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(Message started by: Elaine on Nov 22nd, 2003, 8:03pm)

Title: How many of you get Doctor Bills over a year old?
Post by Elaine on Nov 22nd, 2003, 8:03pm
I don't mind paying people what I owe. It burns me up to get a bill from Doctors and hospitals a year after the fact ! Plus they add a note that says I need to pay it NOW! I want to write back and say it took you almost two years to bill me may take me four to pay you! LOL

Imsurance sucks to I have a co payment but seems everytime I go to the doctor I pay a co payment the insurance pays another $23 and I always get stuck with the rest.

Oh well shit happens they say. LOL Oh well that is one bill that will wait till tax time filing in bills that can wait stack !!!!:-)



Title: Re: How many of you get Doctor Bills over a year o
Post by Charlie on Nov 22nd, 2003, 9:18pm
Rats E: :-/

I've gotten some bills several months old from hospitals but only once from a doctor. He was one of those "consultation" types who walks in the room, and taps your toe, and says you're sick. I told not to send a bill. He did and since this was an ER visit in Baltimore for my gallbladder attack it was easy to ignore. Idiot was a English as a second language resident neurologist who literally walked in and out and sent me a bill for $250. It’s the only MD bill I've ever refused to pay.   :o

I suppose if you have a relationship, you may be stuck. Make them chase you around for another year. Sounds fair to me.  >:(

Charlie 8)



Title: Re: How many of you get Doctor Bills over a year o
Post by nancyc on Nov 22nd, 2003, 11:28pm
I had the same thing happen a few months ago, sis...i have Companion insurance....got a bill from my Doc that was from one year ago..said i was not approved for that visit but it took them one year to tell me...problem is, i was approved...gonna take me two years to prove it probably..i hate HMOS.... >:(nancyc

Title: Re: How many of you get Doctor Bills over a year o
Post by Donna_D. on Nov 23rd, 2003, 11:28am
OK...Listen up folks.  

Elaine, if your doctor is on your insurance plan (contracted or in the directory of participating doctors) he probably has a "hold harmless" agreement with your insurance carrier.  This means he will not hold you responsible for any amounts in excess of your office copay and coinsurance.  Call the insurance company and ask them,

1.  When was claim received and what do you have showing as  the patient responsibility amount.

2.  Is my physician a participating doctor on my insurance plan, if so, shouldn't he be writing amounts over the reasonable charge (or considered not medically necessary, beyond filing deadline) off my balance?

3.  If physician is overbilling you request that insurance rep. contacts drs office for you--9 times out of 10 they will.  You just need to ask.

Charlie,

If they did not write off that amount for the "stop-n-go neuro" contact the hospital and make complaint against dr.

NancyC

Call your insurance carrier.  HMO's are very strict on their contracting physicians.  Don't take the drs office staff's word as to why the bill was not paid.  75% of the time there is a simple error on the claim or a missing approval number on claim form and the office never followed up on it to get it paid.  A simple phone call to your customer service department should clear up everything.  If not e mail me and I will let you know what to do next.

Y'all may already know all of this.  Just trying to be helpful!!  Anyone else with insurance problems, let me know.  I can help!  (or at least try!)

Donna D :D

Title: Re: How many of you get Doctor Bills over a year o
Post by kim on Nov 23rd, 2003, 11:44am
A lot of docs send blood work stuff to labs your insurance does not cover.  Make sure you tell them SPECIFICALLY  where to send the labs to.  Otherwise you'll get those lab bills and be responsible to pay.  That has happened to us a bunch of times!  Those lil skin priks add up to a ton of money if your not careful.... :)

Best way to stay ahead is to call insurance co. and make sure you make clear to doc's office.

Title: Re: How many of you get Doctor Bills over a year o
Post by Donna_D. on Nov 23rd, 2003, 12:08pm
Kim,

Depending on what type of policy you have you may have some recourse, even on the older charges.

If your physician is contracted with your insurance carrier part of his contract (usually in cases of HMO, PPO, POS plans) includes a provision  that requires your physician to use other contracting providers in the same network.

If the physician ordering the lab work is one your PCP referred you to, for example a neuro, then the referral that "authorizes" in network benefits for the neuro can sometimes be used as an "umbrella" for any lab services he orders.  Contact your insurance carrier and don't ask, TELL them that you had no choice in the lab the doctor used and you do not feel it is fair that you have been penalized for the doctors failure to comply with his agreement with XXXXX Insurance Company.  Most insurance carriers can do an "administrative referral" and reprocess the charges to pay at the higher level of benefits.  If you need help drafting a letter, let me know.  

