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Thu 11 May, 2006 05:31 pm
So here's what happened.
I cut my finger.
I looked in the Yellow Pages for a clinic.
I called, confirmed directions, and went to the clinic.
When I get there, lo! and behold, it's not a clinic, it's a hospital! (DECEPTION #1)
I asked them repeatedly how much it would cost. No one would say. (On the back of the bill I eventually got, it states that I am entitled to an estimate before charges are incurred, so DECEPTION #2)
I asked the doctor, who was to send a separate bill, for an estimate of his services and he said about $180. So, I'm thinking, okay, that's not too bad.
When I checked out, the billing clerk claimed that they have an uninsured discount, AND a discount for paying the balance in full. I paid the balance in full for about $117. So, I'm thinking, that's not too bad.
I get a bill from the HOSPITAL (not a clinic as advertised) for another $296, still with an aside that the doctor would also be sending a bill. (DECEPTION # 3)
So, I contact them by email. And they change their story to a balance of only $234, not the $296. No explanation for the change. (DECEPTION #4) I replied that my balance was paid in full when I checked out and that I owe nothing. And they say THAT was just an estimate. And so I'm thinking ... on the back of the bill it says that "payment is due in full at the time services are rendered" so, I mean, how can they "estimate" when payment is due in full at the time? (DECEPTION #5)
I haven't heard back from them.
THREE months later, I get a bill from the doctor. With his "courtesy" discount, it's not $180 like he said, but a whopping $418! (DECEPTION #6)
I mean really, almost $800 they want total from this NON-CLINIC for three stitches.
What's to keep these NON-CLINICS from charging $400,000 or $4 million?
Are there any standards?
Who regulates this sort of thing?
I'm fighting mad!
Thank you.
Oh my gosh!
That is so completely nuts.
I think I would call the attorney general of your state with such a complaint.
Your State's Consumer Affairs office (Usually a part of the AG's Office) would be a good place to start.
Thanks, boomerang.
Are you serious? Or joshing me?
'Cause I really do think I've been lead on here.
Thanks.
Fishin', thanks for the information. I know everyone seems to complain about medical bills these days. I really don't know what would be considered an appropriate amount to pay.
Are there medical rates standards for services rendered I can compare?
dupre wrote:I really don't know what would be considered an appropriate amount to pay.
Are there medical rates standards for services rendered I can compare?
If you could find someone that works for a health insurer you could probably find out what the "allowable rates" are for that insurance company but that's about as close as you'll probbaly get. I don't think there are any rate standards for medical care.
IMO, I'd approach it from a "Their statment says the bill must be paid when services are rendered, I asked how much I owed, they told me and I paid that amount and now they want more." perspective. Let Consumer Affairs figure out what the laws are from there.
I'm not joshing you at all!
You can try and fight it, but the reality is if you are uninsured you pay more. The reason given by hospitals, labs and clinics is that insurance companies negotiate discounts by doing business in volume. It's why some insurance companies will only cover certain labs, hospitals or even doctors.
I would start by contacting the doctor who gave you the "estimate " of $180. If you can't reach him by phone send him a registered letter. He has an assistant who does the billing and that person might have determined the rate based on a general fee scale. Sometimes by complaining (nicely) to the doctor you will get a reduced fee.
Hey, thanks for the good ideas.
I did find a web site, believe it or not!, that seems to list rates by medical billing code. At least it lists what medicare would pay.
And, if I interpret this correctly, the doctor's bill would have been about $60.00.
Here's the site.
The CPT code on my bill is 99283. Emergency Services, non-critical.
http://www.cms.hhs.gov/apps/pfslookup/step0.asp
He doesn't bill from his own office.
He uses a service in another state.
I'm wondering if he sees the same bills his customers see ... ?
I just put in another code from my bill 12001. It would be billed at about $130 for the sutures. .. but my bill isn't broken down by code. It's just a lump amount.
The two added together are about $180.
Somethings fishy.
Yea!
I just checked online at the hospital's payment site and my balance with them is zero!
Original Balance Credits Current Balance Last Pay Date
Patient Portion $411.65 $179.12 $232.53 2006-04-06
UNINSURED DISCOUNT PLAN $221.65 $221.65 $0.00 2006-01-29
Any Internet Payments made will be processed within 24 hours.
That may not line up right, but anyway the balance is zero.
So, now I'll send a very nice letter to the doctor's billing service and copy it to him at a home or office address (if I can find one) and at the hospital emergency room, too. And I'll send a check with a limited endorsement for $180.00.
like: endorsing this check accepts payment in full for services, yada yada,
Any ideas on that?
I'm so pleased about the hospital, because my boyfriend went there about two weeks later, and his bill was about $118.00 for payment in full. They even sent him back .08 cents!
So, I guess they just made an error.
Yea!!!
Happy Dance!
Whoops!
I misread that Internet site.
They say I owe $232.53.
Great news, dupre!
I think they (and many, many other businesses) count on customers not really paying much attention. I regularly check my receipt to see if it's what I expected, and probably 5% of the time it's not, and I go back and point it out, and get money back.
Anyway, glad this seemed to work out, and good for you for being proactive!
Boomer-Often, when you go to one of these outpatient clinics, there are two separate charges. One is for the doctor, and the other is for the use of the facility.
Also, for instance, if you have a CAT scan or an MRI, there might be a charge for the actual procedure, and another for the radiologist's interpretation.
It sounds to me that you have been mislead. If the facility is still insisting on payment, I would definitely complain. I hope that you have all the paperwork, that listed the facility's policy.
Thanks, you guys.
I know this isn't a real big deal or a lot of money. Well, it IS for me.
Anyway, I called. They insist on payment. Had discounted it another $61, hence the different amounts. I'm on a payment plan of $50.
I'm going to send the doctor that note, and after he accepts that check for payment in full, I will contant the DA's office and the Better Business Bureau.
But, I will pay the bill.
That $232. will cost them big time. EVEN if it ends up that everyone takes their side. They still have to address it. And I DO think I have some very valid points, so it should be pursued.
But, in the long run, it's better for me to protect my credit.
Who knows? Maybe eventually, I'll get some of it back.
But they DID mislead me, at the least. The list of "deceptions" seems pretty long to me.
What they are claiming is that the payment when I left was an estimate, and that all of the departments hadn't submitted their bills yet.
Whatever! This is the age of the computers. I mean, really, they should've been able to get a total charge (at least all the hospital charges) to me, since they do demand payment in full at the time services are rendered.
Thanks,
I'll keep you guys posted as this thing progresses.
But right now, I'd be willing to testify before a congressional committee and pursue this to changes in the law for the consumer.
What if the bill had been $4 million?
I'd really like to know how to handle that ...
Do we really gotta pay just whatever they say, no matter what?
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