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Went to E.R., getting bills from everyone and his mother, how do I handle this?
Djeet
Registered User regular
Registered User regular
Went to E.R. because I had fever for 10 days and no other symptoms. Had to be E.R. because clinic "didn't have the testing available they thought I might need" and first nuerologist appointment I could get wouldn't be for 2 weeks or so and my wife, dad, and mother are scaring me with their pointed concern. Blood work and cultures and fun stuff (I politely decline the spinal tap, thank you House, M.D.), oh and a CT scan or maybe it was a CatScan? There's nothing wrong with me. Awesome. I'm discharged, they don't have me pay anything there, no co-pay, no deductible, bupkiss (WTF?). That should've been a warning sign I guess.
Now I'm getting bills from all over the place. I've got them gathered up and plan to call my insurance company and the hospital for starters, though I'm unsure if there are more bills in the pipeline. I kind of went though this when we had our kid, it took 18 months of paying people stuff (I'm sure I paid several bills more then once, literally any jackass could've sent us a bill saying they rendered services that day and I would've paid it cause fuck if I know) and they finally stopped bugging us.
Is there some structured way of dealing with this clusterfuck? Like an order of people I should call, or a list of questions I can ask, or documentation I can ask for that they're required to provide me? The big bill does show that insurance has made payouts/adjustments, but doesn't the existence of the big bill from the hospital mean that if I pay that, then the people who I saw there will get compensated from that?
On the bright side I did score 400mg of tylenol during the visit; I started feeling better the very next day, and apparently I don't have brain cancer or whatever.
Now I'm getting bills from all over the place. I've got them gathered up and plan to call my insurance company and the hospital for starters, though I'm unsure if there are more bills in the pipeline. I kind of went though this when we had our kid, it took 18 months of paying people stuff (I'm sure I paid several bills more then once, literally any jackass could've sent us a bill saying they rendered services that day and I would've paid it cause fuck if I know) and they finally stopped bugging us.
Is there some structured way of dealing with this clusterfuck? Like an order of people I should call, or a list of questions I can ask, or documentation I can ask for that they're required to provide me? The big bill does show that insurance has made payouts/adjustments, but doesn't the existence of the big bill from the hospital mean that if I pay that, then the people who I saw there will get compensated from that?
On the bright side I did score 400mg of tylenol during the visit; I started feeling better the very next day, and apparently I don't have brain cancer or whatever.
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Learn what your copays are for insurance. Mine are listed on the card. Always, always, always present this card and make sure they put your insurance on file. You will have a copay unless you have some sort of insurance I am not aware of, mine is $20 normal, $35 for out patient and $50 for ER. Your insurance will be billed for all charges. They should cover something like an ER visit that you had.
If they don't, be prepared to appeal. I don't know why more than one group would bill you... there is only one hospital that you went to. It isn't like there's multiple companies inside the one hospital. Consequently all their charges would be itemized on one bill. HOWEVER: This is me using my prior experience and also common sense, it may not apply to your area or situation.
Send a copy of all the unpaid invoices to your insurance company's appeals department.
Im not telling you to lie or commit fraud or anything, but maake sure in all your correspondence to the carrier, you mention that you needed to go to the ER immediately because you felt you were at acute and immediate risk. If your 'family pressured you' and a 'neurologist appointment could be had in two weeks, but fuck it', they may not cover you at the ER copay rate, or at all.
You should get an EOB from your insurance company. As long as you were in network, that should say for each bill what you have to pay to what company. For an ER visit, with bloodwork, you're going to have several separate bills: the hospital, including 'equipment' such as the CT machine; the doctor; if you went late at night, the person who came in the next day and read your CT to make sure the doctor wasn't a moron; the lab, for the bloodwork and cultures; the pharmacy, unless they gave you a script and you filled it yourself and paid at point of service. You may or may not get separate EOBs (explanation of benefits) from your insurance company for each of these.
No.
Generally speaking you might get different bills from any of the following organizations:
- The hospital facility
- The emergency physician (or physicians group)
- The lab that did your blood work
- The ambulance company that dropped you off
You may even get yet another bill from the radiology department that did your imaging.
[soapbox]But at least we don't have to deal with the bureaucracy of socialized medicine![/soapbox]
The first thing to do is to call the hospital during business hours and ask for "patient affairs." They'll be able to tell you how many bills you can expect to get.
The second thing to do is make sure you have the actual facilities bill from the hospital. Then call your insurance company and make sure they have that bill and are processing it as an emergency room visit. If they don't, they might pay out the other bills at lower rates, forcing you to pay a higher copay.
