I have no idea if the HCR reform bill will do anything about this, but I am going through sheer hell figuring out the damned bills from my surgery. Because of where I got my surgery done, I am getting bills from the facility (the hospital). I’m also getting bills from a conglomerate of physicians for the surgery and anesthesia. On top of that, I get notices from my insurance agent that allegedly correspond to each of the invoices from the two places I just mentioned, and what the insurance will pay and what is my responsibility.
Then you have to cross reference all of that with the itemized list I got from the hospital to make sure nothing out of the ordinary is there and nothing has been screwed up. To make matters worse, the invoices always say it is “estimated” what the insurance company will pay, but that really means they have already paid that amount, so it isn’t an estimate at all, really. It’s a payment. And then sometimes, the amount the insurance company has actually paid does not correspond to what they told you in the notice I received, so then I have to call them up and go through automated answering service hell until I can get a person on who will give me evasive and confusing responses that make no sense to me.
And then, once you have figured it all out, you get the added insult of writing a damned check for the amount. I was also informed by the nice woman on the phone that a past due balance of $8.11 was sent to collections (a bill I had no idea existed), so now I have to hunt those people down so my credit rating is not ruined by something as expensive as a super-sized McDonald’s Happy Meal.
Also, taxes next week.
r€nato
Just think how much worse it would be if some government bureaucrat was deciding on your health care.
4tehlulz
Death threat. Reported.
Eric U.
It’s always worked for me just to pay the original debt.
Assuming you went with a provider that is in your network, your insurance has an allowable which also caps your co-pay. So whatever the insurance company sends you should say what was billed, what’s allowable, and what your co-pay should be. Good luck.
Mike Kay
Free Markets – it’s a bitch.
cleek
best system in the world, bitches
Gian
the real beatdown is for the working poor not qualified for medicaid who have a job that doesn’t insure them – see if those bills show you the negotiated discount for the insurance company. Imagine having the whole bill to pay without the discount.
Comrade Mary
That really sucks, John. I wonder what would happen if you tracked your time and charged the insurance company for it?
Another rant from a doctor’s (grumpy) perspective.
Sir Nose'D
Are you posting again about the “best health care system in the world” I keep hearing so much about? ‘Cause it seems kind of complicated…
dirk
Imagine if Brits had to do all that. There’d be no time or money for binge-drinking.
BR
When I was traveling in Europe two summers ago, I got sick – on the last day of my stay there. We were in London, and went to the hospital because my heart was beating strangely.
We had the taxi take us to the nearest hospital. They just asked for my name and DOB, and brought me in within 20 minutes (at the ER). They did blood tests, a chest x-ray, and kept me in there for monitoring. They asked me to stay for the night for further monitoring, but we told them we had a flight in the morning and would take our chances. We tried to figure out how to pay on the way out, but were told that there was no charge.
Shalimar
It can be more than just your credit rating. My sister had a bounced check for under $25 that Walmart turned in to the county prosecutors. She didn’t know anything about it for more than a decade since her address had changed and Walmart didn’t stop taking her checks. Anyway, by the time they notified her she had to pay over $400 in court costs and the county put it in their records as a misdemeanor conviction even though she never even saw a judge and handled it entirely through the clerk’s office. They had told her that it would be expunged from records when she paid all of the fines.
To add injury to injury, when she got a job in retail in another state the next year, the company checked her record and refused to hire her until she got a letter from that DA explaining that it wasn’t a real misdemeanor and that was just the way the county did business. So, she was basically unemployable over a small check that no one told her about. Yet another reason Walmart sucks.
jibeaux
@r€nato:
Now that’s funny.
Just this month I paid off surgery I had in October 2007. I am hoping to have my post-surgical scan paid off by September. I’m insured, the deductibles, copays, coinsurance were just in the thousands. And it was sent to collections because I was supposed to pay $130 a month and one month I just couldn’t swing it and I sent $100 with a little note apologizing that I had to hold back $50 for groceries so that was all I could send. Bitchez indeed.
Mike Kay
what’s eerie is the that $8.11 bill is only a dollar from being … gulp…. 9.11!
Da da daaaaam!
MattF
Me too. I had surgery last year + short stay in hospital. Medically successful.
Double-billed by the anesthetist, accidentally, I presume. Of some interest to note that the total “pretend” bill was around $20,000; the bill presented to the insurance company (companies?) was half that, my final co-pay was about $1000. Which was reimbursed through my health-care savings account. Idle question– how much did it really cost?
Axe Diesel Palin
Yes. And six months from now I promise you will get a straggler bill that you will have to deal with. Usually from the Anesthesiologist.
I always find one bill that arrives months later and I have no clue who the doctor is or what service they performed.
Laura W.
Clearly you will feel better if you buy some more pretty things to hang on your walls.
Here’s my corresponding bitch: I got a bill two weeks ago from an Anesthesiology group that gave me good drugs and funny dreams in APRIL of 2009 when I had GI tests. Bill was $560, insurance paid 291.31 and MY responsibility is 268.69. I paid 72.83, probably in May of 09, thinking I was done, as that was the amount billed me as my part.
So apparently they made a mistake and one year later, I am being threatened with collections if I don’t fork over an additional 195.86. Pity the sweet woman who had to take my indignant call. I sent them $50 this week and they can wait for the rest. I’m barely working half-time right now, not sure how to pay utilities, let alone food, etc, and still owe the hospital $400, which I’ve paid at $150/month for a year (they are getting $75 this month!), AND I HAVE DECENT INSURANCE. And this week I learned that I need new orthotics for my poor feet, another $430 I do not have. And really should have some physical therapy, but at $50 an office visit, I will learn to do stretching exercises with a towel for my too-tight calves.
And another thing…out of the blue on Tuesday morning, starting at 8am, I got 2 dozen phone calls from Allstate Ins, an advanced degree firm, a cruise line, Branson Resort… and then I stopped asking who and why and just started saying: “Lemme save you some time. I did NOT go online this morning and request info from your firm. Please take me off your list.” I stopped yelling as the day(s) went on and the calls have finally dwindled way down to a few a day, but for shit’s sake…someone gave my home phone and name to a bunch of agencies that have the right to phone me, DNC list be damned, because they believe I had requested this crap info.
I sort of feel better. I think we need a springtime Festivus. Wanna buy some more art?
Punchy
Had the same prob a few years back for sumpin as simple as stitches in my noggin. Got the insurance company to admit that they waited until collections were called in to finally pay their part, to maximize the interest on that amount blah blah blah. IOW, it wasn’t until I demanded they pay that they said, “yeah, I guess it’s time”.
