Free Republic
Browse · Search
News/Activism
Topics · Post Article

Skip to comments.

Medical Bills You Shouldn't Pay
Business Week ^ | August 28, 2008 | by Chad Terhune

Posted on 09/06/2008 8:56:26 AM PDT by DeaconBenjamin

In a controversial practice known as "balance billing," health-care providers are going after patients for money they don't owe

As health-care costs continue to soar, millions of confused consumers are paying medical bills they don't actually owe. Typically this occurs when an insurance plan covers less than what a doctor, hospital, or lab service wants to be paid. The health-care provider demands the balance from the patient. Uncertain and fearing the calls of a debt collector, the patient pays up.

Most consumers don't realize it, but this common practice, known as balance billing, often is illegal. When doctors or hospitals think an insurer has reimbursed too little, state and federal laws generally bar the medical providers from pressuring patients to pay the difference. Instead, doctors and hospitals should be wrangling directly with insurers. Economists and patient advocates estimate that consumers pay $1 billion or more a year for which they're not responsible.

Yolanda Fil, a 59-year-old McDonald's (MCD) cashier in Maple Shade, N.J., got tangled up with balance billing after gall bladder surgery in 2005. She and her husband, Leon, a retired state transportation worker, have coverage through Horizon Blue Cross Blue Shield of New Jersey. Horizon made payments on Fil's behalf to the hospital, surgeon, and anesthesiologist. Then, in 2006, Vanguard Anesthesia Associates billed Fil for an unpaid balance of $518. Soon, a collection agency hired by Vanguard started calling Fil once a week, she says. Although she thought her co-payment and insurance should have covered the surgery, Fil eventually paid the $518, plus a $20 transaction fee. "I didn't have any choice," she says. "They threatened me with bad credit."

(Excerpt) Read more at businessweek.com ...


TOPICS: Business/Economy; Culture/Society
KEYWORDS: billing; collections; healthcare; medical; medicalbilling; medicalbills
Navigation: use the links below to view more comments.
first previous 1-2021-4041-49 last
To: DeaconBenjamin
"Medical Reform" too often is seen as a question of who pays the crooks - rather than how to make medical delivery better and more efficient.
41 posted on 09/08/2008 10:17:41 AM PDT by GOPJ ("Vegetarian" - Old Indian word for "bad hunter")
[ Post Reply | Private Reply | To 1 | View Replies]

To: paterfamilias

Bump


42 posted on 09/08/2008 10:36:20 AM PDT by AmericaUnite
[ Post Reply | Private Reply | To 12 | View Replies]

To: Tammy8
The first thing that struck me is how happy I am that you are not my doctor with your attitude. WOW you have the very arrogant attitude that I mentioned.

Actually you know nothing about me....but I respect your feelings.

I realize she admitted she put on too much eye cream, but the resulting swelling of her eyes sounds like a scary symptom to me- one that needs to be checked out ASAP, the eyes are not something I would want to wait before getting medical attention.

It wasn't swelling of her eyes. It was the eyelids. Great difference. There you go again.

Many illnesses and injuries are caused by the patient not following directions- so they shouldn’t seek medical attention if they may have caused the problem?

I never exactly said that, did I?

If a man uses a power tool in a way he shouldn’t and causes great injury then he shouldn’t go to the ER, because it was his fault to begin with?

Okay......obviously we can't have a conversation. I can think of many things to say here...But let's just end this here.

Thanks

43 posted on 09/08/2008 10:51:35 AM PDT by Osage Orange (MOLON LABE)
[ Post Reply | Private Reply | To 40 | View Replies]

To: Old Professer

That does look just like the filters we use to strain urine! The hospital costs of all items have to include employee costs from purchase, delivery to Central Supply, filling each floors Pyxis System.

http://www.cardinal.com/us/en/providers/products/pyxis/


44 posted on 09/08/2008 10:51:45 AM PDT by AmericaUnite
[ Post Reply | Private Reply | To 22 | View Replies]

To: AmericaUnite

So does the paint supplies store.


