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Learning, Sharing, and Teaching => Ask a Mustachian => Topic started by: N on November 01, 2013, 12:05:20 AM

Title: What Should I Do About This Medical Bill
Post by: N on November 01, 2013, 12:05:20 AM
Here is my problem:

I have a medical bill from a rehab facility in the amount of 2700$ Its actually my husband's, it is from February 2011
Im not sure of the date I received the first notice of it, but I got one, and then I think one followup reminder, and nothing since.

My husband went into the hospital to have a hip replacement. After a few days the hospital had to release him, but he needed a temporary rehab stint before he could come home. At the hospital, I spoke to the care coordinator person,  who said she would find a referral for us, in network, that could take him. She said she found one in our insurance, and I asked her how long he was going to be in rehab and how long the insurance would cover-she said about 4 days.

So he transferred there on a saturday.

On tuesday, he already felt like he could come home. It was a question of him being able to get up our stairs to our apartment (2nd floor) and he really wanted to get home. On Tuesday I tried to talk to a dr or director that would tell me when he was being released, and got a big run around. The told me there was a meeting to discuss his care on wed. So he would not be released tuesday.

I arrived on wednesday early in the day to find out when the meeting was and if he could come home that day. No one was available to talk to me, no answers, no time on meeting, no one returned my calls-finally at 4 pm I left a strongly worded message on the directors voice mail. she called me back to say the meeting was at 6 pm. So , no release on Wednesday.

On thursday, more run around. By this time, husband was realllllly unhappy and was telling everyone he wanted to leave, no answers from anyone. Finally talked to director and she said that he needed to stay there through the weekend, and he could come home Monday. I asked her what would happen if he just went home? I said that the hospital had told me the insurance would only cover him for 4 days. (which is why we expected him to go home on tuesday or wednesday) but she assured me the insurance would cover him until monday, and if he left AMA, before Monday, that the insurance might refuse to cover any part of his stay.

In hindsight, I wish I had called the insurance myself, but it did not occur to me that I could. I had had surgery on my leg just a few months prior and never spoke to anyone from insurance about it, the drs did it all, and it had been fine.

So the rehab center kept him until Monday, so he was there 10 days.

Then I got a bill for the whole amount, 2700$. I called my insurance-they said the rehab center was out of network and so had to apply out of network deductible (5k?) first, etc. so we were on the hook for the full amount. The insurance people said they showed that the hospital did call them on the date after the surgery, but there is no record of what was said.

So, first of all, we never would have chosen an out of network rehab. And we wanted him released 5-6 days before they would release him.

Ive never spoken to anyone from the rehab since he was released, and as I said, Ive only received two bills, and no collections or anything, although its been over 18 months.

Yes, it would have been better if I had dealt with this much earlier, but I can only say that there has been a multitude of other bills and issues to deal with since then, and since I wasnt getting hassled by them, I thought Id leave it alone as long as I could- head in the sand style.

I cant say what the motive or excuse the hospital person had for lying to me-because she flat out lied to my face, but it seems fairly clear that the rehab center was trying to keep him as long as they could for $$, maybe they did not know he was not on medicaid (seems like most of their other patients were) or what, but they were milking us. but they lied to, since they told me they had talked to the insurance and he was covered.

maybe they know they were in the wrong and that is why they have not pursued this bill, or maybe they are just totally inefficient and behind.

in any case, what are my options? What should I do at this point?

I dont have the whole amount right now to pay. I could probably pay half after Dec 1. or could agree to a payment plan for some  (or all, if I absolutely have to, of the total)

I dont think we really should have to pay the whole thing, but should I go to them and negotiate?

our situation is that we have just paid off all of our other credit card and medical debt (more than 30K over the last few years)
but we are in foreclosure on our condo and live in a state where they can come after you for the amount of default, so I suppose bankruptcy is a looming possiblitity (it is possible for the mortgage to agree to not come after you)

I dont need facepunches, just where to go from here on this particular debt. Thank you.
Title: Re: What Should I Do About This Medical Bill
Post by: gooki on November 01, 2013, 12:23:59 AM
If it was me I'd post them a letter disputing the full amount of the bill.
Title: Re: What Should I Do About This Medical Bill
Post by: MissStache on November 01, 2013, 06:57:57 AM
Write up everything you have written to us, including names of the people you dealth with and dates that each interaction happened, and attach a letter from the insurance company stating what they told you.  Tell them you dispute the full amount of the bill as you were informed that the facility would be covered by insurance.  Send it certified mail.

They may back off.  If they don't, I'd consult with a lawyer to see if you have any options. 

You may still be on the hook for it.  If so, the finance people at the hospital will likely work with you to lower the bills or put you on a payment plan due to your financial circumstances.  Generally they don't want to send an account to collections because they don't get as much money that way. 
Title: Re: What Should I Do About This Medical Bill
Post by: Frankies Girl on November 01, 2013, 07:48:29 AM
I would call my insurance and ask them what your options are. If they truly won't pay the full amount due to it being out of network, then that is unfortunately on you for not confirming through your insurance. It really sucks, as the hospital employee either lied or made a mistake - and I would make sure to report this to your husband's doctor (his office manager) and to the hospital admin as well since they were supposed to be helping during all of that...

