The past few days I have spent time on the phone with Larkin’s secondary insurance, my insurance and navigating bills from an MRI she had back in March. Our primary insurance company had paid most of the bill but there was about $200 left over. Our secondary declined payment and I was trying to figure out why. After some confusion, heated words on my part, several phone calls later resulted in my realizing that the hospital is not allowed to bill us for the remainder. For example, Larkin’s MRI anesthesiology cost $1530 and the contractual allowed amount they billed her insurance was $700 dollars. The set aside amount was $650 and that left a remainder of $176. The anesthesiology office then sent us a bill for the $176. They are not allowed to bill the customer that amount – but they did and they do. Most people pay it. Guess what – they are supposed to write that off. They have a contract with our commercial health insurance company and that is what they get. period. no more. no mas. nada. end of the road. stop. But they don’t stop. They bill and hope that you are unaware and will pay.
I opened up another bill from Carle. I could see where there was a charge to the secondary insurance but a $588 charge to us. I called their billing office to ensure that they had in fact billed both insurances. They had. So what is the $588 you ask? I asked too. Get this – are you ready – we were billed for waiting in Larkin’s hospital room after she was discharged. She was in the hospital in May for a week. We were discharged on a Tuesday morning. I dealt with Infectious Disease doctor, ENT, the Hospitalist and Carle Medical Supply was bringing us a deep suction machine to take home. Yeah – that was my morning. I had a baby who went in on a Tuesday evening, vomiting and dehydrated to her getting a CT scan on Saturday to diagnose a massive infection in her head that was clearly and quickly heading for her brain. IV antibiotics started and hopefully not having to slice her head open and clean out the infection – to the following Tuesday where she was perky and responding to drugs and I was exhausted. SORRY CARLE IF I DIDN’T NOTICE THE EVICTION NOTICE OF 11:00. Yeah – that is what the lady in billing said to me on the phone. “This is like a hotel and if you aren’t out by 11:00 then we pro-rate the amount and bill you. You were in the room after she was discharged and that is non-medical usage” UMMMMM OK. This is so NOT like a hotel. Hotels have indoor pools and mini bars. Tuesday morning I talked with all the players involved in her care, packed her bag, called Andy for a ride and waited for Carle Medical Supply. All of which took a short period of time. I signed her discharge papers that morning and within 10 minutes of getting her medical supplies, we left.
I called up to the Peds floor and spoke with the director. He knows us well. I really like him a lot and he is great at his job. Johnathon told me that if a family is discharged at say 10 in the morning and can’t get a ride until that evening, the hospital steps in and helps them out. THAT scenario I understand. THAT is waiting in a room for hours on end. I was packing up items from a week long stay, working with her health care providers and waiting for medical equipment. Not hanging out cause I love it. Gee let’s compare; my own bed, my dogs, my other child, my house, my shower and the thing I love most – the smell of my own house. Yeah I wanna hang out and pay $588. It aint the Four Seasons and I only want to rent the room not BUY it. I explained to the lady on the phone that we were in fact waiting for medical supplies. She said she would pass that along to “have someone investigate”. Really? I sign more paperwork then there are trees during a hospital stay. Are you going to challenge me cause you better pack a lunch and bring your family pictures – you are in for the long haul. I know this system. I know this hospital. I know these doctors. I know it because she has had 3 hospitalizations within the last 6 months that resulted in a stay for more then a week. This is the first time I have ever been billed for “hanging out”.
The next time you get a bill from a health care provider wanting you to pay what the insurance doesn’t or $588 for hanging out – question it. Call me nutty but me thinks the system just might be trying to creep in the back door and catch you off guard. Thank God I have eyes in the back of my head.
Good for you for staying on top of this and posting about what you learned. I wish I had been more proactive about the bills with my son’s heart surgery. I was just so busy being a mom and keeping up with all the medical stuff that I just paid bills as they came in. I found out later that I paid more than I should/could have.
When will they learn that they shouldn’t mess with you????
When I went through chemo my mother basically got schooled on this crap. Carle (and any other hospital for that matter) will bleed you dry if you let them. Fight the good fight!
I’m so frustrated with insurance companies right now. No matter how good your insurance is, there is always a way for them to screw you over. They want you to jump through hoops to cover what they should have just covered in the first place.