The frustrating thing is that you can go into a veterinarian's office for a major procedure on your dog. You will be given a price sheet before you commit showing the lowest and highest likely total cost for the procedure. This is not even possible for a procedure in the hospital. Many of the costs are unknowable up front.
Well thats because of insurance. Every company is different so they cover things differently and therefore how much the hospital will charge you depends on that. Which is bs. They should have standard flat fees regardless of insurance. Vultures.
What's even worse is that veterinarian has to be better trained than a physician. A vet has to work with patients that can't tell them what's wrong or understand procedures. Maybe we should model our health care system after our veterinary system.
@@jessicaqu it’s crazy bc sometimes (too often actually) the hospital billing isn’t even right about the cost with your insurance. Always double check with your provider and not rely on the biller.
Almost got double billed by a Doctor's office once, and they refused service until I paid. An hour later, they figured out I HAD paid, and what happened was, the billing person in their office had died the same day a year ago, and the replacement didn't do a bunch of that paperwork.
If Advil is $46 a pill, then a bottle of 100 is $4600. So that should be enough to cover a trip to the ER. A bottle of 100 Advil costs you $8.50, so next time you go to the ER take a couple of bottles of Advil that you bought for less than $20 and tell them, if they are charging you $46 a pill, then the two bottles should cover all your expenses.
Once in the doctors office waiting room the receptionist said they wouldn't let me see a doctor until I paid some outstanding bill. They handed me a phone and long story short, I almost paid a bill that wasn't even mine. Luckily I asked what the bill was for before they processed a payment. An hour of my time wasted and not a single apology.
Exact same thing happened to me in 2009. Hospital kept blaming insurance and insurance kept blaming hospital. It became my part time job calling them for about 18 months. Hospital kept saying don't pay it and they will bill insurance again. Then they turn me into collections. One thing everyone agrees it that medical billing is way too complicated.
In '86 I went into a hospital ER due to a metal sliver on my eye. Told them I would pay cash right there. They said 'There's a discount for cash, fifty percent'.
My guess, this caller went 'round and 'round with the billing office and thought he had it straightened out, never heard anything else until the collections notice. That's happened to me on a couple of occasions. Also, I was doing a refinance on one of my properties and during the closing settlement meeting, found out there was a $180 "medical collections" on my report. Bank was going to pay that collections during settlement. I never found out which doctor it was for and I looked back through my records to no avail.
@@harpy5197 Yeah the records should show the doctor and the clinic/hospital if there is a record. If the bill was fraudulent it wouldn't be hard to check. Fake news. 👍 edit: Maybe the bank paid it regardless, which means this story is moot since the $180 cost less than having to process the extra paperwork and most people with medical debt aren't in such positions.
This is wrong. Most healthcare providers have a contract with insurance companies which put requirements on the provider. In my case, my insurance "in network" providers are abide by the insurance companies admin policies and cannot bill the patient unless the patient agreed to services not covered by the insurance company.
This happened to me a few years back and the collections agent “animal” called me names. The bill wasn’t even mine! I was harassed for four weeks. The main agent harassing me called me a f*ing loser..
Getting a doctor's office to file paperwork properly is a PITA. We had a almost opposite situation where they charged us too much for prenatal care and then six months after the baby is born, we get a refund. It's a nice surprise, but it would've been nice to not have to pay that in the first place.
I got a $800 bill for a 15 minute trip to the ER (no ambulance) and all the doctor did was shine a light in my sons ear... they did nothing else because that hospital didn’t have an Ear/Nose/Throat person. I’m a nurse and I was totally floored. Thank god I had insurance but that is insane.
You can also sue on behalf of your insurance company to get the doctor delisted from the insurance. I pursued this against a hospital that I had the procedure on that violated the contract.
My mom experienced something similar to Dave, she was in a car accident, and the ambulance took her to the hospital. We started getting bills, but we never got the ambulance one. After a while I started calling the hospital asking if they know ambulance ever send us one, I had to stand in front of their billing dept window for almost 2 hrs to ask them to dig thru their records why I never got the bill. Turned out they got my mom's address wrong, so we never got it. Luckily I realized that early on and hunted it down, cause the person who hit my mom's car, their insurance was paying all the bills from the accident, if I didn't get that bill, we would have to pay or had to go thru re-opening the case to get the bill covered, which may not be that easy......
