Hospital Debt Advice

[dreamingat30fps]

So I figured I would ask the OT since you guys are well known across the lands for your stellar advice.

Anyways had to get an MRI done a few months ago. Called some independant place where I usually go they said they dont take my insurance so would cost like $800. Ok fine. I then tried the local hospital down the street from my house and they said they do take my insurance but would still be like $800 out of pocket. Ok I have a high deductible so makes sense but at least here the $800 would go towards my deductible.

Schedule the test and they make me pay the $800 right there before they do anything. Fast forward several weeks later I get a bill from them for like $150. Supposedly for the doctors fees something or the other. Ooook... I set it aside and honestly forgot about it. Then I get another bill for $1,200!!! So I call them up and the lady on the phone was extremely rude. Basically she doesn't know anything other than insurance didn't pay enough and I owe them another $1,200 and tough shit.

Now the $150 I would have paid just to get them off my back even if I don't believe I owe it. However not $1200. I mean like I said I have high deductible so I figured I was paying full out of pocket for it like at the other facility. So how their estimate was off by more than double I don't know, but I don't think that's on me.

Fast forward to now and I got a letter from some collection agency for the $150 I had forgotten about. They only sent one bill and then I got the collection letter. I do not want to pay them the $1200 mainly because they are lying fucks. I have not received a collection letter for the $1200 but I can only imagine its just a matter of time so not sure if I should even bother with the $150.

My credit is already meh mainly because I use a credit card for all my business purchases so it's usually always maxed out even though it gets paid in full each month. Still shows high credit utilization. Apart from the credit card I really don't use credit. I have no plans on moving from my home, my cars are paid off and I buy them cash.

What would you do?

[3rdcoast228i]

I'm not experienced with these things but... If you can't get out if paying totally, I've been told by others, alot of times you can call the doc and "negotiate" the price down quite a bit.

[EnVe46]

I sell health insurance so maybe I can help... Have you got an EOB or Explanation of Benefits from your insurance company? Even if you have a high deductible, the bill still needs to be sent to your insurance company so they can apply their negotiated rate for being within the hospitals network. This should reduce that bill quite a bit. Also, $800 is not enough for an MRI these days, so whatever figure they're giving you upfront is a bonus to them. A lot of Drs and hospitals are charging fees upfront due to majority of plan reimbursing on such a low basis. To prevent that form happening, ensure that ALL bills, even non covered expenses, first go to your insurance company. Not only for repricing but so they can be applied to your deductible. If they aren't sent to them first and you pay it, they have no record of you paying anything towards your out of pocket.

[nyalpine90]

medical debt doesn't effect your credit.
I would contact the insurance and find out what was paid to hospital and what you are responsible for.

[dreamingat30fps]

Originally Posted by EnVe46

I sell health insurance so maybe I can help... Have you got an EOB or Explanation of Benefits from your insurance company? Even if you have a high deductible, the bill still needs to be sent to your insurance company so they can apply their negotiated rate for being within the hospitals network. This should reduce that bill quite a bit. Also, $800 is not enough for an MRI these days, so whatever figure they're giving you upfront is a bonus to them. A lot of Drs and hospitals are charging fees upfront due to majority of plan reimbursing on such a low basis. To prevent that form happening, ensure that ALL bills, even non covered expenses, first go to your insurance company. Not only for repricing but so they can be applied to your deductible. If they aren't sent to them first and you pay it, they have no record of you paying anything towards your out of pocket.

Yes it went through insurance supposedly I got $5k discount and I owe like $2000 so the $1200 bill I guess its counting the $800 I paid on site. I just went back and looked at insurance. It was MRI and EKG it seems $7k!!!! No wonder our healthcare system is so fucked up.

I wouldn't have an issue had they told me it was $2k to start with... honestly probably wouldn't have done the test, at least not there. I mean they know what it costs to do the test, they should know my deductible since they have my insurance info. So when they told me I had to pay $800 I knew that wasn't a copay so it had to be because of my deductible. Plus the other lab I had talk to quoted me about the same and they didn't take my insurance at all so could of done it there for the $800 and been done.

