Two weeks ago I wrote about my horrific trip to the hospital including my fight with the receptionist over projected hospital bills. Here’s a brief recap of what happened. Three hours prior to my appointment I was informed that my insurance company refused to pay for my procedure. According to the receptionist the insurance company considered my treatment experimental. In order to keep my appointment I had to agree to self-pay. This means that the hospital would send me a bill directly rather than billing my insurance company.
My husband and I desperately tried to work out the billing problems prior to the procedure but we simply didn’t have time and the receptionists refused to provide any information that would help us resolve the issue. They told me I had to pay $1000 on the spot in order to be treated. They were unable to tell me anything else, including what the procedure would actually cost me. When I asked for more details the receptionist reiterated that I owed $1000 immediately.
How can this be? When you have a car repaired the mechanic provides an estimate prior to competing any work. How can a hospital not provide an estimate of medical care?
I contemplated having this procedure done for almost a year. I kept hoping and praying that my chronic pain would disappear. Obviously it didn’t. When I set up the appointment, (a month prior to that day in the doctor’s office), I had made up my mind: this procedure would help me. Money or no money I couldn’t put it off one day longer. So I forked over $1000 and went behind the gray curtain having absolutely no idea how much I would end up paying.
Well this week the hospital bill’s began to roll in. To date I owe $4200 and the doctor’s bill has not yet arrived. I’m still planning on submitting a claim to my insurance company although I expect they’ll reject it. Of course, I can’t submit a claim until I receive an itemized bill from the hospital. When I called the billing department today they told me they didn’t have an itemized bill since I agreed to self-pay. I was told a bill would be sent out as soon as possible but I have a feeling one will never arrive and that I’ll be on the phone again next week hashing through the same story with yet another hospital employee.
On top of this I may also need to pay out of pocket for massage and physical therapy. My condition is quite rare and unique and to date I’ve been unable to find an in-network therapist who can help me. I’m considering paying out of pocket, up to $100 a session, for a therapist who is familiar with my condition. I am supposed to have three therapy sessions a week for the next three months, which would result in an additional $3600.
Truth be told if the procedure provides relief from pain than it will be worth every penny, but since the procedure is experimental the time ahead is just a waiting game.
I’m sorry for all of your frustration. I hope your procedure helps you out.
Contact your Senator or U.S. Representative for your district. I had a situation where my insurance refused payment, and the hospital/Dr. bills were very high. My U.S. Representative has a person on staff to help people with medical bills and medical insurance. I still had to pay, but was able to have insurance pick up about 30% of the tab; the hospital bills were reduced by 50%. Unfortunately the doc still charged his full amount. And before you ask, no, I am not on welfare, etc. I have good insurance and am gainfully employed making a good salary. I just wanted a little help with outrageous medical expenses.
I’m sorry you’re experiencing so much frustration. I’m sure it’s the last thing you need. I hope the procedure helps!
Sorry I don’t have any useful advice for you, and that this has been such a frustrating ordeal. I hope everything works out.
Thanks for the kind words and good wishes. I am researching all of the possibilities for appealing to my insurance company. I will add contacting state representatives to that list.
I’m sorry you had to go through all that. Hospitals are a nightmare when it comes to panicking about the effect it will have on your wallet.
thanks for the comments at my website. I’m sorry that you had to deal with this.. even as a doctor, i understand the crazy insurance issues. I am also a patient too at my doctor’s office.
You should try to get an in-network exception for the physical therapist. Basically, if there isn’t a qualified therapist in network, they can treat your out of network therapist as in network – and at least cover that much of the costs. This is particularly helpful if, say, your coverage is 80% in network but only 50% out of network. It can also affect deductibles and lifetime limitations.