How Have You Dealt With An Outrageous Medical Bill?

[Huntn]

I‘m thinking about how I’m going to respond to a $2000 bill from the county’s ambulance service to transport my wife 5 miles to the hospital and at most they gave her some O2 on the way. This is associated with and addition to the $4000 hospital bill I’m anticipating when she got heat stroke standing in line to vote on Nov4, and subsequently spending 4 hours in the emergency room while they “observed her” before releasing her.

What is semi-amusing is that the Hospital sent me a form to fill out for financial assistance which I ignored, then I got a letter saying financial assistance has been denied, and now I expect they will send me a bill to be paid in full, except I won’t be paying it in full, at least not all at once. First if it’s not itemized, I’ll be asking for an itemized billing. The discussion with my lawyer will concern negotiating a price after the fact, as we were not privy to the charges up front.

Yes, I can afford to pay it, but the question is should I? Just because they bill an outrageous amount, I‘ll be talking to my lawyer and insurance company about it before taking any action. My wife does have a high deductible insurance plan and the hospital bill by itself hits the deductible, so the ambulance ride may not be that much.

The last time my wife was at the emergency room several years ago, after being billed, I told the billing agency I was going to be making monthly payments, they could take it or leave it. They took it.

What has been your approach? Any lawyers here?

 

[velocityg4]

By bending over and taking it.

Sorry, couldn't resist. As it is an ER visit an itemized list and negotiating is a good idea. Definitely pay the bills for whatever you negotiate it to. As you don't want it ruining your credit if it goes into collections.

While I got hit big with bills one year. It wasn't an ER visit. Rather dental work and ulcerative colitis caused by an NSAID. So, there was no angle to negotiate. All I could do is switch to better dental insurance and low out of pocket health care the next year. As I'd rather not be surprised by big medical expenses again.

 

[Huntn]

By bending over and taking it.

Sorry, couldn't resist. As it is an ER visit an itemized list and negotiating is a good idea. Definitely pay the bills for whatever you negotiate it to. As you don't want it ruining your credit if it goes into collections.

While I got hit big with bills one year. It wasn't an ER visit. Rather dental work and ulcerative colitis caused by an NSAID. So, there was no angle to negotiate. All I could do is switch to better dental insurance and low out of pocket health care the next year. As I'd rather not be surprised by big medical expenses again.

I‘m not so sure in a string of payments I make on a regular basis how much impact resisting a medical bill would have on my credit score and even if I’m worried about that at this point in my life. House and cars paid for, retired, paying all incoming bills.

An interesting aspect of this is that we chose a high deductible plan because the other alternative would have cost +$6k a year (+$500 a month) just to have the insurance. But this does not excuse outrageous billing which I’ve seen since the 90s, yet insurance in the past has paid most of it.

 

[VitoBotta]

I live in Finland, luckily we don't have that kind of issues with health care. I have never understood how "developed" countries like the US and other don't have yet a public and free health care... it's sad IMO.

 

[Scepticalscribe]

I live in Finland, luckily we don't have that kind of issues with health care. I have never understood how "developed" countries like the US and other don't have yet a public and free health care... it's sad IMO.

Completely agree.

The provision of health should be a free public health care service, something that is a right, not a private (and profitable) business, where one's ability to access the provision of necessary health care services depends on whether or not you can afford it.

 

[Wando64]

I am so sorry you have to deal with what here in Europe we would consider a savagely cruel system of healthcare.
I hope you will find a way through this, and through anything that the future might bring.

 

[jeyf]

i had the same thingy happen here:

the amulance costs dont seem out of line. i talked to the insurance company and found out exactly how much they paid out for the ambulance and for services. If sercives wre charged seperate. See if changing the service descriptions could improve the bottom line

usally the ambulance comapny is seperate from the hospital. see if they are willing to change the class of service or reduce the cost. You might be able to reduce the bill by half!

you might look at arranging a payment plan for either hospital and or ambulance. Usuall this plan is interest free and you can extend very reasonable monthly payments over say 2 years.



tough to get sick in Trump America.
a real american would have at least driven to the hospital them selves. Toss a blanket on the car seat to absorb leaky body fluids.

 

[Macky-Mac]

... First if it’s not itemized, I’ll be asking for an itemized billing. The discussion with my lawyer will concern negotiating a price after the fact, as we were not privy to the charges up front....

I had a bill arrive a year after a visit to my doctor.....yes, a whole year later.

There was a charge for some service from a doctor whose name I didn't recognize. It referred to my visit to my doctor. ...So I tried to get an explanation about what services the unknown doctor had provided, but nobody was able to tell me anything other than that I was being charged for his services.

I refused to pay the bill until they could tell me what the doctor had done. Ultimately they sent it to collection.