[gallian93]

Originally Posted by nyalpine90

medical debt doesn't effect your credit.
I would contact the insurance and find out what was paid to hospital and what you are responsible for.

It doesn't but given enough time, they will send it to collection and then it will mess up your credit, alot... I know because in my college days of extreme poverty i had a medical debt chased me until i got my first real job and paid it off...

[EALm4]

I have some insight on hospital's financial operations and may be able to help....Did you do this as standard outpatient procedure via a Dr's office at the hospital? Or was this performed as an ER service? They each have different outcomes as far as debt and collections.

How long was the period from you received the initial $150 bill to the point where you received a collections letter? How has the collections agency been treating you and contacting you so far? Have they called you? If so, what times of the day?

Debt collection agencies are pieces of shit. The Fair Debt Collection Practices Act provides you the consumer with some relief of dealing with their bullshit scare tactics and what not.

[dreamingat30fps]

Originally Posted by EALm4

I have some insight on hospital's financial operations and may be able to help....Did you do this as standard outpatient procedure via a Dr's office at the hospital? Or was this performed as an ER service? They each have different outcomes as far as debt and collections.

How long was the period from you received the initial $150 bill to the point where you received a collections letter? How has the collections agency been treating you and contacting you so far? Have they called you? If so, what times of the day?

Debt collection agencies are pieces of shit. The Fair Debt Collection Practices Act provides you the consumer with some relief of dealing with their bullshit scare tactics and what not.

I just went with Dr prescription to hospital and had it done there outpatient I believe.

The collection letter says date of service 7/25/17 which seems about right. I probably got the $150 bill a month or less after that then didn't get anything else until last week I got the collection letter. I have not received a collection letter for the $1200. In fact the last letter I got was that they somehow enrolled me in some payment plan thing or something, but I have not paid that so I'm guessing it may just go to the same collection people as the $150?

They have not called me, at least they haven't left message, I don't answer numbers I don't know. I called them today and tried to explain to the lady what I said here and although she was no nasty, she just didn't care. She was like ok well I'll make a note of it on your account that you do not want to pay it. I could tell she really didn't give a shit so I was just like ok sounds good.

Like I said I don't have an issue paying the $150 (even though I still think they are in the wrong) but not the $1200.

[Maynard]

I think once it goes to true collection agency you are SOL for negotiating - take the payment plan option if you can and negotiate a really low monthly payment. If it is still coming from the actual medical practice, then definitely try to ensure the bill is correct and they can't discount it any (I'm assuming you don't really qualify for sliding scale by being poor, but if so that's another option).

[RABAUKE]

Originally Posted by dreamingat30fps

So I figured I would ask the OT since you guys are well known across the lands for your stellar advice.

Anyways had to get an MRI done a few months ago. Called some independant place where I usually go they said they dont take my insurance so would cost like $800. Ok fine. I then tried the local hospital down the street from my house and they said they do take my insurance but would still be like $800 out of pocket. Ok I have a high deductible so makes sense but at least here the $800 would go towards my deductible.

Schedule the test and they make me pay the $800 right there before they do anything. Fast forward several weeks later I get a bill from them for like $150. Supposedly for the doctors fees something or the other. Ooook... I set it aside and honestly forgot about it. Then I get another bill for $1,200!!! So I call them up and the lady on the phone was extremely rude. Basically she doesn't know anything other than insurance didn't pay enough and I owe them another $1,200 and tough shit.

Now the $150 I would have paid just to get them off my back even if I don't believe I owe it. However not $1200. I mean like I said I have high deductible so I figured I was paying full out of pocket for it like at the other facility. So how their estimate was off by more than double I don't know, but I don't think that's on me.