You are correct--the best cure is prevention.  But you shouldn't be left holding the bag in uncontrollable situations like that!

Donna D  

Title: Re: How many of you get Doctor Bills over a year o
Post by nancyc on Nov 23rd, 2003, 1:33pm
Thank you Donna D....email on the way to you, sis...smiles,nancyc

Title: Re: How many of you get Doctor Bills over a year o
Post by jonny on Nov 23rd, 2003, 1:43pm

on 11/23/03 at 11:28:43, Donna_D. wrote:
 Anyone else with insurance problems, let me know.  I can help!  (or at least try!)


Ok....My insurance company wont pay for my penis reduction surgery, what can I do?....LOL ;;D

.....................................jonny

Title: Re: How many of you get Doctor Bills over a year o
Post by Donna_D. on Nov 23rd, 2003, 3:02pm
Gee, Johnny,

That's a HARD one....  
               [smiley=slowlaugh.gif]

Is it medically necessary or strictly for pleasure.....


Donna D

Title: Re: How many of you get Doctor Bills over a year o
Post by jonny on Nov 23rd, 2003, 3:42pm

on 11/23/03 at 15:02:35, Donna_D. wrote:
Is it medically necessary or strictly for pleasure.....


Actually, im sick of sending chicks to the hospital...;;D

..................................jonny

Title: Re: How many of you get Doctor Bills over a year o
Post by zenerzoo on Nov 28th, 2003, 1:42pm
Insurance........ What's That?

Title: Re: How many of you get Doctor Bills over a year o
Post by cootie on Nov 28th, 2003, 1:59pm
Sorry jonny....maybe you should jus stick with the ho-ho-ho's with chicks....blahhhhh-ha-ha ! Anyhow where was I.....YES insurence SUCKS ! I got stuck with 5 separate bills for a few exrays and the hospital told me there is anouther bill of about $ 149.00 still out.....huh.......it's been about 6 months ! They told me that bills are sent to insurence and they let them float around a while cuz they don't want to pay them or won't pay them.....then sooner or later the hospital bills you with past due notice. They said the hospitals or docs offices will actually even call the insurense co's about the bill they were sent first which holds things up even longer for YOU to git billed cuz they wait longer for payment. Brad's shop stayed with the same co but changed policy's 3 times....coverage is bit different. I got stuck with these exray bills cuz I had em done at my own docs clinic which is part of the big hospital anyhow in town also with the same name. But...I didn't know this new policy required I go OUT OF TOWN for all work and will not pay anything done in my own  town or docs new big clinic. Now THAT SUCKS !!! Still ain't got that other bill......already paid $ 500.00 myself for jus a few exrays ! Had to pay to have em done...pay who did em....pay for exray film....and pay the hospital ta read em.........and probly pay there gas money to go to work that day........ that's outragious. Sorry fer the rant.....I got on a roll here.....I already had a WHINER thread about this while back. I'll go back into my hole now......Pam that's been ripped off and pissed off

Title: Re: How many of you get Doctor Bills over a year o
Post by Patrick_A on Nov 28th, 2003, 2:11pm

on 11/23/03 at 13:43:35, jonny wrote:
Ok....My insurance company wont pay for my penis reduction surgery, what can I do?....LOL ;;D

.....................................jonny


Quit using that damn Pump Jonny!

Title: Re: How many of you get Doctor Bills over a year o
Post by Giovanni on Nov 28th, 2003, 2:53pm
Greedy bastards............dig you up for a gold filling.

[smiley=JAW_DROP.gif]

Title: Re: How many of you get Doctor Bills over a year o
Post by Mikey on Nov 28th, 2003, 4:16pm
Just reading your post helped me Donna!!

And LMAO Patrick!!

Mikey,  ;;D

Title: Re: How many of you get Doctor Bills over a year o
Post by Elaine on Nov 28th, 2003, 8:17pm
Thanks Donna!

Title: Re: How many of you get Doctor Bills over a year o
Post by FrankF on Nov 28th, 2003, 8:48pm
I have had my problems with doctors billing me for services that wre not approved or that should have been paid by my insurance.

According to all of the HMO insurance deals (three) I have had over the past seven years, I am responsible for my co-pay. As long as I foolow the rules, they pay everything else. Including extra bills from ER room doctors at the hospital. The written agreement when I sign in at the hospital is that I am responsible for all charges, less those that my HMO agreement pays (read it backwards... I am not responsible for any charges that my agreement with the HMO says they will pay for).

Over the past seven years I have been billed four times by various hospital doctors for about $1000. I just tell them that according to my HMO agreement I don't owe it, and take it up with them because I am not paying. One time I got turned over to a collection agency but I threatened to sue them, the insurance company, and the doctor who billed me. Eventually they get it.

