Author Topic: Handling surprise outrageous medical bills  (Read 9776 times)

ac

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Handling surprise outrageous medical bills
« on: October 09, 2015, 08:34:34 PM »
I was expecting a $140 medical bill.  I got a $2527 bill instead. 

We're having a baby in March.  Our OB said cell free DNA tests were inexpensive now, and so we should do it since my wife is in "advanced maternity" at 36 years old.  I told our doc that our High deductible health plan (HDHP) with blue crosss blue shield (BCBS) does not cover anything fancy, so a maternal/fetal nurse at the blood draw facility called the Sequenom representative that she knew well and told us we would pay ~$140.  Sounded reasonable, so we did the test. 

Sequenom billed BCBS for $2762, and BCBS sent us a check for $235 to pass on to Sequenom.  Sequenom sent us a bill for $2762-$235 = $2527.  $2527 is more than $140. 

We're planning on calling up the nurse who told us to expect $140 and asking her 1) who the Sequenom rep was who estimated $140 and 2) to call Sequenom again and get this fixed.

Any better advice on what to do right now?

Any experiences with Sequenom?

In my pessimistic crystal ball I assume I will end up getting no real help from the nurse, bcbs, or sequenom.  I will then mail Sequenom a certified letter with BCBS check and with a $140 check from me.  I will lay out the chronological events by date and emphasize that a sequenom representative is the one who estimated $140.  So $140 is what we mutually agreed to up front.  Now our balance with them is $0.00. By depositing our $140 check and the bcbs check they agree that our settlement is fair.  If they want to discuss further, they can talk with their own rep.  If they send us further invoices, we will mail them to their rep along with a copy of our letter.  I'd also love advice assuming I get no real help from the nurse, bcbs, or sequenom. 

SwordGuy

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Re: Handling surprise outrageous medical bills
« Reply #1 on: October 09, 2015, 08:56:56 PM »
Dispute the bill for the reason you gave.

Make sure your note gets attached to your credit reports.

Take the hit on the credit score (if there is one) and learn the laws on what collection agents can and cannot do.

Hope like hell you can document the collection agents doing illegal acts, because you'll make a handy profit.

If need be, settle for $210 with the collection agent, which is a 50% cost overrun on the estimate, and them removing any bad marks on your credit.


N

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Re: Handling surprise outrageous medical bills
« Reply #2 on: October 09, 2015, 10:31:40 PM »
I have learned the hard way that one MUST call and verify and pre-approve just about every single little thing before you actually do it.
And read your policy backward and forward more than once.
Do NOT rely on the provider to know YOUR insurance's details.

I hope you do succeed in disputing the bill. Your policy will also have info on how to dispute, they may have specific rules.
Call and talk to a rep for your insurance and see what can be done at this point.

good luck.


ac

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Re: Handling surprise outrageous medical bills
« Reply #3 on: October 10, 2015, 03:07:41 AM »
Our experience with this specific case and also others is that when we call bcbs to pre-approve, they ask for a code.  Then we ask the provider for the code, and the provider has no idea what the code is.  That's why the provider called the test lab's representative directly and told the rep our insurance info. 

How do you get pre-approval from the insurance company?

justajane

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Re: Handling surprise outrageous medical bills
« Reply #4 on: October 10, 2015, 06:51:10 AM »
I'm so sorry this happened to you. Our OB recommended such tests during my last pregnancy. I was also 36. I think he quoted a similar low number like that. We didn't end up doing it, mainly because we didn't know what we would do with the information anyway.

Is the blood draw facility connected directly with your OB? If so, I would raise a stink there and see if they will go to bat for you. Maybe we're just lucky, but our OB seemed to really care about what his patients are paying.

Hopefully you will at least get some taken off, but it seems unlikely that you will get it down to $140. Create a number in your head that you are comfortable with and try to get it down to that.

Pregnancy costs stink. I ended up racking up $4,000 in a few hours on some advanced hospital tests to figure out if I had a pulmonary embolism. It sucked to pay it, but this was much more life and death than a genetic test.

pk_aeryn

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Re: Handling surprise outrageous medical bills
« Reply #5 on: October 10, 2015, 10:14:43 AM »
Is Sequenom considered out of network?