Fast forward to now and I got a letter from some collection agency for the $150 I had forgotten about. They only sent one bill and then I got the collection letter. I do not want to pay them the $1200 mainly because they are lying fucks. I have not received a collection letter for the $1200 but I can only imagine its just a matter of time so not sure if I should even bother with the $150.

My credit is already meh mainly because I use a credit card for all my business purchases so it's usually always maxed out even though it gets paid in full each month. Still shows high credit utilization. Apart from the credit card I really don't use credit. I have no plans on moving from my home, my cars are paid off and I buy them cash.

What would you do?

Fuck. Never left a hospital with a bill except for the TV in my room. You guys pay way less in taxes then we do north of the boarder but hospital bills can add up. Hopefully they don't find anything serious, because that's where the big money could start. Peace, hope you're all good.

[EALm4]

Originally Posted by dreamingat30fps

I just went with Dr prescription to hospital and had it done there outpatient I believe.

The collection letter says date of service 7/25/17 which seems about right. I probably got the $150 bill a month or less after that then didn't get anything else until last week I got the collection letter. I have not received a collection letter for the $1200. In fact the last letter I got was that they somehow enrolled me in some payment plan thing or something, but I have not paid that so I'm guessing it may just go to the same collection people as the $150?

They have not called me, at least they haven't left message, I don't answer numbers I don't know. I called them today and tried to explain to the lady what I said here and although she was no nasty, she just didn't care. She was like ok well I'll make a note of it on your account that you do not want to pay it. I could tell she really didn't give a shit so I was just like ok sounds good.

Like I said I don't have an issue paying the $150 (even though I still think they are in the wrong) but not the $1200.

Got it. Ok where the problem started was that it was a Dr's office that prescribed the MRI. This debt goes on the books as just a medical service provided and not ER services. ER services are treated as essential care and there are laws that protect patients both in terms of level of care and financials.

This is what I'd do if I were you and I'm speaking on a personal level of what I solely would do and not giving any financial/legal advice.

I would, definitely not pay the $1200. Regarding the $150 I'd probably go online and pay $10 every other month till it's paid off.

Now the below would depend on how far I'm willing to dodge the bullet and fucking make their life hell. But say if I wanted to just go all out...

The initiation of collections on the $1200 debt has to be first by mail. Then can be followed up by phone. So I'd wait till I received a phone call but no longer than 30 days before taking action. If I never receive a phone call by the 10-15th day. I'd dispute the charge in writing and send them a cease and desist notice. I'd send it certified mail.

Meanwhile, I'd try to recall or get copies of the paperwork that the Dr's office made me sign. There will certainly be some clause in there regarding the handling of insurance, responsibility of payment, collections, etc... Each state has various laws. I'd be looking to see if an interest agreement clause/form was in there. This would state that the office or the collections agency may charge interest. 99% of the time no hospital or dr office will charge interest on services. However, in some states it is legal.

Now the cease and desist doesnt have to come from an attorney. It can be a simple "dont fucking call me" written on a post it note. They have to stop calling.

The debt collector can contact you in writing only for:
1. to advise the consumer that the debt collector's further efforts are being terminated;
2. to notify the consumer that the debt collector or creditor may invoke specified remedies which are ordinarily invoked by such debt collector or creditor; or
3. where applicable, to notify the consumer that the debt collector or creditor intends to invoke a specified remedy.

By this point the debt collector has filed the account away in some box and the next time they'll probably review it is when they are writing shit off.

Now at any point should I receive a call or letter from them (after my cease and desist), I'd type up some formal complaint and send it to the FTC, State's AG of where the debt collector is, BBB of the debt collector's state and CFPB. Same letter to all of them. Probably say something along the lines that I felt harassed after I disputed the charge.

Absolutely at least one of those agencies most likely the BBB or CFPB will take action and usually pretty quickly.

Then probably rest easy that they going to write my shit off. Keep in mind this is dealing with the debt collection agency and not the hospital.