45 posted on 09/08/2008 11:08:44 AM PDT by Old Professer (The critic writes with rapier pen, dips it twice, and writes again.)
[ Post Reply | Private Reply | To 44 | View Replies]

To: PhiKapMom
With the Federal Blue Cross/Blue Shield they tell you that you don’t have to pay the balance because they have paid the agreed amount when the doctor/dentist signed up with them.

Had some of the places try to collect, threaten a bill collector, and then I tell them to check with Federal BC/BS and give them the number and then call the local Federal BC/BS — their calls and letters stop.

They do it to my Mom all the time and I refuse to pay her bills like this but if I wasn’t handling it, I am sure she would pay.

We had one that threatened to ruin my Dad’s credit so he couldnt’ buy a car last year and he died in May ‘97. ou should have heard my comment to that remark. Believe they prey on senior citizens.

I just now noticed this thread.

It is not just insurance write-offs ("adjustments") that are relevant here, either. This past March, I received a bill from a provider for about $1,200 in unpaid charges. However, I had the pertinent EOBs, which I collect and enter into a medical spreadsheet: They indicated that the provider had been tardy in filing with BC/BS for reimbursement (the carrier allows 180 days); therefore, neither they nor we are responsible for the charges.

I sent a copy of the pertinent EOBs (there was a total of five services involved) to the provider, and that resolved the matter.

46 posted on 12/24/2008 8:45:12 PM PST by AmericanExceptionalist (Democrats believe in discussing the full spectrum of ideas, all the way from far left to center-left)
[ Post Reply | Private Reply | To 4 | View Replies]

To: AmericanExceptionalist

I do the same thing with bills and what they submit so I can go back and check on them when they come calling about some deliquency that is their fault not ours.

What bothers me are the people that don’t understand what is happening. There would have been $2500+ paid out this year if I didn’t track everything. The billing departments for medical have gotten so much worse over the last few years.


47 posted on 12/27/2008 4:49:37 PM PST by PhiKapMom ( BOOMER SOONER! Sam Bradford Heisman! LetsGetThisRight.com RED STATE Oklahoma Republican)
[ Post Reply | Private Reply | To 46 | View Replies]

To: PhiKapMom
I do the same thing with bills and what they submit so I can go back and check on them when they come calling about some deliquency that is their fault not ours.

What bothers me are the people that don’t understand what is happening. There would have been $2500+ paid out this year if I didn’t track everything. The billing departments for medical have gotten so much worse over the last few years.

You are to be congratulated for checking your bills (and your mom's bills) carefully before paying them. Like you, I believe in paying my legitimate obligations promptly; but paying for other people's mistakes is quite another matter.

Some people make the mistake of believing that whatever a bill says must be correct. But the people who work in billing departments are not infallible. And there is an old saying that is certainly applicable here: No one else will look out after your interests the way you will.

And you are surely correct in your observation that billing departments, by and large, have become more aggressive in recent years. My guess is that those who work in these departments have been instructed to bill the customer for all unpaid charges--even if the billing department was delinquent in filing the claim, and therefore at fault--in the belief that many will not notice, and will compliantly pay the amount for which they are billed.

48 posted on 12/28/2008 9:40:32 AM PST by AmericanExceptionalist (Democrats believe in discussing the full spectrum of ideas, all the way from far left to center-left)
[ Post Reply | Private Reply | To 47 | View Replies]

To: paterfamilias
I see a patient in the office as an out-of network patient

Let me ask you this. You bill my insurance company, lets say Blue Cross Blue Shield, $276.00 for services to me. Blue Cross determines that the allowable amount is $166.00 They then pay you $149.00 and I pay my coinsurance of $17. End of story.

Now let me ask you this. Lets say I don't have any insurance coverage at all. Are you going to bill me the same $276.00 or are you going to bill me the $166.00 which is what the insurance company would normally have paid you ?

49 posted on 12/28/2008 10:06:37 AM PST by Hot Tabasco (Today is just a little more special than yesterday.)
[ Post Reply | Private Reply | To 12 | View Replies]


Navigation: use the links below to view more comments.
first previous 1-2021-4041-49 last

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.

Free Republic
Browse · Search
News/Activism
Topics · Post Article

FreeRepublic, LLC, PO BOX 9771, FRESNO, CA 93794
FreeRepublic.com is powered by software copyright 2000-2008 John Robinson