I feel embarrassed.

[ChairmanAgnostic]

I just donated, about all I could afford.

Spousette and I were hit by a drunk a while back, and together, we've had about $310,000 in medical, of which only $140,000 has been paid by the carrier. I am not complaining about the insurance company, at least they have paid the minimum in accordance with their agreements with approved providers, less deductables, copays, et al, provides. What irks me is a) docs and hospitals that HAVE agreed to limit their charges for the "insured" rate, ignore that agreement, and send ding letters, and even hire collection agencies to get "full value" of their bills.

Let me put that in english.

Hospital A has a BCBS agreement to pay X for "treatment Y".
Hospital A bills mois $150,000 for major surgery to mois back. IE "treatment Y". (a massive, painful, necessary surgery, from which I am still recovering)
Hospital A sends bill to BCBS, which dutifully pays the agreed amount, $76,950. The TOTAL AGREED COST FOR SURGERY. BY CONTRACT.
Hospital A gets paid $76,950. They then send a bill to mois for $73,050, with threats, deadlines, an offer of a minor discount, and a STRONGLY suggested "contract" to pay that outstanding over several months. Followed by letters from a collection agency, and a letter from a lawfirm (with whom I have dealt with professionally, repeatedly) asking why am I such a beater of the dead.
Hospital A gets a rude, nasty, angry, threatening letter from mois, advising them that their effort at double dipping will jeopardize their ability to practice medicine in Illinois.
Hospital A sends a letter saying it was simply a mistake, and to ignore their threats to ruin my credit, my life and my finances.

I am first and foremost, an artist. Everything I see in life, all my dreams, all my hopes and aspirations are related to art. Creativity. Discovery. Making things. I also practice law, about 23 yrs worth. I've represented AIG in bad faith claims, products cases, even claims against the Catholic sexual child abusers. (I hated that part of the job). I've represented UPS in fatals and quad cases. I've tried so many cases, that I quit keeping count a decade ago. So, I guess I am a lawyer, too.

But for my speeches and CLE courses I taught about Bad Faith Insurance handling, and my experience as a litigator for a couple of decades, I would have been sucked in by Hospital A, and would have fretted about a whole new debt of $73,000+ EVEN THOUGH I WAS FULLY INSURED. I can only imagine how those without 23 yrs of legal experience would react.

With the major impact on my income for the past year (post accident, I simply was unable to work, and after surgery, ((conservative therapy did squat)), the whole cycle repeated itself) I wish I could send more. DU, now, more than ever, is important. We have to push single payer, or a public option. There is no other alternative.

sorry about taking so much time.

[bluethruandthru]

1. This is why we need Single Payer NOW.

It's so awful what you have gone through and, unfortunately, there are thousands more every day who are forced to deal with this crap.

[ChairmanAgnostic]

2. what M.Moore filmed about COVERED folks really hit home

and there are millions of us in similar situations.

I am lucky. I have some experience with the legal system in my state. I take no prisoners, when circumstances require such an approach. but honestly, our whole medical/insurance/coverage/ care giving system is out of whack.

[tinkerbell41]

3. I am embarassed, I can't afford anything

Been out of work for a year as of Saturday.
Regarding the last part of your post, my mom was treated for cancer for 13 yrs. She was always getting double billed and would be busy making phone calls and straightening things out. One day I told her about this happening to me, I received a collection call and was told to get it straightened out with my insurance company, I said "I'm an Electrician, that's not my job it's yours
you do it." Never heard from them again, and my mom stopped making phone calls.

[ChairmanAgnostic]

4. what is wrong with our country? It is completely out of whack

and Ayn Rand "pure" capitalism has put us here. It is time for us to stand up to it and call it what it is. Rape of the middle class.

[tinkerbell41]

5. I don't deal with them anymore.

And I don't give a shit. You figure out your billing problems, I got enough shit to do.

[crazy_vanilla]

6. balance billing is illegal

I am so sorry you had to endure so much medically. Now, to add insult to injury, it sounds like you are being balance billed. Our health care needs serious and real reform.

I've been through this before and won. IMPORTANT: Check with your state's Insurance Commissioner on state regulations regarding "balance billing". It is illegal in most states for in-network services. They usually have the state law on the subject up on a website, but you may have to dig. And yet, for $73,000 I would dig from here to China.

An internet search on balance billing can help you deal with the medical providers. I would suggest dealing with them only through certified mail.

Now, there is a difference between "balance billing" - billing you for the remainder of the amount of a covered treatment, even though your insurance has already paid the contractual amount on that treatment,

and

treatments not covered - for which you will be held responsible.

Here are some links. I hope they help:
http://www.businessweek.com/magazine/content/08_36/b4098040915634.htm

http://www.thehealthcareblog.com/the_health_care_blog/2006/10/the_great_balan.html

http://www.monitorbankrates.com/personal-finance/balance-billing

[yewberry]

7. Thanks for your post, because I learned something important.

I would have been sucked in by Hospital A, and I would have been absolutely terrified.

I had no idea about balance billing. So thanks.

[crazy_vanilla]

9. I learned about ballance billing the hard way

And I want to make sure as many people as possible know it. I am happy to spread the news and show a virtual finger to greedy providers and insurance companies.

[crazy_vanilla]

8. to add to my previous post

If you don't already know - make sure you notify the provider that you dispute the charges - in writing and by certified mail so you can prove you have done it (they are sneaky and may deny they have heard from you otherwise). In most states by law that should give you a 30-90 day buffer for research.

I am not sure if there are volunteer medical billing patient advocates, but there are certainly paid ones that can help you. They know how to sort through the mess. Here is a link to a directory:
http://www.healthcareshopper.com/blog/2006/08/medical_billing_patient_advocates_can_help.html


I wish you the very best of luck. Our family has been in your place and it is a tough road to go. But there is a light at the end of the tunnel. By the way, Rachel just said that the average salary for a Medical Insurance Company CEO is between 11 and 14 million $ a year. I guess we are in the wrong line of work.

[Laelth]

10. I treasure my law degree.

It is very easy for the rich and powerful to take advantage of people who don't know their rights. Most people don't.

:dem:

-Laelth

[crazy_vanilla]

11. you are lucky

most of us have to learn these things through trial and error

Lucky to have the Internet and be able to do the research.

[Laelth]

12. I have been very fortunate, yes.

I try to give back to the community when I can.

And the internet is an excellent research tool, for lawyers and non-lawyers alike.

:dem:

-Laelth

[morillon]

13. I used to be stupid about this double billing stuff...

...and I still have a ding on my credit from several years ago due to a relatively small but quite fraudulent bill that went to collection while I was still fighting the provider over it. It's the only blemish on an otherwise clean report.

We pay higher premiums for 100% coverage for in-network providers, and if I ever get one of these double-dipper bills again, you bet I'm raising hell with the provider and the insurance company the very day I get it.

[babylonsister]

14. Wow. You know. Thanks for sharing your experience. Big hugs from me. nt

[slipslidingaway]

15. Thanks for sharing your story and best of luck with your continued

recovery.

[slipslidingaway]

16. delete - dup n/t

[BlancheSplanchnik]

17. THANK YOU!! you hit a point that enrages me

The need to be a top notch lawyer just to protect yourself from these hyenas. (apologies to actual hyenas everywhere)

My hun often tells me of the double dipping which was a matter of course when he lived in Florida. He did not have the ability to protect himself like you did, so he paid what they demanded (though at the time of the tests, he hesitated, told them he was concerned that it seemed they were going overboard. They promised it wouldn't be a problem for him.)

He did stop further unnecessary tests, though.