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Topic: Bills, bills, bills!

Forum: Employment, Insurance, and Other Financial Issues —

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Posted on: Nov 14, 2019 06:45AM

Mavericksmom wrote:

I am finished treatment. Now I am hit with the bills. My insurance is good, but the billing at the Philadelphia hospital I go to is not!

Two weeks ago I got a second bill for a Doctor I saw one time. I had paid it, so I called. I was told I didn’t pay a bill for another doctor so to keep me out of collections they transferred that payment to that bill. So I wrote a second check

I should note this hospital has no online or phone bill pay system! Very antiquated!

The next week I got two bills in one envelope, one was the hospital bill from January! The other for an office visit. I immediately wrote checks and took them to the post office. Those have not cleared my bank yet.

Then last night, after the billing department hours I got an automated call saying I owed even more money, that I had not paid bills and they were sending me to collections if I didn’t call!

You better believe I will call after work today! I messaged my doctor there, not to help me with billing, I can handle that, but to make her aware of what is happening to patients. I read on Yelp that this occurred to others but I hadn’t experienced it so I didn’t worry. I feel so bad for patients dealing with this hospital while trying to survive cancer! No one should have to worry about being sent to a collection agency while fighting to survive cancer. Again, I am not worried for myself, I am upset knowing if it happened to me, it is happening to others


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Nov 14, 2019 08:25AM Yogatyme wrote:

Mavericksmom, this is such BS!! The stress of treatment is so hard on patients and the last thing you need is this kind of harassment!! I’m so sorry and so glad you are letting your doc know about this.

Yogatyme Surgery 3/2/2019 Prophylactic ovary removal Dx 7/19/2019, IDC: Papillary, Right, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2- Surgery 8/12/2019 Mastectomy: Left, Right
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Nov 14, 2019 08:29AM flashlight wrote:

Are you able to go online and check your insurance claims? I was billed twice for a service that was covered.

Dx 11/15/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- Surgery 11/26/2018 Lumpectomy: Left; Lymph node removal: Sentinel Radiation Therapy 1/27/2019 Whole-breast: Breast, Lymph nodes Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Nov 14, 2019 10:02AM Yogatyme wrote:

Mavericksmom, flashlight is right. Her post reminded me that a nurse told my SIL to be sure to go through her bill with a fine toothed comb as it is not uncommon to be billed for things more than once and to be billed for procedures she didn’t even have. So, check the billing if possible!!


Yogatyme Surgery 3/2/2019 Prophylactic ovary removal Dx 7/19/2019, IDC: Papillary, Right, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2- Surgery 8/12/2019 Mastectomy: Left, Right
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Nov 14, 2019 10:36AM bcincolorado wrote:

Also check with your insurance company since you said you have good insurance. I have had issues in the past where something was coded wrong in the doc's billing office and then the insurance denies the claim because it was coded wrong. Once you find out then you talk to them about it. I have had to get the doc's office to resubmit a claim correctly.

I've also had claims denied by insurance because it was something that required "pre-authorization" and insurance wanted to talk to the doctor's office who never called insurance company back because they were too busy or did not get message. They wanted a "peer to peer" review of the procedure required before approving. Once that conversation takes place the claim gets approved and paid.

So make sure to call your insurer too and not just pay automatically. I know you are afraid of going into collections but chances are they really are not going to put you in there right away if you are working on an issue.

Dx 8/2009, IDC, Left, 5cm, Stage IIA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 1/7/2010 Lumpectomy: Left; Lymph node removal: Left Hormonal Therapy 1/15/2010 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/30/2016 Femara (letrozole)
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Nov 14, 2019 11:13AM DogMomRunner wrote:

You need to find out if your insurance company has a patient advocate. Most do. Get the phone number or email and get in touch with that person(s).

I have learned the hard way to pay nothing (NOTHING!) until you get the EOB (explanation of benefits) from your insurance company.

Here is why.

First – your insurance company doesn't care if you pay the whole bill. Actually they are overjoyed if you do that. So you can pay the hospital, the doctor, the anesthesiologist, the radiology department. They ALL bill separately for their services. If you have a deductible and an out of pocket maximum, then they will force you to pay at least those amounts. But if you pay more (like if the hospital offers you a discount to pay in advance) they don't care nor will they reimburse you.

Second – the healthcare provider doesn't care what your insurance company says you should pay and they usually don't like a low reimbursement rate from the insurance company. So they will try to balance bill you. This means that they will try to make you pay for the balance that your insurance doesn't pay.

This is where your insurance patient advocate comes into play. They can help negotiate payments and they can force the healthcare provider to accept their reimbursement rate. Doesn't mean that the healthcare provider won't try to bill you for it though.

I have been through months of this and I pay nothing until I see the EOBs.

