Health insurance help please

[deere755]

I appreciate all the feed back and the last thing I wanted to do was cause a fight. I have taken a lot of advice from here. I have been on the phone for what seems like a day and a half. My hospital bill was $97000 and the insurance company has offered them around $35000 and they have accepted it. I can't hardly believe they did that but that is a big relief. My deductible has been set up on a payment plan which I am ok with. I did not expect to not have to pay anything on this. What I was not expecting was to have to pay 40 to 50 thousand dollars for it. As for the surgeon they are going to talk to the insurance company and see what they can do on his bill. I talked to a very nice lady with the insurance office and found out we can appeal some of the bill like the blood work and x-rays. I also talked to my state rep. and he has offerd to look into it if I can't get anywhere with them. I have never dealt with anything like this before so it is all new to me. I have used a lot of the ideas presented to me on this thread and I appreciate that it did not get closed as it has been a big help and has allowed me to relax a little. I will be having my next surgery on October the 8th so now I feel a little better about it. Thanks again Deere755.

 

[dave1949]

Deere755 - Good News! Keep your chin up.

You didn't cause any fights.

Dave.

 

[dmccarty]

Because part of the equation is the Doctors basic oath to save life.

So then the Doctors should work for free?

Don't really get your point.

Later,
Dan

 

[dmccarty]

Hey Dan,

Well, tell me what you are really mad about

Dave.

Not much really. Don't see where you think I am mad.

Later,
Dan

 

[MossRoad]

I appreciate all the feed back and the last thing I wanted to do was cause a fight.

It's not a fight.... it's a discussion!

 

[dmccarty]

deeere755,

Its tough to do but you also need to look over your bills to make sure that the bill is correct. And make sure you don't pay more than once for the same charge.

My family does not have good health and I have constant medical bills. Years ago it just got to a point that I put in a spread sheet every insurance claim that we get. Then when the bill gets to us I compare the two and make sure I am paying what should be paid. If I did not do this I would often pay the same bill twice since one hospitals billing is appalling. They have gone through several administrators over the years and its a bit improved nowadays.

It was not uncommon for me to send them a check even with electronic payments and then 4-6 weeks later get another bill for what had been paid. Part of the spreadsheets records when I paid the bill and the check number. It is time consuming to say the least. But we have lots of bills so it has to get done and this way I can verify if the bill has already been paid and show the hospital where to look.

Also there can be billing mistakes where a procedure is marked such that it is not covered or not what was done. We have had a few of them over the years as well. Tracking this is time consuming and not fun especially if the one doing the tracking is sick.

We got sent to collection over less than $50 for bills we never received.... We found out about the bill when the collections people called.

The only reason we put up with the billing incompetence is the doctor we are using is excellent. You find a competent doctor you don't let go of them. We have only had to talk to our insurance company a couple of times regarding coverage issues over the years. I know some doctors I would like to remove from service. They have been far more problematic than insurance companies.

But at least our problems are manageable or fixable.

Just found a friend of mine is a dead man walking. He as a brain tumor and has 6-8 months to live if he opts out of Chemo. If he takes Chemo he has 12-15 months.

Tracking bills is much easier than my friends options.

Later,
Dan

 

[Ronbo]

I am a provider. I needed a MRI. I did not pay anything. The imaging place just billed my insurance and accepted what they payed. I can send patients their and they get it for $400 cash. If they have insurance, they will bill the insurance $2500 to $5000 and the patient has to pay a deductible, often about $2500. They would be better off paying cash.

So what is the real cost to provide that service, $400, $2500, $5000? The insurance companies tell the providers what they will pay, they do not negotiate the price. That means the provider has to bill much more so they can break even. If I submit a bill to medicare or medicaid for a level 3 visit, I bill $75. It costs me about $35 for the visit. I will get $18 for the visit. I loose money with government plans. Private insurance will pay me more, but I want more money so I bill much more so I can make a profit.

When I have been to the ER after accidents, I always let them send me a bill. I then go in to pay and they reduce it by 50% if it is payed in full at that time. I do not even have to ask, they offer. If the providers accept $X amount for a procedure, why should a cash patient have to pay $2x to $10x?

This is why I only do cash now and do not have to charge as much.

Ron

 

[dave1949]

Ronbo - that's a good inside look at what has become huge mess.

Pogo said it; 'We have met the enemy and it us' (or pretty close to that).

 

[dave1949]

Not much really. Don't see where you think I am mad.

Later,
Dan

It was a joke.

I don't know how much of my own home insurance bill underwrites beach homes build on sandbars - but like you I hope it isn't one penny. I think somehow, we pay for that at the Fed. tax level. Partial cost of operating FEMA if nothing else.

Along the coast of Maine, if the towns lost the property tax revenue from ocean beach front property, they would go broke in a hurry. They are never going to zone them out of existance, that's for sure.

Dave.

 

[riptides]

So then the Doctors should work for free?

Don't really get your point.

Later,
Dan

There is no price on life.

Doctors will use every tool available to save a life.

The insurance companies cannot keep up with the tools.

Each person reacts differently to treatment.

Multiple points.