And it took 2.5 hours (no exaggeration) on hold before I reached a rep. MEGA Life insurance….blows.
I have a feeling you’re about to be stunned at the amount that your insurance suddenly “decides” not to cover. Get ready for some near-future near-heart attacks.
David in NY
I believe that I have often failed to get all the insurance reimbursements to which I was entitled just because I got worn out. (Sometimes I get a bill saying the insurance company isn’t paying, I make an inquiry, and that’s enough to change their mind — suggesting that they deny stuff just ’cause a lot of people don’t complain and they keep the money.)
In my experience taxes are a piece of cake beside this BS. And by the way, referring back to discussion on an old thread, I just noted that, as a taxpayer having just wandered into the land of those doing well enough for Obama to raise their taxes (due to a windfall last year), I paid about 21.7% fed tax on my adjusted gross. This is even with the alternative minimum tax applied, which shrinks deductions. (Not including substantial state and payroll taxes, of course.)
geg6
Well, maybe this will cheer you up, John.
A FOX News poll has the IRS as significantly more popular than the Tea Party.
http://nomoremister.blogspot.com/2010/04/tea-party-movement-less-popular-than.html
Damn.
Seanly
John – how could a bill have gone to collection so quickly?
@Eric U.:
Yeah, coz we all have $25,000 sitting around to pay the hospital and myriad of doctors.
My wife had an MRI, then a biopsy and finally the “probably not cancerous but suspicious nevertheless” swollen lymph node removed. Luckily, her max out-of-pocket (including deductible) is only $2000, but we’ve only seen a handful of the bills. I’m sure we’ll run into issues similar to John’s though hopefully the doctors & hospitals will give us more than a month to pay. Especially considering BCBS glacial claim processing speed.
Mike Kay
This is great news for…. Joe Lieberman.
scav
@ geg6: now my head seriously hurts.
PeakVT
A relative of mine had a chronic and ultimately fatal condition. He would spend 3-4 hours per week checking bills and following up with the insurance company. After a few years of chasing BC/BS for money he said to me “The only way I’m going to catch up with the refunds owed to me is to die”. He was $40-50K in debt to his wife’s parents by the time he did pass away.
Belafon (formerly anonevent)
This sounds exactly like the routine my wife and I wen through when our last kid was born, especially since some lab company wanted to charge us and the insurance for something that we were not even sure they did. It took about two years to clear that up.
rapido
things could be worse – you could have these folks showing up at your house:
http://www.nytimes.com/2010/04/09/us/09westboro.html?partner=rss&emc=rss
Matt
Yeah, I’m still paying off the $500 deductible and $1,000 co-payment for my appendectomy from last July. And I still haven’t figured out what the difference is between a deductible and a co-payment.
jibeaux
Yeah, the good news is your taxes will feel like a cakewalk. I always run mine as soon as I get the W-2s in, figure out whether we’ll get money back or we’ll owe. If money’s coming back I do them pronto. If not, I wait until April. I don’t know why so many people sit down to start them in April and have no idea what the damage is going to be….co-worker owes $1600. Wouldn’t you want that information a couple of months in advance if you could get it? Anyway.
r€nato
@David in NY:
yes, this is exactly it. Insurance companies employ legions of clerks, a large part of whose job is to wear down patients, doctors, and anyone else they owe money to.
Of course, to make these jobs worth paying for (including the taxes and benefits for the jobs), each clerk has to figure out a way to withhold, what, $40K each year? Just to break even on what they cost the company.
Oh yes, private health insurance is so much more efficient than government.
Alex
In 2001 I moved from the US to Canada (largely because I’m not allowed to sponsor my husband for US residency because we both have penises, but that’s a rant for another day). The biggest difference I’ve noticed in my relationship with my doctor is that in the US, my primary care physician needed a clerical/reception staff of about five people (for a practice with about five doctors), and I had to wait in line for ten minutes or more on the way out to see one of them and have all my paperwork processed. Here in Canada, my primary care office has eight physicians, and only two clerical/reception staff who I don’t even have to talk to on the way out unless I’m scheduling a follow-up.
moe99
John, have you considered enlisting the Insurance Commissioner’s office in your battle? In WA state they do a great job helping consumers who are caught up in situations such as your own. Don’t know if WVA’s would be as consumer friendly, but it can’t hurt to try.
David in NY
It is not unlawful to bounce a check. Bounced check prosecutions are almost always political in some way — if the person is really committing fraud, as opposed to a mistake, there are almost certainly more serious charges to be brought. I’d consult with a local criminal lawyer about getting the charges vacated. Ultimate costs not necessarily less, satisfaction much greater.
jibeaux
@Matt:
you have to pay your deductible first before the insurance company pays anything, same way it works in car insurance except there aren’t any options about what your deductible will be for most of us.
The Moar You Know
HCR will not fix this, it will just give Americans who couldn’t afford to be caught in this eternal loop of gigantic hassle the chance to experience it for themselves.
That doesn’t change until you get single-payer health care.
I went through the same thing 2 years back getting my appendix removed, including getting bills sent to collections that I didn’t know existed. Good times. It all got resolved, but it’s not something you need to be dealing with on an ongoing basis if you’re chronically ill with something like, oh let’s say, cancer.
All that bitching aside, I’m still very glad that HCR passed, but damn, it sucks to get only incremental reform because the majority of our fellow citizens are retards and our political process is owned by corporations.
BGK
I’ve always found it particularly shriek-worthy that not only does one get a breathtaking bill from the “facility,” but from all the individual
griftersdoctors as well. It’s not like I can see a doctor of my choice, let alone my own MD, in a hospital setting. Also, there’s no rhyme or reason to what’s billed from the hospital versus what’s billed separately. I was in the ER about 3 years ago and received a chest x-ray. The bill for the film and the machine use came from the hospital, but the x-ray tech billed separately.That same visit, I was billed $775 for an actual five minute consultation from an “ER specialist.” Aetna, my insurer at the time, showed it was paid in full. About a year later, I get a letter from a collections agency telling me what a deadbeat I was for not paying the ER doctor. To make a long story short, the billing agency for the ER group changed their PO Box without telling Aetna, and the new PO box was for another ER group in a different city that the same billing group handled; the group names were clearly different. Despite this, the bank deposited the check and the billing agency didn’t find it strange there was no patient from the other ER group with my name. Then I was in a tug of war between the collections agency and Aetna: Aetna refused to cut another check until the other ER group returned the mis-applied funds, but the collections agency said I was on the hook for the amount billed, per the three-page financial agreement I signed on admission. I threatened them with going to the local teevee consumer reporter, and everything was magically resolved.
