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Senior Contributor
Posts: 4,635
Registered: ‎03-11-2007
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Medical Bills and Collections

Questions about medical bills and medical collections get asked so often I figured that I needed to assembled a canned response.

Medical Bills

If you're not yet in collections, but the threats are coming, or even if you suddenly owe a large medical bill, call the medical providers and see if they will accept payments to avoid collections. Even if they charge interest on the account, it's likely they will charge far less than a CA.

I tend to ask about setting up payment arrangements and let them come up with a number, even on small bills. I have generally found that medical providers are far less demanding than the timeline on which I was willing to pay the bill. For example, I just set up payments on a bill that was about $260 and they offered $52 a month for five months and no interest charges. I accepted, said I'd likely pay it off sooner, and I set up BillPay payments to PIF in four months.

The important thing is to call, talk with someone in the billing department or business office, and arrange payment. I've never asked for written terms, and I don't advise it. They aren't looking so much to sue, I believe, as they are to settle and balance their books, make payroll, and establish some cashflow from your payment arrangements. Just calling and talking to someone can mean the difference between amicable payment arrangements and a collection.

 

If they ask how much can you pay, then always have a number in mind and be realistic and reasonable. If it's a $1,000 bill, they likely won't accept $10 a month.

 

Credit From Your Doctor?

Providers, patients and insurance companies make mistakes. As such, sometimes you the consumer underpays what you owe for a doctor's visit so you get a bill. However, sometimes you overpay, and medical providers I've found aren't always forthcoming about ensuring you get your refund.

It's a good idea, from time to time, when you visit the doctor and they ask about the copay to respond, "Do I have a credit on my account?" A credit on your account means that you overpaid the provider, and they owe you that money. Sometimes they act as though you've spoken a foreign language, but in general they understand exactly what you are saying. When they check, if they discover indeed you do have a credit, ask that the credit be applied to your copayment.

When you have medical bills, and you're setting up payment arrangements, the provider will usually determine if there is a credit and ask about applying the credit to your bill. If they don't, be sure to ask about a credit on your account.

If you, your spouse, your kids, or other household members also see the same provider, it's possible that one of your kids might have a credit on THEIR account so be sure to ask about a credit on the account of anyone in the household. Providers sometimes maintain a different account for each person. Other times they lump the household together on one account.

Senior Contributor
Posts: 4,635
Registered: ‎03-11-2007
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Re: Medical Bills and Collections

[ Edited ]
Medical Collections

Some sort of oddness seems to have transpired complete with of allegations of copyright infringement, patent theft, and perhaps even conspiracy to impersonate a human being. If you exercise your Google search engine, or a different search engine of your choosing, look for hipaa process, hippa process (even though the law is HIPAA and not HIPPA), or whychat hipaa letter.

That should carry the day.

Improper Handling Of Medical Claims

As I said, Providers, patients and insurance companies make mistakes. However, if it's someone else's mistake then you should not suffer for it. Some medical collections are caused by providers or insurance companies improperly processing your claim. You might catch a whiff of this because a claim you thought should have been paid was denied. If your insurance company has a website presence where you can check claims, go look and see if any claims were denied, returned to the provider for more info, etc. Denied claims will likely result in large bills to the consumer, and those are likely the bills that end up in collections.

Gather up everything you have, block out some time, and call your insurance company as they tend to be sticklers for rules and they aren't the ones reporting you to the CRAs. Some bits of information they'll want to know are date(s) of service, SSN of the insured and/or patient, DOB of the insured and/or patient, name of the insured and/or patient, address of the insured and/or patient. They also want to know your name to ensure you actually have a right to access this information. I mean they aren't gonna share your medical claims info with me.

If you find denied claims, claims sent back to the provider for more info, et al. ask about them. Find out what happened and what information was needed and from whom. Occasionally they will send something to the patient asking "Please fill this out and return it to us", but in my experience it's usually something that was coded incorrectly by the medical provider and they failed to correct it and resubmit. Sometimes the provider will fail to respond to the insurance company's request for more info. In most of these cases, you the consumer is stuck between these two third parties. Fortunately, when you discover one of these situations, and the insurance company is made aware of it, the insurance company will often be willing to call and talk to the provider in order to resolve the claim. I have had them volunteer to me, "Would you like me to call the doctor's office?" The correct answer is yes. The few times I've talked to an insurance company and they then called the doctor's office, the matter was resolved quickly.
Message Edited by Noah_Bodie on 03-04-2010 05:47 PM
Moderator
Posts: 4,189
Registered: ‎03-24-2008
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Re: Medical Bills and Collections

Great post!! I have a few things to add, I know we can probably talk about this subject forever.lol

 

Be Nice.