Next, put all the bills and paperwork you receive in a single folder and call your insurance company and make sure they've received a copy of each bill and are processing it as an emergency room visit.
No, there's no way of simplifying this. It's up to you, as the patient, to keep this stuff organized.
the "no true scotch man" fallacy.
This isn't true, you're generally going to be billed at least by the hospital and the doctor separately, lab work and late night tests may add another 2-3 bills from other companies.
Just becauese a copay wasn't collected on the way out is not something to worry. Unless it is printed on the card or in the network's system, we cannot figure out your copay. Even worse, sometimes the co-pay may just be x% of the total cost of the visit. Deductibles are meant to be paid over the course of a year.
The only way you would get more than one bill is if
A. Your insurance wasn't active (whether truly or a system error), and thus you are, by default, uninsured, and should get bills left and right for each test, doctor's fees, etc.
B. The Billing Department screwed up. Which, if my hospital is any indicator, is probably more than likely. It could be that they sent you a bill before your insurance cleared, forgot to tell you this, then sent a corrected bill later without any warning or indication that the old one was invalid. Or, it could be they just forgot to verify your insurance. It happens a lot more than you'd think. Hell I work at a hospital and the very same hospital I work at did it to me.
Don't call the Emergency Room with this problem. We know nothing of billing, only co-pay collection. Call the Hospital Billing Department and ask what the nature of the bills is.
Yeah, I just want to reiterate what cabsy is saying here. It is absolutely common practice among most US hospitals for the patient to receive multiple bills from different organizations.
Yeah, this is wrong. Sorry, but it is.
the "no true scotch man" fallacy.
And thank you all for your prompt and thoughtful responses.
You should only get one bill from the hospital itself, and a copay and deductible is not the hospital "getting greedy," it is part of your insurance plan. The doctor bills separately from the hospital who bills separately from the radiologist who bills separately from the lab; you will receive multiple bills even with insurance, you will be expected to pay them all, and it is not the hospital being greedy.
Also, djeet, I don't think you're being especially pissy; I worked in health insurance the first time I went to the ER as an adult, and I was fucking mystified by the sheer quantity of bills and terrms that were suddenly being thrown at me.
On the subject of EOBs:
A problem I frequently have with Blue Cross is that they'll process the emergency physicians fees, labwork, and radiology work as "out of network." But if I went to the emergency room for a bona fide emergency, then they have to process all of the associated bills as "in-network." In order to do that, they need to get a facilities bill from the emergency room itself.
So what usually happens is I get an EOB for the physician first, because they happen to be the fastest to bill (at the hospital closest to me). That EOB will say "this claim was paid at lower benefits because this provider is not in the Blue Cross network." Then, after a month or two, they'll get the facilities claim, which actually says that I was triaged by the emergency department, which is the documentation Blue Cross needs to process the claim at the higher benefits.
The moral of this story is: on each and every bill, you should call your insurance company and make sure that they're processing it, and make sure that they know that it was an emergency visit. Deebaser's advice above is good: "maake sure in all your correspondence to the carrier, you mention that you needed to go to the ER immediately because you felt you were at acute and immediate risk. If your 'family pressured you' and a 'neurologist appointment could be had in two weeks, but fuck it', they may not cover you at the ER copay rate, or at all." Just say you went to the emergency room. If they ask you anything else, just say you thought it was an emergency.
the "no true scotch man" fallacy.
Asking for a full deductible at once is not necessary. I don't mean literally greedy, but they never tell you that you needn't pay the, say, 1000 dollars up front but instead over the course of the year. You can pay it all, but it is not relevant to the care you received at that date.
Gotta get a GP, figured I could skate by until I was 35, but maybe if I had one there'd have been options besides the E.R..
Thanks again guys, I'll wait til I get the EOB before making calls. Really appreciate the steps you outlined Feral.
I do know that there are several entities involved whenever there's diagnostic work done; just comes as a shock when in the span of 3 days you get 5 bills. It's like waiting for another shoe to drop.
No prob.
One last thing to add relates to what Bastard was saying above. You don't need to pay everything right away. Each bill will have a phone number on it; if you need to make payment arrangements, call each number and let them know. Usually they'll let you space out payments over several months.
the "no true scotch man" fallacy.
I certainly hope you didn't decline the spinal tap primarily because of some dramatic exaggerations that you saw on TV.
Yeah, generally the hospital is just the building and administration--everyone providing care is usually a contracted employee of a different company completely (even if that company is called "[Insert hospital's name] Physician Group"). So it's totally possible to get multiple bills if you're treated by multiple people.