J.B. asks from San Antonio, TX on May 06, 2010
Unpaid Medical Bill
We took my daughter to the ER (2008) b/c she was complaining about chest pain and having a hard time breathing. The ER was packed . They checked her in and did that finger thing and said she was getting enough oxygen...so you know that put her pretty low on the list. This particular night was a mess. There was a lady vomitting IN FRONT OF US (hubby had to walk out b/c he started to dry heave - LOL), there was an ederly man bleeding from the head and was told to wait and just other odd stuff. This isn't a county or community hospital. This is normally a nice facility!
Anyway - after an hour (plus), the ederly man's family wheeled him out. We left shortly thereafter and told the receptionist we weren't staying (my daughter began to feel better - and to this day...we think it was gas...). Anyway, a week or so later - we got a bill for $75. I called and argued we were not paying that bill. They suggested I send it to my insurance company (which a friend who works for an insurance co said the moment we file it with the insurance co, shows we agree to the bill). I continued to argue we weren't paying for it b/c she was never seen by a physician. We kept getting bills and I argued again...it finally went away (so I thought).
Yesterday, I get a call from a collection agency that they've been hired to collect this $75. I argued with that guy and explained the situation. He said he can't make any decisions, only to collect. I could dispute it with his company...but since it was in their hands - it will only go in the file as a dispute and I still owe this money. He said he knows nothing about how the bill came about, maybe b/c we signed her in, maybe because "they typed 20 keystrokes" (that's exactly what he said - I thought that was weird) - he didn't know. I get where he's coming from...and I totally understand he's hired to collect this money.
Does anyone have any suggestions on how to handle this? A friend suggested I contact the insurance company, tell them what happened and let the hospital know I've contacted the insurance company to complain about the facility. The facility itself is beautiful and normally a clean and productive center. This particular night was horrible!
I don't know what to do. I'll settle on $10 to pay the clerk that checked us in. But I'm not paying $75 (which is the co-pay if I went throught the insurance co) for sitting in the ER for 1.5 hours. She was never seen!!! No - we did not stay past midnight either.
More Answers
C.B. answers from Kansas City on May 06, 2010
i can see both sides of this. kudos to you for standing up for what you think is right. i would feel the same in many ways. however, a couple points. #1, it's "only" $75. to you and me that's a pretty decent bill, but to the hospital, that's nothing. that's probably why it took 2 years to get to collections to begin with. mine were in collections in less than a year. #2, technically they did "do" something, even if it was just a check in nurse putting the thing on her finger. it's not that all you did was sign in, and now you have this bill after leaving, not seeing anyone. to me, as soon as staff look at her, the ticker starts counting. not fair, but that's how it works. so probably they do have a "right" to charge you for that. (legally- not morally!)
i am married to a man who questions and argues every stinking little piddly charge. it has done great things for our bills, but sometimes you just have to know when your battle is lost. look into exactly WHAT the charge is for, first of all. then decide if it's fight-worthy or not. they may have a charge titled, "check in and initial assessment." in that case, yes, she was checked in, and had an initial assessment, so what are you really fighting? i'm not telling you they are right (I am the first one to stand up and say i HATE the medical industry and pretty much everything about it!) but just that you may want to choose your battles carefully. legally they may have every right to charge you. i have a feeling they do. you said yourself this is normally a very nice facility, so they had one bad night. do you think they were suddenly just letting the place run amok? or were they trying their best to get the situations under control. if it was a regular situation, or if this was the way they always ran their ER, i would feel differently. but sometimes you just can't help when things go crazy, you know? don't let the awful emotional experience color your perception of the actual event.
definitely check with your insurance company too, and see if they paid anything, like someone suggested.
however, i'm afraid this might be one of those battles that isn't worth it. sometimes we just have to swallow the cost and count it as a learning experience. good luck - i hope you find a loophole!
4 moms found this helpful
J.C. answers from Fort Wayne on May 06, 2010
Hey! So, unfortunately, you become a patient at the time you check in. Once you're checked in and they check your vitals, you've already spent money. I would totally pay the bill because it's in collection now which means it's showing up on your credit report. you don't want your credit to be affected over such a small amount. Once it's paid, then you could call and talk to the hospital's billing department, but basically you're stuck right now because the hospital handed it over which means it's the collection agencies amount owed, and the collection agency's job is to collect, and trust me, they're not going to listen to any of your excuses because they hear them everyday. I agree that it sucks, but since they tested for her vitals, I understand where the bill came from.
