Medical Billing Errors - WTHELLO

[Muddyboots]

Ok after 2.5 hours in phone with my ins comp on the payment error on my account page, three different reps they had to say, we don't know and have escalated the issue for escalation team to address. So after stellar performance day before, they cannot explain the payment to a medical group that I already paid for since they had previously stated it was not covered which I agreed reviewing my coverage. If if was covered, I want my money back which is not chump change! I actually had to tell last person NO after they tried to claim all us well trust me! She was on my account page and I told her read the claim and explain. Crickets. Thats when I don't know was uttered and escalation was triggered. This is nuts! Its your database! Just verify payment or not! And they could not or did not want to confirm to me. This might get real interesting in next couple days. Three different rep's found out some people actually understand contractural relationships, read and understand. Another WTHELLO!

 

[xsn10s]

Ok after 2.5 hours in phone with my ins comp on the payment error on my account page, three different reps they had to say, we don't know and have escalated the issue for escalation team to address. So after stellar performance day before, they cannot explain the payment to a medical group that I already paid for since they had previously stated it was not covered which I agreed reviewing my coverage. If if was covered, I want my money back which is not chump change! I actually had to tell last person NO after they tried to claim all us well trust me! She was on my account page and I told her read the claim and explain. Crickets. Thats when I don't know was uttered and escalation was triggered. This is nuts! Its your database! Just verify payment or not! And they could not or did not want to confirm to me. This might get real interesting in next couple days. Three different rep's found out some people actually understand contractural relationships, read and understand. Another WTHELLO!

That's one of the things that I wonder is built into the system. The escalation is EXACTLY what I've experienced numerous times.

 

[lyle2231]

Muddy Then there's the one in a million reply "I don't get paid enough to do that " Made me want to climb thru the phone.

 

[Muddyboots]

They were nice to me but so frustrating that someone outside their organization understands their system such they cannot answer or is it they really don't want to or don't feel they are "empowered" enough to actually give an answer. Which is more I think. In manufacturing, a top tier company will give you enough rope to do your job including outside your sphere as long as you follow company policy. Speed is not part of medical philosophy. Neither is data security.

 

[FrogFire7]

I feel like it's much more rare to get a bill that's actually correct... One of the last ones we got was for my wife... They billed her doctor as out of network (they were not out of network). That's just the latest for us, it goes on and on and on... NEVER pay the bill the first time. Sad it has to be that way

 

[Old Rooster]

For all of these reasons I believe we need a universal Heathcare system like Canada has.
It's hard to fix a broken down system.
Bill Larson I am so sorry to hear your wife passed.My wife and I will celebrate 50 years this September 9th and I don't know what I would do without her.God Bless and take care

 

[Muddyboots]

Please not Canada system! That system is so broken not possible to fix. Before Covid, Canadiens came to US for surgical procedures so they can get it before they died waiting in Canada. Plenty of data in that. Just imagine government running entire medical treatment system? Couldn't even deal with pandemic!

 

[snox801]

Is it me or what? The past year I have received multiple billings that contained billing errors that I was charged for services that were covered by Medicare and my supplemental insurance. It was ONLY after I provided evidence they were paid or have not submitted correct billing information to either Medicare or my supplemental insurance that I was able to remove the billing. Within the past month alone, the total billing errors is about $450! Dang! That's a nice chunk toward a new build! I had similar billing issues in past year that I had to correct as well.

My reason to post up is to give heads up to make sure you review EVERY line item in EVERY billing in comparison to your Explanation of Benefits to VERIFY the billing is 100% correct!

So how many elderly folks just pay the bill "trusting" the bill is correct? So is this just another layer of incompetence? Or worse? Since it is so prevalent you start to wonder.....

Welcome to the Michigan system.
My son turned 3 when I got a call from collections for his birth. First I heard of it.
I called about 5 months after he was born and asked for all bills. Paid them.
The excuse was the hospital did receive a bill from two of the doctors.
In fact just yesterday my wife got a notification form collection for another medical bill for the kids.
Spent the whole afternoon calling and nobody has record of the service provided and the account balance is zero. They confirmed with collection it was not a scam but neither party knows why we owe that.
I'm to the point where I my file a suit against them.
They twice now have affected my credit which is very important to me.
Won't stand well for them when I have never paid a bill late in my life.
Im convinced everything g the government tries to fix they f up.

