A medical billing vent and caution

Discussion in 'The Watercooler' started by Nancy, Nov 9, 2012.

  1. Nancy

    Nancy Well-Known Member Staff Member

    A couple months ago I went to my doctor because I was having a great deal of joint pain. While I've had joint pain at times this was different, it was in many joints and came on all at once where before it was in one joint and would travel to another after a while and there were times when I was pain free. I asked for the blood test to determine whether I had rheumatoid arthritis because I felt so weak. He ordered that and X-rays of my neck, knee and both hands. In hindsight I should have just done the blood test which ruled out rheumatoid arthritis but I went ahead with the X-rays.

    I thought I was doing everything I could to keep my costs down, we have a $10,000 deductible per person, I called the insurance company to make sure the radiology location was in my PPO, I specifically did not go to a specialist I used in the past because they charge very high fees including a facility fee. They took 14 X-rays, 4 of my cervical spine, 3 of each hand and 4 of my knee. During this time I was very uneasy and should have spoken up and stopped it but didn't. He never used a lead shield for any of the X-rays and I would never have consented to 14 if someone had told me that's how many they would take.

    I got the bill for $1300 and with the provider contract price they want me to pay $860. I didn't pay that much for my foot surgery several months prior due to contract pricing. I have been dealing with the hospital for a couple weeks now. The patient advocate sent me a letter last week telling me the charges were correct because that was what the Dr ordered and they don't use a lead shield on women over 55. I asked her to send me a copy of the doctor's order and I received it today.

    The form the doctor filled out indicates 3 view of cervical spine and just had a check mark for right and left hand and left knee. I am calling my Dr Monday to ask him if he knew they would be taking 14 X-rays and if yes why did he order that since he knew what my deductible was and it's arthritis for goodness sake, they weren't looking for a needle in the haystack. I am prepared to pay for 6 X-rays, since I should have looked at the form and seen that's how many he ordered but I am not paying for 14 X-rays. I suspect I will have a fight over this but I'm prepared.

    I learned a very important lesson by this and want to pass it on. First, always ask how may X-rays they will be taking and in my case I should have and would have refused that many. For that matter make sure you know all of the services that will be performed on you. Also make sure you know what the charges will be before any services are begun and if you have a high deductible, make that known to everyone involved. I also should have stopped them and demanded a lead shield (but I didn't even think about it until the end when I saw it hanging up and he told me they don't use it for extremities).

    I believe the hospital saw I had insurance and gave no thought to what my deductible was. Either the doctor has to inform the patient exactly what is involved or the hospital has to tell you how many they are taking but they can't do this in secret and expect us to pay these outrageous bills. I know I made some mistakes in not stopping what was going on and I won't make that again.
     
    Last edited: Nov 9, 2012
  2. witzend

    witzend Well-Known Member

    Nancy, I hope that you will be able to find someone willing to work with you on this. I think it is also a good time to remember that it's getting towards the end of the year, and if we have a dental visit or eye appointment that we can use, we should use it before the next year comes and goes!
     
  3. CrazyinVA

    CrazyinVA Well-Known Member Staff Member

    I have a high deductible plan now and this is one of my worries. I've heard from other friends with similar plans that doctor's offices etc. aren't quite used to the plans yet, and they sometimes are quite confused when you ask how much something will cost. One friend of mine found out, after they scheduled an MRI of her knee at the hospital connected to the doctor's office, that an MRI center across town would costs hundreds less. The scheduling people were puzzled as to why she'd want to go across town, it hadn't occurred to them to schedule anywhere else. I recently had to get a nebulizer and asked the nurse what it would cost because I had a high deductible plan, and she said,"oh, it's les than $100." Well just got the bill... umm no it's almost $400.00. It would be $60 with "traditional" insurance. Wish I'd had time to shop around for that, but, I kind of needed to breathe at the time so I just took what the doctor's office gave me.

    Frustrating. Good luck fighting this!
     
  4. Nancy

    Nancy Well-Known Member Staff Member

    My husband needed an MRI on his knee about six motnhs ago. We called the place the dr was sending him to ask about the cost ansd they couldn;t even tell us, had no idea. We started checking places and calling all over and finally found a place that was able to tell us they would only charge him $300 which was what insurnace would allow. He went there and we saved a bundle.

    We have had a high deductible forever because of a preexisting condition of my husband's and the fact that no one would insure us even tough his "condition" has never cost a penny in medical bills and occurred over 40 years ago. So we are use to trying to keep costs down. But you are right, most places are not use to patients asking prices and are not set up to be able to answer them. They need to get use to it.
     
  5. CrazyinVA

    CrazyinVA Well-Known Member Staff Member

    Yup, they need to get used to it, lots of employers are going this way too. Mine switched a year ago.

    Funny-ish story: I went to get some prescriptions filled during the same illness and when she went to ring me up, the the cashier/pharmacy tech said "oh, it looks like we need your insurance information. Oh wait, wow, that IS your amount after insurance..." Ha.. yup. Welcome to my world.
     
  6. Nancy

    Nancy Well-Known Member Staff Member

    Another funny story, I had to see the financial person in the podiatrist's office before my surgery. She said she has never seen such a high deductible in all her years of being in the field and wanted to make sure I was aware of it....haha I just laughed. We had a very nice discussion. We worked out a great plan, she told me exactly what my costs would be that day and divided the payments over six months and it automatically goes on my credit card. She said they have had to go that route because they are seeing higher and higher deductibles but never as high as mine.
     
