I got a procedure done at a surgery center. They mailed me my bill, along with another patient’s bill. Should I report them for sharing someone else’s medical info with a stranger, or should I just kindly let the facility know instead? I’m sure I have more bills coming, and if they are that careless, I’m worried they’ll end up sending mine to another random person.
I’ve been dealing with an emergency ambulance bill for almost 2 years now and honestly I finally understand why people say the U.S. healthcare system is broken.
Back in 2024, police called an ambulance for me during an emergency situation in California. I had zero ability to choose the provider. The ride itself was maybe 10-15 minutes.
AMR billed me $4,220.
At first, Cigna processed it as out-of-network and only paid around $215, leaving me with a $4,004 balance.
I kept calling both sides because this made no sense to me. It was an emergency ambulance transport. Eventually Cigna agreed and said this should be treated as in-network emergency services, and estimated my responsibility should only be around $734.
But then things got weird.
AMR kept telling me they were “working hard” with Cigna on my behalf. Then once Cigna actually agreed to reprocess the claim, I was told AMR refused the in-network arrangement because they didn’t accept the payment amount.
Meanwhile AMR repeatedly pressured me to accept a payment plan.
They kept telling me:
The tone was always very polite and soft, but looking back, I honestly felt pressured and threatened into accepting the debt before the insurance dispute was even resolved.
The craziest part:
my AMR statement literally says:
“AB716 - Balance Billing - $0.00”
Which means they clearly know California has protections related to emergency ambulance balance billing.
I finally filed a complaint with California DMHC today.
Honestly, if I didn’t have the time, English ability, and energy to spend hours researching laws, calling insurance, calling AMR, and filing complaints, I probably would’ve just paid out of fear.
I can’t stop thinking about how many elderly people or vulnerable patients get pressured into paying bills they may not even legally owe.
I had an exploratory consultation with an orthodontics clinic where facial photos, a CEPH and a dental intraoral scan (not CBCT) were taken of my teeth. I paid $100 for this. I was not satisfied with the treatment plan offered as it did not address my needs and so proceeded to explore out if state options. One dental clinic requires me to share the intraoral digital scan taken so I reached out to the previous orthodontist clinic to get a copy for myself. They were reluctant to share this and finally responds with email asking my for an "admin fee" of $270 before they would share my scan. Is this legal? How can they charge so high for a patient release information? We have had a back-and-forth email exchange which does not seem to be going anywhere. How do I sort this out?
Note that during their consultation I never even got to see the orthodontist. The treatment coordinator took my pics and sent to the orthodontist who gave feedback and they shared the feedback with me. Even when I had questions and required to speak to him for a review this was not granted.
Hi all! Recently gave birth to my first baby 3 weeks ago. Have had United Health Care throughout my pregnancy as it is through my employer. Been on this plan since October of 2025. Recently got an online bill from my dr’s office charging me the whole 9k for provider services for the delivery. For context my deductible is only 1k (which was already met) and my out of pocket max is 4.5k (3,300 was left to meet)
When checking the status of the claim on my UHC app, i’m seeing a note that says: “Your policy was not active for the entire period covered by the global maternity code billed. We asked your provider to send us an itemized claim for the services received after the coverage effective date. (CES341)”
I’m so confused as when I research reasons for this denial i’m only coming up with people who switched insurances during their pregnancy which isn’t my case. It’s the same insurance company, policy, and ID number. I was expecting to pay a couple of grand but not the whole thing being denied outright.
Anybody else experience something similar? Also any tips or advice would be greatly appreciated! TYIA
I had surgery on my foot in December. Insurance covered all the payments except a $40K charge for the hospital bill. Submitted everything they asked for and waited patiently. Nothing happened. I kept getting emails and calls about the $40k charge. Aetna claims they were missing a form which we submitted. The agent asked me the questions over the phone and was able to submit. The form was trying to gauge if a workplace or other insurance provider should be liable. Anyway since then my charge has been stuck in pending. One rep for Aetna said they had everything they needed and it should be a few weeks but then a few weeks fly by and now it's been months. Calls to Aetna just reveal that the status is pending and reps can't do anything. Another requested the reference number so they could resubmit which I provided but nothing. We've had this escalated by everyone we speak to and this just feels like I'm being kicked down the road. I'm worried this could affect my credit. Advice on how to handle would be appreciated.
I don’t know, maybe I’m just frustrated, but I really don’t get how this system became normal.
Insurance costs hundreds a month, and you still pay thousands out of pocket before it really starts helping.
And even after that, there are still co-pays, denied claims, surprise charges, and out-of-network problems.