It is a royal pain in the ass to deal with all of this. And at a time when you are not feeling particularly up to it.

Good luck.

You ain't run far enough to say My legs have failed You ain't gone far enough You ain't worked hard enough You ain't run far enough to say It ain't gonna get any better. Nathaniel Rateliff Dx 4/24/2019, DCIS/IDC, Left, 1cm, Stage IA, Grade 3, 0/8 nodes, ER-/PR-, HER2+ (FISH) Surgery 5/17/2019 Lumpectomy: Left; Lymph node removal: Left, Sentinel Targeted Therapy 6/6/2019 Herceptin (trastuzumab) Chemotherapy 6/6/2019 Taxol (paclitaxel) Radiation Therapy 9/22/2019 Whole-breast: Breast
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Nov 14, 2019 12:49PM MinusTwo wrote:

I can't concur strongly enough. DON'T just pay things w/o at least talking to your insurance company. And probably your doctor's office. So many bills are mis-coded. When the coding is fixed, the insurance company pays. And yes, you should get your insurance company fighting for you.

You don't have your specs posted & I don't remember the dates of your treatment, but I don't think it has been that long. Awfully soon for collection. Wonder if they're just threatening to scare you well ahead of the actual process?

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Nov 14, 2019 05:52PM Yogatyme wrote:

Mavericksmom, if your providers are “in network” with your insurance company, they CANNOT balance bill you for amounts not allowed by the insurance company. If they do, it is considered insurance fraud and you should report them to your insurance company and state insurance commissioner’s office. Your insurance co can tell you whether the providers are in network.

Yogatyme Surgery 3/2/2019 Prophylactic ovary removal Dx 7/19/2019, IDC: Papillary, Right, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2- Surgery 8/12/2019 Mastectomy: Left, Right
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Nov 14, 2019 07:21PM - edited Nov 14, 2019 07:21PM by gb2115

This Post was deleted by gb2115.
Dx IDC in October 2016, stage 2A, 1.2 cm ER/PR+ Her2-, Grade 2, 1/3 nodes. Mammaprint low risk luminal A, Lumpectomy + radiation + tamoxifen. Age 38 at diagnosis.
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Nov 14, 2019 07:24PM MelissaDallas wrote:

Never pay a medical bill until you have the final corresponding EOB to match up to it

LCIS, extensive sclerosing adenosis, TAH/BSO & partial omentectomy for mucinous borderline ovarian tumor.
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Nov 14, 2019 08:28PM Mavericksmom wrote:

A representative from billing called me because I made my MO aware of what was happening. Doctors have nothing to do with billing but they need to know if their patients are being told they haven’t paid when they never received the bills. My MO sent my email to billing, thus the response. ( I thanked her for doing that!)

The representative explained what happened and gave me her direct line for any future issues. She blamed it on the automated computer system and while I don’t know how true that is, she solved my issue and seemed to care when I told her that If it happened to me, it is happening to others, and being a cancer hospital, it is likely happening to people fighting to stay alive!

The bills I received thus far were expected. I know via my EOB from the insurance company what I owe. I have copay amounts so except for certain tests, I always know what I should be charged ahead of time. I was mad at the call because it made me believe there were bills I hadn’t paid because I never received them and they were sending me to a collection agency if I didn’t call and pay them. As others said, there is NO WAY I would pay anything unless I have the bill. My EOB’s often have a note on them stating that the provider should not bill me anything but the copay amount. They have a number to call if they try to balance bill.

Thank you to all who commented.


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Nov 14, 2019 10:13PM edwards750 wrote:

BC told us not to pay a bill until we received the EOB. We all know hospitals and doctors offices try to get you to pay what insurance won’t pay according to them on the front end. I never do. Several times what they claimed I owed was not correct. They have access to the insurance companies websites so I know they already know what is owed.
The women’s hospital where I went for my biopsy was one of those. The clerk claimed I owed $500. I owed $70.

Diane

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Nov 14, 2019 10:53PM AliceBastable wrote:

I got overcharged one time on an up-front charge for a procedure, but my insurance caught it and reimbursed me. But my insurance company seems to really be on the ball. Their nurse called me not long ago and said they hadn't been billed for a blood test I get fairly regularly, and she wanted to make sure I got the test. It's strange to trust my insurance more than a hospital, but that's what's going on.

Endometrial cancer 2010, basal cell multiples, breast cancer 2018, kidney cancer 2018. Cancer's a bitch, but I'm a bigger one with more practice. Dx 5/2018, ILC/IDC, Left, 2cm, Stage IA, Grade 2, 1/1 nodes, ER+/PR+, HER2- Surgery 7/10/2018 Lumpectomy: Left; Lymph node removal: Sentinel Surgery 8/7/2018 Radiation Therapy 10/28/2018 Whole-breast: Breast, Lymph nodes

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