<p>Good timing on this thread. I spent 6 hours waiting by my phone for a callback from physician services which I think is an out of state billing service for our Pitt drs. My first call only took 10 minutes on hold for me to get a live person to tell me the proceedure for my S to give permission for them to talk to me. I called S and he texted me 10 minutes later to say that I could call. On my second call, I was on hold 20 minutes before I got a live person who asked for my phone number and the best time to call back. I explained that I only had 24 hours until his permission expired. He said that someone would call em back before 7 pm. At 6 I called again and when I finally got a person, she said that the callbacks are never done until the next day.</p>
<p>S had two trips to the emergency room and I am sure that he was treated by numerous doctors. We got one bill for one doctor that the insurance refused to pay because they could not I. D. my son. WHAT? Instead of sending me a threatening letter, why don’t they look in their own computer for the information that the other doctors seem to find?</p>
<p>In my area, it is common for every person you see in the ER to bill separately, and most of them are not in-network. </p>
<p>When surgery is needed, there are NO anesthesiologists in-network (I have BCBS, but I’ve been told that none of them are in any insurance plans). </p>
<p>The interesting thing is, when out-of-network providers send you a bill, if you pay it, they are happy to take your money. But if you call them, they ALL (so far, in my experience) accept whatever BCBS pays to an out-of-network provider. Therefore, no copay from me at all. It’s actually less expensive for me, and they explain that it’s not worth it for them to be in-network with anyone and then have to hire people to deal with insurance companies.</p>
<p>I never pay <em>any</em> medical bills (except my in-network copays) without calling the office first.</p>
<p>That seems to be the case in our area. But why charge a separate charge to read the electrocardiogram when there’s no separate charge to read the results of the urinalysis, blood chemistries, and blood counts and use that info in deciding further care? It makes no sense and so the insurance companies reject the charge.</p>
<p>^^Probably because a Radiologist who is not a hospital employee reads the electrocardiogram and bills from their practice and the hospital bills for the actual procedure in the hospital so two bills while the lab workers who might be salaried or hourly hospital employees take care of the simple blood draw results and the draws are read by salaried or hourly hospital employees so there is one charge from the hospital.</p>
<p>Medical Laboratory Scientists perform and report the results of blood chemistries, UA, CBCs, cultures, etc usually with accompanying ‘normal’ or reference ranges on the computerized report.
Attending or ER doc use these results in treatment decisions of course. But unlike on the TV show ‘House’ , in real life, physicians don’t actually perform lab tests.
At least not here in nj…</p>
<p>^ Also, test results that are objective / numeric, can be read by anyone. On the other hand, many other tests are subjective, and require judgment calls. They must be read by medical professionals licensed to make the judgment.</p>
<p>you would be amazed how many claims are submitted incorrectly… I’ve seen them where they didn’t even include the patients name… or also, how many bills are PAID that the doctors offices have no record of. Then you tell them that their check was cashed 6 months ago and they say “uh… can I get a copy of that?” That’s one thing I never enjoyed at work - talking to doctors offices on the phone.</p>
<p>We got an letter from the insurance co last year showing our share of expenses related to the epidural our daughter supposedly had when giving birth in the town next to ours. Quite the miracle as she was on a cruise ship in Alaska with her fiancee and mother-in-law to be at the time (about 3000+ miles away). It all got sorted out and we laugh about her “facation”, but it was a bit of a surprise for her Dad when he opened it. </p>
<p>It was a mistake by the hospital (she had been a patient there many years ago). I was shocked that they could send an insurance claim for completely the wrong patient even if that person had been in the hospital 14 years ago. Was also surprised the insurance processed the claim as there was no other evidence of her having a baby.</p>
<p>I got a letter from a collection agency today for an $82.48 doctor bill. The date of service was February but the doctor’s office never billed me for my portion of the charges until August. I paid the bill the same day I received it - they had to have gotten my check within 5 days at the outside. I can’t believe that the doctor would turn it over to a collection agency so soon after sending me the first bill and without waiting for my check to arrive.</p>
<p>I did get the EOB from the insurance company back in March or April showing that I owed my 15% but the doctor never billed me until late August. It’s not my fault if his billing department is so slow and I’m certainly not going to send in a check until I receive a bill. I plan to call his office tomorrow and raise a little hell about his billing practices.</p>
<p>Going slightly off-topic, but similar thing happened to me this summer. July was the month I got to start paying back student loans. Payment for one of my loans (which I wasn’t aware was managed by another company) was supposed to be due July 27. Imagine our surprise when my dad (co-signer) received a letter from a collection agency August 7. I didn’t get one until 2 days later. For a simple error…</p>
<p>I also was billed by the pedi anesthesiologist when S (minor) had a endoscopy at an out-of-state participating medical center with a participating GI. They said I was supposed to have been sure that only participating & preferred pedi anesthiologist was used. I objected loudly & said it made no sense–as a parent of a patient, you just tell them what you insurance is & that you want to use participating & preferred folks & get out of the way. After a few months of balking, they paid in full & I didn’t have to pay that particular bill. It was like $600 or more!</p>
<p>Medical billing is much wilder than most of us wish it were.</p>
<p>I had back surgery back in May. All the doctors are in-network, hospital is in-network, the hospital made me come in three weeks ahead of time to fill out a crap-load of paperwork, get insurance info, etc.</p>
<p>Fast forward 6 weeks. I get the EOB from the insurance company and it says “Hospital did not get the required clearance, by contract you owe nothing. Do not pay anything, if you paid anything ask for your money back.”</p>
<p>The hospital billed the insurance company over $16K.</p>
<p>Oops. </p>
<p>Waiting to see how this plays out… I can’t believe the hospital will accept this without a fight.</p>
<p>My favorite billing story was when the office staff of my D’s doctor scheduled two operations on the same day. When we showed up, they said he was tied up and we’d have to reschedule. OK, not that big a deal. </p>
<p>Then I got a hefty bill for the “service” they rendered her the day we showed up. They wrote it up as “education regarding upcoming operation”. I called and said I wasn’t paying anything, because there should be no charge; and if there were a charge, it should be insured. We argued for several weeks (in writing), and they put me into collections for the charge for non-existent services.</p>
<p>The punchline was when the collections people sent me a copy of the bill - and attached at the back was the office staff’s internal notes that they’d mixed up two appointments, and needed to bill me for “something”. I sent that back to the collections office, highlighted, with a copy personal & confidential to the physician. Never heard from them again.</p>
<p>A recent visit to my established eye doctor had the billing clerk asking for entire payment up front before insurance was filed. She indicated that after ins payment, I could run a “credit” on my acct. I said, I didn’t think so…she said, “Did I know how much postage cost for sending bills?” Unbelievable!!! </p>
<p>I doubt that the Doc even knew what was going on with regards to billing. Most Docs only want to practice medicine, and not be concerned with running a business. It is only when it is almost too late with regards to their business and need legal help, that they become enlightened.</p>
</p>