Healthcare billing

[iris lilies]

This is mostly a rant and I’m sure others will join me. I’m not going to expend my focus time and energy and understanding so if someone is going to explain it to me, you’re wasting your breath. But I do appreciate your effort!


So I’m now getting those financial reports that make no sense, The ones that America complains about. In the past year I had medical procedures like a colonoscopy. A mammogram. Standard blood tests.

I get reports that say “this is not a Bill” and say something like “your procedure was $9000. Medicare covers $2,300. You may owe $162.35” It’s ridiculous and it makes no sense to me. And then, the hospital where I have this stuff done has screwed up billing. I don’t remember what signaled they were billing me too much because how would I know? But something did tell me the bill was wrong. I called the hospital and they said oh yeah you’ve paid too much, we will issue a credit.

And then, my most recent blood test generated a bill from the lab. And I thought what the hell? Shouldn’t Medicare be paying for a standard blood lab? I want my gubmnt benefit dammit! So I called the lab and they said they did not have my insurance number, the doctor’s office had not passed it on. So that’s fine I gave it to them and they will likely be no charge for that.

But at the moment I’m not gonna spend my time figuring these bills out. My philosophy now is that I will just glance at them, file them away, and ignore anything that comes even if it says it’s a bill. I may pay attention to it a year down the road if it says something like “we are taking you to collections” Or something like that.


By the way, I also learned that mammograms are not free. We hear that Obamacare made so many things free, well not this. Here’s the difference —while a preventative mammogram is free, A diagnostic mammogram is not free.

[Yppej]

If you ever had a suspicious mammogram any mammogram after is considered diagnostic, ditto a colonoscopy. For this reason I do not plan to ever have another colonoscopy. The small benign polyps found last time would now cost me thousands.

My mother was in an accident and the other party was at fault. This was in June and the billing is still a mess. She refused to get a lawyer and now Medicare is putting a lien on her very small pain and suffering payment. She said it is such a common problem that Medicare has printed a pamphlet on how to deal with a lien which they sent her.

Meanwhile she called the new vaccination hotline and got nowhere.

I wish semi-senile Biden did not have staffers and had to navigate these types of things himself. I bet things would change then.

[oldhat]

Agreed, it's complete insane and very stress inducing. I really feel for people who have serious health issues and have to deal with this crazy system on a regular basis.

Even having "good" employer-provided health insurance doesn't insulate you from the madness. Case in point: The week before Thanksgiving I landed in the ER with what turned out to be a kidney stone. Long story short, I ended up having to have the stone surgically removed. A few weeks later the co-pay bills started rolling in. It was wonderfully mysterious--each time I opened one I didn't know if it was going to be for $5 or $500.

What mainly struck me about the whole episode was this: From the moment I walked into the ER I experienced nothing but kind, caring, state-of-the-art medical care. The hospital staff and nurses were fantastic, and my urologist is a great guy. I felt incredibly lucky to get this very painful problem treated so quickly and effectively, especially in the middle of a raging pandemic.

The mystery to me is how we can have a system that is so great when it comes to providing care and such an incoherent mess when it comes to how it is financed.

[Teacher Terry]

I always stay on top of the medical bills because sometimes they haven’t bothered to submit to insurance. I used to pay medical claims for a living before I went to college so don’t mind.

[rosarugosa]

If you ever had a suspicious mammogram any mammogram after is considered diagnostic, ditto a colonoscopy. For this reason I do not plan to ever have another colonoscopy. The small benign polyps found last time would now cost me thousands.

My mother was in an accident and the other party was at fault. This was in June and the billing is still a mess. She refused to get a lawyer and now Medicare is putting a lien on her very small pain and suffering payment. She said it is such a common problem that Medicare has printed a pamphlet on how to deal with a lien which they sent her.

Meanwhile she called the new vaccination hotline and got nowhere.

I wish semi-senile Biden did not have staffers and had to navigate these types of things himself. I bet things would change then.

Jeppy: Your experience is not universal. I once had a suspicious mammogram and my subsequent mammos. were still covered in full as preventative. I've also had polyps removed and subsequent colonoscopies were still covered in full.

[catherine]

Yeah, I stopped paying attention to my EOBs ages ago, unless there seemed to be something wrong. Those statements are incredibly confusing. All part of too many cooks in the kitchen.

[iris lilies]

And then there is the small office of my doctor. I’m not complaining about her because I really like my doctor, she is a direct care physician and I pay out of pocket to see her. Her office is on the tiny Main Street in Hermann.


I have been going to this doctor for exactly one year. Prior to that I didn’t see a physician for something like 10- 12 years. Anyway, within the 12 months I’ve been going to this doctor’s office they have been on three separate computerized patient systems. Things fall through the cracks. My doctor called to apologize for one screw up. I’m not mad or annoyed, this stuff happens. But mainly, my expectations are low.

I knew when she announced last spring that they were going to install a new computer system and run side-by-side systems because one had good charting functionality and the other had good everything else, that would be a cluster ****.And yes it was because within six months she announced an entirely new system.

[SteveinMN]

Yeah, I stopped paying attention to my EOBs ages ago, unless there seemed to be something wrong. Those statements are incredibly confusing. All part of too many cooks in the kitchen.

I used to feel bad that I, a college graduate with a degree somewhat adjacent to English, could not figure out exactly what an EOB was telling me. I don't believe they're designed to be understandable.

Now I just wait for the provider's office to bill me. If the bill looks ridiculous I'll investigate; otherwise it's a lot of my time for a very unclear outcome.

[jp1]

The EOB is how you are supposed to be able to tell if you’ve been over billed. If you ignore those than you are trusting the provider to have done things correctly.

[ApatheticNoMore]

I thought they were about the deductible, but on most PPOs (not just high deductible ones) you simply won't ever exceed the deductible unless you have quite serious health problems that year, so.