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I just got an itemized bill today for a minor fall I took a couple months back.. On top of the nearly $6k in other charges from the hospital, they charged $531

• throwaway1777 7y ago
  Pretty sure if you go through the effort to challenge such charges you can get them changed. https://www.vox.com/2019/3/22/18261698/how-to-fight-expensive-medical-bill https://www.vox.com/2019/3/22/18261698/how-to-fight-expensiv...
  • widowlark 7y ago
    You would need to do this for every change, every time. Hardly a good solution.
  • hayksaakian 7y ago
    Opt-out vs Opt-in
  • Ididntdothis 7y ago
    You need very strong nerves. Their collectors can be very aggressive.
    • chachachoney 7y ago
      Incredibly useful phrase: "I'd love to get this in front of a judge."
  • mehrdadn 7y ago
    The thing I don't understand about tips like these is, what obligation does the other party have to cooperate at all? Like you "ask for a supervisor" (and then a director!) what incentive do they have to not just say no? Or if you ask for an itemized bill, what if they just refuse? How are you supposed to get past a blunt refusal, which to me seems like the easiest response for them?
    • cbanek 7y ago
      Once upon a time, I had a surprise bill for about $4,000 that health insurance decided should have been $700 for that procedure. I fought it and won. But it took forever, almost a year of calling them and going back and forth - and this was actually decent corporate health insurance. It took a lot of reading through the 600+ page plan document and finding loopholes. For example, I asked them that if they thought it should be done for $700, who would actually do it for $700? They couldn't list one provider that would accept the payment rate they thought they should pay. And since this was a reimbursement, and they had already pre-approved the procedure (knowing the price), I think I caught them already saying they would do it, but them not following through. There was a lot of going back and forth about in-network vs out of network, but again, no one in-network would perform the procedure. In the fine print of the plan document, it said if there are no in-network providers, the plan must provide you were in-network rates and deductibles for using an out-of-network provider. So I told them if they can't find anyone who will accept what they are willing to pay, their figure is obviously wrong. It helped that with my health insurance, everything was supposed to be covered, 100% with no copay. So the fact that they tried to charge me for the $3300 overage was very out of line for them. They never just said "no, we're not going to cooperate" it was more just endless stalling on their part. It was never really a blunt refusal, or if they tried that, I just proved how ridiculous their arguments were. I kept a lot of documentation. I think in the end, they just relented because they were spending more dealing with me than actually just paying me my money. But it was certainly an uphill battle the whole way, and not one I would recommend to someone who isn't well versed in legalese.
      • rntksi 7y ago
        These stories are horrifying to me. I live in a less developed country than the US, other businesses may be crooked and all but at least the medical field is manageable.
  • foobarbecue 7y ago
    That lawyer's name is Sue Null!?!?
• merpnderp 7y ago
  I had a deep split over my eye (metal ring tossed while I was still down range) and knew going to the ER for stitches would end up costing thousands for a five minute stitch job, so I pinched it together and put on superglue. Healed better than stitches and cost me nothing. I hate our medical system too.
  • chachachoney 7y ago
    Loctite (blue package) works as good as superglue but stings a lot less.
    • asguy 7y ago
      You mean Loctite’s blue-package cyanoacrylate right, not their thread locker. Right?
      • chachachoney 7y ago
        Absolutely.
  • nickjj 7y ago
    When you say superglue, do you mean an off the shelf superglue that you would pick up at a hardware or craft supplies store? Did it just dissolve on its own after X number of days?
    • jcater 7y ago
      Yes, cyanoacrylate (the group of adhesives that superglue belongs to), are used in medical and veterinary situations for exactly this purpose. https://en.wikipedia.org/wiki/Cyanoacrylate#Medical_and_veterinary https://en.wikipedia.org/wiki/Cyanoacrylate#Medical_and_vete... I've used off-the-shelf superglue on cut fingertips where I couldn't get bandages to stay. I believe it's also commonly used in place of stitches where you don't want the scarring that stitching would cause (e.g., parts of the face.) It wears off in 3-4 days.
    • merpnderp 7y ago
• wil421 7y ago
  What did you pay? What did the insurance company actually end up paying? This is one of the areas that open pricing should help.
