healthcare

I got a bill from my general practitioner(internal medicine doctor) today for $1,200.

I saw him last year, 12/20/13 to be exact.
He takes my health insurance.
I had that health insurance at the time of service,

I had a physical done and he ran some blood work.
I asked at the time of service what I would be charged, I was told, no charge, "ObamaCare pays for 1 physical/year".

I also have the same insurance I had last year and wasn't billed last year, so I was set.

I asked the hospital about the bill, asking what I can do in the future to prevent getting such a high bill without any notice from my doctor, whom Ive seen ~20years.
I was told:
make sure your insurance covers his office
make sure your insurance covers what he plans to do
ask at the time of service the costs

I did all of those things, yet I have a $1,200 bill.
The hospital is going to send me a itemized bill so I can talk to my health insurance and see why this claim, for a checkup, was totally denied.


Any thoughts?

 

Typical health care issues.

If you haven't gone through such nonsense in the last 20 years, you are lucky.

 

Make sure that's not the unadjusted bill, before you do anything else.

We had to take The Guy in to the emergency room last year, and they sent us a bill for nearly $2,000. A week or so later they sent us a new bill, one that had been adjusted to show how much of the total amount was covered by our insurance. That second one was much more tolerable.

 

Just sitting here shaking my head. What did you expect?

http://www.youtube.com/watch?v=vdnY8r7_fLw&feature=player_embedded#!

:-D

 

I guess I'm a little confused. You have your own insurance, yet they're talking about something to do with the new health care reforms? Those shouldn't in any way affect what your insurance covers, or what you have to pay once your insurance adjusts the bill and pays their part.

I've spent entirely too much quality time with hospitals and doctors in the last couple of years, and I've never heard of such a thing as any insurance covering one physical per year at absolutely no charge to you. Sounds to me like they tried to send the bill to whatever company is handling insurance due to health care reform instead of your insurance, and it got denied since you don't have coverage with them.

Or, your insurance company is like the one I used to have, which informed me since I didn't get pre-approval to be admitted for five days through the ER they weren't going to pay anything. And then when that got taken care of, they were only going to pay for three days, because they didn't feel it was medically necessary I be there longer. Eventually, with a lot of help from my doctor's office as well as the hospital billing office, they paid everything (except of course my deductible and co-insurance).

 

In addition to what Sgt Tibbs said, I don't think obama care kicks in for another year or so.

 

That would be patently stupid of them. If they had two brain cells to rub together they would realize that sending the bill to the insurance company that actually covers the patient in question makes it far more likely they will get paid at all.

My insurance actually does cover my annual physical as well as anything else that is considered "pre-emptive measures", aside of course from co-pay and deductible, but I have a good insurance provider and have no problem paying for good coverage. Little things like that ER visit make up for the premiums.

 

Here in Belgium medical insurance is compulsory and when you visit a hospital the first thing they ask for is your identity card (these are also compulsory) they then punch your ID number into the computer and it brings up your insurance details so they know directly if they are going to get paid.
If we visit our local GP we have to pay him/her at the time of the visit and then reclaim it from our insurance.
The system works well but to be honest i am not sure what happens if you are not insured, for instance if a homeless person is involved in an accident treatment would not be denied but who pays?
In the last 10 years i have had millions of dollars in surgery (3 spinal surgeries and both hips and pelvis rebuilt plus a number of surgeries just to tweak the metal parts i have inside,(14 operations in all) and i have not had one problem with the payment,we do have to pay a small percentage of the costs,1% normally ourselves but it is negligible and considering the quality of service i have received it is a price i am happy to pay.
i have visited the US on many occasions but since my accident i have not been able to get full cover insurance due to as they put it "a pre-existing condition" but i have been lucky in never having made a claim.
I realize that the insurance companies need to make a profit but they also need to provide a service it just appears that all they want is your money.
here as with the US costs for medical treatment are exorbitantly high and the practitioners know they can charge these prices because the insurance pays.

 

It's amazing how often things get sent to the wrong insurance company, especially if yours is out of state. My insurance is BCBS out of New York. Every single time I went to a doctor, they would bill BCBS of Michigan, even though I made sure to tell them it was New York and they had a copy of the card with the contact information on it. Which of course got denied, since that's not where I had my coverage. It used to take at least six months to get straightened out.

They've changed the rules now, and all of the different BCBS companies have gotten together under one umbrella so your home state gets sent the paperwork even if your insurance is not through them. Makes it a ton easier. But it seriously used to happen every single time I went to a doctor. I was convinced they did not, in fact, have two brain cells to rub together!