Erik Vanderhoff
Make sure your anesthesiologist is in your insurance provider network, or you’re fucking hosed. Those bastards don’t work for the hospitals — they work for a provider group separate from the hospital (unless you’re Kaiser, which it sounds like you’re not). It is surprisingly easy to be assigned an anesthesiologist who isn’t actually covered under your insurance.
And guess who are the highest paid medical professionals? You guessed it! I wish I could bill $3,000 for an hour of work.
Face
I would love to see the health insurance plans that health insurance companies issue their employees. Would be some wicked karmic justice if those fuckers were treated to the same run-around, random denial, never available for questions bullshit they precisely (intentionally?) apply to all their customers.
WereBear
Why didn’t you shop around for the cheapest surgery? Huh? And a real man would have been awake during it. Just pop a couple of generic aspirin!
Of course, I’m kidding… serious injuries are no joke.
It’s the Republican response to health care that is the black humor, if you know what I mean.
But yeah, just as one loses access to the good drugs, the real suffering begins.
Ecks
I don’t think the health bill will change this at all, unless you are buying on the individual market, in which case if you buy it through one of the exchanges that open in 4 years they MIGHT be required to use saner procedures if you live in a state with a good person running them.
But really who knows.
scav
Semi-OT, vague link provided by waiting lists. There are now waiting lists (700 people) to get into prison in Ashtabula County, OH. Judges telling people to arm themselves. Linky. Cross-pollination from CR.
Violet
Spreadsheet, John! Don’t say I didn’t warn you when you first posted about how much your insurance was going to pay.
Don’t believe anyone or anything. Track it all yourself. Challenge every claim that is denied. Read every claim with a fine tooth comb. Challenge again.
And, never, EVER trust the people on the phone at the health insurance company. Get their name and ID number if you can, but that info won’t protect you. Do everything in writing. Save a copy. Send by certified mail.
Yeah, it’s a pain.
Best health system in the world.
Fergus Wooster
John,
I feel your pain. We just received notice of an outstanding amount bill (or remainder of the bill) for the anesthesiology for my daughter’s heart surgery in September of 2009. 18 months ago and we’re getting billed?
There is no rhyme or reason to it, except that the hospitals and the insurers are playing the odds that you won’t become a full-time unpaid accountant. In order to get everything right, you have to cross-reference and reconcile, then try to document your case to someone in the bureaucracy who doesn’t want to talk to you.
If you don’t have the time to do all of this, and can’t hire someone to represent you, you’ll likely overpay the hospital and the insurer will get away with paying less than its contractual obligations. A classic racket. I’m sorry you’re going through it.
The only upside I can think of is that your taxes will be a breeze by comparison. . .
Jon H
I recently got a bill for ~$180 for treatment from my broken pinky, which happened just after Christmas 2007.
Oddly they never bothered with a collections agency. I half suspect they just slipped that in, in order to collect a bit more money before HCR was passed.
flyerhawk
Justice Stevens has announced his retirement.
It’s gonna be an exciting summer!!!
Kirk Spencer
@moe99: As you note, it depends on the commissioner. Here in Georgia, the commissioner of several years now is running as governor. I’ll shortcut the issue: he’s trying to be the tea-baggies candidate of them all. (He may not get that award as there are a lot of people trying for that.)
BR
You know, sometimes I wonder if insurance premiums would be much cheaper if instead of them paying big bucks for various expensive (and questionable) pharmaceuticals like various opiates/painkillers, etc., folks could just have a marijuana cookie now and then. Because it does seem that getting insurance to pay for prescriptions is one of the easier things (relative to getting them to pay for medical procedures).
Well, I guess this is already true in a few states, but not enough.
I can’t wait to see how pharma goes after the California tax+regulate proposition or the equivalent one in Oregon.
Face
@BGK: Damn. What a nightmare.
barbara
Here’s my personal favorite as far as medical bills go :
I got a call from a collection agency for a bill that I received (for the first time) two days later. Apparently they sent it to me and the collection agency simultaneously — oops!
Nutella
@r€nato:
They’re banking on David and everyone else getting worn out. Literally.
Both the insurance companies and the hospitals.
I once knew an elderly couple with health problems who were a retired nurse and a retired accountant. They had the time and expertise to read and understand the bills they got from the hospital. What they found is that every bill had at least one error and that every error without exception was in the hospital’s favor.
It’s a huge and complex system specifically designed to rob the patient blind.
But single payer or public option are just un-American so we can’t have them!
Laura W.
It is also surprisingly easy to be told by your in-network physician to have your GI tests performed at an outpatient facility which does not contract with your insurance even though there are other options that do, and it is surprisingly easy to not be told of this until 5pm the night before said tests when you have purged your colon all day for nothing. And then you wait another month because your doctor does not have privileges at your participating outpatient facility but for half a day every second Monday of the month, or some bull shit.
I learned last month that it is also surprisingly easy to schedule a visit with your participating physician only to be pawned off on his PA, who is not registered with your insurance? That one will be resolved, I believe. I’ve sold health insurance in various forms three times in my life over the decades, so I understand this stuff, for the most part. But it is truly just whack. Pity the poor.
4tehlulz
Expected retirement is expected
Mike Kay
This is great news for Bart Stupak!
Bill E Pilgrim
Yeah but just be glad that you don’t live in Soc ialist Europe where virtually the entire thing would be paid for without you paying a cent, along with anything else medical you ever underwent but (here comes the scary part) (ready?) (I’m telling you, it’s scary) you’d be subjected to a slightly higher individual income tax rate! (That was it).
Thank god they keep warning us about how terrible it is.
Jamie
and as someone who uses the health care system quite a bit, It’s better than it was twenty years ago.
TJ
AFAIK, if you’re covered thru work, basically nada. Even if you’re individual, there’s not a whole lot in there that cramps the insurance corps creative use of paperwork.
kay
@scav:
Don’t get too worried. This is how it’s done in Ohio. The sheriff and the common pleas judge want the county commissioners to release more funds. It’s just an escalation of a constant battle.
Here, our (new) sheriff issued press releases where he threatened to lay off 9 deputies. He assumed the citizenry would help him out, with public pressure, but they didn’t. The sheriff’s department are unprofessional and roundly disliked locally, in comparison to the city police, who use a “community policing” model, and are actually helpful public servants who use common sense and restraint.
The public reaction to laying off 9 disliked and feared deputies was not what he expected. No help there.