  • x86_64Ubuntu 7y ago
    I'm not sure open pricing would help seeing as how the average person doesn't have much knowledge to defend themselves against gouging. And when I've got a gash on my head, I'm not going to call around for prices and special discounts.
    • wil421 7y ago
      Another commenter said they asked the hospital and they just bill 8x the Medicare rate. Price transparency should help equalize the market. Right now it’s very much a smoke and mirrors pricing scheme.
      • mattmcknight 7y ago
        What we should do is declare that you can't charge any patient more than you charge Medicare. Single pricer.
• rwcemergency 7y ago
  I just got an emergency room bill. I had a severe sore throat and fever for 2 weeks, step tests came back negative. Then at night my back side started hurting so I went to the ER. I paid $850 at the ER and today I received another bill for $850. The only thing on the Bill just says > "Charges": $11,680 > "Adjustmnets: $9,980 I just got off the phone with them and they say that it will take 10 business days to receive an itemized bill. However, that means the itemized bill will be delivered after the current bill is due. How are they going to charge somebody $1700 without an itemization? Furthermore, I am expecting another bill from the ER doctor that saw me because they bill separately and are not covered by insurance. The ER legally cant tell you if the doctor or the hospital accepts your insurance. Thats so crazy. My wife was absolutely mortified. In brazil I never carried insurance but going to the ER I just had to pay R$400 flat fee for a private hospital. Anything else for tests they would give me the prices up front. My wife about started screaming when the woman brought in the credit card machine while I was still in pain in the ER hospital bed. It was so embarrassing. All this is with the top insurance my company (a ~$500 million startup) offers and to make it worse it happened when I was on a company mandated trip.
  • henryfjordan 7y ago
    Talk to a lawyer.
    • cbanek 7y ago
      Also, talk to your company. If it's a company trip, they may be on the hook this.
  • opportune 7y ago
    I am not a lawyer or financial advisor. But I’ve heard that you can’t be sent to collections if you make a good faith attempt to pay your (medical) bill. Which in practice might mean you just pay $5 while you wait for the itemization
    • mehrdadn 7y ago
      That would "acknowledge the debt" or something like that from what I understand?
• deleted 7y ago
  [deleted]
• oppositelock 7y ago
  I went to the ER with chest pains seeming like a heart attack. They did an EKG, determined it wasn't a heart attack, then a blood test, which determined it was low potassium, and did a chest x-ray just in case. I received a saline IV and potassium pills as treatment, and went home after a couple of hours. The bill was about $18,000 for this. The insurance negotiated rate was about $1,500, of which I had to pay about $600, then over the next weeks, I received about 20 bills, each of which was for a large amount, bit the resultant patient "responsibility" was about $20 - all from shell organizations like "CA ER Physicians", or "Hospital Diagnosticians", etc. It's such a mess! Another example was the birth of my child. We prepared for this by setting up an FSA, and having really good PPO coverage that year, supposedly, with a 10% copay. After all the billing shenanigans, my copay was about 30% and well above the out of pocket maximum. How does that happen? You can go to an in-network hospital, and be treated by a mix of providers, all of whom bill separately. Some will be in-network, others will be out of network, so you are in effect deducting against two out of pocket limits. Medical billing is fraudulent. Medical insurance is fraudulent. These people are all acting in violation of tons of existing laws - I don't understand why this isn't prosecuted.
  • hurrdurr2 7y ago
    The lobby for insurance companies, pharmaceutical companies, and hospital chains spend ungodly amounts of money to influence our political process. Once all the politicians are bought and paid for everything becomes kosher.
    • lopmotr 7y ago
      For some reason, Americans keep complaining about the same problems with their government over and over again - particularly lobbying, and yet every election they nearly universally reject all their concerns in favor of tribalism and vote for the same two parties that are responsible for everything they don't want, or nobody at all, which has the same effect. Wouldn't it be fun if whenever somebody criticizes their government, they also state who they voted for to force them to open their eyes to the fact that it's their own fault. People rationalize it by saying that voting for a 3rd party is "wasting" their vote, but in that sense, voting for anybody is wasting their vote because it never comes down to one individual's vote deciding things. Really they just have two driving forces - allegiance to whatever tribe they randomly found themselves feeling like a part of (and mysteriously agree with all the inconsistent aims of), and wanting to be on the winning team. Healthcare be damned.