 

[960design]

What has been your approach? Any lawyers here?

How about doctors and staff that assisted your wife?
We all have to earn a living. Ambulance rides are expensive. If your insurance does not cover it, then head to the hospital and offer to pay cash for 50%. They will typically take it, we did.

It is a numbers game. Most people do not pay for the ambulance ride, this increases the cost for those that do pay. An emergent ambulance ride should cost: $800 for ambulance and equipment on board, $40 for driver, $40 for back seater, $200 for resupply.

 

[44267547]

I’ve worked with a lot of medical professionals, ER doctors and paramedics over the years in my profession and here is my viewpoint:

Two parts:

1.) I did discuss with one health professional reference your scenario. When I asked if anything can be ‘negotiated’ for the ambulance ride, I was told that was an immediate no, and into the same affect, they’ve never heard of ‘negotiating’. [BTW, this is a Gold Cross service used in our region]. If your wife voluntarily accepted the ambulance ride under her own free will , they basically said there’s no way that you wouldn’t be responsible for the transport.


2.) You mentioned your wife was observed for ‘four hours’, so you’re under the notion that you shouldn’t have to pay for services? Regardless if she was observed, where do you think that money should come from and who should pay it? I don’t expect you to answer these questions, but these are questions that you should consider that your ‘attorney’ will also consider. Also, this was an emergency visit in addition, I believe incur higher surcharge fees.

Now, I don’t live in Texas, if you are utilizing and accepting said services, what makes you think that they can be ‘negotiated’ in the first place? To me, that’s something I’ve never even heard of.

If you’re able to dispute the charges successfully and somehow the price is reflected differently, then great. But from my standpoint, take ownership and pay what you owe for services your wife fully utilized. Or, accept the ramifications of collections if you’re comfortable with that option.

The last time my wife was at the emergency room several years ago, after being billed, I told the billing agency I was going to be making monthly payments, they could take it or leave it. They took it

Just for reference, I never been to an emergency room on a personal level, but like I said, I work with health professionals all the time and I can tell you ‘emergency visits’ will make some type of monthly installment payment plan with the recipient, They (Whoever the carrier is) doesn’t expect people just to splurge thousands of dollars for unexpected life situations. I mean, I know you gave them some ‘informed ultimatum’, but they would’ve worked with you regardless.

Think about it, thousands of people every single day that are transported to an emergency room, some have no insurance and no financial means to pay for an ER visit, and obviously they will be billed, and if the recipient can make payments, they work with them.

 

[Huntn]

I’ve worked with a lot of medical professionals, ER doctors and paramedics over the years in my profession and here is my viewpoint:

Two parts:

1.) I did discuss with one health professional reference your scenario. When I asked if anything can be ‘negotiated’ for the ambulance ride, I was told that was an immediate no, and into the same affect, they’ve never heard of ‘negotiating’. [BTW, this is a Gold Cross service used in our region]. If your wife voluntarily accepted the ambulance ride under her own free will , they basically said there’s no way that you wouldn’t be responsible for the transport.


2.) You mentioned your wife was observed for ‘four hours’, so you’re under the notion that you shouldn’t have to pay for services? Regardless if she was observed, where do you think that money should come from and who should pay it? I don’t expect you to answer these questions, but these are questions that you should consider that your ‘attorney’ will also consider. Also, this was an emergency visit in addition, I believe incur higher surcharge fees.

Now, I don’t live in Texas, if you are utilizing and accepting said services, what makes you think that they can be ‘negotiated’ in the first place? To me, that’s something I’ve never even heard of.

If you’re able to dispute the charges successfully and somehow the price is reflected differently, then great. But from my standpoint, take ownership and pay what you owe for services your wife fully utilized. Or, accept the ramifications of collections if you’re comfortable with that option.



Just for reference, I never been to an emergency room on a personal level, but like I said, I work with health professionals all the time and I can tell you ‘emergency visits’ will make some type of monthly installment payment plan with the recipient, They (Whoever the carrier is) doesn’t expect people just to splurge thousands of dollars for unexpected life situations. I mean, I know you gave them some ‘informed ultimatum’, but they would’ve worked with you regardless.

Think about it, thousands of people every single day that are transported to an emergency room, some have no insurance and no financial means to pay for an ER visit, and obviously they will be billed, and if the recipient can make payments, they work with them.

2.) You mentioned your wife was observed for ‘four hours’, so you’re under the notion that you shouldn’t have to pay for services?

Who ever said that? What I’ve said is that the charges for services under the circumstances are extreme. Of course this is my perspective and opinion, based on service provided.