I've also been on the other side of the spectrum to see collections happen. You would not believe the lengths people would go through to not pay like $50. Usually when we received notices from the BBB to respond or the CFPB we were like fuck it.... write that shit off. Even in amount of 10K+ we wrote off bc it was just too much of a pain to collect on after an agency was involved. Non compliance with a federal agency and risking an audit/investigation was not worth trying to collect on 10K+ debt that the person clearly couldnt afford to pay on. So it was just written off the books.

[overcoil]

Don't states have a State Insurance Agency or Commisioner that investigated stuff like this?

[zx10guy]

I also want to add if this is your first notice from the collection agency, chances are you're still fine. I would call them immediately and work out some payment plan.

Due to me handling all of the finances in my household and having been slammed with work and personal stuff, a medical bill fell through the cracks. When I got the notice, I called the agency immediately. The person said since this was their first attempt at reaching me I would be ok if I settle up with them now. They don't report to the credit bureaus automatically until there has been some time that has past when they assumed collection on the debt.

I just checked my FICO score at one of the credit bureaus and my score is still unaffected. I settled up the past due debt a few months ago.

[EALm4]

Originally Posted by ScottSinger

Don't states have a State Insurance Agency or Commisioner that investigated stuff like this?

Yes. State Insurance Administration. All they can do is validate if your health insurance company filed the claim correctly. That's about it.

It wouldnt hurt to file a complaint just as an inquiry but most likely the insurance company did things by the book. Usually they dont get results in favor of consumers unless the complaint is about the way the diagnosis was coded into the system. The nurse or/and insurance rep could've coded the treatment incorrectly or diagnosis incorrectly and that caused the bill to be higher. Now you're then treading on some potential legal action ground.

Now adays with EMR it's almost impossible to code a procedure wrong and transmit it to the insurance company. The insurance company also has their own due diligence as well to validate the claim.

You'd probably only want to contact them if you were diagnosed for cancer but received treatment for rabies and billed 900K or something like that.

They are worthless and only serve as just a way of getting a formal explanation from the insurance company as "why" things were done the way they were.

[dreamingat30fps]

Originally Posted by EALm4

Got it. Ok where the problem started was that it was a Dr's office that prescribed the MRI. This debt goes on the books as just a medical service provided and not ER services. ER services are treated as essential care and there are laws that protect patients both in terms of level of care and financials.

This is what I'd do if I were you and I'm speaking on a personal level of what I solely would do and not giving any financial/legal advice.

I would, definitely not pay the $1200. Regarding the $150 I'd probably go online and pay $10 every other month till it's paid off.

Now the below would depend on how far I'm willing to dodge the bullet and fucking make their life hell. But say if I wanted to just go all out...

The initiation of collections on the $1200 debt has to be first by mail. Then can be followed up by phone. So I'd wait till I received a phone call but no longer than 30 days before taking action. If I never receive a phone call by the 10-15th day. I'd dispute the charge in writing and send them a cease and desist notice. I'd send it certified mail.

Meanwhile, I'd try to recall or get copies of the paperwork that the Dr's office made me sign. There will certainly be some clause in there regarding the handling of insurance, responsibility of payment, collections, etc... Each state has various laws. I'd be looking to see if an interest agreement clause/form was in there. This would state that the office or the collections agency may charge interest. 99% of the time no hospital or dr office will charge interest on services. However, in some states it is legal.

Now the cease and desist doesnt have to come from an attorney. It can be a simple "dont fucking call me" written on a post it note. They have to stop calling.

The debt collector can contact you in writing only for:
1. to advise the consumer that the debt collector's further efforts are being terminated;
2. to notify the consumer that the debt collector or creditor may invoke specified remedies which are ordinarily invoked by such debt collector or creditor; or
3. where applicable, to notify the consumer that the debt collector or creditor intends to invoke a specified remedy.

By this point the debt collector has filed the account away in some box and the next time they'll probably review it is when they are writing shit off.