• reaperducer 7y ago
  I always think that in threads like this one a little name and shame is called for. Most people would be surprised how closely hospitals and other medical companies pay attention to their social media and Google alerts.
• mancerayder 7y ago
  Bill to you or your insurance? I'm less concerned if they're scamming the insurance (although I'm existentially and politically interested) than billing of individuals.
• HorizonXP 7y ago
  I just linked the Schedule of Benefits from OHIP in another comment I made, but your comment made me curious to look it up. Z176 - Repair of lacerations - up to 5 cm = $20.00 Note: Wound closure via tissue adhesives (such as cyanoacrylate) is payable at 50% of the appropriate fee. Meaning, in Ontario, your procedure would have cost us $10. I'd have to look through to see what other costs would be incurred for the ER visit, but suffice it to say, it's probably well under $6,000. Oh, and that's $10 CAD, which is like 2 Freedom Bucks. ($7.52 USD)
• 8ytecoder 7y ago
  It’s worth writing a long article about. In the US there’s no cost conscious party that does price shopping or similar to bring the costs down. There’s only cost pushing parties. Hospitals pushes it to insurance, insurance to employers and employers to the govt as a tax write off. The person getting the treatment only looks at where the “best” care is. That is usually a code word for finding the most expensive hospital my insurance will cover. Insurances don’t have the power - and also they mostly don’t care - to negotiate with hospitals. Employers have to provide coverage by law. So they do the least they can to satisfy it. Who in this system keeps the costs in check?
  • lotsofpulp 7y ago
    The insurers would be able to keep the costs in check, IF the employers were taken out of the equation. With employers, especially white collar ones, siphoning the healthy lives into their own separate insurance pools, the remaining pool of lives is costly to insure and thus only a very small number of insurers can afford to exist. If the pool of healthy lives was bigger to offset the cost of the sick lives, then multiple insurance companies can exist and compete on healthcare.gov to offer lower premiums which they can offer because they negotiated lower prices with providers.
• cmonnow 7y ago
  Do not make money in the sick room - Hippocrates
• samstave 7y ago
  Ok so know that you can go against this. I was once charged $1,500 for a doctor to talk to me (without ever touching my physical body) to “prescribe” me over the counter motrin.... I then questioned them on this and they said “well it was a prescription” : i said you never even physically touched me. “So im going to tell you what this was worth to me: $50” They then said “okay we will charge you $297 for the visit” I said “you made me wait over 45 minites before even seeingg me, at 9:00 pm when i was the only person in the waiting room. NO; im am going to charge YOU $50 for my time wasted” The dropped the entire bill completely. Good samaritan hospital in los gatos ca. (Where my grandmother worked for decades, and after el camino hospital bout them and i was the technology designer for their upgrade) You can negotiate codes with hospitals. Source: i have built more than ten hospitals; el camino, good sam, ucsf, nome, sequoia , zucks sf gen, etc... Dont let their coding depts fuck with you - take a stand.
  • sizzle 7y ago
    Awesome story, any good references for you to date medical coding based off your background?
    • samstave 7y ago
      Codes are negotiated costs between insurance providers and hospitals, individually. So a cost for the same procedure at one hospital or another can be different. Frankly you should challenge every single hospital charge you ever receive, they will always go lower. As an example, just two weeks ago I made an appointment to go see a doctor. They called me back (kaiser) and said “ just come into the ER” I said why, they said I don’t know, that’s what they told me to tell you. So I called and verified my copay $30 and coverage etc. When I got there they took my blood pressure asked a few questions, and then gave me the prescription I was asking for. When I went to pay they tried to charge me $250 I said fuck you, I called and made an appointment, my co pay is $30 so that’s all I’m paying you period. They conceded and accepted.