Punchy
Similar, and I’m the farthest thing from an accountant: I once perused my friend’s bill, who was in the hospital for a week for a “tuneup” w/r/t her CF condition. On each and every day, they had listed meds she never recieved, and better yet — the amount listed of some of her meds per day were enough to kill her. Clear as day, the dosages were listed, and anyone with a background in pharmaceuticals would have spotted it, but the hospitals were so brazen as to expect no one to pay attention.
Even worse: we pointed this clear forgery/overbilling to the insurance company, and they said “ah, fuck it” and paid the full amount anyways. What a racket indeed.
scav
@barbara: Yeah, I think that does wins the wormhole in billing award. Unless the preemptive warfare in billing award is still unassigned. Speaking of which, apparently at least some worms communicate by touch and make group decisions. They’re catching up.
CynDee
Yes, John, that’s how it goes, even with Medicare.
Having “health” insurance is not at all the same as having health care, which is not at all the same as having Health.
That’s why we need a universal system that pays directly for whatever care you need to make you as fully functioning a member of a strong society as possible. Strong people = a Strong Society = a Strong Country = A Better World. That’s the path to life and health.
Otherwise you can quickly lose hold of whatever health you have remaining as you are trying to recover. Make no mistake, these systems take full advantage of you not being at your vibrant, youthful best when you have to deal with them. They hope you will give up.
Weak, sick, disabled people = a weak society = a sick and corrupt country = a more violent, negative and fearful world.
That’s the path to death and destruction.
We have only a few leaders prepared to promote the path to life and health. The rest allow the looting of resources and promote a sick, uneasy, fearful population unable to stand up for the good things. This is how they get us where they want us: powerless and subservient
So each of us has to fight them the way you are, and it can take an awful toll.
Rheinhard
Wow! Seeing the topic I thought I’d jump in the comments and relate my friend’s story, about his little unexpected hospital anaesthesiologist bill which he received about a year after his knee surgery. But it seems about a dozen comments on here have told almost exactly the same story!
Yes, he went to his Aetna-approved primary physician, who sent him to the Aetna-approved hospital and Aetna-approved surgical staff, and long after he had his procedure and thought everything was overwith he gets an approximately $1K bill because the a anaesthesiologist wasn’t “in-network”. As he said “Guys! I don’t approve the anaesthesiologist! Your staff is supposed to clear all that stuff in all the preapprovals I had to get! How the hell am I supposed to know the list of every possible thing that might need approval beforehand anyway? Do you have a checklist?”
After screaming bloody murder for several weeks at his insurer he basically managed to get this worked out, but it didn’t do much for his blood pressure.
Best health care system in the world. (actually as I typed that I made a typo on the first word and typed “Beast”… Freudian slip?)
As to the tax question – I just filed last night and despite making slightly more salary than last year, I am getting significantly more refund. So hopefully filing may help you pay off your hospital bill! And don’t let the wingers tell you Obama raised taxes, because it’s bullshit and I have the refund to prove it!
Fergus Wooster
@Punchy: Exactly. Just like the insurers had an algorithm to try and rescind policies for HIV+ or cancer patients by scanning for bogus “fraud”, the hospitals have some sort of overbilling algorithm built into their system. You have to fight it full-time, and even then you don’t win.
I wonder if this will matter when they start overbilling people under subsidized coverage or coverage through the exchange. Then the federal government is getting defrauded (not that that matters for all things defense).
But I had one thought – these guys overbill as a matter of course. Each time they put an erroneous bill in an envelope and stamp or meter it, they’re committing mail fraud. Each time they email or fax you a fradulent bill, they are committing wire fraud. Federal offenses both.
We’re talking significant fines, and 10-15 years possible sentence, for each instance, plus restitution. I’d love to see some US Attorney break out the big stick. A man can dream.
bemused
@Comrade Mary:
Awesome rant from Dr. Grumpy.
LGRooney
Since many doctors’ offices and clinics now include clauses (yes, I read them) in their notifications we all sign when we first visit that any overpayment on your part will be held as a credit to your next visit, I either argue with them that I won’t sign that (only a few have agreed to strike it) or I wait for about three payment notices before paying. The reason is that their office will continue negotiating with the insurance company to get more payment and the insurance company will negotiate reductions in charges. If you pay on the first notice, it is settled, they stop talking. I had a bill from the dentist last year that went from over $2,000 in the first notice after the office negotiated some payment with the insurer. I waited and three months later I got a final notice from the office, which I put with the stack of notices from the insurance company, stating I owed $33 and some change.
ferd of the nort
I live in the far north.
Spousal unit requires MRI on multiple sclerosis rule-out. She has to wait 6 months for her appointment. They find a potential tumour site – but too small to determine. She is scheduled for another in 6 weeks, to allow a bit of growth and a better picture. Second appointment is made for 6 weeks (3 weeks from now).
Initial doctor visit – under Canadian basic medical,
travel for MRI ($1500 airfare plus accommodations and food) – under work supplied (partially deducted from paycheque, work pays 75% of costs) supplemental enhanced medical coverage (private insurance)
MRI – under basic medical
Follow-up visit with Doctor – Basic coverage
Second trip – supplemental private coverage
Total out of pocket expenses? – she took the opportunity of being in Winnipeg and went shopping… but she is rather frugal.
Total time spent on accounting by me? About an hour of work time (paid at work to get this done).
Yeah, a faster response would be nice on the initial request for an MRI, but if it was critical she would have been medi-vacced to the ‘peg ($20 to 25,000) at zero cost and been in the MRI within 6 hours. It was not critical, just a rule-out procedure. We could wait.
I ask every American to calculate the number of hours spent on medical insurance options study and choosing, on costs accounting work and on figuring out stuff on their insurance plans. Bill that out and add that with your insurance costs to your tax bill. That is a real comparison of relative costs vs. Canada.
Always remember that 90% of what you are told about Canadian health care in the US is BS. Minimum.
We spend a little more on taxes. We get more time for life and less overall cost. Simple basic truth.
Quaker in a Basement
@cleek: What cleekster said.
David in NY
@LGRooney:
My providers rarely bill me, even when I’ve gotten a partial or complete denial from the insurance company. What I believe happens is that the provide appeals and works out something with the insurance company. Maybe sometimes, though, the providers just eat the cost; I don’t know for sure.
ferd of the nort
The entire US medical system is wrong. It must start from a premise that 100% of people need health care during their life. Build upon that basis and things will get better.
Instead you work on the idea that Americans should get health insurance through their jobs.
Jobs don’t need health insurance, people need health care.