Maybe I’m just tired of trying to figure all this stuff out, but at this point it feels less like healthcare and more like disaster protection.
Hoping this post meets subreddit rules.
As a patient advocate, my top goal is to achieve is help people navigate through the insurance landscape and get reimbursed at higher rates for out of network therapists and other behavioral health providers. 🙏
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Hi community! 👋
I am currently researching behavioral health barriers in regards to insurance companies and how they authorize benefits.
I am hoping to speak with anyone who has experience in behavioral health utilization management (think single case agreement, gap exception, etc.).
My goal is simply to better understand how these processes work internally and where patients/providers commonly get stuck, so I can support people more effectively.
If this sounds like you or someone you know, feel free to DM me and we'll take it from there.
If medical bills once they go to collections cannot be reported to my credit agency until a year after they’ve been sent to collections why wouldn’t I just not pay my medical bills and negotiate with a collections agency once they get there for pennies on the dollar and pay them?
I have been trying to negotiate a couple of medical bills which were emergencies with my son and have not made much progress with the providers. After doing some research, I found the above and I’m wondering what the downside of waiting would be?
My son had an emergency situation last year in May 2025 where he had to get a ground ambulance ride to the children's hospital in GR. As far as I knew, everything had been covered by insurance as expected. Fast forward to last month - I received a bill for almost $1k from the ambulance company that the 911 dispatcher sent. I made calls - they said the insurance company didn't pay enough, that they were 'out of network' and I owe the balance. My insurance EOB for this claim shows they paid a partial payment ($579 of a $1,550 bill) and they show no charges denied. WTH. So I can't appeal if there was no denial?? They obviously denied to pay a huge chunk of change - how can they do that? And my research is telling me that ground ambulance rides are not included in Michigan surprise billing protections?! Am I just f*cked? I filed a grievance with my insurance and that went nowhere. Am I missing something? I can't afford to lose $1k rn with these gas prices. Any insight is much appreciated.
Hi All,
I've had wrist pain for a few months and I suspected it was De Quervain's Tenosynovitis. Went to an ortho to get it diagnosed and get a cortisone shot to reduce inflammation. They did a few X-rays of my hand, looked at it to determine that there was no fracture and then gave me the cortisone shot. I was a new patient in this clinic and was maybe there for an hour total. My insurance was billed $2.5K total (see images). Almost $1K for X-rays and another $1.5K for the consultation and injection. I've had to pay ~$620 of that out-of-pocket. This seems a bit excessive so I wanted to check if this is normal or perhaps I got billed excessively and maybe I should dispute? Looking for any insight or guidance. Thanks!
I got diagnosed with diverticulitis - it was done via a CT scan by a doctor. He then scheduled me for a colonoscopy but a week before my insurance reached out stating that while the doctor is in network, the procedure at his office is not (weird right?)
So they recommend I go to another hospital which is close to me. I had to first set an appt with doctor and he reviewed the scans and set up the appt.
The code is not considered preventive care but diagnosis - I don't quite understand this as I was already diagnosed after CT scan, he wanted to check for polyps which there were none. Now I'm being charged $3700 as I haven't met my deductible for this. Does this sound right?
Hospital said best they can do is 20%. It's about to go to collections and I feel like it may be better off and I negotiate with them since by law this can't be reported to credit bureau.
Any thoughts?
Looking for some advice as this will be my first big bill.
I have insurance. However, I only ever go to the doctor for preventative stuff like physicals. I am 48 and my doc suggested a colonoscopy. This is 100% covered UNLESS they find something. Well, they found a less than 5mm polyp that they removed and sent for biopsy.
According to the clinic this now takes the procedure from fully covered to applying to my ded, which is a high ded policy due to my overall health. My ded is 5k and this bill is forecasted to be 3k.
When I receive the bill what are the best steps to take? Do I just call and tell them I cannot afford it and try to see what they come back with? What information do they require in order to do this? Bank statements?
Nearly fifteen months ago I visited several doctors (same medical group, major provider in NY/ NJ) and was told by their offices that their services would be covered by my insurance but after these urgent visits it turned out they were not. It seems they misunderstood/ didn’t bother to verify my exact policy despite me giving them my insurance policy/ card info. I made many, many, attempts to resolve with the provider and after initially being told that it would be sorted out the lines went dead.
Fast forward over a year and the bills have gone to collection. I’ve spoken with the collection agency already and have been offered a 25% discount (I didn’t mention the billing issues/ disputed, only conveyed that I’m unemployed, which is accurate).
