Medical bills from 3 year back

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I just received a $19 bill for my mother from 3 years back, when I called the hospital, they had no record of it but said she has a $65 credit and they will cut a check for it. Reviewing her google hangout messages, I found a message from a collection agency on her google voice number, it does not give any detail but says a scammy message asking to call them. What the bill, 3 years later they billed her for underpayment from insurance? very frustrating.
 

Ws6

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Originally Posted by stockrex
I just received a $19 bill for my mother from 3 years back, when I called the hospital, they had no record of it but said she has a $65 credit and they will cut a check for it. Reviewing her google hangout messages, I found a message from a collection agency on her google voice number, it does not give any detail but says a scammy message asking to call them. What the bill, 3 years later they billed her for underpayment from insurance? very frustrating.
Insurance in America is crap. The whole system is broken and needs intelligent reform. NOT the ACA, but a sensible, rolling change aimed at reducing paperwork, complexity, etc. The patient or family or anyone else should be able to pull the bill up, look at it, explain where every cent went, and what insurance is liable for, without a decoder ring and magic 8 ball.
 
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I've seen them go back up to 7 years to recover what they call an overpayment. By then, the details are fuzzy and they are successful.
 
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Originally Posted by Ws6
Originally Posted by stockrex
I just received a $19 bill for my mother from 3 years back, when I called the hospital, they had no record of it but said she has a $65 credit and they will cut a check for it. Reviewing her google hangout messages, I found a message from a collection agency on her google voice number, it does not give any detail but says a scammy message asking to call them. What the bill, 3 years later they billed her for underpayment from insurance? very frustrating.
Insurance in America is crap. The whole system is broken and needs intelligent reform. NOT the ACA, but a sensible, rolling change aimed at reducing paperwork, complexity, etc. The patient or family or anyone else should be able to pull the bill up, look at it, explain where every cent went, and what insurance is liable for, without a decoder ring and magic 8 ball.
There should not be a financial burden on patients if we want a meaningful health care. But what we have is a financial system that just happens to deal health care.
 
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"I have no record of these charges, I will need an itemized bill." has worked for me. They usually don't have it. Plus, they've written it off by now anyway. I'm not in the habit of simply paying bills that arrive by mail. It would be funny if the bill and the credit existed at the same organization.
 
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Basehor, KS
I believe the collection agency must put the collection attempt in writing, not just email or phone call. I would ignore it until I received a written demand from the collection agency. Then I would follow JLTD's advice about demanding an itemized bill showing exactly how, when and why the bill occurred.
 
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More than twenty five years ago, so my memory is foggy. My mother's PCP moved to another location and she got a different doctor. When she died I got a letter from one of the original doctor's group physicians. They'd never submitted the initial bill to Medicare and just went through old bills (like four years previous) and started billing. I know I never paid that one, sure I was caustic in my reply. Of course defending a deceased person's credit rating is not much to worry about.
 
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Originally Posted by Ws6
Originally Posted by stockrex
I just received a $19 bill for my mother from 3 years back, when I called the hospital, they had no record of it but said she has a $65 credit and they will cut a check for it. Reviewing her google hangout messages, I found a message from a collection agency on her google voice number, it does not give any detail but says a scammy message asking to call them. What the bill, 3 years later they billed her for underpayment from insurance? very frustrating.
Insurance in America is crap. The whole system is broken and needs intelligent reform. NOT the ACA, but a sensible, rolling change aimed at reducing paperwork, complexity, etc. The patient or family or anyone else should be able to pull the bill up, look at it, explain where every cent went, and what insurance is liable for, without a decoder ring and magic 8 ball.
You're correct. I don't know the answer. I had surgery a month ago. Just got the EOB. Total charges were $50,651. Aetna negotiated that down to $15,102. I paid a total of $36.18 and I owe CVS $1.20 for Vicodin that I was afraid to take. Doubt CVS will send me a bill for it but who knows. I'm glad I have great insurance but how much would be charged to a person without insurance? Do they get the full charge? So not only are they paying out of pocket, they're paying $35,000 more than what the hospital and docotors would accept from the insurance company. That's not right. As far as billing though, the EOB was very specific about itemized charges and my liability. Due to HIPAA, they won't share your bill with anyone that's unauthorized. Some providers will just send you a bill and hope that you pay it. I've received bills for questionable services and just ignored them and I never get another bill from them and never hear about again.
 
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There are scammers out there that do exactly this. They look up what they can about someone, frequently through social media, but also through other channels, like credit reports, etc... public record stuff.. Once they have something that they can use, they send out a bogus bill, usually for an amount that isn't considered much, assuming that the person receiving it will just assume it's real and pay it. My wife got one of these a while back from some place that was clearly a call center setup to scam people. I ended up playing with them for a while, collecting some info on them, before finally calling their bluff and reporting them to the police.
 

Bud

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I keep meticulous records for all things medical. I can always provide proof of.payment. If a Doctors billing department says I owe something I don't, the burden of proof is on them. Never had a problem handling it.this way.
 
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Indiana
Originally Posted by JLTD
"I have no record of these charges, I will need an itemized bill." has worked for me. They usually don't have it. Plus, they've written it off by now anyway. I'm not in the habit of simply paying bills that arrive by mail. It would be funny if the bill and the credit existed at the same organization.
I like your style. Do you have any concern of them pencil whipping something up?
 

