Posted on: Aug 25, 2016 12:27PM

glc213 wrote:

Hello to everyone. I have researched online and on this forum and I am at an absolute total loss. I don't even know how to make this story in any way brief, but, here goes!

10/1/2015 I underwent a prophylactic mastectomy. I paid my in network deductible of $1500 to my PS (first one to ask). I have surgery, spend two nights in the hospital and go home for recovery. I was lucky to have no complications and was able to schedule my exchange surgery on 12/28/15. At the end of November/beginning of December I began to peruse my online claims w/Florida Blue PPO. It showed that I owed over $50k to the hospital although I had never received an invoice. I called Florida Blue and they were bleeping clueless. Couldn't tell me any reason for the $50k "amount I owe" and that I should call the hospital. This conversation was at least 45 minutes. I called the hospital and was connected with accounting. The gentlemen said he was "head of accounting" and read off my claim as I saw it online, but, said that the hospital has a contract with my insurance co. and accepted the amount that Florida Blue paid and not to be concerned as I owed nothing. What a relief!

Nope. My exchange surgery was a breeze and at some point in March of 2016 I received a bill from the hospital for $316.00 (from 12/28 surgery) of which I paid. No biggie--what is it for? Once again FB can not tell me anything. So, again I call the hospital and reach a different person in accounting. She tells me it is for something denied completely by my insurance company and narrows it down to something she sees on my invoice for that amount and sends me a copy of that invoice. It turns out to be the anti-nausea patch given to me that is only covered by Florida Blue at the pharmacy level. Want to know how I found that out? I researched the code online then in turn called FB and asked them about the coverage and after one hour the representative was able to give me that explanation. I actually just felt lucky that my in-network deductible and that inflated anti-nausea patch was all I was out for this ordeal.

So, in the beginning of June I open my mailbox to find a bill for $14K+ from a different named hospital. They were bought out or whatever. No idea. This bill is from my 10/1/2015 surgery. I call the number on the bill, but, they are just the billing company and can tell me nothing. The next day I call in vain trying to reach the hospital accounting department, but, no matter how I try I am transferred to this billing company. I call the morons at Florida Blue as a last ditch effort and get the same answer. I am responsible for the $50k as it says on my online claim and all they know is it was either experimental stuff or uncovered. No specifics. Ask the hospital. I did receive my statement from that visit with the hospital which was over $300k and 5 pages.

I'm at an absolute loss. I have not ever received another bill from the hospitals billing company after my initial inquiry when they were to research the claim, but, my online claims continue to say I owe tens of thousands. Has anyone gone through this and have any words of advice? I need someone to point me in a direction? The only thing I can come up with is to contact a patient advocate and pay for them to handle it as I can not get any answers.