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Medical bill question - 11/20/2008 6:51:45 PM
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csl7037
Posts: 2071
Joined: 3/24/2008
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After 11 years (most of our entire married life), dh changed jobs last spring - hallelujah! But I was totally confused and overwhelmed by all the paperwork and it was my understanding that the health insurance expired on one date and apparently it expired on them about two weeks earlier. Well, in that lag time, I was dumb enough to go have the kids' physicals and shots! So stupid - totally stuff that could've waited two weeks, or even two months!
So I'm sitting here with a bill for $465 for each of them (=$926! Merry Christmas  ). I was all set to call the office tomorrow about this and suck it up and work something out - just not doling out $1,000 right this sec but, overtime I will....
Until I looked more closely and realized that what the insurance company was going to pay was only $235 on each!! About half! So I'm feeling really scammed and furious that, since they didn't get their $470 they've got the nerve to come looking for $926?!?!
Has anyone been in this situation? I never have. I hear all the time about negotiating medical bills - can I go back and say, "here's a check for $470" and be done with it? Or how much can I negotiate this. It's stupid. I guess it's wrong of me to want out of it but why should I pay what no one else does? Of course I know the obvious answer - because it's right. . . but is it good stewardship to let myself be taken advantage of? How do these things really work?
Thanks.
(BTW, yes, I'm an idiot. I'm not good at these things, I am willing to admit! And, FYI, dh took a substantial pay cut to take this job, and despite that it's a tremendous blessing - much better environment and potential for him...but since then I've also lost my PT job so I'm not just being cheap. This is a big bill for us right now!)
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RE: Medical bill question - 11/20/2008 10:21:32 PM
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stellaluna
Posts: 4409
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You will probably find that if you look at some old bills, your insurance company paid far less than they were bill, due to "adjustments." This is how I think it works:
Your doctor charges $100 for a $20 flu shot.
Your insurance company tells your doctor, "We'll pay you $20 for a flu shot."
The doctor takes the insurance payment, plus whatever your co-pay is, probably somewhere around $20. So the doctor has still made $20 and everyone's happy.
But if there's no insurance company to limit the amount billed, then the doctor bills you for the full amount he wants to charge.
Now. I could be totally off on that, but I've been noticing this kind of stuff for years and years. I've even been billed later for a few things that insurance didn't cover at all. If I were you, I'd call your doctor's office and tell them you know they don't charge that much to an insurance company and how can you negotiate the lower rate. They might just let you do it.
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RE: Medical bill question - 11/21/2008 9:20:33 AM
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Row1
Posts: 250
Joined: 12/2/2005
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Yes, you will be able to negotiate this bill to be much lower.
Each service has a "full" price. This is like the "sticker price" on a new car.
Honestly: for a $30,000 car, a car dealer is gonna turn away an offer from someone to buy that car for $29,500? No way. No, you shop around and find out you can end up with that car for $23,000. Or whatever.
Health care bills are even more extreme: the "full" price is even higher.
What happens is: nearly all health care is delivered in some arrangement where the various heath insurance plans have each negotiated a set of lower rates. The more people on some plan, for example BC/BShield, the more bargaining power the health plan has.
So, when someone with no ins shows up, like you, you have not already negotiated the deal.
Now is the time for you to figure out how much negotiating power you have. Nowhere near BC/BShield. So, you may not get them to drop the rate that far.
But it doesn't hurt to ask.
You have to do this quickly, since as time goes by, they can threaten to turn you over to "collections," changing the negotiation cuz they will know they got ya where they want ya.
The best way to negotiate, once you found out who to talk to, is to be ready to make an offer and pay the whole bill right then and there, with them declaring, in writing, that any bill is "paid in full."
>>>
A friend just went through this. Injured hand, went to emergency room, and later had $3,000 bill. Freaked out. I told him to negotiate. With very little trouble, they dropped it to $1,000. I think he could have negotiated it lower, but he is not so much into negotiating.
