Need Advice About Medical Bills
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| Sat, 11-19-2005 - 8:03pm |
I'm hoping someone here can give me some advice on dealing with medical bills that we're receiving. It's a little bit of a long story, so I'll try to do the Reader's Digest version! :-)
Dh was laid off last February. Our insurance ran out at the end of Feb. and we purchased independent insurance beginning in March at a cost of almost $500/month for our family of 3 (they don't cover my anxiety meds so we pay out-of-pocket for those, but WalMart price-matches and gives us the AAA discount so that helps).
We've paid our premiums faithfully all this time, and never made a claim 'til ds had a dr. visit about 2 months ago. We paid our co-pay, and they handled the rest.
Last month, I went to the dr. for heart-related symptoms I've been having (palpitations, tachycardia). I figured it was stress-related with dh still not having a regular job but dh and my mom ganged up on me (LOL) and insisted I get checked out. I had all kinds of tests -- EKG, EEG, bloodwork, even a Holter Monitor overnight test.
Everything came back OK (yay!), but the bills are starting to roll in. My insurance company isn't paying them yet because they're trying to determine if this was a pre-existing condition (basically, they are assuming I lied on my application) and until they receive 3 yrs' worth of medical records from every doctor I've seen and all the pharmacies I've been to, they're not paying anything. The most ironic part is that they're trying to rule out a pre-existing condition that doesn't even exist NOW!!!
Obviously I don't want to have to start paying these bills -- my insurance should take care of them once they have proof that I didn't lie (that's so insulting, but apparently it happens a lot!). In the meantime, am I going to end up with big dings on my credit report??
My dh absolutely wrecked our credit about 8 years ago and since then I've busted my butt to repair it. My score is now 750 and his is 680-ish, and I don't want the scores to go down the tubes. We've kept them up even through his unemployment, and it would kill me to have things go to collections because the insurance company isn't getting with the program.
Any advice would be very much appreciated!!!!
Amy

Hi, Amy. First of all, congrats on good news that all is OK! Medical bills. I could write a novel. Several yrs ago, the ins. denied payment for procedure. Said it was pre-existing. DId everything. Certified letters. Numerous calls. Appeals process. Etc. No avail. Fast forward. WEnt to ER several months ago. Am getting bills--ER, Docs, Lab, x-rays, etc. SEnt certified letters. STill havent heard. Sooo
l) Send certified letters to all concerned. Why? So everyone is on same page---that they have the CORRECT bill, final amount, that they're sending bills to right place, have correct account #, etc. 2) Call main ins. number. Ask for billing/claims. Found out that claims and bills are two different depts. One reviews, one pays. 3) Set up payment plan with docs and ER. I finally hadto do this. WHen dealing with docs, ask for their billing person. Not the secy or medical assistant. THis helped. 4)KNow if you have met the deductible. Call HR if you need help. A cautionary tone: I, too, had my "own" insurance at one time. Very expensive. DIdnt pay a thing. But from what others have shared here, deal with them directly and start a payment plan. HOpe it helps. Whiz.
Hi Whiz:
Thanks for sharing your experience. What a nightmare for you!!
So are you saying that your own insurance literally paid *nothing*?? How long did you have that insurance? And can I ask what company it was? It will kill me if we've been paying $500 a month for nothing!!
Amy
I have a nightmare story about insurance as well. Ten years ago, I had my first son. We had ins through dh's work. I went in to have the baby, had complications and ended up having a c-section. We contacted the ins just like they instructed and they informed us that we could stay up to three days to recover. So we did.
The next month or so the bills started arriving. Apparently Dr's I had never even met had done some kind of medical procedure for me. One charge was from a dr (who was with the hospital)who came into my room after the baby was born to tell me different birth control options...I was just listening and thinking nothing of it. Well, they labled it as a consult and my ins didn't cover that. The consult fee was $500. I also learned that my ins didn't cover the stay of the baby for the three days, only me. We tried so hard to get some of the charges taken off our bill (like the "consult") but to no avail. We finally realized our ins wasn't going to pay anything further and the end result of the bill was almost $13,000.
We tried calling the hospital to set up a payment plan because there was no way to pay that huge amount all at once. They wouldn't agree to anything, they wanted the full bill paid. They sent it to a collection agency, we tried to set up payments with them, they also denied it. We ended up going to court (how embarassing) and the judge was basically thinking what we were all along...why couldn't these people make payments? So, he ordered that we be allowed to make payments. It was too late for our credit though. We had to write an explanation letter twice to two different lenders about why that mark was on our credit report. I'll never forget that experience and the hell that we went through. We always joke with our oldest that he was almost the price of a new car...but oh so worth it! LOL!
Holy smokes!!!! I'm so sorry you had to go through all that!! We had an 80/20 when ds was born and ended up with such high bills (complications after) that they got sent to collections 'til we got them to agree to payments, too. But our credit was on a downhill road by then. That's why I don't want that to happen this time!
It never fails to amaze me what a mess healthcare in this country is. We're the most powerful nation in the world, and yet we don't have decent, affordable healthcare. It's absolutely ridiculous!!
Amy
Thanks for sharing your story! And I hope your son had a complete, uncomplicated recovery!
If things continue like this I will definitely look into finding some kind of intermediary as you suggested. So far the ins. co. keeps telling me "We haven't denied anything, we're just waiting to confirm that you didn't have a pre-existing condition." And in the meantime, the doctors and labs are very impatient for their money!!!
Amy
I can't do anything with the doctors or the labs 'til my insurance decides that my condition wasn't preexisting. Hopefully that will be soon!!
And for us, a health savings account isn't an option since my dh's current job is only temporary, as is mine. Here's hoping Santa will bring dh a new, permanent job!!!
Amy