My best story about disputing a bill was over–of all things-- a $10 copay for a flu shot. I went to a shot clinic of the HMO I was using at the time, paid my co-pay in cash, got my flu shot and all was well.
For 6 months.
Six or maybe eight months later out of the blue I got a call from a debt collector who had been assigned by the HMO to collect my co-pay plus another $25 in various late fees. I’d never been billed for the allegedly unpaid co-pay so the call from collections was a shock. At first I thought it was some sort of joke.
Once I had become genuinely convinced the bill collector was legit, I contacted the billing office of the HMO. They said they’d sent me several notices that the $10 co-pay bill was overdue. I’d never received any of them. They insisted they’d mailed me at least 4 billing notices. I asked what address they sent them to—and it wasn’t mine. My first clue that something was very wrong.
I explained I’d paid co-pay at the time of service and that since their procedure was that no one was sent back to the service provider without first paying the co-pay. I must have paid my co-pay otherwise I’d never have received my flu shot in the first place. Nope. Not an acceptable explanation. They wanted to see my receipt. I didn’t have it because I’d tossed it once my EOB statement came and showed the flu shot has been paid by the insurer. (Plus seriously, who keeps a receipt for $10 for 6 months?)
So we went round and round over 5 different phone calls with billing, each with a different individual. I asked why the overdue notices were sent to a wrong address. They had no explanation and refused to waive all the overdue fees or call off collections saying it was my responsibility to know the notices were going to the wrong address! That made me furious. I finally got to a supervisor who actually listened to my story after about 2 weeks of phone calls. She looked up the specific billing ledger from the shot clinic on the day I received mine. I had paid my co-pay! My payment was recorded—but whoever transferred the information into the master billing ledger transposed my payment down one line in the ledger and credited it to someone else who was seen at the clinic that day for acompletely different reason. The person credited with my co-pay was the one receiving the overdue notices. She ignored them because they had my name on them.
Anyway, the billing dept supervisor apologized, updated the billing record to show I’d made my co-pay on the day of service, called off the bill collector, dismissed all overdue fees, and removed all adverse information from credit report.
But, boy, it would have been so much easier to just pay the $35…
My middle son was in the hospital for five days when he was 9 weeks old - he had RSV. So scary. He was on oxygen, but never had surgery.
When I looked at the itemized bill, there was a $500 charge for “OR prep.” Huh. I called the hospital and told them he hadn’t had surgery, and they asked, “Were they THINKING about surgery?” Uh, no. So they took the charge off. Our insurance company would have paid it, but it was the principle.
When our oldest had hernia surgery, he needed recombinant Factor VIIa to help his blood clot. I had been warned that it’s not effective for very long. It happens to be one of the most expensive meds in existence (except maybe for the 6-month anti-psychotic injectable he now takes - currently $27,000 each time!).
They gave him one dose before surgery. But then there was an emergency in the OR so the procedure was delayed. They had to give him an additional dose. He also got a dose after the surgery.
We got the bill and they had charged us for THREE doses. I called and said, “I’m sorry there was an emergency in the OR, but that was NOT our fault and I will not pay for the additional dose.” They took that off the bill, too. That was around $13,000. By this point, our insurance was so lousy we definitely would have had to pay part of that out of pocket.
D was hospitalized at nearly 2 years old. After she was discharged, I got two bills. One for her birth and one for her recent hospitaluzation. I contested both. For her birth, I asked why there was any copay and asked for an itemization since her brother (who was born 2 years prior to her) only had us pay for a $20 tyvek jumpsuit for H to wear for delivery. H never wore it and we brought it for him to wear for D’s delivery. Our insurance coverage and policy was the same for both births. Hospital said they didn’t keep and couldn’t itemize bills that were so old. I said I couldn’t pay if they didn’t itemize so they told me to forget it and I never received another bill for her birth.
The other hospital bill they sent for her being hospitalized showed that they charged $5 for each of the baby aspirins they gave D in the hospital and I contested it and said they must have meant to charge just $5 for the entire bottle. They reduced the bill.
