I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: rookiegirl on April 24, 2008, 10:37:10 AM
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I'm getting very frustrated. Almost every other week, I get in the mail another medical bills from the hospital, doctor's office visit, etc. I have UHC as primary through my employer, UHC as secondary through my husband's employer and Medicare. According to my dialysis social worker, I shouldn't have any balance to pay because what my two insurance doesn't pay will be picked up by Medicare.
Everytime I receive another bill I have to constantly remind them; "did you bill both my UHC and Medicare?". There answer is always "Both UHC has been billed but not Medicare". Why on earth do they not look in their system before sending me a bill. I get really annoyed when I'm having to do their job. To whom do I need to send a complaint about this? This is stressing me out.
Funny how my dialysis center never sends me a bill. I wish the rest of them would get their act together and stop adding stress to my so called life. ENOUGH IS ENOUGH!!!! DARN IT!!!
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rookiegirl, I know where you are coming from. I have been dealing with this since 2001. I have gotten to the point now that I tell all the hospitals, doctors and everyone else involved that they better bill it right because I am NOT paying you a cent. Everytime I take Len for an appointment or to the hospital they ask for insurance cards and make copies of them, but still can't bill right. Must not want their money too bad is all I can say. Don't stress over it, it will just make you blood pressure high. Call the billing department's and tell them to bill it right the first time and to kiss your :sir ken; if they think your going to pay. It will get better. :cuddle;
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We go through the same thing! Every visit, every hospitalization, every procedure that Marvin has, I thoroughly explain that his Medicare is primary and his state BCBS (through me) is secondary. "If you don't file it correctly and in the proper sequence, neither will pay," I tell them. Does that always work? Oh, no! Some idiot billing clerk will invariably get it backwards and both Medicare and BCBS will kick it out. Just last week, I got an EOB (Explanation of Benefits) where a doctor's office had refiled for the fourth time a claim from 1998! When they call me and want me to straighten it out, I'm hard-nosed. "I told you upfront that if you screwed it up, you'd have problems getting your money," I'll say.
"But, technically, it's your responsibility," one chick told me.
"Look, lady, think of me as a turnip," I responded. "And you know what they say about getting blood out of a turnip. It's not going to happen. You better go back and figure it out with our insurance companies. Good-bye!"
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My understanding is if the place accepts you insurance companies card, they have to take what they pay under contract, with you just the co-pay,and with 2 insurance companies where there is a COB (consolidation of Benefits) primary is responsable for 80% secondary 20% and that includes your co-pay. :banghead;
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We go through the same thing! Every visit, every hospitalization, every procedure that Marvin has, I thoroughly explain that his Medicare is primary and his state BCBS (through me) is secondary. "If you don't file it correctly and in the proper sequence, neither will pay," I tell them. Does that always work? Oh, no! Some idiot billing clerk will invariably get it backwards and both Medicare and BCBS will kick it out. Just last week, I got an EOB (Explanation of Benefits) where a doctor's office had refiled for the fourth time a claim from 1998! When they call me and want me to straighten it out, I'm hard-nosed. "I told you upfront that if you screwed it up, you'd have problems getting your money," I'll say.
"But, technically, it's your responsibility," one chick told me.
"Look, lady, think of me as a turnip," I responded. "And you know what they say about getting blood out of a turnip. It's not going to happen. You better go back and figure it out with our insurance companies. Good-bye!"
Good for you! This can be so frustrating!
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Yes, it's the same here. We have a huge folder of bills from Jenna's transplant - some are still coming in 2 years later! Luckily my husband keeps very good tabs on everything - we sometimes have to call; otherwise we mail a response that lists both the private insurance and Medicare and all the billing information - just make a copy that you can send in their payment envelope, hopefully they will correct their billing before contacting you again.
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Yes, it's the same here. We have a huge folder of bills from Jenna's transplant - some are still coming in 2 years later! Luckily my husband keeps very good tabs on everything - we sometimes have to call; otherwise we mail a response that lists both the private insurance and Medicare and all the billing information - just make a copy that you can send in their payment envelope, hopefully they will correct their billing before contacting you again.
Carol - speaking of receiving a bill 2 years later. 2 months ago, I received a bill from the hospital that was related to my catheter placement back in October 2007. The bill was for $123. I called the billing department several times in 2 months and they kept telling me they will research the issue. This is the first bill I received out of the others. Last week I received a letter from a collection agency and I was pissed off. I called the collection agency and told them that I'm disputing the bill and will follow up with the hospital. Called the hospital again and I was angry because I've been told this will go against my credit report. The hospital removed it from collection and again will research. I'm really getting angry now. I asked them why on earth with all my medical bills back in 2007, this is the only one I'm getting. I finally pulled my EOB's from my primary/secondary/Medicare. My insurances paid all they would pay and the remaining are deductibles. Medicare denied the claim because the hospital didn't file electronically. I have told the hospital this and now I'm just really ANGRY!!!! I told the hospital I can't do their billing job for them and if they need help on how to bill an electronic claim to contact their Medicare provider line. This is what Medicare told me to tell them, which I shouldn't have too.
