Help from Doctors (and possibly lawyers?) on here....

[lisamariewillbe 1]

At Dublin I ended up in the E.R. I ended up discharging myself because they were so confused and even told us they didnt know what to do with us "sky jumpers" as there were three of us there just waiting ....After 6 hours I had only had the CAT scan. So they gave me a vicodin and a Rx for more for the broken nose.

A month later I recieve the itemized bill. Vicodin is on there for 9.30, and the cat scans on there.... but also several things I did not have .... I refused a I.V. from both the ambulance and the E.R. yet both places charged me, and the E.R. even charged me for 3 sticks (venipuncture) even though I didnt have one.

Apperently before I left the hospital they gave me some major major drugs (read 17 charges for 41 bucks of stuff I know for a fact I didnt have) and so I called, because there are things on here I dont know what the "code" is and asked for a definition. They said I had to get a notorized letter proving that I am requesting this information and attach it to a copy of the bill to prove I had those services. They I assume are generic terms for there services performed. So I told them I was going to dispute the charges with my insurance company. They said I couldnt do that and to call the billing. So I called billing, and I disputed with them but they reiderated that I dont need to call my insurance company and that they would refund them directly if they find that I did not have these things. So what do I do? I called the insurance company. However BCBS said that its hard to have a successful dispute. This pisses me off. This is why insurance is so high now a days. So I want to make sure this is rectified and that they are investigated for it. Or is this a lost cause and just suck it up. Its no longer about the money its the principal.

I talked to my doctor and he said that if they had given me these drugs in the course of 6 hours Id probably not be able to wake up for a long time and actually the amount they said they gave me would be considered an overdose for my size.

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[davedlg 0]

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I talked to my doctor and he said that if they had given me these drugs in the course of 6 hours Id probably not be able to wake up for a long time and actually the amount they said they gave me would be considered an overdose for my size.

Get a lawyer and sue them for malpractice for giving you all those drugs in a 6-hour period. That'll wake 'em up!
edited to add: just kidding about the malpractice, I am actually very against the level of malpractice suits we are seeing these days, they are what is making medical care so expensive!

[lisamariewillbe 1]

Okay so we have Hospitals lying to insurance providers and over charging , and thus creating insurance costs to be more, and we have people lying for mal-practice causing hospitals and doctors to lose money thus creating more expensive care? What the hell is wrong with this picture?

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[simplyputsi 0]

I have to agree with the malpractice thing. Tell the hospital that you did not have those things. If they insist you did say well I called my doctor here and he told me that if I had all that medication it could be enough to overdose on. Tell them you are thinking about legal advice since they insist they gave you overdose of medication on purpose.
I'm sure they would say fine you do that. Get a lawyer to write a letter for you stating whatever in the lawyer language and send it to the hospital. More than likely they will take the stuff off the bill.

Or next year we could just burn the place down.

Skymama's #2 stalker -

[lisamariewillbe 1]

I dont want to play the same way they are. I just dont understand how or why they would do this. Now to mention my share is alot more because my insurance company wouldnt cover all these medications. They were convinced my boyfriend had beat me, even though I was in my jumpsuit and told them repeated times that I was skydiving (apperently they didnt believe me), they drug tested me, even though I already told them I didnt do drugs and they didnt tell me they were doing the tests, and they charged me 860.25 for a urine test so I do all the work of peeing in a cup, they put a freaking stick in the cup and charge me that much? (covered the test name up with fancy shit) Im not even trying to handle the ambulance bill yet, that will be a fight for a different day as it is no where near as bad as what the hospital is doing.

Ive been working on this stuff all day, and its now having me so fustrated its probably good I dont live in GA anymore

At least now I know to check bills better

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[simplyputsi 0]

Your insurance company should be disputing some of those amounts. I think a pee test is something like 125 tops.
Sorry to hear about this. You seriously might be better off just getting a lawyer to write a letter though. You'd be surprised what legal letterhead and a lawyer signature can do. Shouldn't cost you too much either.

Skymama's #2 stalker -

[lisamariewillbe 1]

Yes the insurance company covered 105.50 of the urine test, Im to pay the rest. My cat scan was 3726.00 the insurance company covered 1452.80 the CBC platelet was 460.03 the insurance covered 152.00....the drug test they werent autorized or ordered to give cost 659.00 and the insurance covered none since it was not needed.

