It pays to fight

After my breast surgery, I received a statement from the hospital where it was done;
and their statement reflected a $418+ charge for prescription eye drops which I never received.
After making a phone call, I filed a formal dispute IN PERSON.
Today, they called me back--the spurious charge has been reversed.
Please feel free to unload about how YOU fought the system and won.

Had a transvag ultrasound that the gyney said gave no usable info because the tech did it wrong. Said not to worry about it which I wasn't but damn it I said if I have to pay over $300 and then whatever it was to have a radiologist read it then I wanted a good test! Gyney didn't want to order another so I called hospital and told them I was not paying for any of what was done on that day. I also said I wanted the test run again with someone who knew how to do their job. I was bruised internally for a week after the first one! He agreed and had the head of ultrasound do it. They waived all the charges for both days. And yes, there was nothing wrong with me though my internist was convinced I had uterine cancer! He's a jackass but it's fun to prove him wrong. No this isn't the first time he was convinced I was dying of something and wasn't You know not all MD's graduate with an A average!

25 years ago I was in a bad car wreck. Lots of internal injuries and broken bones.
Some how or other I got a bill for the radiologist to read my barium enema x-rays...WTF...I didn't have a barium enema so I went down to the hospital to check on the bill and low and behold I was told that I did have a barium enema and insurance paid for it. So I said...."I didn't have a barium enema"...and they said "well maybe you just don't remember it" and I said "trust me, I had a broken back and crushed pelvis and I couldn't even walk at all..I would know if I got a barium enema"....the idiots still argued with me and I finally had to file a formal written request for a full audit of all charges and come to find out the barium enema charges weren't the only charges that got knocked off because I didn't get whatever it was. $1700 worth of charges for crap I didn't get or a service I didn't have.

Pugsy wrote:25 years ago I was in a bad car wreck.

That's why they do everything with bar codes now - every time they do anything they scan your wrist band and then they scan the pill bottle or whatever.

I had an ambulance ride last October - broken ribs, not an emergency but I couldn't move for the pain. My insurance rejected the ambulance ride because I didn't go through their procedure to find an "in network" ambulance company. So I checked the procedure and there AREN'T any in-network ambulance companies. Still cost me $500 but the insurance picked up the rest.

chunkyfrog wrote:After my breast surgery, I received a statement from the hospital where it was done;
and their statement reflected a $418+ charge for prescription eye drops which I never received.
After making a phone call, I filed a formal dispute IN PERSON.
Today, they called me back--the spurious charge has been reversed.
Please feel free to unload about how YOU fought the system and won.

Great job CF.

After I found out I could have bought my Bipap when I was being hospitalized after my septoplasty instead of being forced to use the hospital's machine, I said that the charge shouldn't be on my bill even if insurance would cover it. And it wasn't.

On a different note, when the local cable company outright reneged on a promotional deal, I called the office of the local government to complain that had jurisdiction. To be honest, I wasn't expecting a darned thing to happen but someone from the company called who was higher up and gave me a comparable offer.

49er

They scan everything at this hospital, and they claimed they scanned the eye drops at my bedside.
I insisted that no eye drops were EVER in my room, except the ones I brought from home--WITH PERMISSION.
Eventually, they did the audit. No idea what happened, or why, but it's finally off my bill.

About twenty years ago, I was using propane to heat my home. I rented a 250 gallon tank from a local propane company. They gave me an option of being on "auto fill" where they check the level in the tank and refill as needed. I declined this option and left a note on the account not to fill unless I requested a fill. I did not want unexpected bills arriving for propane when I really did not need it.

For those who have never used propane, the rates per gallon are higher in the winter, than in the spring. Depending on the amount of propane demand, these rates in the winter will be much higher than the spring/summer rates. The company I was using decided that a week before the spring rates took effect, they would top off all the rental tanks, requested or not. In this case, they could charge $50 more for the propane by filling then, instead of filling a week later. This may not sound like much money, but multiply this by two thousand customers... quite a windfall for the gas company.

I pitched a fit refusing to pay for the propane at the inflated price, they had to send out a crew to take the filled tank, and replace it with another with the same quantity of propane that I had before the fill.

Pugsy wrote: So I said...."I didn't have a barium enema......

$1700 worth of charges for crap I didn't get ...

Your choice of slang makes an excellent juxtaposition.

This past summer I had a hemmorhagic retina and went to my local emergency room for treatment (Newton Wellesley Hospital). The doctor on call looked at me and told me they couldn't do anything to treat me so they sent me to Mass Eye and Ear to be seen by an opthalmologist on staff.

Sure enough, I received a bill from the first hospital for a $900 emergency room visit where they did nothing. My insurance company paid $800 of the bill. Ironically, the Mass Eye and Ear bill was only $500 for the same lack of treatment (they looked me over and told me to see a retinal specialist). Again, my share was $100.

I chose to just pay the two bills but it did teach me a lesson about going to the emergency room for eye care.

I onceread a study where they audited hospital bills for accuracy.

Take a guess on what percentage of audited hospital bills were wrong???


100%

Really!

'Nuff said.

Janknitz wrote:I onceread a study where they audited hospital bills for accuracy.

Take a guess on what percentage of audited hospital bills were wrong???


100%

Really!

'Nuff said.

This may seem like a silly question but how does a hospital patient with insurance make sure that the bill is accurate? Should we ask for a post hospital visit audit when we are admitted to make sure there aren't overcharges? It just seems too late after the bill has been submitted to the insurance company.

Anyway, I want to do my part to stop these overcharges. Maybe it is pointless but then again, if we all do this, perhaps things can change although part of me thinks I am living in fantasy-land.

Request an itemized statement. Then you compare it to the paperwork you get later.
Even if you don't understand the mess, they don't know that;
and if they have done something wrong, they could get CAUGHT!

chunkyfrog wrote:Request an itemized statement. Then you compare it to the paperwork you get later.
Even if you don't understand the mess, they don't know that;
and if they have done something wrong, they could get CAUGHT!

Thanks, great advice. Hopefully, there won't be a next time but that is exactly what I will do if there is.

49er

My wife was in the hospital for a long stay, they infiltrated a IV, resulting in a stay that exceeded my ins days $68,000 billing. When the dust settled, the ins paid off all but $6000 of the bill, the charge for too many days treatment.

I placed a conference call between my work and the ins company. All they needed to do was to audit the bill, the hospital will generally apply a 10% credit to settle, problem solved. The Corporate ins co, refused to admit the bill, leaving me in debt, it would have cost them nothing! Jim

chunkyfrog wrote: Please feel free to unload about how YOU fought the system and won.

My wife was in the hospital and when I saw the bill it had thousands of dollars for "Pharmacy". I asked for an itemized bill and one item stood out: $18,543.12 for ONE shot of chemotherapy. She has chronic leukemia, not needing treatment, but causes a white blood cell count of over 200, when normal is around 10 for most people. She can't speak as a result of a stroke, so they just assumed the worse and gave a shot of chemo without our permission.

I escalated it to, finally, a hospital VP. She investigated it and then told me they actually never gave her the shot. I told her I did not believe it because they always scan when administering medication. She said they would take it off the bill and did.

Actually, it did not matter to my pocket book because the total bill was paid by Medicare and insurance. But it was the principle of the thing.