DOES ANYONE PAY THIS?

[waynefmckinstry]

My wife started dialysis last July.  At first it looked like my insurance was paying for all of it.  Then I get a bill for $566 for a couple of weeks back in July.  The insurance did pay thousands, but now they are billing me this amount.

My question is:    Does the dialysis provider (DaVita) really expect this, or are they just hoping that I will give them money?

When I look online at the insurance EOB it is complicated.  DaVita bills the insurance $12,000 and the insurance pays $2,000.  Mostly DaVita accepts this, but they do come up with some things that they say I am supposed to pay.

We do have savings, but at that rate even the “small” amounts could take all our money.  Does anyone else just not pay “their amount”?  Thanks.





EDITED: Moved to Proper Section - Rerun, Admin.

[cattlekid]

I had the same issue with DaVita.  I was on my employer insurance without Medicare as I chose not to have to pay Medicare as my employer insurance out of pocket maximum was quite low.  But I did have a couple of weeks where even though my employer paid thousands of dollars for my dialysis, DaVita still wanted their pound of flesh (the 20%).  I started paying them a few dollars here and there, no more than $50 per month.  All of a sudden, after a couple of months, the dollar amount divided in half, then it went away totally.  I am not 100% sure why. 

I would bring the bills in to your wife's clinic and have the financial folks there explain what is going on.  Otherwise, DaVita does have financial folks you can call at the national level.  If they can't get the remainder to be written off, then at least they can explain why.

[talker]

My wife started dialysis last July.  At first it looked like my insurance was paying for all of it.  Then I get a bill for $566 for a couple of weeks back in July.  The insurance did pay thousands, but now they are billing me this amount.

My question is:    Does the dialysis provider (DaVita) really expect this, or are they just hoping that I will give them money?

When I look online at the insurance EOB it is complicated.  DaVita bills the insurance $12,000 and the insurance pays $2,000.  Mostly DaVita accepts this, but they do come up with some things that they say I am supposed to pay.

We do have savings, but at that rate even the “small” amounts could take all our money.  Does anyone else just not pay “their amount”?  Thanks.

See if there is a Social worker to talk with at your dialysis center.
Address the situation head on.
I'm not a lawyer. My advice could be  very bad .
But it won't go away by its self, so don't ignore it.
You need to push / pull , do what ever it takes to make it go away.
Suggest you DO NOT use your tiny savings.

talker

[Zach]

Just as a comparison, when Medicare is the primary insurer, their approved charge for a single hemodialysis treatment is about $ 239.00 (depending on region and a few other variables) of which 80% is paid by them.

 

[Zach]

Please see attached 2014 Medicare Hemodialysis Payment info.
PS:  So sorry, but only IHD members can see attachments.
 

[waynefmckinstry]

Followup:  I finally talked to DaVita and said I want to set up a payment plan.  They said, no need to set up a plan, just send in what you can.  I sent $40.  I will send a little bit now and then, just so they can't say I am not doing anything.I am not going to bust myself paying a huge company that already gets thousands from my insurance.

Wayne

[frankswife]

We are racking up copays for dialysis at a rate of $75 a week, plus another $100 per month for the Neph's services. We cannot pay it. Period. There is no room for another $400 in my monthly budget. We drive a 17 year old truck that needs to be replaced so we wont have a car payment. Spoke to the SW, he said we gotta pay it. 

[thegrammalady]

In 8 years of dialysis I have never paid Fresenius one cent!  Medicare has a 4 month waiting period. I wasn't even billed for those 4 months. The helped me get a sue mental policy. The finance office did call me a few times but that was after the supplement went into effect. Just told them to bill insurance and gave them the incarnation again. They legally cannot bill you for the difference between what they bill and what Medicare pays. You're still responsible for 20% Medicare doesn't cover but at Medicare rates not there's. They will eventually wright it off. If you really want to pay someone pay your Neph. My Neph doesn't expect payment of the 20% and wrights it off 

[Shaks24]

If you are a private pay insurance patient, you are very profitable to your center compared to medicare only patients. Use that to your advantage and tell them to write it off. Your private insurance likely pays a lot more to them than medicare does.

[talker]

If you are a private pay insurance patient, you are very profitable to your center compared to medicare only patients. Use that to your advantage and tell them to write it off. Your private insurance likely pays a lot more to them than medicare does.

Is much truth here in your response.

talker

[Dman73]

You can't get blood out of a turnip !!!
If you have a supplemental insurance then you are doing your fair share of being covered even though they will always try to get 100% reimbursement.

[iolaire]

My wife started dialysis last July.  At first it looked like my insurance was paying for all of it.  Then I get a bill for $566 for a couple of weeks back in July.  The insurance did pay thousands, but now they are billing me this amount.

We do have savings, but at that rate even the “small” amounts could take all our money.  Does anyone else just not pay “their amount”?  Thanks.

I think you are talking about DaVita billing you for your deductibles under your insurance plan.  Look up your health insurance rates/rules in an area something like: Deductible, Coinsurance, and Plan Limits.

My insurance has deductibles for both in network and out of network.  I pay 20% of in network and much more for out of network.  But each of those deductibles have an annual limit, $1,750 for in network and $3,000 for out of network (but the in network comes out of out of network also).  So what that means is I have to pay my co-pays for dialysis (in network) until I contribute $1,750, after that insurance pays 100%.  So in January I had to pay DaVita a good check of money ($1,750), since then I've hit my limits and I no longer pay DaVita, and also I no longer have to pay my drug co-pays.  If I go out of network I would need to continue to pay the co-pay until I reach the $3,000 limit, less the $1,750 I already paid for in network deductibles.

For people buying private insurance you can effect your monthly premiums by accepting higher or lower deductibles.  For people like us that will pay the full amount of our deductibles (assuming you pay your bills) it may make sense to pay extra monthly for lower deductibles.  So its worth plotting out various plans to figure our what you will pay over the course of year.

And yes I pay my bills.  With the high number of indigent patients on Dialysis, I believe that charity should be saved for those who require help.

[Michael Murphy]

I don't work for either major dialysis provider but I am guessing that the reason behind the bills if they make a good faith effort to collect  the money (send out a bill)  they get to deduct the money as a Llosa on thier taxes.  I  had a large copayment last year and I was upset that I was not warned  prior to receiving the bill I was told by the clinic financial person to ignore the bill.  I have insurance so they pay about 1500 per treatment,  this is such a large profit over Medicare they are generally willing to take the tax write off.

[Simon Dog]

If you are a private pay insurance patient, you are very profitable to your center compared to medicare only patients. Use that to your advantage and tell them to write it off. Your private insurance likely pays a lot more to them than medicare does.

Even more so if you are a transient.

Davata COLLECTED over $4500 per treatment for two in-center treatments I had when traveling.