Thegoblinchief

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Re: Handling surprise outrageous medical bills
« Reply #6 on: October 10, 2015, 10:56:15 AM »
The trouble is you have nothing in writing.

mm1970

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Re: Handling surprise outrageous medical bills
« Reply #7 on: October 10, 2015, 01:03:20 PM »
Honestly, all you can do is keep balking and digging. Like, dig up the info from your health care plan.

This stuff happens ALL THE TIME.

Example: my 2nd kid needed surgery at 9  months.  It was about $20 to $25k.

He has double insurance.

First, we go to our pediatrician in our network.
He refers us to the urologist.
The urologist refers us to UCLA, because he doesn't do the surgeries anymore (he wasn't doing them often enough to stay current).
We get a pre-approval # for the surgery at UCLA.

Note, for the outpatient surgery, our cost, per my  health insurance (the primary) is $125.
It's about the same for the doctor bill (*they are separate).

First up, we get a letter from my insurance: "We have denied the surgery because it was not emergency."
No shit.  That's why we got PRE-APPROVED.
Called UCLA.  They went back through the billing - billed our local urologist, and he submitted it.

In the  mean time, my husband's insurance (High deductible) paid part of it.  But honestly, they shouldn't have, because my HMO should have.)

Eventually, it was covered by  my insurance.
But of course, then we got the doctor bill.
Rinse, lather, repeat.

Do you know how long it took until the bills were finally paid? 
18 months.

Many people would just say "screw it" and pay the bill.
But we are stubborn.

We had similar issues with genetic testing for #1 (I had an amnio, I was 35).
Similar issues with my hospital delivery bill for #1 (got a $3k bill, but our deductible was only $700?)

Sorry about this, but it's going to take some work to pull up all the info, make a million phone calls, to try and work it out.

I just got a letter from my insurance that they are denying coverage for a procedure.  It was from April of 2014.  Really?  I had to look up on line and see what it was!  Physical therapy when I threw out my back.

That's $30.  I'll probably pay it.  Eventually.  With our HSA card.  Once we get a new one.  Because when we were on vacation, someone stole the number (probably the Anthem Hack, or the UCLA hack), successfully stole $1200 or $1500 by taking out $300 several times within an hour.  Before someone realized what was up.

LiveLean

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Re: Handling surprise outrageous medical bills
« Reply #8 on: October 10, 2015, 03:37:25 PM »
This is the reason DW is working. We had self-employed health insurance for eight years and with ObamaCare looming on the horizon in 2010, we knew it would only get worse. I make too much as a self-employed person to ever get the equivalent in a full-time job with benefits.

After first son was born via C-section (while covered under wife's then job insurance) we were looking at our second son being born under our self-employed health insurance. I could never get an answer from insurer as to which would be covered/less covered -- a second C-section or a traditional delivery. If I called two days in a row, I'd get two different answers.

On the day the little guy showed up via another C-section we still had no idea. We ended up paying about $3,000 in various co-pays, including a bill that showed up on his first birthday, another $95 bill for an anesthesiologist. I just paid it rather than deal with more phone aggravation.

Then on Jan. 1, 2011, I woke up with a major kidney stone. Had it happened 24 hours earlier, I would have paid much less since we had maxed out most of our family deductibles for calendar year 2010. Instead I ended up paying $5,000 for ER visit and subsequent kidney stone surgery --- as if the kidney stone wasn't painful enough.

That's why DW works -- basically for health benefits. And we hear that story from people all the time.

Mirwen

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Re: Handling surprise outrageous medical bills
« Reply #9 on: October 10, 2015, 07:29:04 PM »
You have a HDHP.  The fact that you have to pay 100% of expenses up to your deductible shouldn't be a surprise.  If you are pregnant, you should be prepared to meet your deductible this year in any case. 