• dawhizkid 7y ago
  For whatever reason, the cost issue is completely missing from the dem primary debates on healthcare. Everything so far has been focused on health insurance coverage, and the candidates are really just debating what is the best way to cover more people. A world where 100% of Americans are covered under the existing healthcare system is still a disaster because everything still costs so much between premiums, deductibles, copays and coinsurance. And on top of that, patient responsibility is still largely unknown until post treatment. If you look at the cheapest Bronze plans on the Obamacare market, you're probably looking at $400/month for the premium with a $7500+ deducible for a single person. If someone is coerced into buying insurance and they can barely afford the premium, how is that something worth celebrating?
  • nonymouse22 7y ago
    Thank you so much for bringing this up! This is one point that has really irked me in the current discussions. It should be about common sense access and lowered, transparent costs. In the UK, I could walk into a Boots (pharmacy), speak to someone there and get prescription eyedrops for cheap for an infection vs the crap you have to wade through in the US. Same for other doctor/healthcare visits I've had around the rest of the world.
  • AstralStorm 7y ago
    Instead of MAGA maybe Make American Health Cheap?
  • jrs235 7y ago
    Exactly. I don't care about health insurance costs as much as I can about health care costs.
• simplecomplex 7y ago
  Just a reminder for those reading: you don’t need to pay medical bills, nothing is going to happen except a bad credit report. Go to the hospital, let them bill you, and then throw the bills in the trash.
  • matthewaveryusa 7y ago
    They can (eventually) garnish your wages. I wonder at what point they do that.
    • simplecomplex 7y ago
      Only if they sell the debt to a creditor (hospitals and doctors can’t garnish wages) sue you, win, and pursue the judgement. And then they can only take from your disposable income (after rent, food, other bills, etc.) And you can wipe out all of it by filing bankruptcy.
      • Broken_Hippo 7y ago
        I have seen nothing about this - and know folks that were sued by the hospitals. It has been some years, mind you. Is it possible that they cannot garnish wages in your state? Where are you getting your information?
• nonymouse22 7y ago
  Sorry about your friend. Similar to your situation, I went to a dermatologist concerned about a bump. Turned out to be a skin tag which she cheerily said "We can take care of this right now" and snipped. That snip cost $250 (wasn't on the genitals but was close enough for them to bump up the cost). I called their billing company and spoke to their office manager. She said that "the doctor just wants to make sure customers are happy and doesn't really concern herself with the billing part" when I brought up that if something is going to cost something they should say so upfront if it's something not necessary. Thanks for the heads up about the glue. They really do take advantage even when you're a bad situation.
• jen_h 7y ago
  Young and middle-aged people need to vote. I've been in and out of hospitals for the last few years, months, days, hours with relatives, and guess what they don't ever worry about: medical bills. Like never. And guess what they won't ever vote for: Those of us younger than 65 ever having the same luxury. We may be visiting them in the hospital every day, but they don't really see us. And it's hard, because our generation loves them and wants the best for them, but most of us know we won't ever get the same quality of care for ourselves unless something changes...and as a human, well, you know, you get kinda bitter counting up "Wow, this is awesome, but what would it cost if I had this happen to me?" Vote, people, because if our elderly are getting state-of-the-art amazing life-saving care, why shouldn't our young people, upon which our economy depends, be getting the same great service?
  • sizzle 7y ago
    Are you referring to Medicare part A and B coverage? They paid out the whole $50k bill for triple coronary artery bypass. Apparently they cover 60 days of inpatient hospital stay for any health issue. I hope I have this coverage when we hit 65....
    • jen_h 7y ago
      It is amazing...then, if you ever get alllll the way down to their private insurance policies, you find that they are nothing like our generation's insurance policies...they actually pay for stuff and have low deductibles! I try not to get too bitter about it, though, because their great coverage means we don't go bankrupt trying to help them: we're very lucky for that (although eldercare is a whole other ball of wax)... It just kills me to see all of these young people begging on GoFundMe just to afford insulin -- and dying! Over insulin! -- while it's stockpiling pretty nicely in Medicare-recipients' closets thanks to overzealous pharmacies that know Medicare will pay for whatever they keep shipping, and seeing young people cobbling together their own makeshift slings for broken bones while so many nonagenarians are technically part-robot thanks to Medicare's great coverage.