[Prince]

So my sister and her husband have a son (my adorable nephew) who has had some medical problems--mostly minor stuff such as colds, ear infections, bronchial infection, sinus problems. After being in and out of the pediatrician's office, they decided to put tubes in his ears and remove his adenoids--very minor and routine surgeries. Since then, he's pretty much been healthy, but to my sister's shock the hospitals bills are coming in much higher than expected. Some of the fees are absolutely criminal ($1100 to see a doc for 5 mins, in addition to the doc they had with him during surgery). This routine 38-minute surgery had a total tab of $18,000. Even Goldman Sachs can't pull off a scam like that.

My sister has insurance, but it is only paying 60%, and although they make a decent living, they don't have the money to pay for these bills. She expected such a routine and simple surgery to cost no more than $8000 (which is still criminal, but at least manageable). I told her to get firm and negotiate. Tell them you're only paying 'X', similar to how you would handle a credit card company. I figure if the average illegal spic or negro can get their healthcare for 'free', then I figure she should work to get her costs down. She's concerned that she'll be taken to court if she refuses to pay the full tab,but I don't see it happening.

She's really upset and I'm looking for advice to give her... anyone been in this situation?

[ian807]

$this->bbcode_second_pass_quote('Prince', 'S')he's really upset and I'm looking for advice to give her... anyone been in this situation?

[Sheb]

Sorry to hear about your hospital woes! I had a similar situation happen to me 7 years ago. Long story short, I had some 3rd degree burns to my hands and after initial treatment, had the option to stay the weekend at the hospital, 6 hours from my house, so that the burn surgeon could see me again the following monday. Although paying this fully out of pocket, I saw the value in paying for the care and the reduced risk by staying in the burn ward for a few days. I also needed to know how much it would cost.

In the end, I was billed $6k--three times the estimate I was given. After paying the surgeons bill separately (he billed separately, and there was nothing funny with his bill), I inspected the hospital's bills and found several problems, including being billed 3x for the room, being charged for things the surgeon did not recommend and I did not request, and being charged for services not even rendered. I figured this was status quo in an age when insurance companies typically pay these bills and wouldn't know to question any of these items. So, I disputed the entire bill citing the reasons above.

After speaking with an attorney (initial free consultation), he said I probably did not even need an attorney, as the hospitals almost always automatically settle for 1/3 the billed cost and should do that for me based on my disputes. So I took this approach. After some back and forth on this for several months, the issue and the bills from the hospital disappeared. I followed up once after several months, but received no reply. I think the fraud issue encouraged them to simply brush the whole thing under the rug.

It sounds like you were expecting to pay 1/3 of what the final bill ended up being. I'd recommend you look closely at the bill, line by line, as compared to what you expected and were possibly told. Then, keeping all this info in mind, call an attorney who handles these things for a free 15 minute consult and see what they have to say.

Two things I'd focus on:

1. What you *expected* to pay vs. What you actually paid.
2. Where the biggest discrepancies were.
3. Any items in the bill that look like they were "packed" onto the bill (extra services of dubious utility which appear to piggyback on what you came for, e.g. "therapy" "consults", etc).

I agree...it's criminal. Medical costs in our over-insured economy are so overinflated it's mind-blowing.

Good luck!

[Caffeine]

I wonder how long it will be before people start taking small boats to Cuba in hopes of getting medical care they can actually afford.

[oxj]

Sheb: the Amish in my area have a doctor somewhere in another state who goes through records like this to dispute items, line-by-line, and save money. They are aware of the scam, it's well-documented, and have someone who would help them.

[JJ]

Anuerism burst, surgery alone 250,000. my part 100.00 deductible.
then last spring my then six yesr old started having horrible stomach pain, waking up in the middle of the night crying, etc. after many trips to the er, finally admitted to dell childrens hospital. barium radiography (the machine broke while he was in it and I had to crawl in and get him after an hour and a half) an edoscope which showed nothing wrong with his esophogus, stomach or small intestine). Finally they told us to go home as they could find nothing wrong, but fortunately a lady came into the produce department where I work and told me that her children had tested positive for ameobic fragilus. Told our pediatrician who made the compound to treat it; the other kids moms took their kids to the local pediatrician who wouldn't treat it as ameobic fragilus BECAUSE THE CDC HADN'T REPORTED ANY CASES IN OUR COUNTY. I think this is messed up. These are the same idiots that want to immunize our kids.

Dells bills to us, including the broken barium radiography which was inconclusive because the machine was broken, came to tens and tens of thousands of dollars. Our insurance paid some; a year later I'm still throwing them away.

[Pretorian]

Do you know what they charge for sleep studies in US? up to $18000 per night in some "research" hospitals. You know, a nurse is watching 10 dudes sleeping on webcam. One Polish guy I know got it for $15 in Sweden, as he was there in Uni for 6 months or so.

[vision-master]

$this->bbcode_second_pass_quote('Pretorian', 'D')o you know what they charge for sleep studies in US? up to $18000 per night in some "research" hospitals. You know, a nurse is watching 10 dudes sleeping on webcam. One Polish guy I know got it for $15 in Sweden, as he was there in Uni for 6 months or so.