I'm really going to SCREAM my head off and raise my BP if I get another threatening collection agency bill for something I'm not responsible for. What really makes me angry is that the representative told me Medicare denied the claim because it was Noncovered. I told her how on earth would Medicare denied a catheter placement for dialysis as noncovered. This is the only reason I qualified for Medicare in the first place. I'm just ANGRY!!!! Why I'm I even paying $96/ month on Medicare premium if they didn't cover such service.
Just pure DUMBNESS!!! Sorry for long rant.
RG
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I feel for you.
I've had all those same kinds of problems myself. Your "turnip" line was great. Another great response would have been to sing that famous Sinatra song:
"Call me irresponsible,
Call me unreliable,
Throw in undependable too...."
And my insurers have thought up some new tricks, like phoning me on my cell phone as soon as I had been wheeled back to my hospital room from surgery, to tell me that they won't reimburse me for this or that and I have to pay out of pocket.
There I was, just out of surgery, still a bit groggy from the anesthesia, arguing with the insurer on my cell phone.
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This sucks. It is just another pain in the butt you don't need to deal with. Maybe if you complain enough they will catch on. I'm sorry.
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Sort of along those sames lines, I was in hospital about a month when my kidneys failed. I think every Doctor who casually strolled past my room has sent me a "consultation" charge. So far about 30 of them ranging from $75 to $300 dollars. AFTER insurance my medical expenses since Nov 11 of last year exceed $25,000. It has driven me into bankruptcy. Heaven help us all.
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:Kit n Stik; :Kit n Stik; :Kit n Stik; :sir ken; :sir ken; :Kit n Stik;
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I'm with you guys on this. It's not like we don't have other things to worry about in our lives. I'm new to all this, especially with the insurance issues and bills. When I was first diagnosed with ESRD in Nov 07, I was on Cobra from my last job, but on the last month of service. I applied for Medicare, but It would not be effective until the new year. So that there would not be a lapse in my insurance, the social worker suggested MediCal, but I had too much savings. She then told me to spend my account which had over $40k. I was like what!?... After making several frantic calls while still in the hospital, I found out about the HIPPA plans and decided to purchase that. But now that I have Aetna and medicare, I still receive bills, which most people say I should not. I spent months researching and calling several different places to find out about these plans and supplements, but many times given the run around. My dialysis center had several problems billing my insurance, though they supposedly fixed it. Medicare had told me that my primary was Aetna because I pay for it and that Medicare is secondary. However they are billing Medicare as primary and Aetna as secondary. In either case if one insurance covers 80% and the other 20% should I have anything else to pay other than my deductable? Should I be looking for a different health insurance?
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Medical Bills!!! Now there's a topic that can be discussed through the ages!! You know what I don't understand. I don't understand why the hospitals don't automatically give you an itemized list of who saw you during your stay and what exactly you'll be charged for. Those darn bills come from every corner of the world for months, even years, after a hospital stay. How do I know this doctor actually saw me? Why is he billing me a year after my hospital release? How do I know when the bills will end?
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Had one today specifically with UHC/Medicare. I called re. the nephrologist's bill. I asked why I was being billed - having UHC primary and Medicare secondary. The biller said "Oh! Your UHC is regular insurance??" Uhhhh....yeah.... "Oh! I thought it was a Medicare HMO!" A what? "I thought it was your Medicare! Ok, I'll bill this again...."
Please o please o please for health insurance reform....
Oh, and I heard a funny. Apparently the health "insurance" (ha!) companies are fighting hard against the idea of the government offering a plan that people can buy into. Why? Why, because government plans have much lower administrative costs, and they don't have to pay dividends to shareholders, either! It's not fair to ask the insurance companies to compete with an efficient plan!
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It's been over a week now since I last spoke to a representative about my $123 bill that was so called removed from collection. The lady in charge to research the bill was suppose to call me last week. Now, I'm having to follow up again and this time be aggressive and speak to a Manager.
All my hospital bills back in Oct 2007 were paid and this little $123 for anesthesia is not being paid. I've told those people in the billing department this is covered because how can they put me under without anesthesia for surgery??? Come on folks, have some common sense for God's sake.
STUPID! STUPID! STUPID! They will make up anything. I've told them several times, they need to file the claims electronically to Medicare in order for Medicare to adjudicate the claims. The funny thing is I'm a Revenue Billing Analyst for a laboratory and this is what I deal with on a daily basis. I wish I could just walk in their billing department and do the billing for them so I don't have to receive another DARN BILL for $123.
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ohhhhh i could tell you some stories!
the medicall billing industry is having a rough time keeping up! On thei dialysis end, we deal with patients who have commercial NON Contracted policies, commercial contracted (and mixed with PPOs, POS, HMO plans/ In and out of network plans)- then Medicare HMO policies which are considered commercial however they pay at medicare rates with patients having to pay yearly deductibles and copays - then there is Medicare and Medicaid(which vary state to state and let me say, each state is VERY different from another and if you are on Medicaid in one state, do NOT go to another state and get sick, that's another nightmare!!)- then we have a stack of illegals who show up at dialysis units with nothing, social workers are run through the mill with those.