Was it wrong of them to mis-quote you?  I think so, but you don't really have a case here because it's up to you to contact your insurance about what they cover and how your deductible works.  Doctors never understand your cost and it's different for everyone.  It's one of the many broken things about our health insurance system in the US. 

Can you fight it?  Sort of.  You can refuse to pay the bill and put a note on your credit report.  It will still hurt your score somewhat, but medical bills count less exactly because of unfair situations like this.  I wouldn't do this if I were planning to buy a house in the next 5 years.  Otherwise it's probably OK for a Mustachian who doesn't use credit much.

If it were me, I would probably pay the bill because I was prepared to pay my deductible for a pregnancy year with my HSA savings.  It wouldn't matter to me if I paid it now or later.  Perhaps you are due after the first of the year and having to pay twice as much because of this snafu?  That would infuriate me too.

cchrissyy

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Re: Handling surprise outrageous medical bills
« Reply #10 on: October 10, 2015, 10:02:33 PM »
I once had a situation where a provider wouldn't accept the insurance company's payment as full payment and tried to bill me the balance. (my insurance paid 100% of the in-network rate, though provider was not in-network)

I got the insurance co to reprocess in a way that slightly raised the payment. So, 1st thing you should do is look it over for any mistakes, ask them to reprocess.

But it still left a lot uncovered.  The provider sent me 2 invoices and I got 2 collection phone calls.

And they went away! No further problem, no hit to my credit report.

 I think bc I was so "no way in hell" about paying them the difference and they decided my dollar amount wasn't worth pursuing.

I'm just saying this because, although it's a gamble, sometimes it really does happen like that.

ac

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Re: Handling surprise outrageous medical bills
« Reply #11 on: October 12, 2015, 12:04:44 PM »
Thanks for your replies.

The baby's due in March, so hitting the max out of pocket (~$11,000) is not the plan for this year.

Sequenom is out of network.  It sounds like they belong to no networks. 

We got BCBS and the test lab sequenom on the phone today.  Sequenom said to send them the explanation of benefits (EOB), and our out of pocket should be no more than $140.  We said "great, please send me that promise in writing."  They said....well....send me the EOB first.  Super weird. 

So we emailed sequenom the EOB and a asked them to confirm the $140 bit. 

I got some separate advice from a nurse:  When writing the checks, in the memo line write "Paid in Full."  When they cash it, its a nice bit of documentation that they accepted payment in full.

Rezdent

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Re: Handling surprise outrageous medical bills
« Reply #12 on: October 12, 2015, 12:21:02 PM »
Thanks for your replies.

The baby's due in March, so hitting the max out of pocket (~$11,000) is not the plan for this year.

Sequenom is out of network.  It sounds like they belong to no networks. 

We got BCBS and the test lab sequenom on the phone today.  Sequenom said to send them the explanation of benefits (EOB), and our out of pocket should be no more than $140.  We said "great, please send me that promise in writing."  They said....well....send me the EOB first.  Super weird. 

So we emailed sequenom the EOB and a asked them to confirm the $140 bit. 

I got some separate advice from a nurse:  When writing the checks, in the memo line write "Paid in Full."  When they cash it, its a nice bit of documentation that they accepted payment in full.
Meh.
I knew a lady whos ex routinely wrote "paid in full" on every check he sent towards the money he owed her.
She always scribbled it out completely (rendering illegible) before cashing the check at his bank.  Apparently this was sufficient, she wasn't ever denied by the bank.

honeybbq

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Re: Handling surprise outrageous medical bills
« Reply #13 on: October 12, 2015, 12:39:20 PM »
I don't think your plan will work. They will not be intimidated by your threats and will probably just throw your letter away, unfortunately, without even reading it. The person receiving your check doesn't know or care about your situation.

But good luck fighting! Physicians notoriously will have no clue at what you are actually billed. You should have known you were not out of your out of pocket maximum. There is virtually no test on earth that costs less than $150.

I was in the ER once for something completely unrelated, I was menstruating at the time. I told them like 5 different times because there would be blood in my urine samples. Not only did they charge me for tons of tests to find out why there was blood in my urine, they also charged me for a pregnancy test. *head desk* It's all standard procedure because I could be lying and they have to cover their asses so there was no waiving of the fees.

