OT-Old Hospital bill questions

[westcoastmom]

Almost 2 years ago, I had a medical emergency while living in the US. It was the first time I had lived in the US, and I knew we had good coverage where the emergency copay was waived if admitted to hospital.

 

Within the month after my hospital stay, the hospital sent several bills and copies of things that had been paid by insurance. I phoned and gave them the insurance info the for the bills and they said they would be looked after.

 

About a month ago, I received a phone call saying there was $1200 unpaid copay and deductible. I had never received a bill for this, but the few things from the same hospital where they didn't have the insurance info they sent a couple of the same bill. When I phoned the hospital they claim they sent one bill for this within a month after it happened.

 

I live in Canada now, and 2 years later the Canadian dollar is 20% lower than 2007. They also want interest for something that they never sent a bill for. I did ask the hospital to send the entire bill and there is one $2500 procedure which is listed twice which may be a mistake. I don't know who to contact about to check that (insurance? or hospital?)

 

Anyone know what I should do? I don't know anything about US health care. A former colleague of dh said that he always calls the same hospital and says you got this much from the insurance, how about knocking off th 10% and I will pay the deductible. He says they always accept. The hospital doesn't want to deal with me and tells me I have to talk to this very rude fellow that phoned I think from a collection agency.

[Garga]

Please call your health insurance company. I worked at a health insurance company for 10 years. You sound very much like people I used to talk to, so your questions and concerns should be easily handled by someone at the health insurance company. It sounds like you need to have someone at the insurance company go over your benefits with you.

 

Here's what you'll need in front of you to call them:

 

1. Every bill you've received

2. The date of service on the bill (not the date the bill was sent to you, but the date you were having the medical care done.)

3. The name of the provider on the bill (the provider is either the hospital or the doctor or the laboratory, etc.)

 

You'll have to go through the bills one at a time with your insurance rep. You most likely have a bill for the hospital and another bill for the doctor who say you and another bill for the laboratory, etc. This might be why there is confusion. There could be different providers billing you for each of their services.

 

One by one, tell the insurance customer service rep about the bills you've received and find out:

 

1. Did the insurance company receive a bill too from that provider for that date of service?

2. If they received it, did they pay it? If not, why not?

3. If they did pay it, ask them to make sure it was paid correctly. If it wasn't, they'll adjust their payment.

 

It could be that the copay for the emergency room was waived, but then there is a separate copay and deductible for the inpatient hospital stay. You might have heard that if you go inpatient you don't have to pay the ER copay, but you might still be obligated to pay the inpatient copay. I don't know. Each insurance policy is different.

 

Call the health insurance company. I think they'll best be able to tell you what is their part to pay, and what is your part to pay. The hospital is not really responsible for knowing what your part to pay is--you need to find out directly from the insurance company.

 

And collections people are just nasty. Go around them before dealing with them.

[Garga]

Oh, and I know that we used to pay the bills at the insurance company based on the exchange rate for the date of service.

 

I'm not sure how to tell you how to deal with the hospital about that, but we used to call any bank and find out the exchange rate on the date the bill was for, and we'd calculate the exchange rate and pay it that way. Don't know if the hospital will honor that or not.

[gingersmom]

All I can say is good luck!!

 

I would call the hospital and see if they will negotiate a settlement.

 

My insurance company took over 12 months to pay my gynecologist for a routine exam. The insurance company admitted this was covered, the doctor was covered, there was no problem. They just couldn't figure out why they were not paying it.

 

I called over 30 times before the bill got paid.

[littlebug42]

I would call your insurance company. This happened to me once and because the hospital took too long to bill the insurance company, they would not pay it. However, the insurance company told me that because of their agreement, I couldn't be billed for it either. They called the hospital and straightened it out and I never heard from the collection agency again.