Lurker
@Comrade Mary:
Great post from Dr. Grumpy. I hope the 2011 requirement that each insurer must spend 80-85% of premiums on medical services will cut down on auto-denials like that.
moe99
@ferd of the nort:
Thanks for that, and good luck to your wife.
bemused
It’s bad enough dealing with this bs if you are recovered/recovering from what ailed you & have your mental/physical strength back. I feel even worse for the people who are still very sick trying to cope with their illness & this insurance co nightmare at the same time and parents with extremely sick children. All they want to do is spend all their at the hospital with their kids but have to spend so much time fighting about their care with their insurance company. Before my great niece died from a very hard to treat cancer, her parents spent so much time at the hospital, they were so happy when she could be home. Once she had to have an expensive med administered through her port which her mother had become very experienced at. Her mother went to the drugstore to get it & was told the insurance company wouldn’t pay for it unless it was done in the hospital, not at home. On top of your child suffering with cancer, the parents get beat up even more by the insurance companies.
BC
My advice is not to pay anything until the insurance company pays and you receive a follow-up bill from providers showing their charges, the insurance payment, and what you owe. Doctors and hospitals often bill over what is “reasonable and customary” that insurance companies pay, but revise their billing to the “reasonable and customary” (don’t you love it when I talk dirty?). Your responsibility should be limited to your deductible and co-pay.
Jen
I work for a software company in the healthcare industry – specifically, the niche of helping providers get the reimbursement they require from insurance payors. See, this is how the system works:
Healthcare Provider A (a hospital network, a standalone hospital, a physician’s network, etc.) contracts with Insurance Payor 1 to receive a certain amount of money for each claim they submit – say, $10 for service i, $20 for service ii, etc.
Healthcare Provider B contracts with Insurance Payor 1 for the same services, but possibly at different reimbursement rates – $7 for service i, $15 for service ii, etc.
Provider A submits a claim for service ii to Payor 1. Payor 1 engages in what is known as “silent PPO” and reimburses at the rate for Provider B, $15 – and that’s IF they don’t find some way of getting out of paying at all, and after they’ve dragged out the process for as long as possible.
Provider A now has four options: they can write off the loss (CFOs frown on this); badger Payor 1 for proper reimbursement (requires extra staff and manhours); contract with a company like mine to perform collections on Payor 1 (costs money, but usually recoups some owed dollars); or bill the difference to the patient and hope that they will cough it up.
For extra fun and giggles, Provider A also has contracts with Payors 2, 3, 4, etc., and all of them may have different reimbursement rates. Hence, Provider A may not actually know how much they should be receiving from any given payor for any given procedure.
What it boils down to is, the payors operate by the Pirate Code: “Take what you can, give nothing back.” Their profit model is to reap as much money from people as possible, then pay out as little as they can possibly get away with. They will hold onto every penny they can find until it’s pried out of their hands with the crowbar of laws.
But I’m not bitter, or anything.
minachica
@Rheinhard: The exact same thing happened to me when I had a C-section. I was so WTF?? I’m laying on the operating table and I’m supposed to ask the goddamn anesthesiologist if he’s in-network? After hours of screaming to the insurance company, they decided they could “make an exception” and cover it. I’m still pissed about it.
Bill H
After a cardiac catheter procedure to “ablate” and arrythmia, I spent some six months straightening out bills. (Which helped my heart a lot.) One of my (now) favorites was the insurance company’s notations, “Our records indicate this charge has already been paid.” There were quite a few of those, and it did appear the provider had billed twice for one thing. The provider nontheless required me to pay the one that the insurance did not pay. (Because they claimed to have already paid it.)
I finally had a list of no less that $3,900 of these charges and we phoned and corresponded back and forth at length. The provider said I should “appeal” the charge with my insurer, but that if insurance declined that was no skin off of their nose and that I then had to pay it. They would not provide the bills that they had sent to the insurance company, and claimed to have no responsibility in helping me to get the insurance company to pay. The paid/unpaid items in question did have different verbal descriptions, but had the same medical code, and the provider would not offer any explanation for that. There was no possibility that there could be a billing error, and even if there was such an error that would my problem, not theirs. I had agreed to pay anything not paid by the insurance, so pay up.
I finally wrote the chairman of the corporation, enclosing copies of the bills in question and of the correspondence, and said that I was making one last effort to “settle this matter outside of the courtroom.” I got a call from someone shorly after that who told me that they would rebill the insurance company and write off whatever the insurance did not pay, since time limits for insurance billing had expired.
Martin
John, you realize this is only happening because you voted for Obama. McCain voters get the hassle-free service. It’s like that Eddie Murphy SNL skit where he goes undercover as a white person.
In a more serious note, if this had happened to me with Kaiser Permanente, I’d never have seen a piece of paper. I pay the co-pay on the spot when I arrive for the visit, and everything is settled at that point. 6 months of bed rest for my wife when she was pregnant with our daughter, one surgery, 20ish L&D visits, a week in the hospital with complications – my daughter spent another week in NICU because she was 2 months early – we never saw paperwork for any of it. There were some copays along the way, but those are always done up front.
That’s what single payer looks like. I’m thankful every day we had the insurer we did going through all of that (and we had a similar round 3 years prior with my son).
ferd of the nort
Moe99
Not really worried. If it was too small to really see effectively, it is likely highly curable. Good doctor who listened to a woman’s complaints. Too many women in my life died from doctors not paying attention to their complaints. That is not a “canadian” problem though.
gelfling545
I generally pay my deductible and nothing else until all the insurance payments are in because amounts change from “estimated” bill and there are adjustments for no reason I can determine. Then call the insurance company and ask someone to tell you (and write it down) exactly what was paid to whom. Then call each entity that has billed you, make sure that they have credited the insurance amounts and ask them to send you a final bill.
RSA
Join the club, I’m sorry to say. I have a stack of insurance company statements going back to 2007, each containing from 1 to 50 lines of charges, each with its own code, source, covered amount, and so forth–there must be thousands, probably totaling a couple of hundred thousand dollars. I have honestly lost track. If I ever have a mental breakdown, our medical insurance system will be at least partly to blame.
Violet
@ferd of the nort:
Exactly. And this rarely gets discussed when health care is talked about in the US. These types of costs are awful and very large. The emotional and psychological toll, not to mention time, is massive. If you haven’t been through it, you don’t know.
My theory is that most people whining about soshulized health care have never dealt with a health insurance company. Once you do, you change your opinion.
Persia
@Erik Vanderhoff:
Having said that, the job of the anestheisologist is usually to bring you as close to death as possible without actually killing you. I’m willing to pay good money for that.
