So my husband has cancer; why am I getting a bill for $989?

[hedgehog]

It's treatable and most likely curable. We're not happy about it, but at least we should be OK. It's sort of like finding out the house burned down but everyone got out OK. We have insurance, so that should be alright. Except it's not that simple.

Yesterday I got a 40 line bill to cover the treatment so far. The problem is that the doctor has received insurance payments for the initial treatments and payment is pending on the rest. So why the hell am I getting a bill for procedures that the insurance company will pay for? Am I supposed to guess what will be paid for? Clearly, the doctor has a contract with the insurance company so he knows exactly what the payments will be. Is it asking too much to have the billing computer programmed to reflect those amounts?

I'm really looking forward to the hospital bills to come. It took my son two years to be certain all the billing was complete on an appendectomy. Years ago, I received a bill for labor and delivery that included circumcision when I'd just had a baby girl.

I know this is GD and not GD-P, but this is one reason I'm supporting Obama - he considers getting the billing mess straightened out part of health care reform.

[Phillycat]

1. That's not a bill, that's an EOB.

Explanation of benefits. You don't need to do anything with that.

[Catshrink]

3. But check them over.....

I think it's one way to prevent fraud and billing errors.

[hedgehog]

6. No, this was the bill. The EOB comes from the insurance company.

It's been my past experiencethat the EOB just lists a dollar amount to a provider and doesn't break down the payments. To make things fun, the line items on the bills don't always match the payments. What happens is I get one bill for A, B & C, then another bill for D, E,& F. So the the insurance company cuts four checks for C and E, A, B & D, and F over a 1 month period, and I have to guess how the money matches up. Meanwhile, I get a second bill for B, H, I & J!

[midlife_mo_Jo]

14. Welcome to my world.

I'm finished treatment and still getting bills that no one can explain.

PLEASE REMIT.

I'm so glad that your husband's cancer has a good prognosis.

My best wishes to both of you.

[zanne]

2. I've had that happen to me before.

I wouldn't worry about it. They know the insurance will cover it.In fact, they probably know your insurance plan better than you do.)

[sam sarrha]

4. the hospital doesntsend it in for a month or 2, same thing happened to me about my hand..

dont worry

[Rosemary2205]

5. Make sure it's a bill

Yes, sometimes docs do mess up and send out bills prematurely - but more often than not what the patient gets is a "Statement", or "Explanation of Benefits" or some other such worded thing that is not expected to be paid. Yes it is confusing.

Your state government can fix that by mandating the bill clearly provide information on what was submitted to what insurance and when - and what has been paid by what insurance and when. From what I can tell, those laws work very well in the states they ahve been passed.

[hedgehog]

11. I'll double check. The worst part is that even themost logical, organized people

in the world get stressed out by illness. We called our GP four times to check a routine appointment because that's where the stress came out for us. Obama descibes how worried his mother was over her bills. It's probably the univeral experience.

[midnight]

7. My sister worked in Radiology for a Catholic Hospital... It was

standard procedure to bill everyone. The hoptial counted on confusion, and many times was able to receive payment from all parties. You ask good question, although I don't know why you should have to. It seems like you should be able to focus on the recovering of your husband. Hope he has a speedy recovery, and the bills disapear.

[seabeyond]

8. i had a baby uninsured and insured. costed me more cash being insured

being uninsured i received hospital discounts for cash, a lower cost even though i had the money to pay. being insured hospital charged me more and ended up costing me more cash out of pocket with deductables. that included new deductable for the baby that had yet to arrive.

decade later i take child into hospital with what ended up flu. 2 a.m. and he is throwing up all over, and felt much better. still the bill to insurance was 2,000 and i ended up being charged with misc costs for over a year. out of the blue i end up with a 69 dollar bill. almost two years later. no way to know wtf, no way to challenge, just fuckin send in the money cause they tell me to. too much hassle to even try to figure what it is about. i know cause after having second baby i was double billed more times than i could count and hours of trying to get hospital to figure it out

not that we have a choice cause if not paid goes on financial records.

it is all a mess. and it is not just one area of medical. not just hospital, or doctor, or insurance, or those that arent paying causing rising costs.... it is an accumalation of mess from all areas of medical.

