Almost eight months ago now, my adult DS went to the hospital closest to his college at 2 am and was in pre-op 2 hours later for an emergency appendectomy.
He was released 29 hours after he went in to surgery.
Our health insurance states that if we got to an emergency room and are admitted, our co pay is $0
If we go to emergencey room and are not admitted our co-pay is $100.
This hospital claimed he wasn't "admitted" that he was kept for "observation" even though he had emergency surgery.
Ok, so my DH pays the $100.
Two months later we get a bill for the "DIFFERENCE" of what was billed by the hospital and what was paid by the insurance company.
Um, duh, our co-pay was fullfilled with our $100 payment. Can we say double billing.
I made DH report them to our Insurance company. Bill went away.
Today, we get a bill from the surgeon's office for a $25 co-pay for an office visit which is dated the same day of my son's emergency surgery.
Um, he can't be at the doctor's office at 2 am and in the emergency room of the hospital at the same time.
Now trying to triple bill.
My DH calls and is all nice trying to get the fraudulent charge removed. I say loudly in that I am going to report them to the State of Michigan Health Insurance
Fraud board and suddenly the lady says she is waving the $25 charge as a courtesy. I bet she is.
Turning all these bills over to the Fraud Department of both our insurance company and the State of Michigan Fraud Board.
I can't stand that Doctor's billing offices do this. It makes me sick to think of how many people they do this to and that people pay them thinking they have to.
Sorry for my rant.
Life is like a cup of tea,
It's all in how you make it.
Lisa
1|1|The healthcare systems are too big now.....even if I get a bill from my doctor for an office visit, it comes from the system's billing department, not his office.....and I am familiar with coding (part of my job), and while sometimes resubmitting with more accurate coding is appropriate to get the insurance company to pay for something legitamately covered, changing the code to rebill as a double-dip is fraud.|saint6811|waylan@comcast.net|16:34:28|11/09/2011|
" You'll get what's coming to you ... Unless it was mailed."
2|1|I had an issue a while back too, Lisa...I feel for ya!|mindylou86|mindylou86@gmail.com|17:08:43|11/09/2011|
Called BOTH, our clinic's billing office AND our health insurance company...they both told me to check back in a month. When I checked back, NEITHER ONE DID ANYTHING!!!
After a VERY heated phone call to both AGAIN, they took care of a couple of claims, but I still think there are a couple that have not been handled correctly.
I feel very sorry for the elderly (and anyone for that matter) who gets jerked around like that.
M
3|1|My whole problem with this is that it is wrong and that they actually get money from both the insurance companies and other people by this double billing policies. I think the billing companies know that that patients will get frustrated in dealing with this and some will just pay the bill to avoid the frustration.|Ranalt|ainebailey@gmail.com|21:39:04|11/09/2011|
They are lucky that it was my DH on the phone, because I would have added the Michigan State Fraud Department onto our call.
I save all of our medical bills and note who I talked to on what date and what they said.
The Michigan Fraud Department is going to love my package that I am mailing them.
Life is like a cup of tea,
It's all in how you make it.
Lisa
4|2|Right up there w/ them trying to get patients to pay...|Skaytes|skaytez@gmail.com|07:30:42|11/10/2011|
what Medicaid doesn't cover. Any Dr, hospital, lab etc that enters into a contract with Medicaid is bound by what medicaid says in contract they will pay for that service and that is the ONLY payment they get. If a service cost $200 and the contract w/ state says they only pay $80, they have to legally accept it and not bill for remainder. I have fought many times with drs, hospitals etc trying to collect remainder of bill that Medicaid didn't cover. Once I quoted ver batum (sp?) what the state says in the contract (my medicaid rep gave me a copy of her page on that) amazingly they never contacted me again. They know it's illegal to do that and was caught. I agree..feel so badly for the elderly and disabled etc who cannot stand up and fight these companies, drs etc and are taken advantage of and bullied by them to try to get them to pay. :( 5|3|:O They should be turned in to CMS!|saint6811|waylan@comcast.net|07:45:12|11/10/2011|
" You'll get what's coming to you ... Unless it was mailed."