Now at any point should I receive a call or letter from them (after my cease and desist), I'd type up some formal complaint and send it to the FTC, State's AG of where the debt collector is, BBB of the debt collector's state and CFPB. Same letter to all of them. Probably say something along the lines that I felt harassed after I disputed the charge.

Absolutely at least one of those agencies most likely the BBB or CFPB will take action and usually pretty quickly.

Then probably rest easy that they going to write my shit off. Keep in mind this is dealing with the debt collection agency and not the hospital.


I've also been on the other side of the spectrum to see collections happen. You would not believe the lengths people would go through to not pay like $50. Usually when we received notices from the BBB to respond or the CFPB we were like fuck it.... write that shit off. Even in amount of 10K+ we wrote off bc it was just too much of a pain to collect on after an agency was involved. Non compliance with a federal agency and risking an audit/investigation was not worth trying to collect on 10K+ debt that the person clearly couldnt afford to pay on. So it was just written off the books.

Thanks it's not even about the money at this point. $1,200 isn't pocket change, but what pisses me off more is their attitude after they are the ones that estimated wrong by more than double.

I found the paper I signed when I paid the upfront $$ which was actually $700 not $800. Estimated responsibility $0, fucking circled and everything. Estimated based on current OOP of $7k so they knew what my OOP was. I don't think I'm crazy in thinking the $700 was the total cost based on this form they had me sign.

[EALm4]

Originally Posted by dreamingat30fps

Thanks it's not even about the money at this point. $1,200 isn't pocket change, but what pisses me off more is their attitude after they are the ones that estimated wrong by more than double.

I found the paper I signed when I paid the upfront $$ which was actually $700 not $800. Estimated responsibility $0, fucking circled and everything. Estimated based on current OOP of $7k so they knew what my OOP was. I don't think I'm crazy in thinking the $700 was the total cost based on this form they had me sign.

Oh I totally get you. You're not crazy at all and I would've assumed the same. Could be a billing error on the hospitals end but it's rare now adays.

However, given the type of procedure it was, I think it's about on par with what I've seen. I personally would want a detailed explanation of the difference. They are obligated to give you one and you shouldnt feel obligated to pay for it unless you get one.

[rad doc]

First, no offense dude but it is your responsibility to determine how much it would cost you. The hospital bill clearly says "estimate". You had you have a high deductible plan. You should know how much is left on your deductible. 800 is not high. That is the technical fee for having the scan. Not to mention the bill you show is for a tte, not an mri or ekg. Hmm, something doesn't add up!!!

Second, you said "I get a bill from them for like $150. Supposedly for the doctors fees something or the other. Ooook... I set it aside and honestly forgot about it". Typical! I am sure that is the radiologist fee for interpretation. Yes, doctors don't work for free. But you just decided or forgot to pay it! And your mad they sent you to collections? Seriously?

Third, you complain how expensive it is. You do realize an MRI scanner cost millions, hundreds of thousands to maintain annually, plus physicians cost to cover malpractice insurance, staff, and all people without insurance (or that just dont pay like you!)

[dreamingat30fps]

Originally Posted by rad doc

First, no offense dude but it is your responsibility to determine how much it would cost you. The hospital bill clearly says "estimate". You had you have a high deductible plan. You should know how much is left on your deductible. 800 is not high. That is the technical fee for having the scan.

Second, you said "I get a bill from them for like $150. Supposedly for the doctors fees something or the other. Ooook... I set it aside and honestly forgot about it". Typical! I am sure that is the radiologist fee for interpretation. Yes, doctors don't work for free. But you just decided or forgot to pay it! And your mad they sent you to collections? Seriously?

By your username you clearly have some bias but lets take the same scenario and apply it to any other business.

Last year I had some landscape work done. So the landscaper comes, I tell them what I need done and they give me an estimate for $700 to do the work. I think thats fine, I sign the agreement and pay them $700. They do exactly what I requested, theres no unforeseen changes, I don't decide mid project I want to add a pool, nothing. Straight forward. They then say sorry but we under estimated by $1,200!! Oh and you also owe us $150 for the landscapers pay... because why on earth would that be included in our initial estimate.

