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  1. #1
    Join Date
    Mar 2007
    Posts
    17

    Default Hospital Bill For Charges Not Disclosed At Time Of Treatment

    Florida - My son had to have some whirlpool treatments for a surgical procedure. This was done as an Out Patient at the hospital and would be up to 20 treatments.

    We have Aetna HMO from my employer.

    When my wife took my son the admittance area was specifically asked if there would be any charges for us to pay outside of co-pays. The answer was "no, only the $35 co-pay".

    My wife then asked if it was $35 per treatment or just a one time $35 co-pay. Because if it was going to be $35 per treatment we would seek other remedies and decline the OP treatments. Again, she was told it would only be the one time $35 copay.

    We agree to do the whirlpool treatments and before and after each treatment the nurse removes and applies bandages to the affected area.

    This was in Feb, Mar and April of this year.

    In June we get two bills one for $200 and one for over $1200. When we called about this it seems this was for removal and applying of bandages.

    At this point we are in a letter writing campaign, but I have two questions.

    Am I wasting my time to dispute this bill? I am guessing the hospital is probably going to produce some kind of document my wife signed stating we would pay all medical charges not paid by insurance.

    How do they get away with doing billable procedures without disclosing the charges?

  2. #2
    Join Date
    Apr 2007
    Location
    Il.(near StL,Mo.)
    Posts
    5,252

    Default Re: Hospital Bill For Charges Not Disclosed At Time Of Treatment

    It seems you are saying these are bills ins. would not pay.

    I'm just about positive your wife signed the usual contract that she/you would be responsible for any bills in regard to the whirlpool treatments that ins. would not cover.

  3. #3
    Join Date
    Jul 2006
    Location
    Ohio
    Posts
    1,094

    Default Re: Hospital Bill For Charges Not Disclosed At Time Of Treatment

    Quote Quoting SJW
    View Post
    Florida - My son had to have some whirlpool treatments for a surgical procedure. This was done as an Out Patient at the hospital and would be up to 20 treatments.

    We have Aetna HMO from my employer.

    When my wife took my son the admittance area was specifically asked if there would be any charges for us to pay outside of co-pays. The answer was "no, only the $35 co-pay".

    My wife then asked if it was $35 per treatment or just a one time $35 co-pay. Because if it was going to be $35 per treatment we would seek other remedies and decline the OP treatments. Again, she was told it would only be the one time $35 copay.

    We agree to do the whirlpool treatments and before and after each treatment the nurse removes and applies bandages to the affected area.

    This was in Feb, Mar and April of this year.

    In June we get two bills one for $200 and one for over $1200. When we called about this it seems this was for removal and applying of bandages.

    At this point we are in a letter writing campaign, but I have two questions.

    Am I wasting my time to dispute this bill? I am guessing the hospital is probably going to produce some kind of document my wife signed stating we would pay all medical charges not paid by insurance.

    How do they get away with doing billable procedures without disclosing the charges?
    They get away with it because we are in a hurry and don't carefully read the contracts and ask questions. The often have some language in them that make it sound like if you don't sign the contract in entirety then no treatment.

    I just came across one very similar to what you describe. It states something about incidental charges related to the medical condition performed by non-nursing personnel. They fall under a description that is not covered by the insurance- like taking off the bandages before whirlpool.

    The thing to do is ask about these before they are incurred. It is painful to pay $1500 for someone to take off the bandaid. Next time tell them you want to know in writing what any incidental charges might be before you begin treatment. Ask if they will waive the costs if you do them yourself.

  4. #4
    Join Date
    Mar 2007
    Posts
    17

    Default Re: Hospital Bill For Charges Not Disclosed At Time Of Treatment

    Thanks for the replies.

    At this point I think I am going to take the route of asking them [in writing] to provide proof that these charges were approved by my wife prior to them being performed.

  5. #5
    Join Date
    Sep 2005
    Location
    Behind a Desk
    Posts
    98,846

    Default Re: Hospital Bill For Charges Not Disclosed At Time Of Treatment

    I hate hospital bills (and insurance policies), because they are so complex that it is hard to know what is or is not a covered service, what denials result from billing errors or wrongful action by the insurance company, and a lot of the time it seems like staff at a hospital don't even understand their bills or billing practices. If you literally ask, "Is service X covered completely with this single copayment," they may verify that to the best of their understanding and confirm, "Yes." But it may not even occur to them that anybody receiving "Service X" also will require "Service Y", let alone to check to see what the coverage or copayment issues will be with "Service Y".

  6. #6
    Join Date
    Jul 2006
    Location
    Ohio
    Posts
    1,094

    Default Re: Hospital Bill For Charges Not Disclosed At Time Of Treatment

    I think disputing the charges is a great idea!

    Suggestions:

    Find out the name of the Director of Billing Office at the hospital and the name of the Associate Administrator.

    Write a letter to billing office director, cc AA
    Ask for a copy of the UB-92 and a copy of the itemized statement.

    Also request them to respond to your request to know what the hospital agrees to receive from the insurance carriers for those who have coverage for the same charges.

    I think your idea about the actual statement your wife signed to accept these charges is really good.

    Ask for a response within a certain time period.


    I hope they drop the charges or at least negotiate to charge you only what is acceptable for insurance.

  7. #7
    Join Date
    Mar 2007
    Posts
    17

    Default Re: Hospital Bill For Charges Not Disclosed At Time Of Treatment

    Quote Quoting Mr. Knowitall
    View Post
    I hate hospital bills (and insurance policies), because they are so complex that it is hard to know what is or is not a covered service, what denials result from billing errors or wrongful action by the insurance company, and a lot of the time it seems like staff at a hospital don't even understand their bills or billing practices. If you literally ask, "Is service X covered completely with this single copayment," they may verify that to the best of their understanding and confirm, "Yes." But it may not even occur to them that anybody receiving "Service X" also will require "Service Y", let alone to check to see what the coverage or copayment issues will be with "Service Y".
    I think this is what happened, but also I do not think the medical providers really think to inform patients of what is being charged to them because they are busy trying to get the patient well. Which is completely understandable.

    The issue is that if you cannot afford the service and it can be treated another way then you get stuck with a bill, threats of collections, ruined credit (if you don't pay), lawsuits, etc.

    I just don't think it is fair of a hospital to rack up unknown charges and then act as if a patient knew about it all along. It is not as if most people that use a hospital know how all this stuff works.

    It would be like getting your car's transmission repaired and while they were at it they rebuilt the rear end, then charging you for both. We are protected in that case, but not in the case of medical care. Why?

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