[rox63]

9. Look the statement over, and see if it says why the claim was rejected

The hospital may have to resubmit the claim with additional information. This sort of thing has happened to me also. Insurance companies will seize on the slightest technicality to avoid paying a claim.

[mac2]

10. Like most people you think you have insurance

and the best hospital care in the world. We don't. Over the past 30 years it has gone downhill. Not until you are sick or someone in the family do you realize the problems. As a medical worker I saw it with my own eyes.

We need National Health Care for all. The country asked for it in 2006 and still they hang on the promise of better care. It ain't going to happen without Congressional over sight or a President who pushes care for all like other modern democracies in the world.

Other countries have care for all and aren't Communist. We rank below them in life survival and care. They pay less for drugs we develop and pay for with our tax dollars.

International American companies are leaving us for other developed countries where they don't have to pay for their employees health care. We should have it for just this reason alone. For competition and value it would be cheaper.

Go to Public Citizen action group (and other citizen groups) and fight for National Health Care. Your families survival and quality of life depends on it.

Keep a notebook with all bills and statements on just his Cancer so you can track the statements as they come in. You need to be an accountant to keep track of it all. Knowing what is paid, etc. will create less stress at an already stressful time.

So sorry about the Cancer. Time to do some research about this type of Cancer on the Internet (or in the medical ibrary). Don't feel funny about asking too many questions. I'm sure you will!!

[madrchsod]

12. my hospital and doctor are still waiting to be paid

for an operation i had in july. the lady at the billing dept told me insurance companies reject claims at least once then delay until they decide to pay. so it`s standard operating procedure in the insurance industry.

[RayOfHope]

13. This is why I *never* pay hospital bills the first month

and if I do pay, I only make partial payments.

My daughter had an ER visit 2 years ago. First bill we received was for $700. I could only pay $50 at the time, so I did.

The next month, the bill was $500, because the insurance co paid a bit more.

The month after that (the final bill) was $200.

I always wondered what would have happened had I paid that initial $700 right away. I'm pretty sure the hospital would not have refunded me any money, and they wouldn't have resubmittd the claims for my benefit.

Daughter had a unexpected hospital stay last December. First bill was $3000. The next month it went down to $1700.

I've learned to wait it out a few months, and never pay right away.

[Sal Minella]

16. Very useful information. Thank you for posting this.

[hedgehog]

19. That's par for the course, but I wonder how much of the cost of national

health care is due to the fact that hospitals can't put together a proper bill. Daily costs like utilities, food, salaries have to be paid. Are hospitals borrowing to make up the difference?

[Emit]

15. Is this from your doctor or the insurance company?

If it's from your doc, call your insurance and find out the status on the outstanding charges. If the insurance says it's covered but not paid yet, call your doc and tell them what the insurance said -- that your insurance will pay. Don't send any money to the doc until your insurance has paid in full what they owe.

If it's from your insurance company, it might me an Explanation of Benefits (EOB) - and in that case, it will have what your portion of the charges are (may include deductibles you owe, portions of charges not covered by your insurance for various reasons -- they usually explain on the EOB why they are not covering a procedure, etc.)

If in fact you do owe this, call the doc or agency that you owe. Tell them you can only afford to pay in small increments and would like to be set up on a payment program. Most will allow this, as long as you arrange it in advance, and pay when you tell them you would.

Most insurances don't cover 100%.

[pansypoo53219]

17. my grandma was a hoarder and i found the bill for my aunt's birth.

in the early 50's. not even 8.5x11, but maybe the size of a check. unbelievably simple. all costs.
insurance companies must be removed from health care.

[zorahopkins]

18. You Are Liable For All Payments

This happened to me, too.

What I was told was that I was liable for ALL payments until the medical provider actually receives payment.

In most cases, I was able simply to call the medical provider that sent me the bill, and ask if they had also sent the bill to my insurance company. Most said that they had, and most understood that they would be paid by my insurance company. They told me they had sent me the bill because, until they actually received payment from the insurance company, I was liable for payment.

If you have both Medicare and a private insurance policy, examine the statements you get. In some cases, I discovered that the medical provider actually received more -- from Medicare and my insurance company combined -- than had been billed!!