There are billing guidelines for EACH insurance company(payor)- 30 days, 60 days, 90 days, 180 days and some have set date limits(Medicare does that)...... we have policies within our company on when the claim has been exhausted and we can no longer bill the insurance company..... if a patient is compliant and has done their part (with Coordination of benefit forms to their insurance).... we have written off balances to bad debt, because it's not the patient's fault the bill wasn't submitted and followed up in a timely manner. I am very aggressive with insurance companies in getting the claims paid 'correctly' (oh that's another issue in itself!)... I see it this way, people are paying their premiums for these policies, they don't want bills from providers when they have insurance, a patient should only pay their deductiible, copay and/or coinsurance amounts. It's a crazy thing to deal with but someone's gotta do it! If I can help, I will.
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I want to know.....at the end of the day.... does your center make money???? and just how much is enough????
At my DaVita Clinic (2 years ago... I'm at DSI now) they would bill my primary insurance (at the time) and then bill them again in 3 days. My EOB's would say date received 6/3/2007 and 6/6/2007 for the same month. Most of the time the second EOB would say already paid. BUT.... once in awhile the insurance company would screw up and pay twice. I would then call the insurance company and point out the error. In "my" little mind it was DaVita's way of getting an extra buck.
:banghead;
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When I was in center - they charged $2500 per dialysis session, 3 times per week, not including any meds or doctor charges. That's not what they got paid, but that is what they charged.
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I stopped looking at my Davita bill ----- so sue me --- they would lose money -- I am a "hipper".
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I had switched insurances around a couple of times. That, plus qualifying for Medicare midway along, complicated things a lot for me.
My social worker offered to argue with all the providers about which insurance(s) to bill. And so ever since, whenever I get a bill that doesn't look right, I just hand it to her for her to take care of it.
It's so nice to have a secretary again. ;D
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I have Medicare as primary and have a secondary also. I will sometimes get a bill and odd thing;every time I question it ,they will say I SHOULDN"T have got it. Wonder how many bills that should never have been sent get double paid by those who didn't question them.
Oh yes,it was a COMPUTER ERROR,as if that computer has a mind of its own! :rofl;
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You know... I still did't get a response from the representative or supervisor on the $123.00 bill for service rendered back in Oct 2007. I haven't received a collection notice either. I really hate to accept "no use is good news" because I'm afraid, it will come back and bite me later on. But each time I call them, they keep telling me they are still researching the problem. Why don't they just either bill it right or write off/adjust the darn bill. Isn't there a filing time limit to bill a patient after 2 years going on 3?
I can't stand calling those people every week, every month, etc... Like I don't have enough worries in my life. Just plain PISSED!
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I want to know.....at the end of the day.... does your center make money???? and just how much is enough????
At my DaVita Clinic (2 years ago... I'm at DSI now) they would bill my primary insurance (at the time) and then bill them again in 3 days. My EOB's would say date received 6/3/2007 and 6/6/2007 for the same month. Most of the time the second EOB would say already paid. BUT.... once in awhile the insurance company would screw up and pay twice. I would then call the insurance company and point out the error. In "my" little mind it was DaVita's way of getting an extra buck.
:banghead;
that money HAS to go back, the insurance company eventually catches the error, sometimes it is returned by a credit department at DaVita before the insurance company catches it
trust me, it's a two way street on these issues.... it was billed twice, i'm gonna guess because the first time it went 'electronically'... the biller who manages the center may have also submitted a paper bill......sometimes I send two, mainly because when I called to see if the claim is on file, get told 'no' from the insurance co, i send again, only to find out i called a day before it was entered into their system. ... then there are times the claims duplicate electronically in either their system or our system, rare but it happens..... computers are man-made and run by humans... we will make mistakes.
when you get a bill from the provider (in this case a dialysis company) you have to make sure you've saved your insurance EOBs to go over with them to make sure they aren't making an error in the patient responsibility... some EOBs are complicated even for me! You can call the insurance company to find out, sometimes there is a processing error at the company, that happens more than people realise, in those cases I ask for the claim to be processed again, I'm sure my patients get the EOBs and wonder what the heck is going on with the claims.... i'm not a patient biller but get calls from the person who does the patient billing for my centers with questions like 'did you bill it twice?' and 'are you SURE that is the patient's responsibility??' some of the deductibles are extremely large (sometimes over $2,500).... I question insurance companies when they go high so the patient is being over charged.....
i must admit, since being on this site, I've been more cautious with billing and moving patient responsibility more accurately.
anyHOO... have a good day!
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Oh I hate those bills that never go away. I got a call from a collection agency once where the bill was from six years before! Say what?! I didn't even know what it was for, but the guy was so rude. I told him to stop speaking to me like that and he said, "You have not heard anything yet." I hung up on him. He calls me again a few days later and I tell him to figure it out. All my bills for my transplant had been paid through my insurances and that I never paid anything out of pocket and that there must be some mistake. He calls me back a few days and later and said there was a mistake. The bill had been paid. :Kit n Stik;