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BigBUG

Need help - Forigner with US medical bill

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Dear friends,

I am need your help.
This March, while visiting California, I had some off-landing and seriously hurt my leg (ankle). I went to Oceanside Urgent Care, this is a little emergency help point, where they washed my scratches and bruises (PLF over rocky road made mainly of cement :) ) and I bought crunches from them (I left then in Sckydive San Diego, hope no one will ever need them :) They were so small and didn't have an X-ray machine, so I was sent to Tri City Medical Center for X-ray to determine is there a fracture in the ankle or it is just hit badly and swollen, but without bone problems.
I was registered and pay like 100 dollars in advance for X-ray. Waited for like an hour and have it done. Didn't get any results and I been said that they will send it to my doctor (I thought that that meant doctor in Urgent Care). 2 days go and I did not receive anything from them, no results, nothing. Then, because this is my time to leave California, I again went to UC station and been said that there no fracture, but didn't see any films, nothing. Since I felt better, I assumed there is no fracture and forget about that - just bought a fixture and jump with it (and earned USPA AFF Instructor license :) )

I did not receive any word or bills or whatever from these hospitals. Until today, I found in my ground mail a letter from Californian Business Bureau a letter, which said that I owe Tri City hospital a nice sum of 929 USD. There is a just a short notice, no e-mail, no bill details, nothing. Just "pay or this matter will be submitted for supervisory review"

So I am seriously concerned about this and would like to ask to help - WTF is this all about? What should I do?

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The first $100.00 goes toward a deductible against your insurance.
Your insurance covers the the rest.
My assumption is you don't have insurance.
Nobody has time to listen; because they're desperately chasing the need of being heard.

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I had it, but all the bills should be settled within a month. So i didn't have any. And i was asking several times if I covered expence with my payment upfront, and receive affirmative answer. I would not go for 900 dollars xray.

And, moreover, i did not get any results at all. So i could not quite understand why I am charged for the job which no one ever did, let alone the amount. I suspect a fraud there. I went to yelp and found several cases like this.

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Did they ask you if you had insurance or if you would be paying cash? Often times (with medical in the USA) there are two different prices and it applies to providers, procedures and medications. This is due to insurance providers only paying X% of whatever the bill is. If a clinic knows that your insurance company is only going to pay 25% of your x-rays, they charge the insurance company $1k...that way they get their $250. If you do not have insurance tell them at time of check in "I AM PAYING CASH". You will get a different price. FACT
Truth is the distilled meaning of facts, for any truth refuted by a fact becomes a fallacy.

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BigBUG

And, moreover, i did not get any results at all. So i could not quite understand why I am charged for the job which no one ever did, let alone the amount. I suspect a fraud there. I went to yelp and found several cases like this.



The X-ray was taken, processed and had to be read by a radiologist. It's not their fault if the doctor didn't communicate the results.
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So this is normal when they do not show you any numbers? My credit card slip was saying 'right ancle xray - 97usd' and that was only number i knew and only number i authorized. So they now could say - ok, your treatment cost 100 000 and i need to pay that?


Trying to figure it out.
I really want to play it fair, but it seems that i'll just leave them with funny perspective of collecting money from soneone from Russia.

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BigBUG

So this is normal when they do not show you any numbers? My credit card slip was saying 'right ankle xray - 97usd' and that was only number i knew and only number i authorized. So they now could say - ok, your treatment cost 100 000 and i need to pay that?


Trying to figure it out.
I really want to play it fair, but it seems that i'll just leave them with funny perspective of collecting money from someone from Russia.



Welcome to the US healthcare system.

First off, no real diagnostic procedure is going to cost $100. That $1000 for X-rays is pretty typical.

Second, none of the people treating you have any idea of what the stuff they are doing costs. That's the job of the billing department. The nurses, X-ray techs and such are very good at their jobs, but they have no idea of, nor control over what you are going to get charged for it.

That $100 you paid is what we call a "Co-pay." It's a token payment to the provider at the time of the treatment.
Normally, the provider then sends a bill to you and the insurance company. The insurance company then sends the patient a statement detailing how much it cost, how much they are going to pay and how much the patient owes. Sometimes there's a deductible (patient has to pay a certain amount before insurance pays) or sometimes certain stuff is only partly covered.

Since you didn't have insurance, they sent the whole bill to you. Ok, I missed that you said you had insurance. Russian insurance or "Travel Insurance"? I'm guessing that the insurance either denied coverage or it got lost in the system. I've had that happen - The insurance company misplaced the paperwork and I started to get threatening letters from the provider. You might check with your insurance company and see what they say.2nd edit - You said you were paying cash. They did the procedure and sent you the bill for the whole thing.

Technically, yes, you owe the extra money.
You could send them a note saying that they never gave you the X-rays or a full report from the radiologist and won't pay until they do.

Or you could simply not pay it. They'll send you threatening letters and such things (threatening legal action and damage to your credit rating) but that's about it.

Edit to add part about insurance coverage.

