Help With Hospital Billing Problem

Discussion in 'After Hours Lounge (Off Topic)' started by Carl Miller, Jun 21, 2003.

  1. Carl Miller

    Carl Miller Screenwriter

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    I'm gonna try to keep this as short as possible, but I could use some advice here. Back in 2001 my father was a terminal cancer patient. About 2 weeks before he died, my father had broken his arm leaning on a cane (cancer had spread to the bone and the arm just snapped) and ended up in the hospital for his final weeks.

    6 days before he died, and just a few hours before he was transfered to a hospice care facility, an orthopedic surgeon visited him when nobody was around and did an exam on my fathers arm.

    For months after his death, my mother got tons of health insurance invoices, bills from various doctors and the hospital. She couldn't deal with all that and gave them to me to handle.

    In the middle of literally hundreds of these invoices, receipts and bills was a charge from the orthopedic surgeon for $1,100...For the consultation and 2 subsequent consultations that allegedly took place at the hospice center we were never aware of.

    The insurance company labeled these consultations unnecessary and refused to cover them. Within their rights according to the policy, and I agree in principle with their determination.

    The man was days away from dying, and there was no need or purpose for an orthopedic surgeon to consult. That's the insurance companies position and my position.

    After about a years worth of bills from the hospital and several battles with a collection agency, I finally managed to get the hospital to cancel the bill. I have written correspondence to this effect, and thought this problem was long solved.

    Then, out of the blue the other day, my mother got another bill for this same charge. I contacted the hospital, tried to speak to the same person I had dealt with before only to find this billing manager was no longer working there.

    It seems the re-opening of this situation was caused by a hospital auditor, whom I spoke to. The auditor claims the billing manager I had gotten the letter from didn't have any authority to "forgive" the charge and took it upon herself to eliminate the charge from the computer system...So the hospital now insists my mother owes this debt.

    My mother is retired and on a fixed income and really can't afford to pay this. I could pay it just to be done with the whole damn thing, but it's a lot of money to me too and I'd rather not absorb the expense. Add to this my opinion that this consultation is a blatant abuse of the insurance system and I just don't want this bill to be paid.

    My question is how to best go about dealing with this. Is there anything we can do? Small claims court? Anything? My mother paid out about $22,000 in uncovered claims of the near $400,000 in hospital/doctors bills it cost to treat my father over the last year of his life...I can't believe we're having to even deal with this crap 2+ years later.
     
  2. Glenn Overholt

    Glenn Overholt Producer

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    If you have a letter from the hospital canceling the bill, then just send them a copy of it.

    You also could tell the insurance company what they are trying to do. I have a feeling that they have at least one attorney that they can get to stop it.

    Another idea is to contact the state licensing board, and see if they have received any other complaints about the doctor.

    Glenn
     
  3. Jay Heyl

    Jay Heyl Stunt Coordinator

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    I don't know how legal this is or whether it will keep the collection agencies out of the picture, but an old friend told me of a billing dispute he had with a hospital many years ago. The situation was different though the net effect was the same -- they said he owed them money and he disagreed. He knew there wasn't a whole lot he could do to fight them, so he decided to surrender... sort of.

    Every month he wrote them a check for some odd, small amount. One month it would be $1.27, another month $0.62. Every month like clockwork they would receive his check. The key here is that he was making regular payments. In the state he lived in that was apparently enough to keep the hospital from turning the debt over to collection. The fact that it cost the hospital more than what they were receiving just to process the payment, well, that was just coincidence.
     
  4. Eric_L

    Eric_L Screenwriter

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    I'm no expert, but I believe that the 'probate' process is the procedure whereby the state settles all of the decedents final expenses and settles all debts, then distributes the remainder to the heirs. Once probate is closed I believe that any remaining creditors are technically hozed. (and yes, hozed IS the legal term for it)

    Terribly sorry to hear about your loss...
     
  5. Brian Mansure

    Brian Mansure Second Unit

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    Carl,

    I would contact your State's Attorney General's office.

    Let them know what's going on and make sure you have many copies of the correspondence between your family, the hospital and the insurance company to hand over.
    Hopefully they can start a preliminary investigation and get the situation straightened out for you.

    Good Luck,
    Brian
     
  6. Cees Alons

    Cees Alons Moderator
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    Cees Alons
    If the person who wrote you the letter (on Hospital paper?) "pretended" to have the proper authority, and it "ain't so", then that is her/his problem and the hospital's (the legal employer!) not yours, unless the claim was apparently preposterous (e.g. the person being the cleaning lady).
    If that was a billing manager, or any job title that sounds impressing enough, then under the legal system in my country (sic!!) the letter binds the hospital. It's not of your concern that he/she didn't really have the authority (if that really is the situation!). You were perfectly entitled to proceed, trusting the letter, in the knowledge that your father (or his estate) didn't owe that debt anymore, which in turn may result in the estate not being able to pay that amount anymore.

    You need to find out if in that respect the law works the same way in your country.

    Good luck!

    Cees
     
  7. Carl Miller

    Carl Miller Screenwriter

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    Thanks guys!

    I spent half my work day on the phone with the hospital today. A big run-around led me to a managing auditor who is the supervisor of the auditor who I spoke to previously. I tried saying everything mentioned here and then some, and got nowhere.

    So this afternoon I left work early and went to visit my wifes uncle who is a labor attorney. Not his speciality, but he contacted the same managing auditor and had the matter solved in less than 5 minutes.

    He termed the concept of a surgical procedure being done on a man a week away from death "non-judicious", which he said would lead any judge or arbitrator to conclude the consultation and resulting insurance claim fraudulent.

    He threatened lawsuit, bluntly told the managing auditor that he'd leave no stone unturned when he reviewed records and gave the guy 60 seconds to decide whether he was willing to risk losing his job over the collection of this and what he was sure would be other fraudlent insurance claims.

    Presto, problem solved. There's a Fed-Ex due to arrive tomorrow by noon releasing my mother of this bill.

    It's amazing what can be accomplished if you have the words Attorney at Law after your name.
     
  8. Micheal

    Micheal Screenwriter

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    Congratulations Carl! I'm really happy that everything worked out for you.[​IMG]

    My Father also passed away from Cancer, he had to spend the last month or so in the hospital. I'm just glad that since I live in Canada I didn't have to worry about the financial aspect of the illness. It's terrible that you and your mother had to deal with such matters during a very traumatic time in your lives. I'm just glad that everything worked out for your family in the end.

    Take care,

    Mike
     
  9. Francois Caron

    Francois Caron Cinematographer

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    Carl, if your wife's uncle hasn't billed you for his excellent work, send him a gift! Even if he billed you only a small amount, send him a gift anyway!
     
  10. Carl Miller

    Carl Miller Screenwriter

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    Mike, thank you! It's most upsetting having to deal with mountains of bills floating in for so many months (in this case years) after the fact. Every one is a reminder of a very bad time. They need to do a better job here in billing to avoid things like this, there's enough to worry about as it is.

    Francois, you're absolutely right! He didn't bill me, and I bought him some golf balls because he always says you can never have enough of them. He was pleased, and having received my statement from the hospital as promised, so was I.
     

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