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RE: Medical bill question - 11/21/2008 10:43:05 AM
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GroupW
Posts: 2863
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From: Up in the hills of Colorado (very BIG hills...)
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I agree with Row1 and agree with his strategy as well. Any doctors office, faced with a bird in the hand, is much more likely to listen to your offer if he feels he can get paid now and be done with it.
_____________________________
“For every problem, there is a solution that is simple, elegant and wrong.” -H.L. Mencken
"Most people would rather die than think; in fact, they do so." -Bertrand Russell
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RE: Medical bill question - 11/21/2008 10:58:15 AM
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coolfamily6
Posts: 340
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CSL, I had to take my son to a therapist that doesn't take my insurance. The receptionist talked to the Dr. and he was willing to take the amount my insurance would have paid which was just $10 more than my co-pay. Also, if this is your regular peditrician, I cannot imagine that he/she would not work this out with you. I would call the office mgr and talk to them about it.
_____________________________
If your bible is a mess; your life won't be.
~Encouragement a mom gave to our children at our First Grader's Bible Ceremony!
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RE: Medical bill question - 11/21/2008 11:26:52 AM
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Kat_D
Posts: 3041
Joined: 9/2/2005
From: Where We Shake, Rattle & Roll!
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Physicians and hospitals contract with insurances and as part of that contract, accept partial payment from that insurance. However, your services turned out to be private pay or cash only, and when there is no coverage, all bets are off and the provider has every right to ask to be paid in full.
You could call and ask for a discount or permission to set up a payment plan.
_____________________________
~Kat
"...And God will wipe away every tear from their eyes...no more death, sorrow, nor crying."
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RE: Medical bill question - 11/21/2008 12:20:34 PM
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csl7037
Posts: 2071
Joined: 3/24/2008
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This is all very encouraging! I think I'll call and offer to bring $400 Monday. If they want the $900 it's gonna me a long time till they see it all. We've been with this doctor almost 7 years. Ive never dealt with the accounting people so wish me lick. Thanks
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RE: Medical bill question - 11/21/2008 12:33:47 PM
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metoo
Posts: 36
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quote:
ORIGINAL: csl7037
This is all very encouraging! I think I'll call and offer to bring $400 Monday.
I think you should be willing to pay the full $470 the insurance would have paid. Why should it cost the doctor $70 for your mistake?
I used to manage a medical office. If someone came to me in your situation and offerred to pay, right then, what insurance would have paid I would have done it but let them know we were not obligated to do it. If they came and offerred me less, I would have said "no". The doctor's office is under no obligation to reduce your fee. If they want to pay over time, that's fine, too because they would be charged 1.5% per month on the unpaid balance. That is in the agreement they signed when they agreed to let us treat them.
You probably signed something to that affect at the time of service as well.
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RE: Medical bill question - 11/21/2008 12:41:23 PM
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pbaribeault
Posts: 1106
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Wow. I can see why people hate private health care systems. Not only do you have to pay, but the charges are dishonest and all over the map! Crazy. I bet doctors could charge less if they didn't have to pay staff to deal with billing and 'negotiation'.
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RE: Medical bill question - 11/21/2008 1:10:45 PM
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Kat_D
Posts: 3041
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From: Where We Shake, Rattle & Roll!
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quote:
ORIGINAL: pbaribeault
Wow. I can see why people hate private health care systems. Not only do you have to pay, but the charges are dishonest and all over the map! Crazy. I bet doctors could charge less if they didn't have to pay staff to deal with billing and 'negotiation'.
I don't hate it at all...it gives us choices. When there is competition for insurance enrollment, it ensures that we get better care, medical providers, state-of-the-art equipment, etc. Not so much with socialized medicine as my brother-in-law in Canada can attest. He, his family, and friends who have the means to pay cash, travel to the US for all their important medical needs.
_____________________________
~Kat
"...And God will wipe away every tear from their eyes...no more death, sorrow, nor crying."