Im gonna get a lawyer I think to write a letter. Im also going to contact the other "sky jumpers' who were in the hospital there to compare notes

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[Akey 0]

Not a doctor (yet), i'm a nurse, but for what its worth...
Assuming you are a fairly normal healthy patient who probably has quite good veins, the idea that someone took 3 attempts getting one in says alot. I.E- they are either completly retarded or it never happened, either way it is something that you should bring up. (Random side note, good way to check if you've got 'good' veins, hold your arm and open and close your hand, if your veins plump up and are straight they are good, i.e easy to get a cannula into). As fot setting up an IV, that woud have to be documented by the person setting it up, so make sure the person that 'gave' you the IV has actually sighned for it, otherwise they have no proof that it was put up. Also talk about your condition, did you need an IV? I.E- Would there be a reason for you loosing fluid in your system (loss of blood etc.) if not, i do not see why they would give you one, and giving 2 in the space of 6 hours sounds a little excessive... something else you should point out.
To be honest if you want to fight for the principal, fair enough, but 3 venflons, 2 IV's and some drugs... it is comming out of the insurence companies pocket, if they are bothered about it, fine, its their problem. I don't know much about insurance companies (come on NHS!) but if you have to pay an excess, i would expect that the MRI would mean you would have to pay it anyway...

[simplyputsi 0]

You know most times it's the insurance that pisses me off, but in your case it seems it's both. It looks like you have lots of unhapy phone calls to make. I'd ask why they are charging 3 hundred some odd dollars for a test that cost about one hundred. You need to get some answers to some things. Write it all down. Document names and prices. Don't give up.

Skymama's #2 stalker -

[lisamariewillbe 1]

Well the E.R. says they did a IV and so does the Ambulance, they are seperate enitities. Neither did as I refused an IV because of the extreme pain they cause me. And as far as the sticks, if they had done them, 3 wouldnt be bad for me as I have had more unsuccesfull attempts at a vein then successes and now refuse any IVs unless they knock me out which they wouldnt ever do I dont think (except for surgeries) . I had thearpy through IV for a long time so weak knotty veins that collapse. But I never had this done there they only took blood and the nurse listened to me about the vein to use so it was a one stick thing. I and the insurance company are both requesting my chart. However this is kinda a big deal to me because even if I dont have to pay, this is the reason insurance companies probably charge through the roof. I doubt I am the only person to ever have fake shit on the bill. So it isnt their problem, its everyones problem.

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[lisamariewillbe 1]

So there are standard type costs for these services? Is there a place where I can see that online so I can figure out some of this? I did get a contractual adjustment of 512.62 for the total bill however out of the 7 plus grand bill the insurance covered 1943.03. Technicually I can do that whole thing by saying I cant afford and they can get money from elsewhere blah blah blah, or I can pay 5 bucks a month. However I am now going off of principal, and pissed off emotions.

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[simplyputsi 0]

The insurance company should know what the standard fees are for such services. That is why they only cover so much for certain things. Whatever they don't cover is either because they only pick up a percentage of it or because they will not pay for an overcharge. They should be able to tell you what the standard charge is for that region.
What a pain this all is for you.
I think we have our firewood for next year at dublin

Skymama's #2 stalker -

[chaoskitty 0]

I just looked up the charge for a urinalysis at one of my hospitals. $54.02.

[lisamariewillbe 1]

I did find out that there are different costs depending on which insurance you have, if your self pay , etc, so basically they charge depending on what they can get ...self pay pay more...

Im kinda at a loss of what to do, but I cant do much until I get the chart from them. Im glad I had someone in the room with me at all times and that they said they gave me all these medicines. If they had given me these medicines there is no way Id have been awake or coherent to discharge myself and walk out of the hospital.

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[chaoskitty 0]

Yep.. sounds like they screwed up your charges. I dont know which system they use, but most rural hosptials start with a charge sheet, then manually key charges to your account. If they file that charge sheet, that would be a good place to start.
Give them a chance to fix it. They might surprise you.

[lisamariewillbe 1]

Should I call and request that charge sheet?

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[chaoskitty 0]

Not yet. You should be talking to the business office manager about your bill. Give her the opportunity to do the research on her side and correct your bill.

If she comes back and says that there are no errors, then you should request your medical record chart, and any charge sheets, edit listings from manually keyed charges, or edit listings from order entry charges. All of that should include the doctor who ordered the charges as well as the nurse who placed the charges.

I can see this getting messy. Hopefully the business office manager will handle it.

[lisamariewillbe 1]

Im just so confused. Ive already disputed the bill and informed the insurance company so they are sending the charts. Guess once we get that we will go from there.