Argyle

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Re: Handling surprise outrageous medical bills
« Reply #14 on: October 12, 2015, 12:46:55 PM »
Testing for blood in urine during your period does sound asinine.  However, to my astonishment I found out that you can actually continue to have periods for a few months while pregnant.  Who knew?  I don't know if this was why they were testing you, but it's possible.

ac

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Re: Handling surprise outrageous medical bills
« Reply #15 on: October 12, 2015, 12:52:11 PM »
The letter would mainly be for paper trail consistent explanation to give folks related to collections or credit score issues.  Don't care about "intimidating" or "threatening" the publicly traded company. 

I don't understand you here:  "You should have known you were not out of your out of pocket maximum. There is virtually no test on earth that costs less than $150."  There are plenty of tests that are less than $150, especially after insurance kicks in.  My kids get them every time they go to a check up.  My wife just got one last month. 

Winter's Tale

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Re: Handling surprise outrageous medical bills
« Reply #16 on: October 12, 2015, 12:55:18 PM »
Do you have an employee assistance plan (EAP)?  Our EAP offers a service called "personal health partners" they have trained specialists available to help people navigate insurance issues such as this one.  Might be worth looking into.  Good luck.  This sounds like a very frustrating situation.

ac

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Re: Handling surprise outrageous medical bills
« Reply #17 on: October 12, 2015, 12:57:27 PM »
I'm in a 2 person company.  I'm the closest thing we have to HR.  I assume the EAP is a big employer thing.  Thanks though. 


ac

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Re: Handling surprise outrageous medical bills
« Reply #18 on: October 12, 2015, 01:00:59 PM »
Testing for blood in urine during your period does sound asinine.  However, to my astonishment I found out that you can actually continue to have periods for a few months while pregnant.  Who knew?  I don't know if this was why they were testing you, but it's possible.

We've gotta stop testing for every little possible problem though.  The odds of menstrating while pregnant have to be tiny.

We only bothered doing our genetic test because I have trisomy 21 (down syndrome) in my family, and my wife is in a high risk group too.  And we thought it'd be a reasonable price. 

honeybbq

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Re: Handling surprise outrageous medical bills
« Reply #19 on: October 12, 2015, 01:04:33 PM »
The letter would mainly be for paper trail consistent explanation to give folks related to collections or credit score issues.  Don't care about "intimidating" or "threatening" the publicly traded company. 

I don't understand you here:  "You should have known you were not out of your out of pocket maximum. There is virtually no test on earth that costs less than $150."  There are plenty of tests that are less than $150, especially after insurance kicks in.  My kids get them every time they go to a check up.  My wife just got one last month.

But that's the point of the HDHP - there is essentially NO insurance until you meet your max out of pocket, except for the routine wellness exams (usually, depends on the plan).

ac

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Re: Handling surprise outrageous medical bills
« Reply #20 on: October 12, 2015, 01:53:26 PM »


The letter would mainly be for paper trail consistent explanation to give folks related to collections or credit score issues.  Don't care about "intimidating" or "threatening" the publicly traded company. 

I don't understand you here:  "You should have known you were not out of your out of pocket maximum. There is virtually no test on earth that costs less than $150."  There are plenty of tests that are less than $150, especially after insurance kicks in.  My kids get them every time they go to a check up.  My wife just got one last month.

But that's the point of the HDHP - there is essentially NO insurance until you meet your max out of pocket, except for the routine wellness exams (usually, depends on the plan).

Incorrect.

My HDHP drastically reduces the cost of medication.  Out of network costs are paid at 50%.  After the deductible is met, coinsurance is 50%.  I do not think this is extraordinary for HDHPs because I've reviewed many insurance options for our company. 

ac

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Re: Handling surprise outrageous medical bills
« Reply #21 on: October 12, 2015, 02:00:53 PM »
Honestly, all you can do is keep balking and digging. Like, dig up the info from your health care plan.

This stuff happens ALL THE TIME.

