Billing Question?

[BUCKYLE]

:2004: :box: :sleep2: :bones: :teeth: :frown2: :cheers: :topic: :susp: :stupid:

 

[Mike80]

My head hurts.....

:(

 

[BUCKYLE]

My head hurts.....

:(

 

[scooter1369]

It may be a simple mistake in the date of service entered on the claim. If she was under the plan when she saw the doctor, but the office submitted it to the insurance company with a date after her plan expired, it may be as simple as having them resubmit the claim with the correct date on it.

 

[Mike80]

EXACTLY the response I was looking for

 

[BUCKYLE]

EXACTLY the response I was looking for

 

[CrabMan]

Depends on who the bill is from...is it from a provider or from the insurance carrier or from the plan administrator? Without knowing more about the situation I think you would be best to call them up and get clarification first. Something doesn't sound right. I work in the industry and you'd be surprised the stunts that get pulled every day.

Yeah, payers are notorius for intentionally delaying payment or finding any reason not to pay the provider. Call them and ask why they denied payment. Either way, the patient is ultimately responsible for paying the bill since services were provided and assuming the patient signed a financial consent.

My guess is that if she received the service/treatment she is liable for the payment. Generally you are responsible for any medical services provided to you that your insurance doesn't cover.

If she paid a premium to Ohio State for the insurance (and they rescinded the insurance) she should be entitled to a refund from Ohio State for the premium.

The "pisser' is that doctors/hospitals/labs have a variety of rates for the same service. The amount that they amount that they would pay the insurance company (Ohio State insurance's rate) is a lot less than the amount that they charge an uninsured person. Since they "told her she was covered at the time" I would at least make sure that they are charging her the insurance rate vs. their uninsured person rate. They may be reluctant to reveal their pricing date; but the bottom line is: any medical bill is negotiable and just how bad do they want paid? They may claim that their "policy" is to not reduce a bill or negotiate: however, there are always exceptions to every "corporate policy".

Many hospitals have an uninsured/underinsured discount policy that grants a 10-20% discount if the patient is self pay. Also, every hospital has some type of charity program and nearly every hospital in Ohio partcipates in HCAP. Charity and HCAP programs are based on your income and/or assests with many hospitals granting a discount to patients that earn up to 400% of the federal poverty guidelines.

If your insurance doesn't pay the bill, call the hospital and inquire about their financial programs. If you don't qualify, make a reasonable settlement offer (15-20%) and the hospital will more than likely settle. If you can't pay in full, most will offer an interest-free payment plan for 12-24 months.

 

[jimotis4heisman]

My wife was covered by OSU's health insurance during the last quarter of her internship but we got a bill yesterday for $432 saying that she owes because they rescinded that insurance plan.

They told her she was covered at the time and now are asking for the money.

I'm going to call them when I have time but she is not liable to pay for that is she?

you got hosed, i got my $77 bill taken down to $49.99...

 

[Flocka]

That must be a good/sad tennis match they are watching.