Got the bill for the birth of my daughter about 2-3 months after having her, but we’d prepared to pay it beforehand. So i called and asked if i would get a discount if i paid it in full that day and sure enough, saved me like $500
I hurt myself three years ago on ice. Somebody called the ambulance and I declined. Had Uber pick me up. Charged $12 with Uber instead of being billed for $1500.
@@blackworldtraveler3711 I declined an ambulance that someone called for me one time and they still sent me a bill for showing up. It was like $150 or so. Apparently that is legal!
This makes me appreciate the NHS in the UK so much. As a doctor, I'm yet to meet even 1 patient with a bill problem from hospital or General Practice because the NHS will cover it
This is not the doctors fault. I work in a doctors office and if we don’t get the referral at the time of the visit the patient is fully responsible for the visit as we can’t back date the referral.
@@r.rodriguez4991 but the bottom line is that he got a service that he did not pay for. Actually at our office if you are a self pay patient you get a nice discount.
@@r.rodriguez4991 If you think the price is too high, they you go elsewhere. You can't accept the service, and then after the fact decide the price is too high.
I'm a beekeeper, allergic to honeybees, and have been going through desensitization treatment for over two years. I log on to my hospital's portal, and settle the bill once a month. I logged in the other day, and there are now eight treatments, one per month, from eight different months, that I was never billed for until the other day. My copay is only about fifty bucks total for all the injections, but I can't wait to hear their excuse on why it took them over a year to get around to billing me.
Not if the Doctor is in network with the insurance company. The Doctor has a contract with the insurance company and is contractually obligated to either file correctly with insurance or write it off. If it’s not the patients responsibility (such as a co-pay, deductible, or co-insurance) the Doctors office is not legally allowed to bill the patient for a reimbursement that’s supposed to come from insurance.
@@rrrealitycheck patient problem is he walked away from the issue instead of addressing it. Now he has to address it. Hopefully the insurance doesn't use the fact that "time has past" and "he doesn't have coverage with them now" as reasons to not pay the bill IF he can get the doctor office to rebill
@@Sexy40baby1 - how is the patient supposed to address it if he doesn’t know it needs to be addressed? The Dr is contractually obligated to file insurance claims in a timely manner. If the Drs office doesn’t then they are legally required to write it off. It’s illegal for them to bill the patient.
@@rrrealitycheck you get in the mail a letter from the insurance company stating what they were billed for, what amount they paid and what amount you are responsible for. If you move around then it is your responsibility to complete a change of mail form with the post office or call around to everyone and make sure they have your new address. or at the very least ask if you owe anything. In this day and age you can set up accts online with the insurance provider and pull this info up right from your phone. You can claim what a doctor is contractually obligated to do but understand that everytime you go to get service done, you are signing a paper that states that YOU are responsible for payment, especially any amount your insurance doesn't cover. Its weird to me that people even owe money to doctors and dentist because mine make me pay BEFORE they render any service to me. therefore i am forced to check to see if I was told the correct amount to pay.
apparently, a 10mi ambulance ride is now about $2.7K, my insurance paid 700, and I pay the balance. I asked my brother to drive me to the hospital. he said an ambulance was better.
Almost all ambulance services (even private) do soft billing which means they will attempt to collect money beyond what insurance will pay but they will not put it into collections. I wouldnt pay it. Its at least worth inquiring before paying. What services were rendered if you dont mind my asking?
He just said that the insurance company did not get the referral in time. If his policy requires a referral from a primary care doctor to see a specialist and the insurance company didn't receive it prior to his appointment that is 100% his responsibility to pay.
Got a paper from my insurance that my primary physician was no longer accepting my insurance. Called my doctor’s office and they said ignore and they still accept. Then I got a bill after my physical. I asked the doctors office and they said my insurance rejected their claim. After calling my insurance they said my doctor’s office filed it wrong and they needed to resubmit. Second time of filing went through but why did I need to middle man. Why didn’t my doctor’s office just call my insurance? Instead let’s just bill the client and have them get to the bottom of it even though it was our fault!
When I broke my arm a few years ago all the bills were paid by insurance except one that I never received. It was for less than 30 bucks, I didn't find out it existed until it went to collections...
Here’s a question or two that should have been asked that I don’t hear being asked. First of all, what does the Explanation of Benefits say? Does it show this balance as patient responsibility? Secondly, if the patient required a referral and he/she did not have one, it’s not the responsibility of the billing provider to obtain it. Referrals are obtained by a primary care physician and absolutely the responsibility of the patient to obtain it. Most specialists will have a patient sign a waiver that their insurance may not pay at all or pay at a reduced rate if they do not have the referral.