Example: my 2nd kid needed surgery at 9  months.  It was about $20 to $25k.

He has double insurance.

First, we go to our pediatrician in our network.
He refers us to the urologist.
The urologist refers us to UCLA, because he doesn't do the surgeries anymore (he wasn't doing them often enough to stay current).
We get a pre-approval # for the surgery at UCLA.

Note, for the outpatient surgery, our cost, per my  health insurance (the primary) is $125.
It's about the same for the doctor bill (*they are separate).

First up, we get a letter from my insurance: "We have denied the surgery because it was not emergency."
No shit.  That's why we got PRE-APPROVED.
Called UCLA.  They went back through the billing - billed our local urologist, and he submitted it.

In the  mean time, my husband's insurance (High deductible) paid part of it.  But honestly, they shouldn't have, because my HMO should have.)

Eventually, it was covered by  my insurance.
But of course, then we got the doctor bill.
Rinse, lather, repeat.

Do you know how long it took until the bills were finally paid? 
18 months.

Many people would just say "screw it" and pay the bill.
But we are stubborn.

We had similar issues with genetic testing for #1 (I had an amnio, I was 35).
Similar issues with my hospital delivery bill for #1 (got a $3k bill, but our deductible was only $700?)

Sorry about this, but it's going to take some work to pull up all the info, make a million phone calls, to try and work it out.

I just got a letter from my insurance that they are denying coverage for a procedure.  It was from April of 2014.  Really?  I had to look up on line and see what it was!  Physical therapy when I threw out my back.

That's $30.  I'll probably pay it.  Eventually.  With our HSA card.  Once we get a new one.  Because when we were on vacation, someone stole the number (probably the Anthem Hack, or the UCLA hack), successfully stole $1200 or $1500 by taking out $300 several times within an hour.  Before someone realized what was up.

Sorry to hear these stories.  I'm sure surgery on your baby would be very hard to deal with.  We thought we might have to do that with our first kid, but things turned out OK. 

I used to be a full libertarian.  The frustrations from my family's totally unremarkable medical needs have turned me into supporting universal healthcare.  What an arbitrarily messy system we have. 

mm1970

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Re: Handling surprise outrageous medical bills
« Reply #22 on: October 12, 2015, 02:01:06 PM »


The letter would mainly be for paper trail consistent explanation to give folks related to collections or credit score issues.  Don't care about "intimidating" or "threatening" the publicly traded company. 

I don't understand you here:  "You should have known you were not out of your out of pocket maximum. There is virtually no test on earth that costs less than $150."  There are plenty of tests that are less than $150, especially after insurance kicks in.  My kids get them every time they go to a check up.  My wife just got one last month.

But that's the point of the HDHP - there is essentially NO insurance until you meet your max out of pocket, except for the routine wellness exams (usually, depends on the plan).

Incorrect.

My HDHP drastically reduces the cost of medication.  Out of network costs are paid at 50%.  After the deductible is met, coinsurance is 50%.  I do not think this is extraordinary for HDHPs because I've reviewed many insurance options for our company.

True.  My husband has HDHP at work.  I cover myself and the kids, he covers the whole family, so he's the only one not double covered.

And he does get reduction in medication costs.

justajane

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Re: Handling surprise outrageous medical bills
« Reply #23 on: October 12, 2015, 02:02:41 PM »
Out of network claims are 50% paid for prior to deductible? What does that mean exactly?

Medications work differently, but honeybbq is right that prior to the deductible being met, you pay 100% of the negotiated rate. Like I said above, we paid 4K for various tests during my last pregnancy. We essentially reached our deductible in 2 hours! It stunk, but thank god it was in the first week of January rather than the last week of December. That would have colossally suck.

You have my sympathies for having big pregnancy bills in two calendar years.

NoraLenderbee

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Re: Handling surprise outrageous medical bills
« Reply #24 on: October 13, 2015, 03:56:44 PM »

I got some separate advice from a nurse:  When writing the checks, in the memo line write "Paid in Full."  When they cash it, its a nice bit of documentation that they accepted payment in full.

