Medical Bills

[solocam_aggie]

I know this topic has been beat on many many times now, but man it gets my blood pressure up. I dont understand how 7 months after the fact, and after we were told we had met our out of pocket max, that we continue to get bills from them "resubmitting" to the insurance company.

In addition, we've had a few visits to the local fast aid for a quick diagnosis for ear infections so we could get prescriptions. Every time, we argue that we've met our out of pocket max, but they insist we have to pay the $50 copay. So I then have to wait a week for the bill to get processed, call billing, have them verify we have met our deductible, then issue a refund. Unless I call, they just keep that money that was unjustly paid.

I'm teetering on the thought of telling them to pound sand. The wife and I have excellent credit scores, and I've always been one to pay my way, but this is just getting ridiculous. How long can this "resubmitting" drag out?

[DTala]

if I don't agree with the bill at the time I tell em send me a bill AFTER submitting...and I NEVER pay before I get seen. And yes, they will just keep the unjust payment.

[hpdrifter]

you think it would be better if the government was running it?

I hear ya man. Sometimes I wonder if the service industry employees even try to think.

I've been trying some technical support for various items. Each and every one of them ask the same questions over and over again like they can't read the history of a case.

If the situations weren't so darn pathetic, it could ALMOST be humorous.

[SaltwaterSlick]

Had a similar deal last year with my Doc and colonoscopy/upper GI tract tests... He's on our plan, we paid our co-pay with our company benefits card, then 6 months later they send us a $900 bill because the anesthesiologist they used was NOT on our insurance so out of network... I had a quote on costs, for both from them. I told them, "not my problem"... You quoted me this... go pound sand... They didn't like that one bit. It got ugly, then they gave me the "option" of paying their "cash" price for this service, otherwise we were to be turned over to "collections"... I paid it... been pist at myself ever since I did. Told doc, next time I'm due, IF I use him, I flat will NOT pay for out of network services if he is still in our network. He better find out the details BEFORE he does anything. Surprisingly, he agreed. He didn't even know about all the hassle I'd gone through...


It's a dang racket and verges on a scam!

[kingranch]

Hot tip
Only go to physicians premier er
They are friends of mine and will never charge you the balance bill etc.
Copays are sometimes dependent on your ins company

[BlackoutRam2500]

Personally I think medical insurance is a scam. I know some people get really sick and need hundreds of thousands of dollars of treatment that they couldn't otherwise afford but for the vast majority of people it is a money pit. It's worse than social security.



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[Hoss163]

Yeah big scam my daughter had a skiing accident and has been going to PT for the last two months they said we can’t cover that we don’t know for sure if it was a accident are not . I said nope she broke her hip and arm on purpose just for the heck of it so she couldn’t do anything she loves like swimming ,playing basketball . They finally said ok we will except it but you need to reach your deductible 1st . I said I already have about three times over in the last month . Finally last week I started seeing a break in the PT bill.

[dhall1414]

The entire medical industry with regards to pricing and collections is a scam. If literally any other industry charged the prices and pulled the insurance crap that the medical industry does they'd be in jail in no time. There were lawsuits against gas stations and whatnot that were price gouging when Harvey hit, but the medical industry does this every day. Most medical service providers will refuse to quote anything up front and their prices our outrageously high given the cost to produce or manufacture them.

Can you imagine going to a gas station only to find that there is no advertised price and you can only find out how much it is after you've already filled up and given them your car insurance policy? Or calling an HVAC repair guy when your AC goes out in the middle of July, being refused a quote even after an inspection and giving your home insurance info, only to find out how much it cost after the guy is done? And then finding out that he actually broke your compressor, which was previously okay, and then charged you parts and labor to replace it? And on top of that doubled the rate he charged your neighbor because he's got farmers and you've got Texas Farm Bureau? Oh and probably would throw in an "emergency" fee, not because he showed up same day but just because it's July.

This is the crap that happens literally every day in the medical industry. I could go on for hours about it.

[skinsfan]

[QUOTE=hpdrifter;14892944]you think it would be better if the government was running it?

I know this won’t be a popular opinion but sometimes I wonder if it would. Medical industry Is a joke. From pharmaceuticals to hospital stays to x-rays it’s all a scam. If everybody had some sort of coverage maybe the doctors and hospitals wouldn’t stick it to those of us with coverage so bad. I don’t have the answer but something has got to give. Most doctors making 300+ a year and RN’s making less than a manager at a fast food chain.

And before you call me a skinny Jean wearing democrat I vote Republican and have very good (by national standards) medical coverage.

[gonzaleziam]

If you can, AVOID free standing ERs, hospital ERs and Urgent Cares if you can. Your primary care provider usually has a call service. Call them first before going anywhere. Your cost to an ER or urgent care will shock you (even if you have insurance). Ask me how I know.

[rater1979]

My 2 1/2 year old broke her leg mid April. Got the cast removed the first week in May and now just got released from Cooks on Monday after 8 days in the hospital & emergency surgery from a ruptured appendix. Let the medical bill BS begin!

[solocam_aggie]

Im not at all a proponent of a centralized healthcare system, but there has to be some kind of balance between what we have now and medicare for all. What's difficult is once you let the government in for regulatory oversight of our current system, it just paves the way for the aforementioned.

[Hooverfb]

Happened to me 2 years after the fact with an operation my wife had. Its ridiculous.

[S-3 Ranch]

It’s very convoluted
I am diabetic and was delivered to the ER , saw a doctor twice , 1st on admittance 2nd on discharge , “ told to follow up with my PCP and drink water “
6 months later he sent me a $1500 Bill because he was outside my network
Now he has turned his bill over to a collection agency ( who call weekly)
Very frustrating