Lurker
@Martin:
This depends on the level of Kaiser health insurance. The “good” Kaiser plans are paperwork-free, but they do not come cheap.
Kaiser also offers cheaper plans with high deductibles and/or HSA-compatibility, however. Lower premiums, but you will get bills in the mail. A friend who had used the “good” Kaiser plans for seven years downgraded to an HSA-compatible Kaiser plan with a lower premium when finances were tight. He was shocked when his “free” annual checkup billed him later for the cost of lab work. It was a different experience than what he was used to getting from his older Kaiser plan.
-+-
I picked a Kaiser HSA-compatible plan for now because I need to get an old HSA the hell away from HSA Bank. I need HSA-compatible insurance to open a new HSA without hassles elsewhere. As soon as I can afford it, though, I’m upgrading to Kaiser’s Plan 50 or Plan 30. I would prefer a paperwork-free, hassle-free plan like the one you have. :-)
Barry
John, I serously suggest that you hire an accountant for this; there will be massive duplication, with the attending increase in error rates, and several organizations who both feel that their errors are you problem, and who make a living off of making others pay for their actions.
PurpleGirl
I’ve had three surgeries in the past 16 years. The first was a hemilaminectomy. My insurance at the time was HIP of New York. It was an HMO. They had there own physicians groups and contracted out for some specialists and procedures. I never saw a bill… no bill at all for any part of the process from initial exams through the surgery itself. And it included three MRIs.
Second surgery is for torn cartilage in my knee. By that time my company provided insurance had changed to Oxford. I got my primary care physician to refer me to an orthopedic surgeon who I picked out and who I knew was an Oxford provider. I had co-pays for the X-ray and an MRI. Surgery itself was completely covered by insurance EXCEPT for the pathologist. I get a bill from the hospital that Oxford didn’t cover that and it also turns out that they are offering less than the charge for the pathology work. It turns out to be $20.00 less. I make a few calls, and am told Oxford will cover the pathologist after all but at that lower amount. I finally decide to just pay the $20.00 difference and then the hospitals sends back the check as Oxford has paid the whole charge. I’m supposed to know that the pathologist is a covered charge or covered under the contract Oxford has with my doctor and hospital? WTF.
The third surgery is the removal of fatty tumor from my back. Again I pick a doctor by reference from a friend (who had similar problem and surgery) and get the referral from my primary care physician. It’s approved by Oxford. The fatty deposit is visible on those MRIs from the herniated disk, so the surgeon doesn’t need to have any imaging done. Again, Oxford and I go through the dance about paying the pathologist. This time I make the phone calls and in time the hospital tells the bill has been paid in full.
The easiest surgery with regards to finances was the one done with HIP. And about six months after the knee surgery I’m contacted by a third-party company hired by Oxford to find out if there is another insurer who they can cross bill for the procedure. I’m on the phone for 20 minutes answering questions before I convince the agent that I’m not married so there is no spouse’s insurance to cross claim, it wasn’t an occupational accident that caused the tears so they can’t cross claim to workers compensation, and my parents are on Medicare and don’t have a supplemental policy.
Egilsson
There are a lot of people out there who have no idea how totally screwed up our health care system is.
You can’t negotiate prices or services when you sick, you can’t even find out what the prices ARE until months later. It’s not like shopping for a muffler.
When my daughter was really ill for a long time, it was just a joke what poured in the mail. No human being could go through stuff, much less under those kind of circumstances. I carted that stuff out by the garbage bag.
The more I look back at it, the more ticked off I get. It’s a joke of a system.
bystander
I have no idea if the HCR reform bill will do anything about this…
No. SATSQ.
The structure has not changed, the mechanisms and pathways for the interaction of all the counter-parties hasn’t changed, the number of actors and their accompanying interests hasn’t changed, ergo, it will be this bad – and even more expensive – for the next surgery we all hope you don’t have to have.
Tsulagi
It won’t. But look on the bright side, many more will get to delight in the joys you’re experiencing right now. Maybe even get some meds to cope with it.
Been there, got the t-shirt. Ten years ago Mom had cancer and wasn’t expected to survive. Dad was doing everything he could to comfort Mom and ensure she had the best treatment to maximize her chances. Some proposed treatment the carrier didn’t want to cover. To relieve some pressure off Dad, I became point man in dealing with their insurance carrier and providers bills.
What I found was health care deliverers pick a number for their services. More often than not a number that is above the most “generous” carrier’s reasonable and customary allowance. No one wants to leave any money on the table. It’s not a secret. There were some bizarre charges and itemizations; more chances to shake some money loose from the insurance money tree.
In my experience, most providers accepted the carrier allowance even if below their charge then closed their bill. No contact needed. For those that didn’t, I created a form letter requiring a detailed justification why their charge(s), not known in advance, was above reasonable and customary warranting further payment. That cleared out a lot of those. Remaining ones after that I called and we came to agreement. On a few got the carrier to increase their allowance. Fun times.
Ed Drone
Well, if you hadn’t had the insurance, HCR would have meant that you get all this. If you were one of those ‘lucky duckies’ without insurance, you’d just get it free, right? That is, other than the bill collectors, dunning notices, wage garnishing, and possible threat of arrest if at any time you appear to have ‘committed a fraud’ in your attempts to pay or argue the bills. And you could kiss your credit rating good-bye forever, as a bonus.
Ed
jncc
John,
I’m not sure of this, but I don’t think that medical bills sent to collection adversely affect your credit reports since it’s technically not an extension of credit – it’s just an unpaid bill.
You might want to look into this _carefully_ before you start sweating the bills, especially the small ones. In the past few years, I’ve had screw ups on my med bills and other things – I’m talking a few bucks or a couple of hundred bucks – that got sent off to collections. I ignored them. I had to qualify for a loan during the credit crunch and the lender went through my credit very carefully and there was no mention of this stuff in my credit reports.
Anne
I’m going through the exact same thing after two brief hospital stays and a battery of tests in December. I’m convinced that it’s intentionally confusing and difficult so that you don’t question anything and just pay up. Maddening. And of course it’s the last thing you have the energy, willpower, or patience to do–let alone want to do–while you’re ill. What an awful, awful system.
dobrojutro
We need the health care equivalent of Turbo Tax.