    Last edited: Nov 9, 2012
  7. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Doctors are overdoing testing now. Especially if they have patients with medicare or medicaid because they know they will pay for the tests even if they dont pay much. They will just send dozens and dozens of patients through needless tests and procedures. I have had more CT scans than I have ever needed. This idiotic pain clinic sent me to get a CT scan on my back and when it came back saying that the image could not detect what I was sent to have detected, the doctor told me that they knew it would come back that way because the CT scan wouldnt show bone issues only soft tissue and stuff like that. So in essence they sent me for a test they knew wouldnt do me any good! And CT scans expose you to a ton of radiation.
     
  8. ThreeShadows

    ThreeShadows Quid me anxia?

    Nancy, in terms of radiation, the areas to be careful about are the thyroid and the eyes.
     
  9. ThreeShadows

    ThreeShadows Quid me anxia?

    husband says that he would have waited for the results of the blood test before proceeding with any x-rays. I believe that you are being soaked.
     
  10. Nancy

    Nancy Well-Known Member Staff Member

    I agree. I should have waited. I knew that as soon as I left. That's why I'm hoping others learn from my mistake.
     
  11. DDD

    DDD Well-Known Member

    That's ironic...I have to have CT scans to "monitor whether the cancer has spread". Geez Louise. At least I don't have to pay for the testing etc. since we are old and have supplemental insurance. What a crock the whole thing is! DDD
     
  12. 1905

    1905 Well-Known Member

    Call someone in the office, tell them you know what they did. This is bs. They will work with you on the cost. They have to. My husband had surgey for something very minor in Aug., everyone billed his ins. co. around 3-7 grand. The anesthesiolgist, the dr., the place he had it done... it was not even needed. They are all out to line their pockets. you know it and I know it.... tell them you know it, trust me, they will work with you.
     
  13. Nancy

    Nancy Well-Known Member Staff Member

    I already talked to the billing office and they put me in touch with the patient advocate. They have not offered me anything and in fact have sent me three bills in the past two weeks. I did what I could and now my attorney husband is taking over and calling them next week. They should have offered to split it in half and I would have done it. Now that I uncovered the order shows 6 xrays I won't pay even half of the 14.
     
  14. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Unbelievable.
     
  15. susiestar

    susiestar Roll With It

    I think that many people do not think of health care as they would any other purchase. There are a LOT of docs who have no clue how much they charge for services. Often only the billing people seem to have that info. As the purchaser, we need to push for more info on our bills and for accountability. I have yet to get a hospital bill that didn't have a mistake. Like charging me for six iv setups when they got the iv needle in the first time and no second attempt even happened, much less a second attempt with a new iv setup. I have almost always gotten charged for medications I didn't get. Hospital billing seems to think that since insurance pays all but the deductible then as the patient/consumer I shouldn't 'make a fuss'. It all comes out of my pocket in one way or another, so it is my business.

    I also think that we need to get copies of any tests. Not just a paper that says that tests are all normal, but the actual results that the lab sends to the doctor. Even if you don't at this time want to graph or track those results, you might in the future. I have had office people at the doctor's tell me that I wasn't allowed to get the lab results, just the dr report, and each time they regret it. I do this because I know how quickly the files are thrown away and all that info is lost. Yet in ten yrs I might need that info. Having the info from some docs I saw as a teen helped my docs trace my vit D deficiency back to my early teens. They then figured that there must be some reason my body won't use it or make it, but they don't know why. Knowing it was very much a long term thing really changed how they addressed the problems. While it hasn't helped much, at least we know some of what not to do.

    I hope that someday we can get to the point where prices are more standardized for medical care and where those prices are known to the consumers, not just the insurance co's and doctor's billing offices.
     
  16. Nancy

    Nancy Well-Known Member Staff Member

    Susiestar, I have a Vit D deficiency also and have had for a long time. Do you have any symptoms? Are you taking prescription Vit D now? I am and it's low normal still, at least it's in the normal range now. Do you have problems with soft bones?
     
  17. DaisyFace

    DaisyFace Love me...Love me not

    Nancy--

    If you feel like taking a gamble....don't pay a dime on this bill. In six months, by law they will be required to sell your account to an outside collection agency. Usually, the collection agency will "bargain" with you to get you to pay. (sometimes they won't....like I said, its' a gamble.)

    We've done this when my husband had outrageous hospital bills. In one case, we were able to get the bill cut in half by working with the collection agency - in another, we were able to get about 30% off and on another we worked out a payment plan.
     
  18. Nancy

    Nancy Well-Known Member Staff Member

    I hate ruining my credit over their abuse. I'd rather pay $5 a month, they can't turn it over to collection then as long as I pay something. It will cost them more to mail me a bill every month.
     
  19. DaisyFace

    DaisyFace Love me...Love me not

    Can't argue with that.

    FWIW - none of the hospital bills have appeared on either of our credit reports. Reporting the debt is a usually negotiating point with medical bills.
     
  20. TerryJ2

    TerryJ2 Well-Known Member

    What a hassle! I am sorry you have to go through that, on top of the pain.
    So, what did the blood tests show?

    I'm going to show this to my husband to see if he has any ideas. But it looks like you are doing all the right things.

    Thank you for the warning!
     
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