me anything for free?

You just have to Laugh……

Cathy Sikorski