No, it isn't. The memo line doesn't have legal force. If the check is for less than the amount owed, you (general you, not your situation specifically) still owe the balance, and the creditor still has the right to go after you for it. Writing "paid in full" does not mean that the creditor, by accepting the check, agrees to settle the debt for less than the original amount. You could write "Payment for sexual favors" on the memo line, as my college friends used to do when they paid the phone bill; that doesn't mean the phone company, by cashing the check, provided documentation that it engaged in prostitution.

ac

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Re: Handling surprise outrageous medical bills
« Reply #25 on: October 20, 2015, 08:49:41 AM »
Update:  after calling Sequenom and explaining my expectations, they asked to see my insurance company's explanation of benefits.  I sent it, and they sent back an invoice which leaves me with the $140 cost I was expecting. 

So a short term happy ending for me.  But it still seems like a terrible way to conduct business.  Our OB said his guess is that they send the $2762 bill to Medicaid and some insurers, and it just gets paid.  But Sequenom's also happy to take much less money.  Even as little as $140 apparently. 

ac

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Re: Handling surprise outrageous medical bills
« Reply #26 on: October 20, 2015, 08:59:00 AM »
Out of network claims are 50% paid for prior to deductible? What does that mean exactly?



Yeah, its odd.  In some cases its better for you to go out of network than in.  But its nothing to count on.

Here is how it worked for us:

Sequenom is out of network
They sent a claim to BCBS for $2762
BCBS said $495 of that was "covered expenses"
BCBS paid 50% of the covered expense = $247.50 (I wrote the wrong number earlier above) even though I have not reached my deductible.

ac

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Re: Handling surprise outrageous medical bills
« Reply #27 on: October 20, 2015, 09:07:46 AM »

Medications work differently, but honeybbq is right that prior to the deductible being met, you pay 100% of the negotiated rate.


I really don't want other people to be confused by HDHP insurance.  honeybbq is absolutely not right. 

honeybbq said No insurance until you meet your max out of pocket.  Very wrong. 

Much more accurate is what you say:  Prior to the deductible being met you pay 100% of the negotiated rate.  That is also how health insurance usually works.  Its just that for a High Deductible Health Plan, the deductible is...high.

The_path_less_taken

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Re: Handling surprise outrageous medical bills
« Reply #28 on: October 20, 2015, 09:32:48 AM »
I think the best thing to do is to document date/time/NAME/title of everyone you talk to in the insurance process: "I spoke to Jane Doe at 10am on 9-2-15, and she said...." and get any kind of code or pre-approval possible. If it's something you can semi-plan for like a surgery or a birth, I'd even try to get crap in writing.

I just had an MRI on my knee. The insurance required me to get pre-approval, the doctor office required pre-approval, they called, I called, we were both told it was $250 out of pocket for me.

I just got a bill for $847.

I'll be abducted by aliens before I pay that.

skunkfunk

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Re: Handling surprise outrageous medical bills
« Reply #29 on: October 20, 2015, 09:42:26 AM »
A similar thing happened to me last year, with Sequenom. In our case it was to check for cystic fibrosis genes.  It was a bit different since my wife has a normal insurance plan that paid for her side of the test, but we owed the full amount for mine. We said that we were told a different cost and they waived the balance.

mm1970

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Re: Handling surprise outrageous medical bills
« Reply #30 on: October 20, 2015, 10:33:24 AM »
Update:  after calling Sequenom and explaining my expectations, they asked to see my insurance company's explanation of benefits.  I sent it, and they sent back an invoice which leaves me with the $140 cost I was expecting. 

So a short term happy ending for me.  But it still seems like a terrible way to conduct business.  Our OB said his guess is that they send the $2762 bill to Medicaid and some insurers, and it just gets paid.  But Sequenom's also happy to take much less money.  Even as little as $140 apparently.
sounds like what happened when I had my first kid.  Hospital billed me $3k-ish.  I called them for the bill.  I tried to line it up with the EOB.  I called the hospital back.  They said "we'll take care of it".

bacchi

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Re: Handling surprise outrageous medical bills
« Reply #31 on: October 20, 2015, 10:52:50 AM »
I once had a situation where a provider wouldn't accept the insurance company's payment as full payment and tried to bill me the balance. (my insurance paid 100% of the in-network rate, though provider was not in-network)

I got the insurance co to reprocess in a way that slightly raised the payment. So, 1st thing you should do is look it over for any mistakes, ask them to reprocess.

