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Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

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  • Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

    I’m fit to be tied! It’s no wonder folks go plum loco and do irrational things. Three months ago I had blood work drawn at the laboratory for the hospital that we go to. As it turned out Medicare would only cover six of the nine tests included in the doctors orders but somewhere along the line the system broke down and the cross-over between Medicare and my secondary insurance didn’t happen. As a result I ended up with a bill from the hospital.

    Immediately upon receiving the bill I called up to inquire why I had received it and was told that my insurance wouldn’t cover the cost so it was my responsibility. I took their explanation at face value until I called my insurance company and was told that they had never received anything from the Hospital and that as soon as they did they would be happy to pay for the tests in question.

    From there the story does nothing but go down hill. For over three months myself and my insurance company repeatedly wrote and called the Hospital and requested the Medicare paperwork showing that the tests had been denied but for three months the Hospital either ignored the requests and/or flat out lied about their existence.

    Last month the Hospital put my account into collections and things really got serious because first off we’ve never in our lives had an account in collections, and secondly, we got perfect credit and intend to keep it that way. Fortunately, I was able to talk my insurance company into accepting the Medicare summary that Medicare sends Medicare recipients each quarter in lieu of the paper work that the Hospital should have provided and they paid the bill based on the information contained within it.

    I have since called both the collection agency and the Hospital and determined that I have a zero balance. However, they have yet to respond to my letters requesting notification that closure of my account has not affected my credit rating and nothing was sent on to the credit bureaus. But then they have yet to respond to any of my correspondence during this entire fiasco so why should they bother worrying about my credit rating?

    Now for the clincher! This morning, one and a half months after my account was placed into collections and turned over to the collections agency and over two weeks after the insurance made final payment on the amount owed, I received in the mail a bill for the entire amount from the Hospital.

    I immediately called the Hospital and was told that I had a zero balance and that something must have gotten crossed in the mail. I questioned the billing date in relation to the payment date by the insurance company and basically was told that I didn't know what I was talking about. When I asked why was I being billed again by the hospital, the representative again couldn’t provide me with an answer so I asked for a supervisor. I was put on hold….. I’m still waiting!!!!!!!!

    GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  • #2
    Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

    EDDY,

    With each bill that the hospital sends out there must be a section that states something like, "Report Medical Fraud". They make it pretty easy to do it too. I have done it, for basically the same kind of run around. Got some action too. Hang in there though. This kind of treatment won't happen under the new govt. medical plan.....will it?

    tom H
    http://beginnerscarvingcorner.blogspot.com/

    Comment


    • #3
      Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

      Thank God I'm Canadian,
      With my spine issues I'd be in debt up to my eyes with medical bills if I lived in the US. In Canada I'm covered for pretty much everything.

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      • #4
        Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

        Ed, having worked in the health insurance business for many years I have 2 suggestions.
        1. Contact your state insurance department and open a claim with them.
        2. Call a lawyer or legal aid if you have it in Fla.

        Good hunting.

        Comment


        • #5
          Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

          Tom.... I'm not sure anyone knows what's going to happen when this new health care bill gets fully implimented. Afterall, didn't I hear one of our astute legislators say that they had to pass it to find out what was in it?????

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          • #6
            Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

            Dan... And if we'd have been smart we would have blue-printed our health care system after yours but we've got too many insurance and drug companies in the pockets of our politicians to do anything the simple way. Our nature is to search out, destroy and then re-invent!

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            • #7
              Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

              Paul... I remember you telling me about your expereince and I'll keep that in mind. Right now I think I'm going to wait 3-4months and then get a credit report to see if anything shows up. If it does then I'll start raising hell. If it does show up I might even be able to get it eliminated myself from the credit bureaus with all the documentation that I have. Of course I'd have to address each bureau seperately. What a pain in the a#%!

              Comment


              • #8
                Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

                My understanding is .. If it is put in your credit report they will not delete it. You will be able to put in a letter with your explanation and hope it will be accepted by whoever is checking it.
                I guess I was luckier than you were. When I was sent for an MRI the receptionist told me that the code the Dr put in Medicare would not pay for I would be responsible for $4000.00 When I called the Dr office they said they would fix it and then they put in the same code. I made the decision it was not necessary

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                • #9
                  Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

                  Most places around here do the billing with a billing agency. Now you talk about getting it gooffed up, they can do it. But they cannot ever get it straightened out. The doctors office does not even know about it. So they are not responsible, how about that. Now try to get that understood by the insurance outfit. We have to have more paperwork at the doctor than we do to cross the international border.
                  Carve On,
                  Kadiddle

                  Comment


                  • #10
                    Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

                    There once was a carpenter who helped people, and all he asked was that they loved one another...
                    .....Just sayin'

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                    • #11
                      Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

                      feel yr pain eddie i got a whole stack of insurance didnt pay stuff that i dont know what to do with

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                      • #12
                        Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

                        Robert... I had a long discussion about this with my doctor duing my last visit. I attempted to explain that she had ordered a test that Medicare wouldn't cover and as diplomatically as I could I asked why ( I certainly didn't want to get fired by my doctor!). She was real nice and explained that the reasons vary. It could be a miscommunication between her and her staff; or it could be a mistake in coding by her coding clerk; but more often or not it's because the Medicare adjudicator didn't get any the night before and was in a foul mood. To sum it up she said there is no rhyme or reason in how or why Medicare turns down tests because some times they will approve them and others they will not. She told me that yes they do have a set of rules and regulations but for the life of her she can not find the logic in them.

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                        • #13
                          Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

                          Kadiddle... It isn't going to get any better with this new health care plan. Any time Uncle sam tries to fix something he usually only mucks it up worse!

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                          • #14
                            Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

                            If you all have the option, I'd strongly suggest going over to a Medicare Advantage plan. We were with Kaiser Permanente when I was self-employed. When I turned 65 they contacted me and gave me the option of staying with them if I wanted to and all I had to do was sign over the medicare to them. We have been very happy with them. They call us and tell us that we should have tests and physicals. We just have to pay an occasional $5 or $10 copay. It's been great so far. Of course, I can't wait to see what happens when our healthcare is free.

                            Ray

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                            • #15
                              Re: Venting....GRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

                              Jim... Sure could use that guy back here again! I don't think we learned much or at least we forgot all we learned.

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