In my experience, it’s worthwhile being quietly persistent if you have the time and energy. Hospitals and insurers should not be allowed to be sloppy and get rewarded for coding errors.
I’ve battled my insurer about several other things successfully as well. Sadly it does take time, which insurer knows and they figure most will just pay and move on with their lives.
So my contest the hospital bill is a little different…
I ended up in the ER after a fall at a school where I was volunteering. They wanted a co-pay on the way in as per my insurance.
Later, the school gave me workmen’s comp paperwork, as I was covered. Filled out, submitted, and called hospital to get my co-pay refunded. In the meantime my insurance paid, workmen’s comp paid.
Had a somewhat amusing phone call with the hospital in which I was told that they don’t reimburse double payments unless the insurance company asks. Insurance company told me they’re not supposed to do that. Ended up on a three way call to reach a resolution. As there was no OOP for me, I think I left it to the insurance company and the hospital to complete resolution.
I was floored by the hospital’s attitude regarding double payments.
Similar story to @WayOutWestMom ;
I received a Collections letter for a $20 unpaid copay (for an eye appointment). Prior visits (with same insurance company through same employer, at same eye MD) never required a copay. In the past, my eye appointments were typically covered by a combination of vision insurance and/or Medicare (depending on service). So, I was not anxiously awaiting a bill, nor was any received. Plus aren’t copays usually collected at time of service?
I assumed the Collections letter might be a scam, so called the MD office direct. Yes, I owed a copay. No problem, and I realize that the insurance policy may have changed. However, I asked why they never contacted me (by letter or phone). She forcefully (and not very politely) insisted they tried to call 4x, and the number was disconnected. I assured her I did not change my phone number, so asked what number they used. The number she shared was correct – and happened to be same number I was using during my current call. She became angry and just repeated I now owed them $20.08 (for interest?). I was most angry at the excuse that they repeatedly called my (not) disconnected number, and instead sent a $20 bill to Collections.
I admit though out most of my life I would have just paid the bill and been done, unless it was really high.
I do remember one odd situation.
My son was in college in NY, and we live in MD. We had BC/BS insurance, which was good nationwide.
I (well really probably HE, because he was the patient) received a notice from a collections company for a bill I don’t think I knew existed before then. Turns out son had been in the hospital (kidney stone), and the doc who treated him billed the wrong BC/BS company. I guess there’s one in NY, and that wasn’t who should have been processing it.
I had to find the docs real office, call them, and ask them to take care of it. They understood the issue and I never received anything else.
I remember my son worrying about that when he was applying for a security clearance, but all was fine.
How about a sort of opposite saga. I fought with BC/BS for over 18 months because they were double paying us when DS was a premie in the NICU. We got double payments for every day he was in the NICU. I’m not joking. DH and I mailed many of the duplicates back to BC BS, never cashing them. But they kept coming.
We had a spread sheet which we sent to them that had every payment, every EOB number and every check number…and the dates (don’t ask me why they were paying us directly…our hospital and doctors were all participating and we had assigned payment).
We finally contacted our lawyer. He told us to put the duplicates in a dedicated savings account that held no other money.
We had a number with BC BS direct line to the person who was managing this on their end. They audited our account THREE times and couldn’t figure out what was happening. I’m not sure why they didn’t just look at the spread sheet we sent them.
After 18 months of back and forth and audits, the insurance company told us they would not pay any more after a certain date (about two weeks before discharge)…and any funds we had from them could be used to cover those costs.
Honestly, it was stressful enough having a premie in the NICU, but dealing with this snafu just about put me over the edge!
At least one of my providers does not require the copay at the visit. The explanation is that it’s difficult for them to be able to establish what the copay should be so it’s easier for them to wait for the insurance to figure it out. I pay it at the next appointment when they have the correct amount that should be paid (I guess from billing the insurance for the previous visit?).