Title: Re: How many of you get Doctor Bills over a year o
Post by Giovanni on Nov 29th, 2003, 11:02am
Frank,

If that doctor(s) are "providers" under the HMO plan, then you should owe no more than the co-pay.  Am I wrong?

[smiley=huh.gif]

Title: Re: How many of you get Doctor Bills over a year o
Post by Prense on Nov 29th, 2003, 11:23am
My insurance co. gives me the impression that prior to being honored by a medical facility, prices are pre-negotiated for services.  Although, the hospital/clinic bills the full amount, the excess amount is for tax purposes.  Every visit I have, I get a bill for the remaining amount...when this happens, I contact the insuarance co., and they tell me the same thing, and that I do not pay that amount.  I have never gotten more than one bill for the same service...like you would get if they expect you to pay it or something.  Again, if I don't follow the procedure with the insurance co., I will be responsible for the full amount.

I was under the impression that this was pretty standard for HMOs with the exception of deductibles, etc.  Maybe not...

Chris

Title: Re: How many of you get Doctor Bills over a year o
Post by fubar on Nov 29th, 2003, 2:40pm

on 11/23/03 at 15:42:16, jonny wrote:
Actually, im sick of sending chicks to the hospital...;;D

..................................jonny



... for infections  :P

Title: Re: How many of you get Doctor Bills over a year o
Post by jonny on Nov 29th, 2003, 3:46pm

on 11/29/03 at 14:40:02, fubar wrote:
... for infections  :P


You can do better than that cant you?...............................jonny

Title: Re: How many of you get Doctor Bills over a year o
Post by fubar on Nov 29th, 2003, 6:43pm
That one was a bit easy, I'll admit that.   ;;D

Title: Re: How many of you get Doctor Bills over a year o
Post by cootie on Nov 29th, 2003, 6:48pm
Interesting word for the day........
INFECTION ? for such a crappy word check out # 5 description.........

Main Entry: in·fec·tion
Pronunciation: in-'fek-sh&n
Function: noun
Date: 14th century
1 : the act or result of affecting injuriously
2 : an infective agent or material contaminated with an infective agent
3 a : the state produced by the establishment of an infective agent in or on a suitable host b : a disease resulting from infection
4 : an act or process of infecting; also : the establishment of a pathogen in its host after invasion
5 : the communication of emotions or qualities through example or contact

Title: Re: How many of you get Doctor Bills over a year o
Post by Donna_D. on Nov 30th, 2003, 9:02am
Cootie,

Exactly how far out of town do you have to go to see a participating doctor on your plan...most insurance companies will set up a referral if you have to drive more than "X" distance.  If you will email me some specifics I will see what I can do to help.  I hate to see anyone pay for stuff they shouldn't have to...

Donna D.

Title: Re: How many of you get Doctor Bills over a year o
Post by FrankF on Nov 30th, 2003, 4:11pm

on 11/29/03 at 11:02:52, Giovanni wrote:
Frank,

If that doctor(s) are "providers" under the HMO plan, then you should owe no more than the co-pay.  Am I wrong?

[smiley=huh.gif]

There was a scam going on for years at the local hospital where doctors hired by the hospital would bill patients for ER and other services that they claimed were "over and above" the hospital ER charges.

According to the papers I filled out when admitted to the ER I am liable for all charges over and above what my HMO contract says they will pay. My HMO agreement says they will pay everything, except I owe a $35 copay. The way I read it, I don't owe anything more, no matter who hires them or who they work or what their payment arrangements.

Still, the doctors (EEMG, Inc.) would bill me and threaten me if I did not pay. I just told them to pound sand. One time when my wife in a COMA at the hospital,  I was billed $600 by a psychiatrist for psychiatric therapy.  When I threatened to sue the doctor for treating my wife without her or her PCPs permission and asked why the fuck they were trying psychiatric therapy on a patient who was in a COMA anyway?... I never heard from the doctor or billing company again.

BTW... all EEMG, Inc. doctors were recently fired by the hospital for the same fraudulent billing practices so I don't have to worry about hearing from them anymore.



Title: Re: How many of you get Doctor Bills over a year o
Post by Elaine on Nov 30th, 2003, 7:25pm
Looks like my insurance company tried to pull a fast one on me. They want to say my Doctor is out of network. But he wasn't I went to their web site when I picked this doctor, and thank God I printed it out and kept it. Guess what he is not on there now. So they don't want to pay. To bad they will have to pay he was on there at the time I went to him! :-)
Thanks Guys! Thank God for printers :-)



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