Prior to paying, I’ve asked for something documenting that the debt would be considered resolved if the negotiated amount were paid, and that they would not report to any credit agencies. They’ve refused to provide any kind of documentation before payment and won’t speak to credit agency reporting.
I’m considering emailing vs calling again (I’m a lot better negotiating in writing) and while I’m at it trying to get a discount larger than 25% given the circumstances. The full debt is around $1500, providers are in NY state, and I lived in NY state at the time of service (now in PA). Any suggestions on language to use/ points to make/ records to request?
My main concern is avoiding a significant hit to my credit, though I’ve been told by a few parties (including by the original provider “off the record”) that medical debts like this are NOT reported by either the provider or collection agency. Is this accurate? It’s now been well over a year as mentioned so I am quite concerned.
Sorry for the long winded post. I’m going to post on other subs so I’ve included all pertinent details. Thank you!
TlDR: Went to ER for cat scratch at night and got a tdap shot. Coded as HC 99283 emergency visit level 3 for 1953 USD and charged 675.98 USD for the tdap.
Backstory: Sorry if i have weird formatting or gramme. My cats got into a big fight and I broke it up. Ended up getting scratched pretty and bit pretty deep. At the time, i thought i was okay, fast forward a couple hours into the night, my hand swelled up. I had no fever or anything out of the ordinary and to be honest i wouldve been fine if i didnt go but my family wanted me to go. I go to the er because its the only thing open at night and wait. The doctor sees me and ask a couple of questions and looks at it for like 5 seconds and prescribes antibiotics and to just keep it wrapped up and clean. He also offers me a tdap shot that is optional, doesnt really tell me the cost. Afterward I go home.
I get the bill a month later and I was coded as HC 99283 emergency visit level 3 for 1953.00 USD and 675.98 USD all for a cat scratch. My MyChart says diagnosis cat scratch, no significant medical past, no other injuries , no fevers no chills, no vomiting nausea, no weakness no tingling.
I know er rooms cost a lot and i probably shouldnt have gotten the shot at the time but i didnt expect it to be that high. I was just wondering if it was coded correctly and if theres anything i could do to lower it or dispute.
I had a consultation with a pulmonologist. They took my weight, blood pressure, temperature, and the doctor spoke with me for 15 minutes. They ran my insurance, and insurance refused to pay.
I called their billing department and asked if they could reduce the bill to something more reasonable. The lady just kept telling me that there was nothing she could do outside of a payment plan. I explained that I could have just paid out of pocket and that we could have avoided insurance if they had told me they were out of network, but she kept telling me that if you have insurance, self-pay is never an option.
Should I just let the bill go to collections and pay a reduced rate at that point? I explained that I don't have $461 to pay them and that I don't see any other option. I offered to pay them $150 for the appointment if they would change the bill amount, but she said that it was "not possible" to do.
Should I just let the bill go to collections in a few months before trying to renegotiate? My understanding is that medical debt is bought for between 1% to 10% on the dollar. Also, since the debt is under $500, does that mean that it won't go on my credit report?
I'm just trying to figure out the most strategic way to handle this bill.
Hi my boyfriend went to the er within his network was quoted 350 for foreign object removal from his ear he did not pay there and now is being quoted almost 2,000 from his insurance. Hospital says there's no bill when he called. How is there no bill from the hospital yet insurance is telling him to pay almost 2,000?
My outpatient doctor referred me for occupational therapy for tendinitis. They billed more than $1,300 for the 45-minute initial evaluation and treatment
It looks like they billed “hospital services” instead of outpatient.
Can I fight this? It feels absurd
I'm trying to figure this one out. My wife took our daughter in for her yearly check up with her PCP last year. Just a routine visit, no issues with my daughter. In addition, my wife did have a school form she had prefilled for a sports clearance and all the doctor needed to do was sign. No physical exam was performed. Imagine my surprise to receive a $508 bill a few months later. We called the doctor's office and they said they were working with insurance. It seems at some point some of it must have gotten covered as it was reduced to $298, but still, I don't feel I owe anything other than our $30 copay. We have a PPO plan and this doctor is in network.
Can someone help make sense of why our insurance is denying the claims from the doctors office? Are they not coding correctly or are they double billing? It seems we were charged for an office visit (consultation 99408?), a second office visit (99394), but the other items I feel should have been a part of the routine yearly check up?
I’m honestly shocked how random pricing in medicine seems sometimes.
I had no idea this was even a thing, but a friend recently told me hospitals will sometimes reduce bills if you negotiate or ask for an itemized statement.
Now I’m wondering how common this actually is because most people I know just panic and pay whatever amount shows up.
Has anyone here successfully gotten a medical bill reduced? What worked for you?
