I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: G-Ma on March 03, 2009, 03:46:02 PM
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I got a statement yesterday from RAI wanting $1360.00 for my part of January 2009 TX....WTF...I have never had to pay any part of dialysis...I walked it into the Director's office and if no answer, change by tomorrow when I go in, I'm calling UHC and Medicare to see what is going on..this has got to stop. Do any of you have to copay dialysis????
I have been unable to stop crying all afternoon. Is this how they get us to stop dialysis??? I heard there is a new Davita Center about 3 miiles from me but it is not listed anywhere and of course no one at RAI knows about it..ha ha...so guess I need to call Davita???
I can't talk to any family or friends about how I feel emotionally.....no one really gets it.......and I don't want to bother my sons...the oldest just had his neck surgery and already went back to work and youngest is working around the clock, just glad he has a job. If I call my sisters they are clueless and call my sons and ask "what's wrong with your mother?" I feel like I'm a bother to all of them. I thought I had worked through the depression so have no idea where this came from all of a sudden. Sorry about the rant, thanks for being there.
:Kit n Stik;
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:grouphug; Give them the :Kit n Stik; I can't believe dialysis centers make profits in the US . I am in Canada and MCP covers treatments. There is no charge at all to the patient. I really hope our health care systems doesn't change!!
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Hi G-Ma,
I know it's incredibly frustrating but I think it will resolve once you find the right person to rectify it. Unfortunately it's going to take more effort on your part.
Rant all you want, you are 100% justified in having a good cry. Just keep pounding on doors and making calls until someone listens.
As far as your family, only you know how much you can lean on them. But it's ok to let them know you're struggling.
You've got family here too! Please let us know how you're doing.
:grouphug;
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G-Ma, I trust that there's been a mistake somehow and it'll get sorted out but I'm so sorry you have to deal with it on top of everything.
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Hopefully they billed you in error. If you have never been charged before, something has gone amiss. I would be crying too. Let us know what happens.
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:grouphug;
I'm having one of those "Why can't something go right, just once?" weeks, too. I'm prescribing chocolate and good book under a warm blanket to treat mine. (Because my tv died and I can't watch anything anyhoooooo. . . .)
Honestly, do something nice for yourself. Get someone to hug you. Read the joke post and call someone and tell them the funniest one.
Remember, we are here; we have been there; and we understand, so rant as much as you feel like.
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I'm sorry you are so upset over this. First of all try to find your EOB's (Explanation of Benefits) from both Medicare and UHC for your January treatments. If you don't have them contact them and ask for copies. Each one will have an area that will say something to the effect of pateint liability. This figure is all that your center is allowed to bill you for.
Do you have Mediare primary or secondary? I work for Davita (I know) and did billing for a long time. If you have Medicare primary then UHC should pick up the remaining 20%. The figure you quote sounds like a lot for 20% even if you have a deductible or out of pocket to meed with UHC. If UCH is primary and Medicare is 2nd then they should not be billing you at all. At least at Davita we had to write off the balance is a patient has Medicare 2nd.
So, please know that we will help you here and obtain the EOB's that you need. Let us know what you find.
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I got a bill one time after I had switched dialysis centers to a Davita clinic. The bill was for over $20,000 and it said this particular clinic was "out-of-network". I was so scared I would have to go back to my old dialysis unit which was a clinic from he-- (you insert the last two consonants).
My husband called the insurance and Davita and finally got it all figured out. I didn't have to pay for anything and never did pay Davita any money for the whole time I was on dialysis.
I hope it goes the same for you!
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Thanks all for your concern......Thanks Scooter...yes UHC is Primary and Medicare is Secondary and just from the Director's reaction I believe they are trying to collect money that should be written off...I worked as a collector for years and know what is supposed to be done but these companies think we are idiots...I'll find out tomorrow if they are going to "fix" this or if I need to call Medicare and UHC for audits.
Okarol..thank you and yes I know I "should" let my family know I am struggling and have but as I said my sisters just ""have no clue""...and aren't about to get one. I have sent them several articles and one said one time...is that really true???...and that is all..so I know what I can't count on there...so I will work on getting this depression under control again and work on moving forward.
:thx;
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Good God. You would think they could bill you right! After all they do it all the time! :Kit n Stik; :Kit n Stik;
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Maybe dialysisbiller could advise in this situation.
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Well....director today said...we bill everybody...we are in this business to make money.....and then came later and said she called corp office who told her I have to pay them the UHC deductible. So, tomorrow after another Dr appointment I'm going to be calling Medicare and UHC and whoever else needed, and guess I'm going to see about finding a closer Davita center.
:Kit n Stik;
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I always got bills from my dialysis center, but they told me I didn't have to pay it if I couldn't afford it... well duhhhhh! I was only getting disability and it was 1/3 of what I was used to making.... so therefore I never paid a penny and it was perfectly fine with them.
