Insurance approvals. Billing departments. Administrative requirements. Layers of paperwork.
As a physician and practice owner, I see the administrative burden from both sides.
We need to talk about the cost of nealthcare bevond the exam room
I owe almost $400 in debt to a hospital, I genuinely don’t have the money. Should I make a payment plan or just let it go to collections?
My insurance initially denied a hospital claim and has now agreed to reprocess it. While I've been trying to sort that out, I got a collection notice for the hospital bill.
The insurer says to wait for the new claim result, but hospital billing told me the account is already with a collector and gave me their number. I haven't paid the collector because I still don't know what my share of the bill will be once insurance finishes reviewing the claim.
Who should I be talking to here? If insurance changes the amount I owe, does the hospital notify the collector, or am I supposed to send the updated paperwork myself?
I'm worried about being chased for the original bill. I also don't know if this has already shown up on my credit report.
Does anyone know how to get money up to pay off a couple of ER bills, I did the charity care for my surgery that was covered but the ER visit and radiology the other thing was separate entities and they don't count with the charity care I believe...
Hello, I live in GA and I had to go to lots of testings and biopsies throughout this year - all with the same hospital network. Now I have multiple outstanding bills and one of them is in final notice phase, that is, it will be sent to collection if I don’t pay.
Would be grateful if someobody can share their wisdom for my questions:
Where do I even begin? I got itemized bills and the EOB but still had no clue what to do next, since I have at least 5 different bills for more services than I can remember and that’s overwhelming.
I’m not good at negotiating but I simply can’t pay the full amount. I literally just finished paying of $3000 from LAST year in monthly installments.
I’m in the U.S. and have an EPO health insurance plan. My plan does not require referrals to see specialists.
I recently had an outpatient surgery and am now being billed almost $14,700 by the facility, even though I tried to verify everything before the procedure.
Before surgery, I contacted my insurance company directly. I gave them the exact CPT code for the procedure, the surgeon’s information, and the facility information. I specifically asked about coverage and whether a referral or prior authorization was required.
The insurance representative told me:
The procedure was covered.
The surgeon was in network.
The facility was in network.
No prior authorization was required.
I also separately contacted the facility’s office before the surgery, and they told me that based on my insurance benefits, no prior authorization was required.
My EPO plan also does not require a PCP referral to see a specialist.
After the surgery, something strange happened:
The surgeon’s claim was processed and approved, with nothing owed by me under my benefits.
The anesthesiologist’s claim was also processed and approved, with nothing owed by me.
But the facility claim was denied. The facility charged around $15,000 and is now billing me approximately $14,700. The denial on the facility claim shows code Z84 (denial due to missing referral).
What I don’t understand is why only the facility portion was denied when the surgeon and anesthesiologist for the same surgery were processed normally, especially since I verified the facility was in network and was told by both the insurer and the facility beforehand that no prior authorization was needed.
I’m trying to determine the best way to handle this.
Should I ask the facility’s billing department to submit a provider appeal/reconsideration or corrected claim first? Should I simultaneously file my own member appeal with the insurer? Should I request that the insurer reprocess the claim based on the pre-service information I was given?
I’m also planning to ask the facility to place the account on hold and not send it to collections while the insurance dispute is being resolved.
Has anyone dealt with something similar where an EPO plan approved the surgeon and anesthesia claims but denied only the hospital/facility claim?
Could this be a coding, place-of-service, referral, or claim-processing error?
Any advice on what I should specifically ask the insurer and facility billing department would be appreciated.
Last year, when I was insured, I got an ultrasound at the hospital. Was billed a copay for $80, paid it, great. A year later, I get a surprise bill for $600. Apparently they started billing my insurance two months after my visit, with no response from my insurance. In the bill I see 11 attempts, of three different medical codes, all ignored. Starting at $134, then $300, now $600. Finally, they're billing me.
My question is, how do I dispute this? I was insured. I was not made aware of my insurer's lack of response even one time in the whole year since I had treatment. Now due to their lack of response, it's my responsibility to pay?
Who do I contact first, what do I even say?
I had a stroke, barely get by on a government pension now I have a few ambulances bills … not very fair to
low income seniors
I work for a nonprofit that helps homeless women get back on their feet. We have a woman who was badly injured by her husband and she spent weeks in the hospital and has no insurance. We’re trying to get her on Medicaid but getting nowhere because she lost custody to the state because her husband is in jail and she was in the hospital. So unfair!
Now medical bills are rolling in. Does anyone have experience in getting medical bills waived? Can I negotiate on her behalf?
Any suggestions are appreciated!
Hello everyone. I was found unconscious outside my hotel room on the 17th of September and someone called the ambulance. I only woke up in the ER so I have no recollection of which ambulance took me to the hospital. I gave the hospital my insurance details the next daybut I don’t know what to do about the ambulance bill. I’m also absolutely terrified about what that ambulance bill might be. 😭