What is wrong?


beagleboy

Recommended Posts

Back on Feb 14, I had a spinal fusion. The total time of the surgery was approx 3hrs. I just got a bill from the surgeon because my no-fault insurance has denied the bill. Hold on to your seat. The doctor's bill for the procedure came out to $43,000. What is wrong with this world when doctors could charge what they want? This is why this country's health and welfare is where it's at. This is totally ridiculous. Hopefully my health insurance will cover 80%.

Link to comment
Share on other sites

...I know this doesn't help your frustration ...but-( you might already know this..)...if you just pay religiously $10 /month, it will never go to collections...also-talk with the hospital admin./ the surgeon's groups and a lot of hospitals and doctors groups will wave a big block of the charges, especially if you make them an offer to pay a 1/3 or 1/2 in cash....just a thought...

I really hope you get relief with this,Beagleboy....

Link to comment
Share on other sites

You can hardly blame the doctors IMHO. The whole medical system doesn't work in this country IMO. Thank God I have great insurance because I racked up over $200,000 in medical bills in 2006/07.:(

Right there with you Tominator! I am certain I've passed the $500,000 mark since 2003. (The hospital gave me a free T-shirt... Whoo-Hoo!) Yes there were lawyers involved to get the insurers to pay their part. You have to get a lawyer with a situation as nasty as mine was. There was simply too much money involved for folks to blindly be signing checks.

The doctors themselves don't get that much of the bill. Neither does the staff that assists them, nor the hospital. An amazing amount goes to cover insurance for the folks that worked on you and facility the work was performed at. This is in case anything goes wrong and you end up suing! It's boils down to one insurance company paying the premium for another.

Your other insurer should have an "Out-Of-Pocket" maximum. Even if the 20% of the bill is more than that specified maximum, the maximum is all you pay. Some company policies are $2500 maximum out of pocket and some are more but it is likely significantly less than $8600.

Depending on your current earnings a major medical expense may also be tax deductible.

Hope this helps.

Link to comment
Share on other sites

i'll disagree with the lawyer aspect, leo. each state has an insurance commissioner, to make sure insurance companies don't cheat on their policy. so, call the insurance commissioner, and you'll get results free.

75% of what you are about to pay goes to cover attorney fees when someone sues, and they lose. unless we get tort reform in this country, expect to pay and expect attorneys to make hundreds of millions....

Link to comment
Share on other sites

Was the surgery not pre-approved prior to admission? Most of the time the hospital/surgeon's office will call your insurance prior for preapproval? I would check on that. I would also get documentation from your insurance and do as Steve suggested and contact your state insurance commisioner. If all else fails sometimes you can contact the hospital/surgeon and see if they will just accept what insurance will pay--the 80% (if they agree on that).

good luck

todd

Link to comment
Share on other sites

this country , need universal health care...soon..

As bad as this situation is, we do NOT need universal health care!:(:(

Look at the VA system and you will see what "government universal health care" is like in this country! It is horrible!:(:(

I have paid out over $250,000 from my own pocket in my lifetime. Yep, it hurts but I have done it and now I have better coverage so I won't get hit with those kind of bills again!:mad::mad:

I have never had anything to do with the system in Canada, but from what I hear, you have to wait forever to get treatment sometimes!:(

Link to comment
Share on other sites

i'll disagree with the lawyer aspect, leo. each state has an insurance commissioner, to make sure insurance companies don't cheat on their policy. so, call the insurance commissioner, and you'll get results free.

75% of what you are about to pay goes to cover attorney fees when someone sues, and they lose. unless we get tort reform in this country, expect to pay and expect attorneys to make hundreds of millions....

I wasn't trying to indicate Beagleboy needed a lawyer, I suppose it may appear that way. I agree, that's the direction you turn only when you have to. The two worst kinds of lawsuits you can be involved in, are ones you lose and ones you win :(

One bill, one doctor and facility. The insurance commissioner and Maximum out of pocket should handle everything solidly.

My case covered three different states and several different hospitals and doctors. It was pretty messy.

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.