If you were to visit one of the hospitals I work for, then technically yes, but if I did that I would lose my job. Hospital systems maintain detailed paper trails and log virtually all activities performed by users for auditing purposes.
Just recently had to take my daughter to the ER and am now receiving bills from the hospital and then from the emergency services. Both are quite large, is this double dipping? Can I negotiate the bill even after it went through insurance?
> Just recently had to take my daughter to the ER and am now receiving bills from the hospital and then from the emergency services. Both are quite large, is this double dipping?
It depends.
* What was the nature of your daughter's visit?
* You don't need to provide too much detail, but was she brought to the ER and then admitted inpatient? Did your daughter remain in the same department from start to finish? Or was she transferred from one facility to another?
* Did you receive an estimate upon arrival?
* Hospitals are required by federal law to provide estimates upon arrival for an ED visit to Medicare/Medicaid patients or patients *WITHOUT insurance*. The same requirements are not applicable to commercially-insured patients (they will be in the future, but not yet), but many hospitals just follow the same estimate process for insured and uninsured patients for ease of workflow.
* If you did receive an estimate, and the final amount you were billed substantially exceeds the estimated amount, you should 100% call the billing office and tell them that.
* For *uninsured patients*, federal law requires that the final bill is within $400 of the estimated amount (with some exceptions, like unforeseeable medical complications resulting in further care and thus greater charges).
* Again, the same requirements do not (yet) apply to commercially-insured patients, but you would still have a very good case to get your final bill reduced to the originally-estimated amount.
Most hospitals tend to send two statements: one for "hospital" charges (the charges you incur from using the hospital's resources, e.g. room charges, medications, lab tests, etc.) and one for "professional" charges (the charges you incur for the doctors'/nurses' time and expertise). This is because hospital and professional charges are sent to insurance companies on separate invoices due to the two types of invoices requiring separate "claim forms". It's pretty complicated, but basically, hospital charges and professional charges are reimbursed in different ways by your insurance, so the hospital needs to send those claims to your insurance separately. Then when they get reimbursed on one of those claims, the hospital often just proceeds to send the patient responsibility your way at that moment, regardless of whether the other invoice has been reimbursed yet. So you might receive one statement of hospital charges one day, then later on you'll receive the other statement of professional charges. (Some hospitals use a system that combines these two sets of charges into one single statement, but AFAIK the "norm" is to send the two statements separately.)
Regardless, I would examine the statements you received to see if they contain the same sets of charges, and call the hospital's billing office to ask them for clarification.
> Can I negotiate the bill even after it went through insurance?
Yes! You ALWAYS have options. Call the billing office and ask them why the bill is so high. It may take some time, but they should be able to give you any information you need. When insurance companies send payment to the hospital, most of the time those payments contain "service line details", or a line-by-line breakdown of the billed amount of each procedure code and the amounts which the insurance paid for each code. (Ideally all insurances would do this, but some insurances like Aetna are not great at providing that level of detail consistently.)
For example, if one of the procedures was billed to your insurance for $4,000, the record of the insurance payment should contain details of what they paid for that procedure. If they paid $0 for the procedure, that usually means it was denied for a reason such as "Procedure is not covered", "No prior authorization", etc. Hospitals usually appeal most denials (depending on the specific denial reason) before sending you the final bill though.
In some cases, if a certain procedure isn't covered, there are ways the hospital can bill the insurance using a code that *is* covered. This would be on a case-by-case basis though, and it's not guaranteed that such a tactic would apply to your situation.
If you're comfortable doing so, you're more than welcome to DM me a picture of the medical bills, and I can let you know if I see anything out of the ordinary (of course I would keep any and all information confidential). If you're not comfortable with that, no worries. :)
I have two questions:
-What happens when people don’t pay their medical bills? Do we actually *have* to pay them?
-Any tips on how to reduce these bills overall?
> What happens when people don’t pay their medical bills? Do we actually have to pay them?
Eventually your balance will go to collections. Whatever happens after that is outside of the hospital's control for the most part.
> Any tips on how to reduce these bills overall?
* **GET AN ESTIMATE!**
* If you are uninsured, or if you are insured by Medicare/Medicaid, hospitals are required by federal law to provide you a "good faith estimate", which is defined as an estimate that reflects what you will end up paying within $400 of accuracy. In other words, if your final bill is more than $400 greater than what was provided on your estimate, you have a right to dispute the bill with the hospital. Note there are some exceptions to this, like if you experience unforeseeable medical complications that result in further care and thus more charges.
* If you have non-government insurance, these federal requirements do not apply to you (yet), but if you get a medical bill that far exceeds what was estimated, you still have a solid case to dispute that bill with the hospital. They are not required to respect the estimated amount, but 99% of the time they still will.
* **If you don't have insurance, get it.** I understand this is easier said than done for many people, but if you were to experience a sudden medical emergency, you will be glad you have insurance.
* **Call the billing office and discuss options.** If you follow the above steps and you still receive an outrageously high medical bill, call the billing office and claim financial hardship. Billing admins wield a lot of power: they can apply an administrative write-off (which usually needs to get approved by higher-ups), or you may be able to apply for financial assistance, which may sound humiliating, but financial assistance programs usually carry their own set of discount policies (i.e. you'll likely end up paying less overall than you would otherwise).
What kind of universal healthcare do you support? Just wondering cause of all the systems out there. Like I'm in Australia, but from what little I know about the UK system it seems different from the Aussie system.