@@thelogicaldanger My insurance already have that info available for in and out of network with search function and direct link to facilities and doctors.
@@blackworldtraveler3711 Very good. But it sounds like this guy just went to the specialist without checking to see if he was in-network, and without making sure the referral was done. It doesn't matter if your insurance makes it easy to check, if someone still doesn't check.
Same thing happened to me. I got a collections For a alleged doctors visit from three years ago. I asked the collections agency to prove the debt with an invoice from the doctors office and they couldn’t provide it so I disputed the debt and I was cleared within a week
If this is TRICARE or another insurance that requires a referral for any coverage this is not actually the issue with the doctors office it’s an issue of making sure your referrals were current before you go in for any appointments. If it is like TRICARE and you don’t have your referral current at the time of service you are responsible for the entire bill. This has happened to me a couple of times with Tricare and you absolutely cannot get out of it, and they will not backdate anything.
This is so true! This is not the doctors fault. I work in a specialty office and if we do not have the referral at the time of the visit the patient is responsible for the entire bill. It is not the doctors fault.
If the doctor office messed up that was supposed to put the referral they will backdate it or they will be in trouble with tricare, you have to fight them about it though. Write dates down of visits and what you went for so you have the records. It’s a mess though, I agree unfortunately I have to deal with them all the time for my younger two kids. Triple check everything, it’s a headache otherwise.
@@Ria24Ria it’s not considered backdating when the doctor office messed up and didn’t put it in to begin with. I’ve unfortunately had this happen too many times with my two younger kids who have to see many specialists. Where the specific reason we went was for a referral and they messed up and have it in their notes but the staff didn’t put the referral in. They had to correct the problem with Tricare(military insurance) each time. Not the specialist but the Primary care doctor (didn’t put the referral in) as the result they had to fix it or eat the bill( again the pcm not the specialist.
@@jrn3342 It's not the doctor's responsibility to get a referral, they have no way to know if the patient needs a referral and until they see the patient's insurance (which is usually at the 1st appt.) It is the patients responsibility to get the referral, and insurances make this clear. It is also illegal to back-date an office visit.
This is one side of the story. If they were ignorant of what their insurance covered then that is potentially on them. Depending on the situation. On a smaller scale we deal with similar issues where patients get mad because they were double billed for a well check. But if you come for a well check and then bring up illness concerns, we have to bill for a sick visit. We are committing insurance fraud if we undercode just like we are committing fraud if we overcode. Without knowing the details of the situation here it's not possible for anybody to really know who's in the right
Same thing - used a medical facility and never received a bill. Started getting collection calls but never received a bill from medical facility (it was for blood test). This should be illegal. Send the dadgum bill before sending it to collections! How can I pay it if I don't know how much I owe?
@@blackworldtraveler3711 So if I go to the doctor and they never send a bill, I'm supposed to think to go out of MY way to call them and ask if I owe money, how much, and how to pay it? I see your point, but it's also highly unprofessional from a business standpoint to provide services to your customers and then make it difficult to pay or even know how much money you owe them.
@@blackworldtraveler3711 yeah because instead of giving the person the price and chance to pay it is too much to ask. Let's just send the bill to collections instantly because that's" normal " and right
@@blackworldtraveler3711 exactly, I was always taught to stay on top of things. I always call and make sure I don’t owe anything. I work at a doctors office and you won’t surprised at how ignorant people are of there insurance and bills .
@@MichaelAnderson-wk1no I go out of my way before leaving the office. Will have something before anything is started. I'm a believer in getting things in writing for everything. I will have something in my hand before leaving. Also use my AmexBlue then if possible if need be. But I have United Healthcare. Hand them the card and everything is taken care of anyway. Any copay or coinsurance I pay then.
Just got a bill for $50 copay bill even though I paid the copay in the office before I left. Funny thing is the bill had a line item for $50 unapplied funds. So, they have record of a payment but didn't apply it to the office visit. At least 15 days before the bill date, I went for a second office visit. The lady at the front desk told me about the issue and saw the unapplied funds. So, for 15 or so days, they never did anything with the funds. 🤷🏾♂️
@@r.rodriguez4991 the drs don't look at the bills. they render services and they have medical office and billing people doing the bills. (those people are often trained by online correspondence courses and those courses often advertise on daytime tv. what kind of people are getting to fill those positions?-that's the problem!)