But it still left a lot uncovered.  The provider sent me 2 invoices and I got 2 collection phone calls.

Something similar happened to me. Thankfully, the SO's mom is a lawyer; the provider quickly backtracked after a letter was sent.

Britan

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Re: Handling surprise outrageous medical bills
« Reply #32 on: October 20, 2015, 11:57:04 AM »
Just going to throw this out there: check your state law regarding balance billing. Some states ban this practice (what the provider did). Some don't ban billing, but note that the consumer is not required to pay the balance, but neither the ins company nor te provider has to tell you that you dont HAVE to pay it. The latter is stupid, but some states are like that.

Might not apply here, but thought it might help someone.

ac

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Re: Handling surprise outrageous medical bills
« Reply #33 on: October 20, 2015, 12:44:25 PM »
Just going to throw this out there: check your state law regarding balance billing. Some states ban this practice (what the provider did). Some don't ban billing, but note that the consumer is not required to pay the balance, but neither the ins company nor te provider has to tell you that you dont HAVE to pay it. The latter is stupid, but some states are like that.

Might not apply here, but thought it might help someone.

Good point.  It doesnt help me, but in case others are interested here is a comprehensive chart

http://kff.org/private-insurance/state-indicator/state-restriction-against-providers-balance-billing-managed-care-enrollees/

NCGal

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Re: Handling surprise outrageous medical bills
« Reply #34 on: October 20, 2015, 02:07:56 PM »
This makes my blood boil. I'm so sorry this happened to you.  Every facility makes you, the patient, sign off on 'I understand if my insurance plan doesn't cover the costs I am responsible for the bill'. But none of them will sign off on 'I understand I have given you quotes for specific services at X dollars for said services. If our asinine system invoices you for other services, we are responsible".  The problem is that the medical industry is not transparent. 

There's an interesting article in the Atlantic about another woman's 'Obamacare pregnancy' while on an HDHP.
http://www.theatlantic.com/business/archive/2015/10/pregnant-obamacare/410356/

honeybbq

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Re: Handling surprise outrageous medical bills
« Reply #35 on: October 21, 2015, 02:14:15 PM »

Medications work differently, but honeybbq is right that prior to the deductible being met, you pay 100% of the negotiated rate.


I really don't want other people to be confused by HDHP insurance.  honeybbq is absolutely not right. 

honeybbq said No insurance until you meet your max out of pocket.  Very wrong. 

Much more accurate is what you say:  Prior to the deductible being met you pay 100% of the negotiated rate.  That is also how health insurance usually works.  Its just that for a High Deductible Health Plan, the deductible is...high.

Ok, you're right, that is what I meant but stated poorly.  You still get the insurance rate, but it's not like you go into co-pay mode or anything. You are responsible for the full bill.

ac

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Re: Handling surprise outrageous medical bills
« Reply #36 on: October 26, 2015, 09:58:52 AM »
This makes my blood boil. I'm so sorry this happened to you.  Every facility makes you, the patient, sign off on 'I understand if my insurance plan doesn't cover the costs I am responsible for the bill'. But none of them will sign off on 'I understand I have given you quotes for specific services at X dollars for said services. If our asinine system invoices you for other services, we are responsible".  The problem is that the medical industry is not transparent. 

There's an interesting article in the Atlantic about another woman's 'Obamacare pregnancy' while on an HDHP.
http://www.theatlantic.com/business/archive/2015/10/pregnant-obamacare/410356/

Yes I liked the Lexus vs Honda example she gave.

When I read it, the comments were full of people slamming her - mainly for the title.  Very very few agreeing with her.  I was shocked.  The content of the article was fantastic and addresses a huge problem with healthcare in the US.