Nylund
I had a car accident in November. The EMT took me to one hospital, but later I was transferred to another. Followups at a different clinic. Each place has its own set of doctors, imaging centers, labs, admissions center, anesthesiologists, etc. All in all, I have about 40 – 50 different bills from different sources, all in different formats. Some for thousands, some for $3. many slide through the cracks, have collectors and credit agencies after me left and right for $9 here and there (that I didn’t even know I owed). Some ONLY accept check, no credit cards, some only credit cards. Some must be mailed, some must happen online. There is no rhyme or reason. Some of the bills don’t even specify what they are for. They are simply an amount that I am supposed to pay someone for God Knows What.
Its now 5 months later, and I am still sorting out and paying bills (and STILL getting new ones in the mail from new people claiming they did something for me that deserves me paying them). I have nearly an entire file cabinet dedicated to it and an increasingly complex spreadsheet tracking everything. At its height, I was getting about 10 letters a day. I was very overwhelmed. I actually had to use 2 vacation days just to sort out the literally hundreds of pages of paperwork and bills associated with it all. I actually pushed every piece of furniture against the wall so that I could use the entire living room floor to sort it all out.
Sly
I received a letter a few days ago saying that my policy was terminated back in January, leading me to think that, for the past 3 months, I was uninsured. No reason for the termination, just “You’re policy ended on this date, here’s proof that you had insurance when you apply for a policy from someone else.” Rather shocking, really, since it’s a large-group plan and I received no word that the insurance plan had changed or was changing.
When I called up to ask what the fuck it was all about, I was informed by the nice lady who works at Aetna that about 6,000 people in some of their large group plans were sent that letter in error. Hey, mistakes happen. Then someone in the same plan told me that Aetna was having trouble negotiating a hospital benefits package with the plan administrators back in late December, and so they sent out those letters to scare the shit out of people and ours just got buried in the bureaucracy for a few months.
Good times.
@jncc:
I’ve had collection agents after me twice before because of unpaid bills (on services I never asked for) and I outright refused to pay them, and my CR never went down because of it. So you’re probably right.
BombIranForChrist
Tell the hospital you need drugs for the pain.
D-Chance.
Obamacare will take care of all of that. It’ll even buy you an ice cream sundae once you’ve finished your Happy Meal…
darms
I second Egilsson above, when bills dribble in over the course of six months after the procedure, how is one supposed to comparison shop? It’s impossible.
My pet peeve is the insurer discount on services. Recently my wife had a diagnostic procedure which the facility charged $1600 for. But she had insurance so after the insurer discount we were charged ~ $500. But how much did the insurer pay? $0.00. Nothing. Nada. Apparently the facility just ate the $1000 difference. But what would they have charged us had we not had insurance? The person at the billing office came out & told me – we would have been billed the entire $1600. Looks to me as if the uninsured here are expected to subsidize the insurance companies & the facility. Am I wrong?
jl
Excellent IGTUTTTBBIC post, Cole.
different church-lady
But, ya know, you don’t want the government putting a bunch of bureaucracy between you and your health care, do you?
MTiffany
Wait until you find a notice from your insurer saying that the $8.11 was paid, and that some grossly negligent troll at the hospital never entered the payment into their accounting system. And when that DOES happen (and it will, trust me on this), the very next thing you do is call a lawyer and SUE the hospital for the full $1000 due you for their violating your rights under the Fair Credit Reporting Act, plus demand all court and attorney’s fees.
daverave
I had a hip replacement three weeks ago. The bills are starting to roll in, the most significant being $83,000 for TWO nights in the hospital with no complicating factors. Doctor, anesthesiologist, visiting nurses for Coumadin monitoring, etc., etc. will be on top of that.
My solution to the insurance complexities was to marry someone 30 years ago that works in the industry and she gets it. My brain turns off anytime anyone says the word “deductible.” She is tireless in hounding people that know one-tenth of what she knows. And even she has to admit that much of the time it is impossible to figure out. BHCSITW!
Timmy B
Thank God that the recently passed HCR legislation mandates that all Americans will get hosed in this manner by the medical and insurance industries.
Mnemosyne
Even if every insurance company spontaneously combusted tomorrow, we would still have this problem because we have a profit-based healthcare system. Hospitals expect to make a profit. Doctors expect to make a profit. Labs expect to make a profit. Every single one of them has their hand out to get their share of the pie, which just happens to be your healthcare.
At this point, even switching to single payer would be a clusterfuck because you would still have for-profit hospital chains and medical groups sucking up as much money as they possibly could. Unless you’re proposing a total government takeover of an entire industry at the same time, from the Wellpoint hospital chain right down to the doctor down the street who runs his own practice, and good luck with that one.
Plenty of countries run their universal coverage through private insurance companies, including Germany and Japan. But they’re all nonprofits. The profit imperative is what’s distorting our healthcare, not the insurance companies per se.
Arclite
I used to be part of an HMO, Kaiser. There was one place I paid, and everything came itemized. Then my company spun off my division and they no longer offered Kaiser, so now I’m part of BC/BS PPO. Everything is billed separately. IT’s a total pain in the ass.
Nutella
@Nylund:
Your 2 vacation days are just part of the stupendous drag on productivity that is the US health care system. Idiots like Noonan say we shouldn’t do anything about health care but should work on the economy instead but I think that a good 10% of all economic activity in the US is wasted on this instead of on the production of useful goods and services.
Ruckus
I want to make a snarky post, but I just can’t bring myself to the table anymore.
The whole system is broken. And on purpose. And not just the insurance industry. I do feel a little for the docs and hospitals as they have to deal with this everyday. But we think that we went to the hospital, we checked in with the hospital so we should get one bill. But that would be too easy and focus responsibility to two parties, you and the hospital. Fewer profit centers mean less profits, so that can’t be allowed. I can’t even imagine the productivity lost in this country due to our healthcare billing system. So what hospitals and docs do is shotgun the bills, send everybody an inflated bill and hope somebody pays something. The insurance co knows this and because they don’t want to pay anything out at all, they deny, delay and obfuscate the entire process. Sooner or later the hospital and docs get paid something, the insurance co makes more money and the patient gets screwed. And no one is willing to actually fix it because as crappy as it is, everyone who is trying to make money does, and if you suffer that’s just your bad luck.
Just look how many healthcare money problem stories there are in this one post on this one blog. Multiply by all the millions of people who don’t read and post here. Broken is not even close to the right word. And for all the health care bill does, and it does a lot, what is going to actually change? Almost nothing to fix the underlying problem.
Joe L.
