How do you fight unfair hospital bills in the US?

So latest update - I just got off the phone with Horizon blue cross/blue shield. I was calling about something else - i upgraded my insurance this year ( effective date Today) but they have yet to send me the new insurance cards ( odd that they did remember to remove the much higher amount from my bank account) - they'll get them to me in 7-10 business days

I explained this case to the person i got on the phone and they agreed to call the hospital's billing department while I was on hold - 30minutes later -she got back to me and said that the best she could get was for them to "review the case once again" and then supposedly contact the insurance company if they still had complaints.

The insurance representative said she explained to them that since they were IN NETWORK they had to accept what the insurance company paid or take it up with the insurance company as is stated in their CONTRACT but they were supposed to leave me alone.

They would NOT agree to that, basically their view is that if they want more money they should be able to go after whomever they want.

SO the insurance company rep predicts i'll get billed again in February

In the US, the cost of overhead and bureaucracy is one THIRD of total health care costs - enough to provide everyone with health insurance

My conversation with the hospital's patient's advocate was a bigger fiasco but I'll save that for another time

My conversation with the hospital's patient's advocate was a bigger fiasco but I'll save that for another time

Awww, I can't wait to hear.

Meanwhile, if that's their attitude, it's time to file a FRAUD complaint with your insurer and the proper state agency for unfair billing practices. This needs to be in WRITING, don't rely on telephone. When there's a written complaint, they will have to respond.

I know what a PIA this has been for you. I do think that eventually (whenever eventually is) that you will stop being billed and won't be paying that money. That said and as I mentioned previously, if you don't prevail send them $5.00 a month and forget about it. Unless things have changed drastically when it comes to hospital bills, sending $5.00 monthly shows good faith and there is nothing more they can do.

I would NOT pay anything on this amount.

If you do pay something, that is tantamount to you agreeing that you owe the whole amount. Then, you WILL have to pay the full amount.

Have you called a lawyer yet?
We were sent a bogus bill (with threats), and our lawyer said,
"My fee will be more than the amount of this bill; why don't you just pay it?"
My husband said that they would just keep coming back for more,
and it was worth it if he could make them back off-for good. It worked.
This was over a decade ago; and we've yet to have any more trouble.

Please don't pay them a penny! This is fraud and breach of contract and they shouldn't get away with it.

They won't take you to court and sue you for that small amount--it costs too much. You should continue the fight because:
1. If they are doing this to you, they are doing this to others. It's not right.
2. They might report you to a credit agency and affect your credit.

You need to light a fire under your insurance company to help with this--a formal fraud complaint is the way to do that.

I am also wondering why you were charged the $200 co-pay upfront. A colonoscopy is a preventative healthcare measure, and Obamacare made those a $0 cost visit. I know that all fees were waived when I had mine done back in 2012. If this procedure goes all the way back to 2011 then ignore what I mentioned since the change was only effective starting in 2012.

Sounds like they are trying to give him another colonoscopy !

StuUnderPressure wrote:Sounds like they are trying to give him another colonoscopy !

No, they just want him to subsidize their rectal-cranial extraction

Blindrage wrote: "
I am also wondering why you were charged the $200 co-pay upfront. A colonoscopy is a preventative healthcare measure, and Obamacare made those a $0 cost visit. I know that all fees were waived when I had mine done back in 2012. If this procedure goes all the way back to 2011 then ignore what I mentioned since the change was only effective starting in 2012. "

Obamacare rules haven't kicked in yet - one irony ( among many ) was that i remember that while i was on hold with Horizon prior to the colonoscopy and calling them to see if I was covered - the phone kept playing a message about how everyone over 50 (that's me - and in addition my father died of colon cancer) should get a colonoscopy - and then they came back on and told me I was covered but it required a $200 co-pay

US does preventive care REALLY poorly - this place is a great example of that - as is my apnea case - if you really cared about reducing OVERALL health costs you'd be doing everything you could to get people with apnea diagnosed and on a machine since it is much cheaper than future costs of heart disease and strokes .

My case was my eye glass doctor diagnosed optic nerve damage in my right eye last July - since i didn't have glaucoma he told me to get tested for sleep apnea - insurance company refused to pay calling it "diagnostic" so i paid for my own home test which diagnosed moderate apnea with an ahi of 21 and sold me an apap machine - when the machine didn't get the apnea under control i went to a board certified sleep doctor and Horizon refused to pay again now claiming i had " a pre-existing condition "

US healthcare is so awful it's almost funny - the 10s of thousands who die unnecessarily does limit the joke

No, no no, do not make a payment on the bill (even 5.00) if you do you are acknowledging the debt as valid.

One of the pp gave you a list of steps to take, letter to certain people etc. I would do all of those things plus file the fraud complaint. They are billing you for something that is not a valid debt. Also, keep pushing it back to your insurance company, go higher up the ladder than the patient rep you get on the phone, ask for a supervisor, a manager, a director, a VP. keep pushing to have the INS company deal with the hospital

If they have a contract to accept what your insurance states they will pay, there is something wrong if they bill you and your insurance says you do not owe. If the patient advocate did not help you, I would try the administration office.

Gina

Just a thought; if they are successfully collecting on any other bogus charges, maybe the IRS might be interested.

Janknitz wrote:Please don't pay them a penny! This is fraud and breach of contract and they shouldn't get away with it.

They won't take you to court and sue you for that small amount--it costs too much. You should continue the fight because:
1. If they are doing this to you, they are doing this to others. It's not right.
2. They might report you to a credit agency and affect your credit.

You need to light a fire under your insurance company to help with this--a formal fraud complaint is the way to do that.

I agree with Janknitz, this is FRAUD and needs to be handled as such. Obviously phone calls didn't work, so start writing letters. When you do, send them 'return receipt signed' from the U.S. Post Office, this will be proof they received your letter stating the fraud. Attach to your letter the EOB from your insurance company that shows your part of the bill is $0.00. This should get them hopping, since they don't respond to a phone call, the written word should get their attention. Someone else in this post mentioned the letter writing and I think that is an excellent idea. FRAUD is serious, but I know from experience hospital billing offices commit fraud daily. If they can get you to pay, that is 'gravy money' for them, something above what they are supposed to get. Keep FIGHTING this, don't pay & keep getting louder by sending letters to the hospital, insurance company and state attorney general. The more I've thought about your situation, the madder it makes me to know that millions of people out there would pay the bill and get 'taken' on such a scam.

Hang in there & let us know the outcome, I'm pulling for you.
Jen

And I'd bet money the IRS doesn't even get their cut!