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[peregrinerose 0]

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I did find out that there are different costs depending on which insurance you have, if your self pay , etc, so basically they charge depending on what they can get ...self pay pay more...

This is illegal. We charge the same fees to private pay as to insurance companies.

Insurance companies pay us whatever the hell they feel like giving. I can spend an hour with a patient, bill the insurance company $200 for a full hour of face to face doctor time. Know what they say my time is worth? $32. It doesn't matter that in real life overhead alone is far more than $32, that's what the insurance will pay, so that's what I have to take (which is why I don't participate with that particular insurance company).

Do you really think the docs are out to screw you? You have no idea just what we have to accept as 'full pay' from the insurance company. Or how many fees we have written off for those who can not afford the care they need.

I don't know what was/wasn't done in the ER and how the billing was done and what codes were and were not appropriate. But what an insurance company says are 'standard fees' only reflects what they want to pay, not what an actual procedure is worth in equipment and time.

Jen

Do or do not, there is no try -Yoda

[TrophyHusband 0]

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Yes the insurance company covered 105.50 of the urine test, Im to pay the rest. My cat scan was 3726.00 the insurance company covered 1452.80 the CBC platelet was 460.03 the insurance covered 152.00....the drug test they werent autorized or ordered to give cost 659.00 and the insurance covered none since it was not needed.

Im gonna get a lawyer I think to write a letter. Im also going to contact the other "sky jumpers' who were in the hospital there to compare notes

this is why i think insurance companies are one of the holy trinity of evil corporations. with the amounts that they cover, you are money ahead to just not have insurance and pay your entire bill out of pocket.

"Your scrotum is quite nice" - Skymama
www.kjandmegan.com

[lawrocket 3]

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they charged me 860.25 for a urine test so I do all the work of peeing in a cup, they put a freaking stick in the cup and charge me that much?

I'll bet you a buck it was a pregnancy test.

There's so much going on I dont' know what to think about this. Considering that you are paying a high amount of the costs (your insurance is only apparently covering about a third) it makes sense to duke this out.

A good place to start would be with the medical board in your state to find out whether there are any "nonjudical' ways to get this worked out.

Your medical records should be fairly clear about what you've had done. Compare it to the bill.

Many of these codes and charges are uncognizable to those who aren't in the know. And some minimum wage data entry biller is bound to make mistakes.

Get your records, compare your records to your bill, and move on with help from the state board. It'll be a couple of weeks...

My wife is hotter than your wife.

[peregrinerose 0]

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this is why i think insurance companies are one of the holy trinity of evil corporations. with the amounts that they cover, you are money ahead to just not have insurance and pay your entire bill out of pocket.

Not necessarily. Most insurance policies state that the patient can not be billed for the difference between the facility's bill and what the insurance pays the facility. Lisa, double check on your insurance coverage to see if that is the case or not. You may not actually be responsible for the difference in fees. This is why it ends up being the facility that is screwed, not you.

Do or do not, there is no try -Yoda

[lisamariewillbe 1]

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Do you really think the docs are out to screw you?

In this sample yes, IF it isnt a mistake and they are saying that in a 6 hour period of time they gave me the following medicines for a broken nose and concussion

Hydrocodone Bitartrate 500 mg
Vicodin PO
oxycodone hydrochloride
Macrobid
hydroxyacetanilide
Epinephrine Inj



along with several other mostly being pain medicine like Tylenol 3s and so fourth. So I guess that to make the insurance pay what doctors feel they are worth they make up bullshit to put on the bill? So you dont think that it would be screwing someone over if the doctors charge for things they did not preform? If its a mistake with billing then it will be discovered soon, but if it is not a mistake and they continue to charge these then they are screwing people over.

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[lisamariewillbe 1]

It definitly wasnt a pregnancy test, they asked if I was, I stated I had a full hysterectomy and that the baby house was closed. They did state they did a drug test but I didnt think to ask if that is what the urine was for... either way I dont care about the tests they did as long as they did them, I just care about all these fun pain meds I didnt get to have. And the fact I cant seem to understand why it is going to take so long for them to research it all.

Sudsy Fist: i don't think i'd ever say this
Sudsy Fist: but you're looking damn sudsydoable in this

[IanHarrop 37]

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Do you really think the docs are out to screw you?

Simple answer YES.

Edit to add:

http://www.cbsnews.com/stories/2006/03/02/60minutes/main1362808.shtml

"Where troubles melt like lemon drops, away above the chimney tops, that's where you'll find me" Dorothy