Now that may be common place in healthcare, but that's one fucked up way to run a business.

Plus if you read my post I'm not mad they sent it to collections. I honestly don't give a shit about the $150, if that was the end of the story I would simply pay the notice and this post would of never happened. I'm mad they estimated $700 and then try to tell me their estimate is wrong by $1350. That would not be acceptable pretty much anywhere else.

[radiofrequency]

Originally Posted by EnVe46

I sell health insurance so maybe I can help... Have you got an EOB or Explanation of Benefits from your insurance company? Even if you have a high deductible, the bill still needs to be sent to your insurance company so they can apply their negotiated rate for being within the hospitals network. This should reduce that bill quite a bit. Also, $800 is not enough for an MRI these days, so whatever figure they're giving you upfront is a bonus to them. A lot of Drs and hospitals are charging fees upfront due to majority of plan reimbursing on such a low basis. To prevent that form happening, ensure that ALL bills, even non covered expenses, first go to your insurance company. Not only for repricing but so they can be applied to your deductible. If they aren't sent to them first and you pay it, they have no record of you paying anything towards your out of pocket.

This...even though I have "Cadillac" insurance, I shop around. My first stop is my Insurers website for preferred providers. My current insurance also has to approve imaging studies of any nature, and while it creates a small hassle in that I have to drive a little further, it saves me a great deal of money. medical imaging is a bit of a racket these days. Prior to having my current insurance, I required an MRI. As I was paying out of pocket (read cash!), I shopped around. my local hospital wanted $5 000, however, I found the same service for $1 000 all in. With respect to Imaging, the service is somewhat generic in that a Radiologist reads the film and produces a report on the findings. It turns out that the same Radiology group I went to in this instance also reads the films for the hospital that wanted to charge me $5 000. So, essentially, I was getting the same service for $4 000 less. Do the same with Dentists, you'd be shocked at how much you can save if you do the above and locate a Dentist with a current GroupOn coupon, you may end up paying nothing at all.

[aozer]

Originally Posted by dreamingat30fps

By your username you clearly have some bias but lets take the same scenario and apply it to any other business.

Last year I had some landscape work done. So the landscaper comes, I tell them what I need done and they give me an estimate for $700 to do the work. I think thats fine, I sign the agreement and pay them $700. They do exactly what I requested, theres no unforeseen changes, I don't decide mid project I want to add a pool, nothing. Straight forward. They then say sorry but we under estimated by $1,200!! Oh and you also owe us $150 for the landscapers pay... because why on earth would that be included in our initial estimate.

Now that may be common place in healthcare, but that's one fucked up way to run a business.

Plus if you read my post I'm not mad they sent it to collections. I honestly don't give a shit about the $150, if that was the end of the story I would simply pay the notice and this post would of never happened. I'm mad they estimated $700 and then try to tell me their estimate is wrong by $1350. That would not be acceptable pretty much anywhere else.

its just a bunch of greedy fucks exploiting people because they know that medical care is not a luxury, it is a necessity.

[Maynard]

Agreed it is really a necessity, so lets get our collective thumb out and get everybody covered by decent insurance. Calling doctors 'greedy fucks' might feel good, but greedy fucks go work in Wall Street shuffling the money for other greedy fucks, not spending 10-15 years in med school so they can deal with the worst of life's bummers. People on this forum go ape when a dealership cuts corners or they can't get OEM parts for an insurance repair, yet you are suggesting finding the cheapest provider you can find? God help us if we get to the point where medicine becomes just a commodity that goes to the lowest bidder.

[EL Jeffe 5]

Same s#it happened to me last year not to go in all details
I just ignored all their letters they reported me to collections I honestly didn't care \
I wont be talking loan out for anything big. so any time I get letter its goes straight to recycle.