3 moms found this helpful
D.K. answers from San Francisco on May 06, 2010
First of all your daughter went to the ER. That means patients are see based on their condition. It's not first come, first served. It's seems you think this facility is not so "nice" because others were seen before you.
Second, the ER did perform a screening exam. Therefore they provided a service and deserve to be paid for it. You state you left without seeing the doctor. Which means you essentially left AMA (against medical advice). Insurance companies usually don't pay if you leave AMA. This is only a $75 bill. You could ruin your credit, spend a lot of time arguing about and still end up paying the $75. Is it worth it? You decide.
2 moms found this helpful
S.G. answers from Savannah on May 06, 2010
If you are being billed only 75 and that is what your co pay is, they might have already billed your insurance company for the rest. You should call them and ask if they paid any claims that came in for that service date. If they did, then you need to find out what the hospital billed for and then explain to the insurance company what happened that evening and how your daughter was never really seen. They should better be able to guide you in where to go from there. If the insurance company sees it your way, they may not be happy that they paid on that bill too for what seems like no services being rendered.
Good luck and stick to your moral guns as much as possible!
S.
1 mom found this helpful
M.O. answers from Chicago on May 06, 2010
I won't bore you with the details, but we recently went through something similar.
#1 Call the billing department and ask to speak with a manager. Get the name and DOCUMENT your conversation details. Tell him/her that you are arguing the bill... Ask them to stop collections immediately. Ask the manager who you need to "greive" the claim with...name, address and phone number.
#2 Figure out if this has already been sent/processed through your insurance company. The billing manager should be able to tell you that.
#3 If it has, call your insurance company and ask them to stop payment. Find out from them what the process is to "grieve" the claim from the hospital.
#4 Write a letter to the hospital contact to grieve the claim. You need to include your name, your child's name, the date in question, and the claim number from the hospital bill...and of course your phone #. Then call the person directly. KEEP IT BRIEF. Explain that you have an important letter to send regarding a problem you are having that needs his/her immediate attention. Ask for a fax # and send it immediately (as them to call you back to confirm receipt of the fax). Then drop it in the mail too.
WORST case scenario - they "force" you to pay the $75. It's not worth your credit rating for a $75 bill. If this is the case, it should definitely be processed through insurance first.
BEST case scenario - the billing manager and customer relations manager do their job and "void" the claim based on your experience and lack of medical treatment.
Msg me if you like.
1 mom found this helpful
S.D. answers from Grand Rapids on May 06, 2010
You can tray calling the hospital but my experience is that they won't talk to you. They will refer you to the collection agency.
You need to call the insurance company. You were given wrong information about filing with the insurance company. You should have gotten them involved right away. You then could have had them fight with the hospital, that you were never seen, therefor there was no reason to have a bill sent to you. I know i have received bills and ALWAYS call the insurance to find out about the bill if i don't understand it at all. Then they can tell me if i have to pay it or not. They are the most helpful people as they know what the policy you have it, and they also know the policies at a lot of the hospitals. plus since they deal with hospitals and doctors offices on daily basis, they have a good working relationship.
It sounds like it was something that was overlooked and should be easy to take care of. At the bottom of that letter you received from the collection agency should state that you have 30 days to write to them to dispute the charges. File the dispute. Becasue that means you don't agree with it. And then the collection agency has to go back to the hospital and get the proof from them about the bill and they only have i think 30 days to send that do you. If they can't provide that to you, then the bill is discarded. That's the law, and should state on the letter this.
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H. answers from San Antonio on May 08, 2010
It doesn`t matter if you were seen by a physician or not, you were given attention and results. The minute you are attended to and you walk into a hospital you are expected to pay $$$$.So just pay up and be happy that nothing was seriouly wrong with your daughter.
H.
Updated
It doesn`t matter if you were seen by a physician or not, you were given attention and results. The minute you are attended to and you walk into a hospital you are expected to pay $$$$.So just pay up and be happy that nothing was seriouly wrong with your daughter.
H.
N.G. answers from Dallas on May 06, 2010
You have consumer rights. Research the TX consumer rights, specifically regarding medical bills. I'm not sure exactly what the law states in this situation but there are certain laws that protect you in situations where you never agreed to pay that bill. You also are able to report this to the credit reporting agencies to get this removed from your credit report within 30 days. I would not pay this bill either, it's ridiculous!!
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