It’s SOP for insurance companies to try to get you to pay for things they should (and often eventually will) be covering. I’ve seen it happen over and over. Don’t be too quick to write those checks out; at least make sure they are legitimate expenses that you are responsible for.
mai naem
We were getting bills for eighteen months after my dad died for HC services. And a lot were for $5 copays. Are you kidding? $5 copays from docs who are easily making upwards of $250k/yr. The initial big ones I kept track of but the $5 copays – I am pretty sure I paid stuff twice but who the f#$k keeps track of this stuff 18 mos esp. if its for a family member’s death which you really don’t want to deal with anyway. And, oh did I tell you about the threat of the bill going on my dead father’s credit record? Does god check your credit score when you enter heaven? Do you get sent down to hell if your credit score isn’t 750?
Wendy N
When my mom passed away it took me over a year to get all the bills settled. Sometimes the insurance company would not pay because the hospital sent the bill to the wrong PO address. How come I can walk down the block to CVS, buy a can of Coke and by the time I get home the transaction is already visible on my banks web site????? But a hospital and an insurance company use PO boxes???
Hospitals and insurance companies don’t communicate effectively on purpose…..hoping that rather then try and sort out the billing people will just pay out of pocket. If I would have paid all those 50 and 75 small bills that eventually were all paid I would have spent over $500.00.
Oh and by the way….don’t you love how friendly and helpful the billing department people are on the phone??????
Marshall
What I love is how, months after almost any major medical event, I will get a new bill from some medical hanger-on, and, of course, I am expected to pay it. Anesthesiologists especially love to do this.
What a concept ! Suppose that, months after, say, you had your car worked on you got a $ 400 bill from a “spark plug specialist” or a “emissions diagnostician.” You would probably either toss it in the trash, or call the service station and tell them where to put it, but in the medical world, this is routine.
I assume a certain fraction of these are totally bogus, but always pay them anyway.
MazeDancer
Doctors charge what they want. And bill you for what insurance won’t cover. If they are in your “network” sometimes that doesn’t happen. Sometimes it does.
And you get bills from all kinds of doctors you never even actually saw, who looked at something on your chart or something, and are not in your network. And charge whatever they please. And insurance pays what they determine they’ll pay.
John Cole’s experience is like most people who go to the hospital for the first time: Are you kidding me with this insanity?
Even people who work at hospitals are shocked the first time they have to check into one.
That’s why, among the lucky enough to even be insured, there are people who have been sick, and understand health care is broken and people who haven’t been sick yet.
tatertot
My dad died in 2004, with pretty decent healthcare insurance as far as I can tell (me having lived in the Socialist paradise of the United Kingdom for the past 25 years) – my mom is still getting demands for his treatment, and now getting lots for her own cancer treatment. I love it when I go back to my mom’s – it’s like a paper mountain nightmare.
Rainy Day
I just want to echo what BC said Comment #70.
My hubby was in the hospital for a week. We had bills coming in from every direction, but I paid NOTHING. I considered that their ‘first draft.’ And, it actually was. After 2 months, the bill dropped to a fraction of the original. It was almost as if they were testing to see if we would pay the original ‘frightening’ bill.
But, I say this as a person with a flawless credit history. I have never had any collection agency contact me for any amount on any purchase/service. I’ve always enjoyed a polite ‘reminder’ call if I failed to pay something.
However, even if you don’t have a perfect credit history, it seems reasonable to tell bill collectors (if they call), “I’m waiting until I have all the bills in front of me, so I can check for duplicate charges and what my insurance paid. If there is a charge I dispute, I will contact you immediately.
Bill collectors just need to see SOMETHING on their computer screens that indicates a willingness to pay. Blank screens make them suspicious and therefore, snippy.
And, NO LAW is going to prevent bill collectors in any arena from contacting you. Likewise, no credit report is going to deem you a bad risk if the ONLY bills you have outstanding are medical ones (if you pay them within 90 days). The current HCR bill MAY result in a more simplified bill, but I wouldn’t count on that any time soon.
Hope this helps!!!
Platonicspoof
A soc1alist is a capitalist who’s been mugged by the American health care system.
DPirate
Waaa. You got fixed. Be happy.
Pat
I’m living in Canada now, and a couple of years ago I had my appendix out. So 3-hour ambulance ride, MRI, surgery, four days in the hospital. Zero–ZERO!–paperwork. To top it off, my health care card had expired. Their response: Make sure you renew that soon!
I recently needed emergency care in the US, and yes, those bills were sent to collections before they were sent to me. But here’s the rub: The collection agency is a subsidiary of the doctors’ billing company. My theory is that since they can bill at the 10x non-insurance-negotiated rate, they “send it to collections” so they only have to pay the doctors at that 10% rate. The rest is pure grease, baby.
bcinaz
Who’d ever want to reform a system like that? Why make things easier for Doctors & Patients? How dumb do they think we are?
Good luck! (I know I’m an old fashioned girl, however, putting stuff into a database, like excel sometimes helps to see it more clearly)
Mnemosyne
More and more I realize how lucky I was that, when I injured my knee, I injured it at work and entered the soshalistic worker’s comp system instead of having to deal with it through my private insurance. No bills, no statements, a decent amount of paperwork that had to be sent to the state, but the doctor’s office took care of most of that.
There were annoying things about it, like the tussle over getting more physical therapy, but at least I didn’t have to worry about paying for anything.
Teemu
Greetings from Scandinavian socialist hellhole!
Couple of years ago, I discussed with my doctor whether I should have a tonsillectomry. Week later I undergo the procedure (all ok) and overnight stay. Recovery doesn’t go so well, with six ER visits, two overnight stays and one ambulance ride, mainly due to profuse bleeding. Later, I get a bill of $180 for all the above combined. I pay it and that’s it.
A friend was diagnosed with prostate cancer. Consultations, tests, then prostate removal and a month of radiation treatment. He got a bill of around $300.
Another friend had a stroke during a stay on remote location not accessible to ambulance. He was immediately sent a helicopter with doctors, roughly 80 miles there and another back to hospital. Quick treatment with anticoagulants(?) saved him completely. He showed me the hospital bill of roughly $100. We had a good laugh over the item “emergency transportation: $8.20”.
This week I went to posh private dentist for few quick fixes. Bill was around $300, but when I showed my “national insurance card”, it was reduced to $140 (with $160 going to state). Ie. I only paid for the extra added fanciness, while state paid the basic care. I’ve always considered having to remember to bring up the NI card as tremendous hassle.
Cheevans
I work for a Canadian company that specializes in negotiation between providers and Foreign / Domestic insurers. It’s amazing what Dr’s and their billing companies will charge compared to actual costs. It’s very common to settle for $0.50 on the dollar and still feel like we have overpaid for services. But hey, it’s the best healthcare system in the world and we Canucks are aparently flocking across the border for treatment……..