The best comment there. “$46 per tablet of advil”. And “I love America”. This is why a single payer system is tons better. No way this current system is sustainable. It’s healthcare for those with money.
i'm going through the same thing right now. Collections called me the other day saying i owe $670 for a routine gyno exam that i had back in October!! Spent all day going back and forth with my insurance and doctor's office. My insurance says they have no record of a claim being filled, and my doctors office says they sent the claim but my insurance rejected it. So idk what to do at this point
I had this exact problem a few years back. Eye doctors office submitted the insurance paperwork improperly by submitting portions of it separately. Insurance wouldn't pay it because of the error. Told them exactly what Dave said in this call and threatened collections. I just paid it
Our insurance company said if a bill isn't recieved within 18 months you don't have to pay it. It happened to us and when we went back to the Dr. About it we didn't have to pay.
The fact that every adult in the U.S. has one of these horror stories relating to hospitals, doctors, and/or medical insurance indicates the problem is totally systemic. I would argue the root cause is our godawful, privatized, for-profit healthcare system which stands out among 1st world countries as being uniquely terrible for ordinary people. The overseers just view our illnesses and maladies as moneymaking opportunities. We are considered customers and not patients. Price-gouging is rampant and you have to know tricks about "settling for pennies on the dollar" and haggling with clerks to pay anything close to a reasonable price for treatment. It's an immoral and despicable healthcare system, probably the worst among OECD nations.
There are many advantages to living in the USA but you’re right, the USA is the only country in the developed world with such a crooked, thieving, for-profit healthcare system. I’m so happy I live in Canada and I am well taken care of, thank god.
@@blackworldtraveler3711 Yes, I have a chronic condition. If I lived in the USA it would have cost me millions to be treated but thank you Canada medicare system!
“This little idiot kept calling me” You mean the guy who you owed money to and whose calls you evaded for months to avoid paying? And he’s the idiot here?
I have settled outstanding medical copayment as to the ER doctor or hospital but always asked for written confirmation or email upon settlement. I always wrote down the name, date and time of the person I spoke with before I filed this away in my filing cabinet. I never ever trusted these transactions based on their recording. Your rights are protected only if you can have written proof, get it!
From what I can get, there's no way to pay it when you visit....i've tried a few times, you ALWAYS get a follow-up bill, something usually like a 3rd party reading xray or just some bogus sounding charge. Now I don't pay anything and have insurance tell me what I owe...it's impossible to get a refund from a hospital if you overpay. What really makes no sense is when you get a collection call a few months later for a bill you never received and can look at the dates of everything, it was turned over to collections 10 days after my visit.
I used to do "claims denial management" for a hospital. In the contract between the insurance company & the medical provider/facility, there is almost always a clause for "timely filing" (usually 30-90 days from date of medical service). If the provider does not file the claim within this timeframe, the insurance is off the hook. However, the provider should not be able to bill the patient (except in cases where they were waiting for information or action on the patient's part which caused the claim to be filed late). If a claim was denied for untimely filing, we just wrote it off.
A similar situation happened to us. My wife had a routine checkup on a lump (one that is covered by insurance as a routine, annual check). However, the doctor coded it as "elective" rather than "routine." Insurance wouldn't cover it for that reason. After six months of appeals and going back and forth, we got worn down. We finally just paid the $500, but lesson learned. We make sure that we have it in writing that the checkups are routine.
The dentist I go to did the same thing to me. And now after paying 2100 now I owe them an additional 1200 because my insurance didn't get a pre authorization form from them. The sad thing about this is they waited my second visit after everything is almost done in the right side of my mouth to bring it up after the visit. I was angry at my insurance but during that call I found out it was my dentist fault and not theirs.
I almost had a similar situation happen to me with a lab after my GI specialist performed a diagnostic procedure on me. The lab filed a claim with Medicare incorrectly and when Medicare declined to pay they gave me a "courtesy call" to tell me they would turn the matter over to a collection agency because I didn't pay a bill that was never sent to me. Needless to say I was very angry and let them know it. They resubmitted the claim and it was finally settled. Medical billing is a nightmare for everyone due to the different types of insurance and the number of carriers out there. Many doctors subcontract out their billing as a result.