But you can still negotiate with the facility itself. Call the facility and talk directly to their billing department. Tell them that you cannot afford the bill. Ask them what they can do. Ask them for a reduction. Tell them what happened and chances are, they will start out offering you a slight discount. Tell them that you still can't afford the bill (don't take the first offer of reduction as they generally can reduce further). They can actually reduce the bill quite a bit, but they have a protocol they have to follow in stepping down the amounts they want you to pay. Some hospital/facilities coordinators will walk you through what they need to say and what you need to say to get to the best discount they can offer; I've just recently read of that on one PF blog I can't find right this minute...
In a hospital, if you are offered a 10 or 20 percent discount, press on. That is not a big reduction compared with the markup they are probably charging. "Go up the chain of command, calling the billing manager or the vice president of finance and so on, building a relationship with each person by telling your story," says Cohen. Make sure you write down every person's name, title, and contact information; the date and time you called; what you asked; and what each person said. If you reach an agreement, get it in writing.$2762-to-$200-with-a-1-min-phone-call/
Title: Re: What Should I Do About This Medical Bill
Post by: bogart on November 01, 2013, 08:22:53 AM
Besides the letter-writing others have recommended, I have had good results cc'ing our state insurance commissioner/regulator when I've had (legitimate) problems arise.  I really do send the cc's, and I send them certified mail also.  I haven't researched this approach systematically but it seems to yield prompt(er?) supplies and results I am happy with (reduced charges and such).
Title: Re: What Should I Do About This Medical Bill
Post by: lsalinas on November 01, 2013, 10:25:50 AM
I wanted to throw out there that there are statutes of limitations on medical bill collections.  I am not a lawyer (I am a finance manager who has worked in hospitals, insurance companies, pharmaceutical companies and medical device companies) - but I believe that the limitations can be 3 to 15 years depending on which state you live in.  So for example if the statute is 3 years and you got the bill in February 2011 and the follow up notice was in March, the facility can't make you pay after March 2014.  They can still send you letters after the statute of limitations, but you can legally ignore them.  However, if you do contact the facility and respond to letters after the statute of limitations, it restarts the clock on collections. 

So this is another what is legal versus what is ethical discussion.  I appreciate that you are trying to be honorable about paying off expenses you incurred, however how ethical were the charges in the first place?  Are they not actively trying to collect because they know that thier bill was unethical?  If they aren't contacting you, do you just let the statue of limitations run out?  (If you decide to do that you should probably check with a professional first that can tell you exactly what the law is).  Or do you call them and agree on a fair price?  I am sure that if you call to negotiate they will realize that whatever you are offering is better than nothing.   

Title: Re: What Should I Do About This Medical Bill
Post by: Numbers Man on November 01, 2013, 10:30:09 AM
Check your credit report. They have probably posted the bill as late on your credit report. Try to negotiate a reduced amount from the bill and then get on a payment plan. When this bill goes to the collection agency it will be much tougher to negotiate.

As you said before you should have had a consensus between the Insurance company and the hospital about this situation, but you dropped the ball. So try to mitigate  this situation as much as possible. Call or go to the hospital directly to negotiate. Don't be too surprised if you can't ever get a hold of someone when you call.
Title: Re: What Should I Do About This Medical Bill
Post by: SunshineGirl on November 01, 2013, 10:59:54 AM
Am I reading correctly that the last time you got a bill on this was a couple years ago?

If that's the case, I'd focus on your housing situation first and not to anything until you hear from someone again. Maybe set aside some money here and there so if it picks up again you can deal with it, but it almost seems like you'd stir up a hornet's nest if you did anything at this point other than pay the bill in full.
Title: Re: What Should I Do About This Medical Bill
Post by: Catbert on November 01, 2013, 01:17:01 PM
Don't sure I have a thought on what to do with the bill.  However, 10 days in rehab cost somebody much more than $2700.  I'm guessing that's your portion to meet your deductible or co-pay. 
Title: Re: What Should I Do About This Medical Bill
Post by: N on November 01, 2013, 04:06:15 PM
The rehab facility also lied to me and said that they had talked to the insurance and verified he was covered for the time they told me he had to stay. They said if we tried to leave early, that there was a chance the insurance would refuse to dispute the necessity of his being there at all and refuse to pay.

I did think about the legal statute of limitations, but even after the time expires, we still owe it, but they cant sue us for it.

If I do write a letter to them disputing, it does reset the clock on the collection.

I did check husbands credit report perhaps 6 mos ago, and it was not on there.
Title: Re: What Should I Do About This Medical Bill
Post by: gooki on November 01, 2013, 04:39:06 PM
If it was me I'd post them a letter disputing the full amount of the bill.

Just to confirm my advise wasn't aimed at settling the bill, but more to keep it in perpetual dispute until you are certain of your financial future. A collection agency can't do jack while the bill is in dispute.
Title: Re: What Should I Do About This Medical Bill
Post by: N on November 01, 2013, 11:22:59 PM
thanks everyone for the ideas.
I will think about what I am going to do. Id really like to get it settled-Id like it behind me.