[JJ]

I had a panic attack and called them in to disconnect me.

[drew]

$this->bbcode_second_pass_quote('Prince', ' ')I figure if the average illegal spic or negro can get their healthcare for 'free', then I figure she should work to get her costs down.

[Pretorian]

$this->bbcode_second_pass_quote('drew', 'Y')ou have what 30 million black folk down there, and probably 50 million + Hispanic people. They're not all scamming the system at your expense are they??

[Ferretlover]

You might want to suggest that they Very Closely, line by line, go over the incoming bills. We were told by a hospital admin friend of ours that hospitals will often send out the full (with all the add-ons they can think of) bills to the client before submitting them to the insurance company, hoping to get full payment out of the client. It is not unheard of for a hospital.clinic to bill both the client and the insurance company.
In addition, if there is a service that is usually done with another procedure, the patient will be charged for that service--even if it was NOT done with that procedure in this instance.

[Prince]

Thanks for the advice so far. I passed the info along to my sister and already she's making progress (she's a bigger hard-ass than I am . After getting the run-around from the gash at the hospital admin office, she called me back and we came up with a game plan and a concise list of exactly what to say to them.

She asked for a single itemized list without cryptic hospital codes, rather than the cryptic invoice she's gotten so far, spread across 10 separate invoice sheet. First they said no, and then maybe, and after ripping the lady a new one and mentioning that she had talked to a lawyer (which was a lie), you'd be amazed how quickly the woman was left speechless and "him-hawed" and worked in my sister's favor. Turns out that they "accidentally" overbilled the procedure under the wrong (read, more expensive) code and asked my sister to keep quiet and calm while they figured things out (which is another way of them saying that they want to cover their ass).

This is going to be a long process, I'm sure, but she's making progress. Appreciate it.

[vision-master]

$this->bbcode_second_pass_quote('Prince', 'T')hanks for the advice so far. I passed the info along to my sister and already she's making progress (she's a bigger hard-ass than I am . After getting the run-around from the gash at the hospital admin office, she called me back and we came up with a game plan and a concise list of exactly what to say to them.

She asked for a single itemized list without cryptic hospital codes, rather than the cryptic invoice she's gotten so far, spread across 10 separate invoice sheet. First they said no, and then maybe, and after ripping the lady a new one and mentioning that she had talked to a lawyer (which was a lie), you'd be amazed how quickly the woman was left speechless and "him-hawed" and worked in my sister's favor. Turns out that they "accidentally" overbilled the procedure under the wrong (read, more expensive) code and asked my sister to keep quiet and calm while they figured things out (which is another way of them saying that they want to cover their ass).

This is going to be a long process, I'm sure, but she's making progress. Appreciate it.

[drew]

$this->bbcode_second_pass_quote('Pretorian', '')$this->bbcode_second_pass_quote('drew', 'Y')ou have what 30 million black folk down there, and probably 50 million + Hispanic people. They're not all scamming the system at your expense are they??

[Prince]

$this->bbcode_second_pass_quote('drew', 'W')hat I'm suggesting is that off the cuff racism is bullshit. Not every honkey is a straight up character either. Prince's statement smacks of bigotry, and I called him on it. Either that or he's not very thoughtful about what he writes.

What about you, Pretorian? Are all blacks lazy no good 'negroes', in your books? What about the 'spics' ? Can you differentiate, or do they all suck?

Pray do tell.....

Drew

[vision-master]

Three cheers for private medical insurance.

[Prince]

$this->bbcode_second_pass_quote('vision-master', 'T')hree cheers for private medical insurance.

[vision-master]

Private medical providers = hightest possible profit.


Duh.

[mattduke]

$this->bbcode_second_pass_quote('Prince', 'S')o my sister and her husband have a son (my adorable nephew) who has had some medical problems--mostly minor stuff such as colds, ear infections, bronchial infection, sinus problems. After being in and out of the pediatrician's office, they decided to put tubes in his ears and remove his adenoids--very minor and routine surgeries. Since then, he's pretty much been healthy, but to my sister's shock the hospitals bills are coming in much higher than expected. Some of the fees are absolutely criminal ($1100 to see a doc for 5 mins, in addition to the doc they had with him during surgery). This routine 38-minute surgery had a total tab of $18,000. Even Goldman Sachs can't pull off a scam like that.

My sister has insurance, but it is only paying 60%, and although they make a decent living, they don't have the money to pay for these bills. She expected such a routine and simple surgery to cost no more than $8000 (which is still criminal, but at least manageable). I told her to get firm and negotiate. Tell them you're only paying 'X', similar to how you would handle a credit card company. I figure if the average illegal spic or negro can get their healthcare for 'free', then I figure she should work to get her costs down. She's concerned that she'll be taken to court if she refuses to pay the full tab,but I don't see it happening.

She's really upset and I'm looking for advice to give her... anyone been in this situation?