Disputing a hospital bill

[Sightwindow]

So the oldest daughter broke her ankle pretty a few months back. Along the way in the check-ups and different cast progressions, there was an offer by the staff for her to spend about ten minutes with a staff physical therapist. Bill for that particular part of the visit came to a cool $700.

I'm going to dispute this - I know there's something to be paid, but find the charge to be outrageous. Anybody got any strategy? I can provide other details.

Thanks

[swamp snorkler]

It sucks..... tell them you refuse to pay the whole thing and you want to settle for a lower price. My neighbor went in to get his heart checked it was $1400 for one particular test. His sister in law who works in billing told him next time to tell them he doesnt have insurance, the same test is $435 if he doesnt have insurance. Then submit the claim himself and let his ins. pay. It's all a money racket.

[cajunforeman]

It's awful, I brought my son last year to the ER with 103 fever. They told me to give him Motrin and Tylenol and said he had strep throat. Also, gave him codine for a cough. Keep in mind he wasn't even a year old. By Monday he wasn't better, brought him to the peditrition he had nemonia in both lungs. That doctor was really upset and told us in his 30 years of pratice he never prescribed codine to a kid and he didn't have strep. Needless to say I was pretty pissed. Tried to fight the bill with the claims department but it didn't work. Good luck it's all a bunch of crap if you ask me.

[SaltERedneck]

Request an itemized bill which includes the Current Procedural Terminology code (CPT)... it may even be on your bill. This is a numeric code used for billing purposes. You could then investigate the reimbursement or "Fee Schedule" for that particular code on the web. Once you have found a baseline price you can dispute the markup on the code. Companies will often mark up the price to compensate for other costs that are not reimbursable using a formula. This attempt may get them to take another look at their formula and pricing.

You can claim that the price exceeds the fee schedule allowance. You can even call other facilities and inquire about the CPT code pricing. Tell them you are interested in getting Physical therapy and inquiring about the price of the particular CPT code.

I am not sure what your insurance is but you should have some deductible being that its the end of the year... I would ask if insurance has made any payment on this as well.

You can always get an external auditor to look into the bill as well.... but you would be spending more money. He could then determine if the documentation reflects the billed CPT code. If its not documented it DIDNT happen.

These places want $$$ ASAP soo you may be able to settle for discount if you offer to pay so much upfront. Let me know if you have any questions.... I used to settle this stuff for both patients and the hospital.

[1fastmerc]

The worst place is St Pats and their clinics/ Dr offices that are affiliated with them. They was bought out or something along those lines and I guess trying to get all the money they could out of billing customers. They put a flag on me so that when I tried to schedule my yearly check up with my Dr it said I was behind on my bill. Come to find out it was a bill that they was sending to a wrong address. They wrote it off then tried getting me to pay the bill which was 4-5 yrs old. They refused to see me until it was taken care of by paying it or making arrangements to take care of it. I have no problem paying my bills but don't punish me for your mistake. I hate even thinking of going to any place affiliated with them.

Sent from my SAMSUNG-SGH-I317 using Tapatalk

[papap]

I had the ballon sinus procedure done a few weeks ago. Dr told me my portion was normally $3700 but hey would only charge me $500. Thought this was not to bad. Then when I got insurance statement I see why he only chartered me $500. He billed them for $40,000 and they ended up paying $17,000. The procedure was done in his office and took lest than an hour. Most of that time was prep work.

[bmatte8]

I went to lake area medical back in May to get a treble hook removed from the top of my head. A nurse made a small incision and removed the hook no problem. Never even saw a doctor. My insurance covered the first bill from the hospital, then a month after that was processed i was hit with a $1,150.00 "Emergency Physician Charge". The problem with this is that I never even saw a physician. I'm still disputing this bill today.

[Sightwindow]

Thanks for all of the advice, men! Keep 'em coming. It's insane what they can get away with..

[goldenrod]

You only have to pay what your insurance plan says is your out of pocket or deductible. The doctor or hospital can bill whatever they want, but the insurance carrier will not pay any more than the fee schedule that they have set up for that procedure.