When talking with the billing personal, they are there to help you.Yes they want to get paid, either by the insurance company or by you.

So when you walk out of the medical office, don't think its up to the insurance co and the provider to take care of your bill. It up to you to

see the provider get paid.If you are too sick, find someone you can trust and is responsible to help you with your bills

 

Time

All insurance companies have a certain time limit, that they will pay on a bill, most are 12mos some are 18mos.Even if they would've paid

on your bill, if they don't have all the information to pay on the bill, within that certain time limit, the entire bill is your responsibility to pay.

My experience is that they do not mail out monthly statements.I guess they are trying to save on stamps.Just recently I called the dr office

about my balance, they said they had sent a statement a few weeks ago.Guess what I never received it,but it was a good thing I called

and had it all straighten out. Don't wait too long,because something can not be fix. Want happened with me was, the dr marked on the

record for me to get an injection, but as the visit went on I had changed my mind, not to get it.So a few weeks later, the nurse

remember I didn't get it,so they had to change the bill and mark that off. 

Cash Fees

Some providers not all have a separate charges for cash only,a lower fees then insurance paying customers.You don't know, if you

don't ask.same goes for medical supplies at the pharmacies or the home health companies. My knee braces are $109 each.

Wow I have two bad knees so I need two.I told them I had insurance but it didn't pay for braces.They offered me a cash price

of $55 each. Now that was a deal. 

Medicines

Ask for samples. If the dr gives you a new prescription, get  enough samples for a fews weeks or so.That way you will not pay for a whole

months worth of medicines you can't use, because of the side effects.Ask the dr about, how much the medicine is going to cost, if too

much ask if he/she can give you something else,that will do the same thing.If you are already at the pharmacy,and they give you a price

that you fall thu the floor with,ask if it can be changed to something else.Sometimes the pharmacist will call the dr for you, and get

the prescription changed.The same goes for insurance covered medicines, if not covered by your insurances ask what will be covered. 

Hospital bills

ask if there is help,sometimes if you go to the hospital in your county they will give you a discount.Also check out the

health dept,and see if they have a program to help you. One that i know of has a indigent care program, that if you are sick or injured

after hours, that they will pay for the ER 

 

Be put it all in a nutshell....Do not Wait! Speak up, ask questions and ask what your options are.

 Good Luck to You!!   Eat healthy and stay fit.

FICO's Oct 2013 TU711 EQ713 EX723~~Live below your means and always keep an emergency fund -Love Everybody ~ Big Kenny ~ Big and Rich ~~~~~Credit Scoring 101 - Common Abbreviations - Freq Req Threads - Free Credit Reports - What Steps Do I Take?DV? PFD?
New Contributor
Posts: 97
Registered: ‎05-03-2010
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Re: Medical Bills and Collections

What if the medical bills have gone to a collections agency? Should they be treated the same as any other collection?

 

Thanks

Valued Contributor
Posts: 2,487
Registered: ‎02-18-2010
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Re: Medical Bills and Collections

Dear FreudAndBeck,

There is a segment of this post that mentions Medical Collections.  It's called "Medical Collections".  That's the primary medical collection advice you'll get here.

 

Sincerely,

mauve 


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New Visitor
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Registered: ‎05-31-2010
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Re: Medical Bills and Collections

I had an accident in October of 2008.  The hospital sent some of the claims to my health insurance plan but apparently not all.  Now some 18 months later, they are suing me for non-payment.  It is too late to send them to the insurance company.  The kicker is they have NEVER sent me a bill for these charges. I don't believe I should have to pay for their mistake.  How do I proceed from here?

Moderator
Posts: 22,406
Registered: ‎01-17-2008
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Re: Medical Bills and Collections


rj74 wrote:

I had an accident in October of 2008.  The hospital sent some of the claims to my health insurance plan but apparently not all.  Now some 18 months later, they are suing me for non-payment.  It is too late to send them to the insurance company.  The kicker is they have NEVER sent me a bill for these charges. I don't believe I should have to pay for their mistake.  How do I proceed from here?


I would contact the OC and see if they will work with you.  Keep in mind that the patient  is always responsible for the bill whether you have insurance or not. 


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