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RE: Medical bill question - 11/21/2008 1:15:17 PM
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csl7037
Posts: 2071
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quote:
ORIGINAL: metoo
I think you should be willing to pay the full $470 the insurance would have paid. Why should it cost the doctor $70 for your mistake?
Whatever the negotiated rate was. I was posting from my phone earlier. That's what I meant.
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RE: Medical bill question - 11/21/2008 1:17:04 PM
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csl7037
Posts: 2071
Joined: 3/24/2008
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quote:
ORIGINAL: Kat_D
quote:
Ive never dealt with the accounting people so wish me lick.
I don't see how a "lick" will help you, but O.K., here it is 
Ugh! I hate how my phone corrects typos with what it thinks I mean. I didn't even notice that.
I agree that it's not a perfect system by any stretch but it's leaps and bounds better than anything socialism would (will?) give us!
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RE: Medical bill question - 11/24/2008 9:39:58 AM
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coolfamily6
Posts: 340
Joined: 4/18/2005
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quote:
ORIGINAL: metoo
quote:
ORIGINAL: csl7037
This is all very encouraging! I think I'll call and offer to bring $400 Monday.
I think you should be willing to pay the full $470 the insurance would have paid. Why should it cost the doctor $70 for your mistake?
I used to manage a medical office. If someone came to me in your situation and offerred to pay, right then, what insurance would have paid I would have done it but let them know we were not obligated to do it. If they came and offerred me less, I would have said "no". The doctor's office is under no obligation to reduce your fee. If they want to pay over time, that's fine, too because they would be charged 1.5% per month on the unpaid balance. That is in the agreement they signed when they agreed to let us treat them.
You probably signed something to that affect at the time of service as well.
Metoo, My dr would take the lower amount. If her office manager, who knows my voice when I call said no. I would go to Dr. T about the matter.
This actually happened to me years ago and not one but 3 doctors wrote off parts of their bill due to my "error".
_____________________________
If your bible is a mess; your life won't be.
~Encouragement a mom gave to our children at our First Grader's Bible Ceremony!
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RE: Medical bill question - 12/9/2008 12:07:57 PM
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csl7037
Posts: 2071
Joined: 3/24/2008
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This is stressing me out. It's making me sick. I can't call this woman. It's not going to go well. I just can't do this kind of thing. My dh can talk to people but he's leaving me holding the bag on this. He is incredibly busy at work right now, I know. But somehow he thinks a ten minute telephone call is more stressful than me losing sleep and making myself sick over this for about two weeks. I must sound so pathetic but this is just one of those things that just about makes me hyperventilate...and I just know wont go well at all if I do it. This is so bad.
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RE: Medical bill question - 12/9/2008 2:57:17 PM
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iwillfearnoevil
Posts: 4479
Joined: 11/6/2007
From: upstate NY
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if you can't call by phone, write a letter, they'll get it the next day. make sure you specify you'll be paying immediately and with cash (no credit card fees for them to eat). the sooner you approach them, the sooner you'll feel better. i think you have lower chance of success with writing, but it's better than them sending to collections which might be happening soon since this service occured in the spring.
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Photoblogging My Life
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RE: Medical bill question - 12/14/2008 12:07:29 AM
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MrsTracy72
Posts: 2060
Joined: 2/28/2007
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CSL,
If you can call your insurance company to find out what the contracted amount is for those services, then you can talk to the doctors billing and ask if you can pay that. If they accept a contracted amount from an insurance company, then you may or may not be responsible for the leftovers. It all depends on how the contracts are written between the insurance companies. Most are contracted so that you would only pay what they would pay if they didn't cover, but usually the billing offices bill out the rest anyway because most people don't know this or look and then pay. If you got an EOB from your insurance company, it should say what amount you are responsible for.
If you truly are responsible for that amount, then ask to make payment arrangements and if they will accept a smaller amount. Most will.
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