 

[snox801]

For all of these reasons I believe we need a universal Heathcare system like Canada has.
It's hard to fix a broken down system.
Bill Larson I am so sorry to hear your wife passed.My wife and I will celebrate 50 years this September 9th and I don't know what I would do without her.God Bless and take care

This could be the dumbest thing I've every heard.
Please do some more research into this.
First out system has by far the best quality of outcome of any country period.
Second again the problem is the government getting in the way. Red tape, money, and the fda.
I could find millions of examples of people from other countries mainly Canada coming here for care. Why?
If we get rid of our system you may not have the option for the care that saves your life.
What we need to do is get some type of transparency in that system and let the market work.
Take a look at lasik for example. When it came out it was very expensive. But most insurance won't cover it, and government backed care would not either. With time and supply demand cost has come down so low you can get it done much cheaper.
Heck I know people that paid less for that than I did for 20 stitches in a finger.
First bill was $1300 when I called said I had no insurance or money.(true at the time) bill magically like Jesus magic came to $389.

 

[snox801]

Please not Canada system! That system is so broken not possible to fix. Before Covid, Canadiens came to US for surgical procedures so they can get it before they died waiting in Canada. Plenty of data in that. Just imagine government running entire medical treatment system? Couldn't even deal with pandemic!

Government can't take a **** without getting it's shoes wet.
Name one thing they haven't messed up. Literally one. I can't think of a single one they haven't screwed up they said they would fix. Now you want them to run a system like health care. Lol
Think cost are high now? Have you every seen any government run system be efficient or cheap? They don't know how. Most employees fail up. Fauci has been wrong on everything g he's done. He thought you could catch aids by using the same cereal box. Yet they put him in charge. Sorry rant over.
Just hits close to home right now.
Muddy let me guess spectrum?

 

[Muddyboots]

File dispute with all 3 credit bureaus to start, request documentation of previous billings actually sent to you not paid, attorney send letter to hospital with lawsuit threat since they are root cause.

I am in same boat with collections threat but I was able to put on hold with above steps except for attorney. I informed them my legal action will be walk in park with chronological information I have to prove their failure to provide normal and customary communication.

Document in WRITING EVERY single communication from everyone involved in a structured chronological document, date, time, organization, person, subject discussed, resolution, corrective actions by them, by you, phone numbers, next planned schedule communication, risks, receipt of confirmation of expectations etc.

I have submitted my documentation to the organization with expectation of their responsibility going forward.

This level of documentation is absolutely necessary since IMO medical organizations are so poorly trained there is no continuity of closure to your billing issues.

Just remember EVERY time you call in you have to re-educate that person to the problem regardless of possible notes on your account.

Freaking RIDICULOUS!!!

 

[P7M13]

November 2021, I visit a clinic that I hadn't been to since 2014. They bill me $1,400+ for services received in 2014 !
Still fighting them on that one.

 

[Old Rooster]

Please not Canada system! That system is so broken not possible to fix. Before Covid, Canadiens came to US for surgical procedures so they can get it before they died waiting in Canada. Plenty of data in that. Just imagine government running entire medical treatment system? Couldn't even deal with pandemic!

I know folks that don't have any insurance as it is so expensive.
Too young for medicare and have older folks health problems but can't go to the doctor or dentist so what else does the greatest country on this earth have to offer?Our tax dollars should go for something other than line political leaders pockets.
I'm lucky as I have a supplement and medicare but millions don't have anything.They are one accident from abject poverty.
Something needs to be done.

 

[Muddyboots]

I know folks that don't have any insurance as it is so expensive.
Too young for medicare and have older folks health problems but can't go to the doctor or dentist so what else does the greatest country on this earth have to offer?Our tax dollars should go for something other than line political leaders pockets.
I'm lucky as I have a supplement and medicare but millions don't have anything.They are one accident from abject poverty.
Something needs to be done.

100% CORRECT! Most people think on Medicare - no worries. What a joke! Prescriptions we paid $25 are $200 since the pharma discounts we got are no longer applicable since we are now on Medicare. WTHELLO! No vision, no dental now you have to buy which the ROI is not there so you just pay through your nose or your other cheeks. Annual phyicals were covered as preventative but now they are not! WTHELLO! Yeah you get a Medicare Wellness Visit - Freaking JOKE! All they are is "So how are you feeling today? WTHELLO! How do you think? Medicare won't pay annual physicals, prescriptions are higher in some cases and I mean a LOT higher, no longer have dental coverage and gee, elderly folks have lifetime of abusing teeth so guess we don't need it since we can just gum our food, vision is obviously needed more but not covered now. Great system.