Give them the whatfor and if that doesn't work, there is always the :boxing; option! :cheer:
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Because I work full time, I receive co-pay bills from Medicare that are anywhere from $200-$500 (you think it would be the same every time, but this is a government agency after all) I spoke to my social worker (who is awesome) and she contacted the National Kidney Fund, a non-profit that helps patients in need.
When the bills arrive now, I give them to her and they pay the bill.
There is help out there, but sometimes your particular support staff my not be up on the latest organizations that help.
http://www.kidneyfund.org/patient-grants/
Take care.
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Thanks Stacy
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That is not correct. As I said I did billing with Davita for years prior to moving to a different area. When Medicare was secondary to a private insurance we had to write off any remaining patient liability such as deductibles, etc... due to legal reasons. It was not a Davita policy, it was not legal to bill the patient for this balance if Medicare was secondary.
You were not given the correct information.
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G-ma, What a mess. I am sorry you are dealing with this. I do understand why you don't want to share everything with your family. I do the same thing. I "share" after I have figured out the problem. Not the best way to handle things. And I think it just takes one thing (like the co-pay bill) to make depression rear it's ugly head. Sending you good thoughts and wishes :cuddle; I hope the sun is shining on you today. And I hope there is an easy solution to the billing problem.
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:-(
b@stards
:cuddle; sorry you have to deal with this stuff G-Ma...........
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Thanks Paris for understanding this little part of me.....my youngest and his wife get so upset that I use the ""burden"" word but that is just me.
Well, I called UHC, Medicare and no one seems to know of any legal guidelines for dialysis patients and both said yes RAI can collect up to my out of pocket total, which is what they are doing...so I called RAI and told her there is no way I can pay that total all at once, she said no problem, will take payments, however I am going to keep checking on this issue..and probably go back to Davita just because of business practices like this. It won't help for this year anymore but going forward it will. No sleep at all last night but I left at 6 AM to get to the ortho office by 8 AM and it was sunny when I got out of that appt so I just took my time coming home, stopping and enjoying the sun..maybe that is what I've been missing with all the rainy, snowy, gloomy weather...
I hope all are having a good day, and better end of the week.
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I'm very sorry to hear all of this G-ma. I hope you get this straightened out soon. As far as the sudden "outburst" of depression, I don't think it's all that uncommon and I don't think you have to worry about it. On Monday I had to call my surgeon's office who did my chest cath. It was starting to fall out. The nurse there is kind of mean (her voice doesn't help either) and she started lecturing me about how that is why they don't take the sutures out that hold it in place. Well, no one told me that!! I started crying as soon as I got off the phone. I know my depression has been doing really well since I had my therapy and am on meds. It was just a little moment of weakness when something sent me over the edge. I think it happens to all of us once in a while.
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Paddbear..I am so sorry with how you were treated by the nurse...I have heard of caths falling out even with sutures...no don't consider that "a little moment of weakness"..."""we""" all of us here are much stronger than most ""healthy"" individuals. We are stronger because we have each other.
:grouphug;
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If you have Medicare as secondary then RAI needs to show you evidence that they billed Medicare as secondary and Medicare did not pay!!!
Do you have the Medicare EOB's from the month of January? I'll be they were not billed.
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Thanks Scooter..that's my next step because I can't see anything about Medicare being billed and RAI doesn't want to send proof so I'll call Medicare again next week. I have time on my side.
Thanks.
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They don't want to send you proof?? What the hell is that about? By law, they have to provide you proof if you request it. I would call them again tomorrow and tell them you will be contacting your lawyer unless they send you something. Doesn't matter if you don't have one. This threat works every time. When you do call, if you get no where with that person, ask for their supervisor and keep working your way up the food chain until you get an answer.
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Thanks PB...yes I am determined to work my way up the food chain...in the meantime I called Davita this morning and started a transfer to a Davita center near me and am glad I did. Today was a day of alarms again with me having to call someone when my machine alarmed and one time a tech said "I know" and walked away before coming back, and this is not just my machine that is ignored. They are having nurses working in place of some techs due to economy and the nurses are not helping the techs when needed so the techs want to play that game too. I'll be about the 8th patient in 3 weeks to jump ship I believe. Grrrr.
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G-ma, I hope you can enjoy this incredible weather we are having. The sunshine makes things feel a little better. I am keeping you in my thoughts :cuddle;
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Thanks Paris...my first yahoo this week...I had to see my eye surgeon for possible lazer surgery and he said nope, don't need...my eyes look good for their condition so went home and enjoyed the fresh air and by this afternoon migraine was almost gone. Hope you are having a great weekend.
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Thanks PB...yes I am determined to work my way up the food chain...in the meantime I called Davita this morning and started a transfer to a Davita center near me and am glad I did. Today was a day of alarms again with me having to call someone when my machine alarmed and one time a tech said "I know" and walked away before coming back, and this is not just my machine that is ignored. They are having nurses working in place of some techs due to economy and the nurses are not helping the techs when needed so the techs want to play that game too. I'll be about the 8th patient in 3 weeks to jump ship I believe. Grrrr.
Man, at that point I would have just shut the d**n alarm off myself!! >:D