I know people who fly to Istanbul because guess what? they have universal health care. its actually free for a citizen to go to a hospital have a scheduled procedure and walk home. it’s cheaper to buy a ticket to and from there than go see a dentist in NY. this shows how messed up is US healthcare or notcare system is
I get on my knees and thank the lord I live in Australia. The most I have ever paid is $35 for when I see my GP, and maybe $50 the most for a medication. The rest is free.
I'm also in Omaha. I had a similar situation happen and I got out of it. They never sent me a bill and then I got a letter from collections three years after the service. I fought it and demanded they submit to insurance. They knew it would be denied as they didn't submit it for three years. I told them I was willing to pay my portion after insurance paid their portion. Mine was through UNMC and I'm wondering if his was the same.
Not sure why this guy has the idea he doesn't owe this bill 🤷♀️🤷♀️🤷♀️ At this point it is really too late to try to go back to the doctor's office and try to hash it out with them. Once it's been sent to collections, the doctor can't really work with him on it.
yes they can, you just tell the dr. I am not dealing with collections I will pay you as my contract is with you. the collections doesn't know anything about insurance or whatever and they often dont have the paperwork to prove that you actually owe the debt. they would have to get that from the dr's office. so call them and tell the dr what the issue is and force them to solve it.
Call the billing department for the doctor's office and whatever documents need to be filed in order to have this taken care of should have be taken care of. If you have to pay for this out of pocket to get this out of collections then I would take this paperwork to the insurance and file a claim with them so you get reimbursed. Whatever documentation you need from the doctor's office in order to file the claim is what I would request copies for.
I had to fight the hospital and our insurance for a year after giving birth to our son. All because the office lady at my husband’s work put the wrong birth date for our son. I lost count of how many people and phone calls etc. I had a whole set of pages of names and promises etc. It was a huge headache and panic. But no way was I letting it be left to those who didn’t know how to do their jobs. lol I hounded them until I finally got people who knew how to do their job. And I made sure to stay on top of the hospital to make sure they sent everything through. I wanted to make sure they didn’t throw out the “oh we forgot this bill”.
This right here is a perfect example of how horrible the American healthcare system is. Sent this to my relatives living in Europe and they can't even fathom this lunacy.
Technically the Doctor has a contract with the insurance company and is contractually obligated to either file correctly with insurance or write it off. If it’s not the patients responsibility (such as a co-pay, deductible, or co-insurance) the Doctors office is not legally allowed to bill the patient for a reimbursement that’s supposed to come from insurance.
Bad, incorrect advice. As long as the doctor is a participating provider with the insurance company, it is illegal for the doctor to bill you before billing the insurance company. So no, the doctor cannot legally go after the insured as long as they were smart enough to go to a participating provider.
Medical expenses are the number one cause of bankruptcy in the US. Sometimes its cheaper going directly with the hospital than insurance if you can negotiate well.
The issue isn’t the healthcare provider, it’s the insurance company that creates obscure rules and regulations. The office is just trying to get paid for the help they provided
I don't understand the whole thing about insurance not getting the referral. I have a funny feeling the bill was run properly thru the doctors office. If not, this guy would have chewed out the office. He acts like he is afraid to call them.
It really sucks that the American healthcare system is treated as a business and not as a basic service. How is dealing with all this nonsense better than having a single payer universal healthcare system?
My mom had the same issue Dr. Came after her for 2K they didnt properly submit to insurance. She called her health insurance and they called the dr and she never got a bill again.
My get my referral mail before I go. If I didn't get my referral I'll call to make sure I'm covered. If he didn't do his part to make sure it was covered this wouldn't happen.
I’m willing to bet he made the appt and got the service before insurance company was given a heads up. Not siding with insurance but I don’t think he did what he was supposed to 🤷🏾♀️
then you are not liable. The Explanation of Benefits you get from the insurance company should show you do not owe it and that they have to write it off.
Exactly! I doubt this is the entire story. I work in a doctors office and you would be surprised at how ignorant people are of what there insurance coverage entails.
Doctors don't just have problems with billing and math, they also have a HUGE problem with time. Doctors invariably think that there are six (or more) fifteen minute increments in an hour. Don't guess they teach them anything about time in all their college studies.
My doctors office has a sign that reads: The contract you have with your Insurance is between you and them, not with them and the doctor. If they dont pay your claim, you are responsible for it."
This is why medical services should be like everything else in our society ... paid for up front. No billing months or even years later that was never disclosed and you are expected to pay. Give me a price and I accept it or reject it ... none of this blank check nonsense.