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Started By
Message
re: Surprise Dr.'s bill (They got me)
Posted on 3/6/25 at 3:47 pm to 0x15E
Posted on 3/6/25 at 3:47 pm to 0x15E
quote:
It’s not their job to explain your medical plan to you
Kewl, b/c you didn’t explain it, I’m not paying it, nor do I care if you report it to any credit agency as no one cares about unpaid minor medical bills. And if you don’t like that, I’ll just go to one of the other hundreds of doctors in my area.
2
Posted on 3/6/25 at 3:48 pm to TeddyPadillac
quote:
b/c you didn’t explain it, I’m not paying it, nor do I care if you report it to any credit agency as no one cares about unpaid minor medical bills. And if you don’t like that, I’ll just go to one of the other hundreds of doctors in my area.
doctor's offices/hospitals always negotiate, and they rarely call your bluff
Posted on 3/6/25 at 3:51 pm to Clyde Tipton
So, let me get this straight,
You are in a healthcare plan that requires all providers be in their network before they will pay?
You are in a healthcare plan that requires all providers be in their network before they will pay?
Posted on 3/6/25 at 3:58 pm to Spankum
quote:
So, let me get this straight,
You are in a healthcare plan that requires all providers be in their network before they will pay?
Most folks I work with (I take a range of commercial to Tricare and Medicaid/Medicare) if you’re not in network the client pays up front and then we provide a superbill for out of network reimbursement to the client.
Posted on 3/6/25 at 4:01 pm to Spankum
Thank y'all for the responses.
I've been making calls since I started this thread and it seems like the ball is rolling. They are now telling me that they in fact are in the network and that something looks odd about the coding of the bill. Wellness code was not listed first, and that can result in the insurance not covering it. I'm not really sure what that means, but when I got to the supervisor of the billing department, she seemed to actually give a damn and start looking into it. She told me not to pay it and that it would be resubmitted with the wellness code listed first.
My wife works for the State. We have some of the best insurance there is. There seems to be some discrepancy about the lab, not the doctors office, not being a "first choice provider" even though they are in the network. Again, I do not know what any of this means.
I've been making calls since I started this thread and it seems like the ball is rolling. They are now telling me that they in fact are in the network and that something looks odd about the coding of the bill. Wellness code was not listed first, and that can result in the insurance not covering it. I'm not really sure what that means, but when I got to the supervisor of the billing department, she seemed to actually give a damn and start looking into it. She told me not to pay it and that it would be resubmitted with the wellness code listed first.
quote:
So, let me get this straight,
You are in a healthcare plan that requires all providers be in their network before they will pay?
My wife works for the State. We have some of the best insurance there is. There seems to be some discrepancy about the lab, not the doctors office, not being a "first choice provider" even though they are in the network. Again, I do not know what any of this means.
Posted on 3/6/25 at 4:05 pm to Clyde Tipton
i just stopped paying medical bills. they just send you a couple notices and then i guess they write it off or something. haven't paid in a while. no issues.
Posted on 3/6/25 at 4:08 pm to Clyde Tipton
quote:
I've been making calls since I started this thread and it seems like the ball is rolling. They are now telling me that they in fact are in the network and that something looks odd about the coding of the bill. Wellness code was not listed first, and that can result in the insurance not covering it. I'm not really sure what that means, but when I got to the supervisor of the billing department, she seemed to actually give a damn and start looking into it. She told me not to pay it and that it would be resubmitted with the wellness code listed first.
Good. Sometimes it as simple as someone picked the wrong drop down in the system. I had issues with one of the insurances having my taxonomy code listed incorrectly on their end.
If something isn’t covered that you feel should be, always appeal it. I had to do this with my diagnostic mammogram and biopsy.
Posted on 3/6/25 at 4:17 pm to Clyde Tipton
quote:
They inform me that they changed networks when they moved, and I'm on the hook for the bill as the lab I was sent to was for my "convenience" and that I could have gone to any lab in my network if I didn't want a bill.
This is not your problem if you did not choose the lab to send samples to. You can tell them to keep the results and that you will get the tests repeated at a covered facility. They cannot ram charges down your throat after the fact.
I had something like this happen on a biopsy test. The doctors office called me and informed me my results were negative and that was it. A month later I got a bill for $3000 for some study results beyond the biopsy result. I asked my doctor about and he told me not to pay it and ignore it.
Posted on 3/6/25 at 4:19 pm to Sofaking2
quote:
hope I don’t ever feel that way.
I hope so for you too. But the odds are not in your favor
Posted on 3/6/25 at 4:24 pm to sigsauer
Trash it. If it’s under $500 it won’t show on credit.
Posted on 3/6/25 at 4:24 pm to Clyde Tipton
You would think the Dr office would let you know the billing situation that would give the Dr the best chance to be paid. They should give you a heads up if something isn't covered. It's BS like the ER being out of network in a named in network hospital. I would tell them I will pay them a dollar a month for their nonsense.
Posted on 3/6/25 at 4:26 pm to Clyde Tipton
Unless it’s a cash only transaction, no healthcare provider should be able to provide services to a patient unless they will accept that patient’s insurance, unless it’s an emergency and the out of network is the only available provider.
Posted on 3/6/25 at 4:27 pm to BluegrassBelle
quote:
My insurance (BCBS) stopped covering same day bloodwork last year.
That’s why I sober up for a couple of days between my annual checkup and getting blood drawn. You have to separate the doctor visit from the bloodwork. BCBS will figure out my hack eventually, but until then…
Posted on 3/6/25 at 4:38 pm to Jerrysworld
quote:
i just stopped paying medical bills. they just send you a couple notices and then i guess they write it off or something. haven't paid in a while. no issues.
Classy
Posted on 3/6/25 at 4:43 pm to Clyde Tipton
Some 15% of those working at the federal Center for Consumer Information and Insurance Oversight, or CCIIO, were fired two weeks ago, according to the agency's former deputy director in charge of operations, Jeff Grant.
Get ready for a lot more surprise billing.
Get ready for a lot more surprise billing.
Posted on 3/6/25 at 4:49 pm to 0x15E
I had mine done today at oschner. Looking at my plan, that particular oschner is not listed, but every other one is. Even the urgent care and the 65 plus oschners are listed. Just not this specific location.
I wonder if im going to be charged out of network for this.
Kind of sucks I would have to go to a complete different oschner if I wanted blood done instead of doing it at the one my in network doc works at.
I wonder if im going to be charged out of network for this.
Kind of sucks I would have to go to a complete different oschner if I wanted blood done instead of doing it at the one my in network doc works at.
Posted on 3/6/25 at 4:53 pm to 0x15E
quote:
It’s not their job to explain your medical plan to you
You have no idea what you are even taking about
Posted on 3/6/25 at 5:05 pm to Clyde Tipton
It's virtually impossible to collect a medical debt, if you didn't agree then its not a valid bill.... so use that how you will
Posted on 3/6/25 at 5:15 pm to BluegrassBelle
quote:I've never noticed this.
My insurance (BCBS) stopped covering same day bloodwork last year
Posted on 3/6/25 at 5:16 pm to Cleopatra
quote:
Look up the “no surprises act” that went into effect a couple of years ago & mention that to them. I’m sure they will make some adjustments after that :)
Likely not covered under the act. He went to his primary care and a lab. There is no “surprise” other than he thought it was in network and it wasn’t.
The act covers stuff like you going to an in network hospital and then getting billed by an out of network person that you might not have even known was going to perform some service (you see it with anesthesia a lot).
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