 

[Huntn]

How about doctors and staff that assisted your wife?
We all have to earn a living. Ambulance rides are expensive. If your insurance does not cover it, then head to the hospital and offer to pay cash for 50%. They will typically take it, we did.

It is a numbers game. Most people do not pay for the ambulance ride, this increases the cost for those that do pay. An emergent ambulance ride should cost: $800 for ambulance and equipment on board, $40 for driver, $40 for back seater, $200 for resupply.

The difference is making a living vs exorbitant pricing for services provided. I will try this. Note the ambulance ride was 5 miles, the charge was double that.

 

[kazmac]

@Huntn

Out of network and surprise medical bills are sadly the norm. For my two recent ambulance trips, insurance covered the first (My body was starting to shut down from blood poisoning), but not the second (fractured arm and lacerated chin due to a fall).

I think it depends on the insurance co and the circumstance. Very grateful to waive a significant amount of fees from the near fatal incident and understood I had to pay for the ambulance, fracture and stitches for the second incident.

Regarding fees, if @Huntn you’ve paid part of your wife’s medical bills, you can call the hospital or doctor’s billing department to see if they can waive some of the fees beyond the ambulance.

@960design thanks for that tip about the ambulance. That’s great.

 

[Apple fanboy]

Wow you guys have it tough. To even imagine this sort of thing is completely alien to my mind.
If my wife or I got sick, the last thing I’d want to be worrying about is the bill.

 

[Bug-Creator]

Note the ambulance ride was 5 miles, the charge was double that.

/me guesses they charged for the empty ride to pick up you wife, so that would make some sense

As for the premises of the thread : Does not compute

 

[Apple_Robert]

You have a right to see an itemized bill. That right doesn't mean you can ignore payment due. Don't ignore any payment notices. If you receive a payment notice before you get an itemized bill, pay $100 to show good faith (at least). The hospitals aren't shy about sending to collections and ruining credit.

In regards to the ambulance cost etc., the service is not obligated to tell you the price before you accept treatment and allow them to place you in the vehicle. Unfortunately, at a stressful time with a loved one, the onus is on the potential patient. I would contact your local insurance commissioner and find out if there a cap for ambulance service that can be charged.


If you have insurance, your insurance company should be doing the heavy work (read: confronting the hospital about the price). If you don't have insurance that covers the bills, you are obligated to pay the full amount unless you can prove that services were not rendered as stipulated.

I am glad your wife is ok. That is the main thing.

 

[benshive]

Completely agree.

The provision of health should be a free public health care service, something that is a right, not a private (and profitable) business, where one's ability to access the provision of necessary health care services depends on whether or not you can afford it.

Wonderfully said. The fact that this simple statement of all things is not something many of my fellow Americans and I can agree on is very disheartening.

I‘m thinking about how I’m going to respond to a $2000 bill from the county’s ambulance service to transport my wife 5 miles to the hospital and at most they gave her some O2 on the way. This is associated with and addition to the $4000 hospital bill I’m anticipating when she got heat stroke standing in line to vote on Nov4, and subsequently spending 4 hours in the emergency room while they “observed her” before releasing her.

What is semi-amusing is that the Hospital sent me a form to fill out for financial assistance which I ignored, then I got a letter saying financial assistance has been denied, and now I expect they will send me a bill to be paid in full, except I won’t be paying it in full, at least not all at once. First if it’s not itemized, I’ll be asking for an itemized billing. The discussion with my lawyer will concern negotiating a price after the fact, as we were not privy to the charges up front.

Yes, I can afford to pay it, but the question is should I? Just because they bill an outrageous amount, I‘ll be talking to my lawyer and insurance company about it before taking any action. My wife does have a high deductible insurance plan and the hospital bill by itself hits the deductible, so the ambulance ride may not be that much.

The last time my wife was at the emergency room several years ago, after being billed, I told the billing agency I was going to be making monthly payments, they could take it or leave it. They took it.

What has been your approach? Any lawyers here?

I'm sorry you have to deal with that. Unfortunately here in America it's not a rare occurrence for people without a lot of money to have charges like this ultimately dismissed through bankruptcy after an emergency. Richest country in the world yet we can't shuttle people to where they can get emergency care without bankrupting them. At least, as you mentioned, you're financially secure enough to afford it if you need to so there's a bit of peace of mind. But the bill should've been $0.

 

[Huntn]

Wow you guys have it tough. To even imagine this sort of thing is completely alien to my mind.
If my wife or I got sick, the last thing I’d want to be worrying about is the bill.

If I am not mistaken, it was Richard Nixon, a Republican who signed a bill allowing something along the lines of for profit medical services in the US. Now if accurate, this is not the only reason medical is sky high, and the thing is which should register with everyone, average citizens can’t afford it.