Edit again because I apparently can't read today.:$
"There are NO situations which do not call for a French Maid outfit." Lucky McSwervy

"~ya don't GET old by being weak & stupid!" - Airtwardo

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theonlyski

***And, moreover, i did not get any results at all. So i could not quite understand why I am charged for the job which no one ever did, let alone the amount. I suspect a fraud there. I went to yelp and found several cases like this.



The X-ray was taken, processed and had to be read by a radiologist. It's not their fault if the doctor didn't communicate the results.

Sure it is, they have given the doctor privilege in their medical facility.

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BigBUG

So this is normal when they do not show you any numbers? My credit card slip was saying 'right ancle xray - 97usd' and that was only number i knew and only number i authorized. So they now could say - ok, your treatment cost 100 000 and i need to pay that?


Trying to figure it out.
I really want to play it fair, but it seems that i'll just leave them with funny perspective of collecting money from soneone from Russia.

Our health care system is seriously messed up. Many small doctors are being bought into large corporate medical practices that then begin charging pretty much whatever they want for procedures. Insurance companies get huge discounts but still play the game. We spend about double what most countries do for health care, and it's not really any better.

If your insurance covers it, fine. If not, tell the facility you're self insured and ask for a discount. I've actually done that after the surgery because the cost was higher than anticipated. I made a good case and they cut my portion of the bill in half. Good luck. :)

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I would suggest you write a Dispute Letter.
Explain what you came in for
What you paid for
You received no reports
You presented insurance at the time (which they may not want to take the time to go through a Russian organization).
In short; there is a fine print clause that states, "The patient is responsible for all bills if the insurance company does not cover the charges."
Nobody has time to listen; because they're desperately chasing the need of being heard.

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BIGUN

I would suggest you write a Dispute Letter.
Explain what you came in for
What you paid for
You received no reports
You presented insurance at the time (which they may not want to take the time to go through a Russian organization).
In short; there is a fine print clause that states, "The patient is responsible for all bills if the insurance company does not cover the charges."

http://blogs.wsj.com/health/2009/01/09/balance-billing-nixed-by-california-supreme-court/
I hold it true, whate'er befall;
I feel it, when I sorrow most;
'Tis better to have loved and lost
Than never to have loved at all.

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shropshire

You gave you REAL name and address? :P



hmm, yes :)
I thought this is over when I paid my bill upfront.

I still considering to send this mail to a trash can, so I am not THAT honest. But, generally I am law-abiding and do not feel good about making a fraud. But in this particular case, it seems that the fraud was on me - maybe this not a fraud, but they are definitly used the fact that I am a forigner, my English is far from perfect and I do not have any idea about the healthcare system and the way it works there.

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Iago



If you have any paperwork it should have a 'Visit' or 'Encounter' on there. That is what you will use to request the 'coding' from the Patient Accounts department. You may need to submit a Release Request Form to the hospital for HIPPA- they can't just give out medical records without a documented request.

Then tell them it's too much.

;)

I would ignore this other letter you got in the mail. Certainly don't send them any money. You don't know them.



that's the sad part - I trowed all papers away just a week before getting this letter :( stupid deal, but I had absolutely no idea that this case is not closed 3 month before...

And as I remember, there wasn't anything like 'Visitor' or 'Encounter'. Just my name, and 'X-ray of right foot'.


I would like to thank everyone who spend their time to answering me and giving advices. I really feel bad about this - I hate to have debts (I am no American so I'm not used to live on credit :) ), the very idea of being owed to somebody depress me. But it seems that there no mant ways to solve this - I am certainly not in the position where I could send 1K of money for what I didn't ever got.

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My advice assuming that you are residing in Russia.

Just ignore the bill, and be done with it.

The US healthcare system is the real fraud; not your unwillingness to pay $1,000 for a diagnostic procedure that is billed at $50 almost anywhere else in the world.

BigBUG

***You gave you REAL name and address? :P



hmm, yes :)
I thought this is over when I paid my bill upfront.

I still considering to send this mail to a trash can, so I am not THAT honest. But, generally I am law-abiding and do not feel good about making a fraud. But in this particular case, it seems that the fraud was on me - maybe this not a fraud, but they are definitly used the fact that I am a forigner, my English is far from perfect and I do not have any idea about the healthcare system and the way it works there.

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mpohl


My advice assuming that you are residing in Russia.

Just ignore the bill, and be done with it.

The US healthcare system is the real fraud; not your unwillingness to pay $1,000 for a diagnostic procedure that is billed at $50 almost anywhere else in the world.

******You gave you REAL name and address? :P



hmm, yes :)
I thought this is over when I paid my bill upfront.

I still considering to send this mail to a trash can, so I am not THAT honest. But, generally I am law-abiding and do not feel good about making a fraud. But in this particular case, it seems that the fraud was on me - maybe this not a fraud, but they are definitly used the fact that I am a forigner, my English is far from perfect and I do not have any idea about the healthcare system and the way it works there.

Well, it is NOW!
I'm not usually into the whole 3-way thing, but you got me a little excited with that. - Skymama
BTR #1 / OTB^5 Official #2 / Hellfish #408 / VSCR #108/Tortuga/Orfun

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