CKN

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By law they have to provide a transaction of the amount they are trying collect. <span style="font-weight: bold">It's a FEDERAL LAW.</span>
 

Ws6

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Originally Posted by Alfred_B
Originally Posted by Ws6
Originally Posted by stockrex
I just received a $19 bill for my mother from 3 years back, when I called the hospital, they had no record of it but said she has a $65 credit and they will cut a check for it. Reviewing her google hangout messages, I found a message from a collection agency on her google voice number, it does not give any detail but says a scammy message asking to call them. What the bill, 3 years later they billed her for underpayment from insurance? very frustrating.
Insurance in America is crap. The whole system is broken and needs intelligent reform. NOT the ACA, but a sensible, rolling change aimed at reducing paperwork, complexity, etc. The patient or family or anyone else should be able to pull the bill up, look at it, explain where every cent went, and what insurance is liable for, without a decoder ring and magic 8 ball.
There should not be a financial burden on patients if we want a meaningful health care. But what we have is a financial system that just happens to deal health care.
Well, a large part of it is people getting what they want. The amount of QA/QC and liability in healthcare is absolutely STAGGERING, and that all costs, and people aren't going to work in healthcare for less than a very decent wage considering how many jobs there are out there that are much better. So you cannot slash care provider pay. Then comes the fact that institutions eat so much money some of them near Mexico close because of it because of laws that REQUIRE people be treated, whether they will ever pay or not, so you're also picking up the tab for them (or your hospital will close). So, what we have: -Crappy jobs that have to pay well to keep people coming to work. -Extremely demanding performance considerations which require TONS of oversight. -Charity cases which will be losses financially with no gain, often in the millions of dollars per patient. Then we get into corporate abuse where drugs are marked up (insulin, Epi-gate, etc.) and so on. The whole thing is an absolutely convoluted mess.
 

Ws6

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Originally Posted by dlundblad
Originally Posted by JLTD
"I have no record of these charges, I will need an itemized bill." has worked for me. They usually don't have it. Plus, they've written it off by now anyway. I'm not in the habit of simply paying bills that arrive by mail. It would be funny if the bill and the credit existed at the same organization.
I like your style. Do you have any concern of them pencil whipping something up?
No, they don't care. What WILL happen is this: Your insurance will say they need the ICD coding. The hospital will say "we sent it". The insurance denies getting it. The hospital refuses to "double bill" (re-submit it) as it's a crime to double bill. The hospital will then say they need payment. The insurance company will say they have no record of services. The hospital will then turn your bill over to collections and ruin your credit. THAT is much more likely than someone who gets paid $12-18/hr talking to constantly berated people all day in billing/records taking the time to "pencil whip something up".
 
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Insurance is nutty. My wife just 4x her salary simply fixing billing codes (typically incorrect or miscategorized) from professionals for maximum gain reviewing charts. She did this as side project in department and they gave her an office in corporate floor. She makes the hospital tons of money. Curious if the billing fell into audit and flipped back.
 
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Originally Posted by Leo99
...Total charges were $50,651. Aetna negotiated that down to $15,102...
Two industries rife with fraud and corruption. And other scammers, too. We were asking for $50 but we'll take $15. Sheesh.
 
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I think the google voice vmail is for another person and probably not my mother, anyway I will ignore it. I am going to swing by the hospital later tomorrow, not sure what is going on with that, the lady I spoke to said that all her bill are in archive as it has been a while since she was there.
 
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Decades ago, I had a sinus surgery and the insurance company sent me the money to pay the anesthesiologist. So I cashed the check and waited for the bill. Payed everything else that was sent to me. Months and months went by and I forgot about it since I never got a bill from them. A couple years later when I was buying my house, I was notified by my broker that I had a collection against me. What the...???!!! I went down to them right away and they explained it to me. The doctor had moved/quit the business and sold all his debt to the collection agency. Pretty low thing to do, IMO, since it put a negative on my credit, delayed the house purchase, and I had the money ready to pay if they'd just sent the bill like they were supposed to do.
 
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Battle Creek, MI
Originally Posted by splinter
Originally Posted by Leo99
...Total charges were $50,651. Aetna negotiated that down to $15,102...
Two industries rife with fraud and corruption. And other scammers, too. We were asking for $50 but we'll take $15. Sheesh.
A friend of mine that was a nurse for the longest claimed they do this for tax purposes. That $35k "loss" is tax deductible. No point in asking for what the insurance company is going to pay.
 
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Originally Posted by SVTCobra
Originally Posted by splinter
Originally Posted by Leo99
...Total charges were $50,651. Aetna negotiated that down to $15,102...
Two industries rife with fraud and corruption. And other scammers, too. We were asking for $50 but we'll take $15. Sheesh.
A friend of mine that was a nurse for the longest claimed they do this for tax purposes. That $35k "loss" is tax deductible. No point in asking for what the insurance company is going to pay.
Your friend is incorrect. In healthcare you have prices and then you have contracts with insurance companies on how much they will pay. For example, Medicare and Medicaid have their own fee schedules that look very different what the prices are. So prices and charges are largely irrelevant even though that's what media keeps talking about. Plus, hospitals will take whatever they can. Insurance companies have a tendency to not pay their obligations because in their contracts they specify that they will only pay for medically necessary procedures. Medical necessity is something that they determine so essentially have a freedom to decide what they will or will not pay. Near every quarter, they will have mass denials so that they can show good quarterly results.
 
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