Bans medical bills on credit reports: The rule bans consumer reporting agencies from including medical debt information on credit reports and credit scores sent to lenders. This will help end the practice of using the credit reporting system to coerce payment of bills regardless of their accuracy. Lenders will continue to be able to consider medical information to verify medical-based forbearances, verify medical expenses that a consumer needs a loan to pay, consider certain benefits as income when underwriting, and other legitimate uses. https://www.consumerfinance.gov/about-us/newsroom/cfpb-finalizes-rule-to-remove-medical-bills-from-credit-reports
Well, I haven’t heard ANYTHING back from the hospital, so maybe that means they are re-coding and re-submitting as they haven’t emailed me back anything and haven’t called. This is the 1st day I haven’t spoken to them since Monday! It is THEIR money they are trying to get from insurer, so I would think they want to do what will get them their money the fastest, which is re-coding and resubmitting!
This morning, I sent an email to the billing supervisor of the hospital, telling them I’m ASSUMING that since they didn’t return the form with a signature, they will be recoding and resubmitting the claim and that we will be happy to pay our share AFTER they get our federal medical insurance to pay their share of the outpatient pharmacy charge.
When my father died, I was cleaning up some of his bills and one was from a medical company for an ambulance co-pay (don’t know if it was from the last ride or another time, as he’d had several). I saw that it was being billed incorrectly so I called them to say “Hey, if you want to be paid, you should bill xyz.” (I think they billed the wrong insurance or something). Then I get what Thumper got, that they could only speak to the patient. He’s dead. Well, that’s who we have to speak to. I said that I didn’t really care if they got paid or not but I was their only hope, and I was just letting them know that I saw a mistake and was letting them know. The guy just couldn’t talk to anyone but him.
A few months later, another bill from same company. Called them again and said the same thing. This guy was smarter and said they’d just write it off. So they could have been paid but, well, they couldn’t talk to me so therefore didn’t get paid.
I was just trying to clear a mammogram bill from last Nov. They’d tried to collect a $10 copay at time of appt, but I told them that I didn’t have a copay for mammos, and in fact I didn’t have ANY $10 copays (either $30 or $40) (they don’t argue, and in fact I think I’d reached my OOP max by then). In Jan the billing office said the charge was still outstanding. I just contact the insurer and they said it was denied for being submitted past the 120 days, so insurance isn’t paying. I’m not paying. They have to eat it. I do not feel bad.
A few years ago, DS had a minor injury at a ski trip, where there was not great supervision, I subsequently learned. He cut his chin on ice and the medical office at the mountain thought he might need stitches. His chaperone was going to drive him to the ER but the medical office said there was another skier with a broken arm and he could just ride in the ambulance with her.
I later got a bill for the ambulance ride. I tried and tried to fight it, saying the ambulance was already called (and I assume paid for) for another person and he had been going to transport himself.
It was a mess, between talking to the insurance company, the ski place, and the ambulance company. In the interim, DS turned 18 and so suddenly no one was allowed to talk to me anymore. I finally gave up and paid them the $400.
(This is a reminder that every parent of a kid over 18 should think about having that adult’s healthcare POA in the event of something catastrophic. Once your kid is an adult, you don’t automatically have access to their records,doctors, etc. or the right to weigh in on decisions)
Yes, before our kids went off toe college, I got them to each sign a healthcare POA for this reason. I also got them to sign an authorization so that I could talk to insurer about any issues on their behalf, as I had been doing since they were born. It was helpful.
I have heard this advice over and over and I do not disagree. However, twice my son has been in the ER and both times the docs and nurses called me and spoke to me over the course of his treatment.
Is that because he said, hey call my mom? Is that sufficient for them to talk to a parent? What if he was unconscious and they needed to know if he was on any meds etc?
If your child is conscious and gives permission the staff will talk to you. Those documents go into effect if they are incapacitated and can’t communicate.
When my daughter was about 20 and in college, she had a terrible case of TMJ which took many health care practitioners to resolve. Every one of them was happy to talk with me to discuss her treatment and diagnosis. Maybe, because my daughter gave them my name and number, therefore implicitly giving them her permission. It was very useful as she was not feeling well and my keeping track of things really helped.
Providers can be more flexible if it appears there’s a good family dynamic. My kids MDs were talking to me when they knew I was just trying to sort out medical info and/or billing. My H’s providers talk to me because it’s easier and I can answer their Qs and they know I often accompany him to medical visits — just makes things easier.
