Medical Bill VENT

[gcvmom]

I just need to get this off my chest somewhere...

difficult child 1 has Crohn's and was diagnosis'd two years ago this month. They did an upper and lower GI scope back then, along with some biopsies and some specialized blood tests to make the official diagnosis. The total bill for that day came to about $7,000 and we didn't have to pay a penny because it was a participating provider and had already met our deductibles for the year.

Fast forward to last month, when difficult child 1 needed another scope (upper and lower) to rule out disease activity because of some problems he'd been having. Different hospital, but essentially the same procedures and they also took a biopsy. No specialized blood tests though.

Through the magic of modern medical billing, this year's procedure totalled over $20,000!!! That's right! No typo there -- TWENTY GRAND. And even though it is also a participating provider, and our plan percentages are the same and we've already met deductibles, our portion is about $950.

I called the insurance company just to make sure they really billed for what was done, and it looks like everything is in order, unfortunately for us.

I know it could be a lot worse, blah, blah, blah. But when you're not expecting a bill like this, it just plain svcks.:2dissapointed:

Thanks for listening.

 

[Shari]

All I can say is "YIKES".

Gas prices truly must be affecting EVERYTHING.

 

[Abbey]

Oh my. That's a bit of a raise. Even the $950 would get my goat.

Healthcare. Geez...

Abbey

 

[flutterbee]

If only we got the kind of increase in pay that the health care system gets in increase in charges. We'd be sitting pretty, wouldn't we?

 

[Andy]

Make sure you only pay what your Explanation of Benefit (EOB) from the insurance company states. I know some places that will take entire bill less what insurance pays and bill you the rest. You only have to pay what the insurance company says is your responsibility. If it is less than your bill, write "per insurance company, our portion is $____" on your bill near what they state you owe then send a copy of your EOB circling or highlighting your share back with the bill.

 

[timer lady]

I understand your frustration. I got the bill for the first day of testing & one consultation at Mayo ~ over $12,000. The other bills have floated in & I'm buried.

Like you, we have decent medical coverage yet our portion is climbing & now over $2500. That doesn't include the ongoing medical bills here between appts.

 

[gcvmom]

Thanks for listening, ladies ;D

Adrianne, the $950 IS the amount on my EOB. I'm hoping I can talk that number down a bit. My brother in law is a private insurance "negotiator" and wrangles down payment amounts for folks every day (for a fee). Usually it's for people who have no insurance. I think it's time to call in a favor if I can't get anywhere on my own!

Timerlady, it absolutely overwhelms at times, doesn't it? What's so disturbing to me is that this was a 45 min. outpatient procedure (not counting recovery time). And yet husband had his BRAIN surgery at the same hospital, with MANY, MANY specialized tests, a night in the ICU and a 7 day hospital stay which all totalled about $150,000. Something seems out of balance here...

 

[Abbey]

The only thing worse than the expense is having TWO insurance companies that fight over who is NOT going to pay. been there done that to the tune of $350,000. The laws are so specific. In CA, an insurance company cannot by law deny a claim. You always have the right to appeal. Sounds good, right? No.

My primary continued to not pay my bills because I went out of network because the docs they sent me to were very inept in dealing with my situation. My secondary says...no problem! We'll pay everything, but your primary has to formally deny the claim. The circle starts. Well...we can deny, but not really deny because you can appeal.

Fast forward 5 years and a lot of baloney and lawsuits, it finally got settled.

Very frustrating.

Abbey