 

[Huntn]

I am so sorry you have to deal with what here in Europe we would consider a savagely cruel system of healthcare.
I hope you will find a way through this, and through anything that the future might bring.

If directed at me, thank you. Upfront I said I can afford it, but it still strikes me as a rip off and will make efforts to mitigate it. What is laughable is a hospital handing an average citizen this kind of bill and thinking it will be paid pronto. Haha, good luck with that. Many will let it go to collection.

 

[Huntn]

Did I tell you all the story about the 45 minute gallbladder operation where the surgeon coughed up a charge of $20k? The insurance company said nope, knocked it down to $9000 and we ended up paying about $2000 for everything,insurance covered the rest.

You have a right to see an itemized bill. That right doesn't mean you can ignore payment due. Don't ignore any payment notices. If you receive a payment notice before you get an itemized bill, pay $100 to show good faith (at least). The hospitals aren't shy about sending to collections and ruining credit.

In regards to the ambulance cost etc. The service is not obligated to tell you the price before you accept treatment and allow them to place you in the vehicle. Unfortunately, at a stressful time with a loved one, the onus is on the potential patient. I would contact your local insurance commissioner and find out if there a cap for ambulance service that can be charged.


If you have insurance, your insurance company should be doing the heavy work (read: confronting the hospital about the price). If you don't have insurance that covers the bills, you are obligated to pay the full amount unless you can prove that services were not rendered as stipulated.

I am glad your wife is ok. That is the main thing.

Thanks, actually I have not received a bill yet from the hospital, but I did get a notice from the insurance company as to the expected amount. I did get a bill from the ambulance which does not look like it was sent though insurance. I will be talking to the insurance company tomorrow, and then maybe the hospital, starting to wonder if their bill got lost in the mail.

 

[ThunderSkunk]

What has been your approach?

Simple. I haven’t used healthcare services in the US since 1994. When I lived in San Diego, I crossed the border to visit the dentist in Tijuana like everyone else did, and when in Duluth, crossed International Falls & vacationed for a week in Ontario to use the Canadians functional healthcare system instead. Neither are free, but aren't driven by over-inflated costs to absurdity. And you can actually get seen instead of the 2-3 month wait times we have here. If you’re rich, then great, enjoy US hospitals at the expense of everyone else in the country, but it ends there.

 

[ThunderSkunk]

I have never understood how "developed" countries like the US and other don't have yet a public and free health care... it's sad IMO.

The US is not a developed country.

 

[Huntn]

The US is not a developed country.

We are developed in some ways, and undeveloped/irresponsible in others. ?

 

[960design]

The difference is making a living vs exorbitant pricing for services provided. I will try this. Note the ambulance ride was 5 miles, the charge was double that.

Those are the actual costs (or rather a good estimate - of course service/region/ect varies). This does not include the 'profit' tax needed to stay in service. Emergent ambulances do not add or calculate a fuel / idle cost. The $800 is the actual cost of the ambulance divided by the number of average trips per year. Very busy ambulance services can push this down to $600 or so, but then you start getting aging equipment. No service can afford the liability of an ambulance that breaks down with dying child in the back.

 

[A.Goldberg]

I am a partner in a residential psych program. We primarily treat addiction and complex co-occurring psychiatric disorders.

We are a private pay facility, meaning we don’t take any insurance, but we do give our clients itemized bills that they can submit to their insurance out of network for clinical services (counseling, psychiatrist consults, group therapy sessions, etc)- that is if their insurance permits OON billing.

One big expense typically is the routine drug testing, which is done 2-3x per week. Most facilities will bill this through insurance because they can get a reimbursement, often of hundreds of dollars, for “collection”. A single standard 12 panel drug test is billed to insurance for about $1200.

I know a lot of patients who have been stuck with tens of thousands of dollars in bills from programs. This is often due to the lab screwing up the billing, or the insurance intentionally making things hard.

Upon starting this business my partners agreed not to deal with insurance on this because it causes too many problems with clients. So we buy instant test cups for $4 each and send positive or suspicious samples to the lab for confirmation testing, which costs $25-45 depending on what is being done. Makes things a lot easier.

Many of these labs are not very reputable and get in trouble with billing fraud and basically running the equivalent of “pill mills” and drug tests.

Years ago I had this problem myself when I was in pain management for a back injury. Responsible pain management docs drug test as obviously there are a lot of problems in this field. I ended up with $5,000 in bills due to billing issues. Some tests were covered, but randomly others were not. When I contacted the lab to sort it out they told me they were going out of business and would settle for $35. Yes, $35. Glad I didn’t give them $5000. The lab was being shut down for illegal kickbacks / fraud, naturally.

As a business owner, I can say it’s a lot easier not having to deal with insurance.