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Old 02-01-2012, 02:23 PM   #1
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Just need to vent

And thought the mamas here might understand. I got a call today from a collections agency. Well she didn't start off saying she was from collections but that is who she is. Back in Sept Kearnan had a growth hormone stim test done at Cook's Children's Hospital. The patient portion of this was supposed to be $280.68, our insurance was supposed to pay close to $1,000. Kearnan is also covered by Medicaid who was supposed to pick up the $280.68. Well somehow they magically doubled how much the test cost despite the fact that we were at the hospital under an hour. I did not know any of this until earlier this month when I got a bill (why did they wait until January to send me a bill for services provided in September?). I assumed the bill was directly from Cook's billing department right? The bill was for a shocking $756.63! I called them up and reminded them that medicaid was supposed to be paying for the other portion of the bill and the woman on the line said she would send it on to them and call me back in a couple of days. Well it has been almost a month so I figured it was taken care of (yeah that would be far too easy ). So I got a call today demanding I set up a payment plan to pay back this ridiculously inflated sum, no explanation as to why it has gone to a collection group vs being handled by the hospital months ago when it wasn't originally paid by the insurances. There is also no explanation as to why the sum is so much higher than I was originally told it would be or why they doubled the amount they charged my insurance for the procedure in the first place (more than likely the reason the patient portion is so high). I told her I would speak to medicaid myself and get back to her. Well it turns out that September is one of the months he wasn't covered by medicaid. Medicaid will cover retroactively up to two months and he is never out of medicaid for more than one month (it has to do with his SSI benefits because sometimes dh makes too much money for him to qualify). It is just that in the past when he slipped in and out of medicaid coverage whenever a bill was sent to them they would refuse it and then when it was sent to them again when his medicaid became reactive they would pay it, now you have to file for retroactive coverage and get it all fixed. There is also something about a window of opportunity to do this and we may be outside the window because Cook's waited so long to contact me, in which case I could wind up responsible for the full bill simply because they were stupid. Unfortunately Medicaid decided to "go green" and went paperless last year so we now have a Medicaid card vs the old letters they used to mail out once a month that confirmed your medicaid status so I never know from month to month if his medicaid is active. It never mattered before with the way retroactive billing has always been handled.

Sorry about the novel. I just needed to type it all out to some one who might get it. I don't know where this leaves me for his monthly meds. They cost us $200 a month without medicaid. Do I have to try for retroactive coverage several months a year when SSI screws up (periodically they just mess up even though we actually qualify). UGH!!!!

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Old 02-01-2012, 05:47 PM   #2
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Re: Just need to vent

Hugs!!! That sounds incredibly frustrating
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Old 02-02-2012, 08:44 AM   #3
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Re: Just need to vent

Can you call the hospital and tell them all this? We have been able to talk to the billing department before, fill out a paper stating our income and then they just write it off.
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Old 02-02-2012, 09:26 AM   #4
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Originally Posted by Twinvillageiowa View Post
Can you call the hospital and tell them all this? We have been able to talk to the billing department before, fill out a paper stating our income and then they just write it off.
I have never heard of that but it is worth a try. Thank you. I am still waiting for a call back from the supervisor at DHHS so I am still hoping that we can get the medicaid thing sorted out but if not this would be really helpful. Honestly at the initial patient out of pocket it would have been hard but we could have figured it out but this new number is just too much.
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Old 02-02-2012, 09:39 AM   #5
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Re: Just need to vent

I've had hospitals do this before too. I hope that you get it settled soon.

Our insurance is ok, but mercy we end up with alot of bills still. Last year we did some blood tests for DS, and we got a bill for $800-something AFTER insurance. Then even though we were paying monthly they sent it to collections AFTER it was paid off!! I had to call the collections and the hospital like for hours and hours one day to get it all settled. I had to get the hospital to acknowledge that I'd paid it off, then make them contact the collections to admit their mistake...which took them 3 days to do. Then we got another bill for the same blood tests 9 months after the tests and our paying off the bills. I swear it is like they enjoy gorging people!

Now last month our insurance denied ALL claims due to "not receiving a response to the questionaire the month before". Ok WHAT questionaire?! I had to call them and they were like oh ya we just need to know if you have any other insurance. I am shocked! They denied all claims FOR THAT?! So I had bills coming in from everything, and I had to call and discuss the problem with each clinic, dr., and hospital to explain that the bills would be reprocessed by insurance. Now I'm dealing with the bills coming still, while insurance is dragging their feet reprocessing them all. I just know I'm going to get threatening bills soon, cuz I'm not paying thousands for 1 month of maternity services and chiropractic services just due to an idiot question that I never got in the mail from the insurance.

Sorry I feel your pain, and just had to commiserate.
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Old 02-07-2012, 11:16 PM   #6
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Re: Just need to vent

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Originally Posted by Jewelgurl137 View Post
I've had hospitals do this before too. I hope that you get it settled soon.

Our insurance is ok, but mercy we end up with alot of bills still. Last year we did some blood tests for DS, and we got a bill for $800-something AFTER insurance. Then even though we were paying monthly they sent it to collections AFTER it was paid off!! I had to call the collections and the hospital like for hours and hours one day to get it all settled. I had to get the hospital to acknowledge that I'd paid it off, then make them contact the collections to admit their mistake...which took them 3 days to do. Then we got another bill for the same blood tests 9 months after the tests and our paying off the bills. I swear it is like they enjoy gorging people!

Now last month our insurance denied ALL claims due to "not receiving a response to the questionaire the month before". Ok WHAT questionaire?! I had to call them and they were like oh ya we just need to know if you have any other insurance. I am shocked! They denied all claims FOR THAT?! So I had bills coming in from everything, and I had to call and discuss the problem with each clinic, dr., and hospital to explain that the bills would be reprocessed by insurance. Now I'm dealing with the bills coming still, while insurance is dragging their feet reprocessing them all. I just know I'm going to get threatening bills soon, cuz I'm not paying thousands for 1 month of maternity services and chiropractic services just due to an idiot question that I never got in the mail from the insurance.

Sorry I feel your pain, and just had to commiserate.

What is it about insurance companies and not wanting to pay? My mother brought up a good point that I need to check with my primary insurance company to be certain that this is even the correct adjusted amount I am supposed to owe. It is all very frustrating. It just doesn't make sense for them to quote me such a far different amount and I think I will check on it online even though medicaid will be covering the other portion (it isn't fair for medicaid to foot an inflated bill either).

Well after waiting and waiting and waiting to receive a follow up call I spent this afternoon making phone calls to pretty much every number you can imagine for DHHS and medicaid. Apparently no one knows who I am supposed to call with this question but finally I found some one with the answer I needed. She will be sending me the paper work I need in the mail and the bill should, in theory anyway, be settled soon. So fingers crossed.
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