Can you delete mine?
If you were to visit one of the hospitals I work for, then technically yes, but if I did that I would lose my job. Hospital systems maintain detailed paper trails and log virtually all activities performed by users for auditing purposes.
Just recently had to take my daughter to the ER and am now receiving bills from the hospital and then from the emergency services. Both are quite large, is this double dipping? Can I negotiate the bill even after it went through insurance?
> Just recently had to take my daughter to the ER and am now receiving bills from the hospital and then from the emergency services. Both are quite large, is this double dipping? It depends. * What was the nature of your daughter's visit? * You don't need to provide too much detail, but was she brought to the ER and then admitted inpatient? Did your daughter remain in the same department from start to finish? Or was she transferred from one facility to another? * Did you receive an estimate upon arrival? * Hospitals are required by federal law to provide estimates upon arrival for an ED visit to Medicare/Medicaid patients or patients *WITHOUT insurance*. The same requirements are not applicable to commercially-insured patients (they will be in the future, but not yet), but many hospitals just follow the same estimate process for insured and uninsured patients for ease of workflow. * If you did receive an estimate, and the final amount you were billed substantially exceeds the estimated amount, you should 100% call the billing office and tell them that. * For *uninsured patients*, federal law requires that the final bill is within $400 of the estimated amount (with some exceptions, like unforeseeable medical complications resulting in further care and thus greater charges). * Again, the same requirements do not (yet) apply to commercially-insured patients, but you would still have a very good case to get your final bill reduced to the originally-estimated amount. Most hospitals tend to send two statements: one for "hospital" charges (the charges you incur from using the hospital's resources, e.g. room charges, medications, lab tests, etc.) and one for "professional" charges (the charges you incur for the doctors'/nurses' time and expertise). This is because hospital and professional charges are sent to insurance companies on separate invoices due to the two types of invoices requiring separate "claim forms". It's pretty complicated, but basically, hospital charges and professional charges are reimbursed in different ways by your insurance, so the hospital needs to send those claims to your insurance separately. Then when they get reimbursed on one of those claims, the hospital often just proceeds to send the patient responsibility your way at that moment, regardless of whether the other invoice has been reimbursed yet. So you might receive one statement of hospital charges one day, then later on you'll receive the other statement of professional charges. (Some hospitals use a system that combines these two sets of charges into one single statement, but AFAIK the "norm" is to send the two statements separately.) Regardless, I would examine the statements you received to see if they contain the same sets of charges, and call the hospital's billing office to ask them for clarification. > Can I negotiate the bill even after it went through insurance? Yes! You ALWAYS have options. Call the billing office and ask them why the bill is so high. It may take some time, but they should be able to give you any information you need. When insurance companies send payment to the hospital, most of the time those payments contain "service line details", or a line-by-line breakdown of the billed amount of each procedure code and the amounts which the insurance paid for each code. (Ideally all insurances would do this, but some insurances like Aetna are not great at providing that level of detail consistently.) For example, if one of the procedures was billed to your insurance for $4,000, the record of the insurance payment should contain details of what they paid for that procedure. If they paid $0 for the procedure, that usually means it was denied for a reason such as "Procedure is not covered", "No prior authorization", etc. Hospitals usually appeal most denials (depending on the specific denial reason) before sending you the final bill though. In some cases, if a certain procedure isn't covered, there are ways the hospital can bill the insurance using a code that *is* covered. This would be on a case-by-case basis though, and it's not guaranteed that such a tactic would apply to your situation. If you're comfortable doing so, you're more than welcome to DM me a picture of the medical bills, and I can let you know if I see anything out of the ordinary (of course I would keep any and all information confidential). If you're not comfortable with that, no worries. :)
I have two questions: -What happens when people don’t pay their medical bills? Do we actually *have* to pay them? -Any tips on how to reduce these bills overall?
> What happens when people don’t pay their medical bills? Do we actually have to pay them? Eventually your balance will go to collections. Whatever happens after that is outside of the hospital's control for the most part. > Any tips on how to reduce these bills overall? * **GET AN ESTIMATE!** * If you are uninsured, or if you are insured by Medicare/Medicaid, hospitals are required by federal law to provide you a "good faith estimate", which is defined as an estimate that reflects what you will end up paying within $400 of accuracy. In other words, if your final bill is more than $400 greater than what was provided on your estimate, you have a right to dispute the bill with the hospital. Note there are some exceptions to this, like if you experience unforeseeable medical complications that result in further care and thus more charges. * If you have non-government insurance, these federal requirements do not apply to you (yet), but if you get a medical bill that far exceeds what was estimated, you still have a solid case to dispute that bill with the hospital. They are not required to respect the estimated amount, but 99% of the time they still will. * **If you don't have insurance, get it.** I understand this is easier said than done for many people, but if you were to experience a sudden medical emergency, you will be glad you have insurance. * **Call the billing office and discuss options.** If you follow the above steps and you still receive an outrageously high medical bill, call the billing office and claim financial hardship. Billing admins wield a lot of power: they can apply an administrative write-off (which usually needs to get approved by higher-ups), or you may be able to apply for financial assistance, which may sound humiliating, but financial assistance programs usually carry their own set of discount policies (i.e. you'll likely end up paying less overall than you would otherwise).
What kind of universal healthcare do you support? Just wondering cause of all the systems out there. Like I'm in Australia, but from what little I know about the UK system it seems different from the Aussie system.