I wasn't saying insurance shouldn't cover an annual physical...what I was saying is that I can't imagine it would cover it at no cost to the patient, which is how I read the original post. Meaning no charge whatsoever, even co-pay or deductible.

 

I was gonna mention that, but I know some of it took effect immediately, with a time frame for the rest of it to phase in. It will be next year before the entire thing takes effect, but I wasn't sure if this was one of those things that was in the earlier parts or not. I didn't pay that much attention, since I already have insurance.

 

A few things to check into that may lower the bill:

* If you have insurance, the provider should be billing you the insurance company's cost (not the retail cost) of services provided in the event it's an issue of your deductible. As an example, the "retail" price of lab work may be $500; the insurance company's negotiated payment for the same service may be 50-75% less.

* Call the provider's billing office and ask for an explanation of the charges not covered by insurance. More than once, I have had cases where lab work or other services were mistakenly not submitted to the insurance company and I was billed for them.

Hope this helps.

 

Here, we can't require a photo ID to vote because it might disenfranchise minority voters.

The next 5 years or so will be interesting, to say the least. :-D

 

The only problem with the UK healthcare system is that like any government funded project (no matter which country) it is overloaded with middle management who tend to look first at the numbers instead of the patients.While front line staff do their best they are hampered by bureaucratic decision makers who many of which are not medically trained and do not understand the logistics of patient care.
Looking after sick people is an intensive occupation done by dedicated nurses and doctors who do not look first at the cost.

 

I didnt realize all how many gov funded project deal with patients?

funny doncha, think, that the responsible persons to take care of a sick person arent the sick person
they dont need to be at the correct weight, workout, eat smartly, dont smoke, dont drink, etc

the squeaky wheel gets the grease,,instead of rewarding those who take care of themselves, the sick get the discounts and the healthy are forced to pay for them
what would Darwin think? we have no more survival of the fit,l instead the weak get to breed and spread their genes more than the fit.
its like the movie
Idiocracy
http://www.imdb.com/title/tt0387808/
http://en.wikipedia.org/wiki/Idiocracy

 

They told me that this december as I was standing at the desk to checkout with insurance card in hand. I asked a TOUGH question,
HOW MUCH DO I OWE?
nurses/receptionists told me different things
1 we dont know till we run it through your insurance
2 no charge, its OBAMCARE you get a free preventive physical every year

you think too highly of them, they didnt know what insurance I had, they just said what they thought/felt---remember, I am in their office right after I saw the doctor asking them what I owe when they told me what they did. I havent talked to his office since, I call the hospital billing dept, his office didnt send me a bill yet.

actually, YES MY INSURANCE IS A LOT LIKE YOURS

I have a doctor in St Louis, he's a "Neuro-Ophthalmologist", the surgeon who did both my double vision surgeries and prescribed prism glasses.
he retired
I found a new Neuro-Ophthalmologist who took my insurance in KC, where I live.
Because I have student health insurance, I get a deduction off my deductible if I first go to my school health center and get a referral.

So I went to the school nurse and had her write me a referral to see the Neuro-Ophthalmologist.
Eventually, I got to see my Neuro-Ophthalmologist, MD, not a optomertist,
I wish I had seen the optometrist now as I could for <$100, which was a lot less than seeing the MD, who wrote me a script and I got some glasses that help me read for prolonged times in skool.....err.... school

so now, If I talked to my school nurse, after I get a final bill from the insurance/doctor, I'll save $100 or so.

I get some help in this matter from my mom, who had to deal with my insurance(thru my dad's employer) when I was in a coma.....that was a headache.:wave

 

In the UK health care is free to all and is funded by government but it gets badly abused by what are known as health tourists who arrive in UK as visitors and then get themselves admitted to hospital for very expensive operations and when they recover return to their home countries without paying as there is no legal structure to recover the costs so the system is under ex-stream pressure from extra patients and the constraints of government trying to cut costs.

 

Australia's health care system, (Medicare) isn't to dissimilar from England's N.H.S. system. Wage earners pay a compulsory 3% of their earnings, (subtracted automatically by employer), and it means anyone, (who can get to a Doc who charges at Medicare rates), ('Bulk Bills) can at least get free medical attention and very heavily subsidized medicine if on S.S. payments. It's not perfect and is over-burdened, but it's one of the best health care systems that I've come across.
When I lived in the U.S., I was amazed at how many people were paying anything up to a third of their income in medical insurance. Not a good way to go, i.m.o.
Sure, you can privately insure here, too, if you want your choice of Dr., private room, etc., but it costs you, for sure. And yes, most private insurance covers annual medical checkups, too, (I am private, myself).

 

Sweet! Now if I could just get over my fear of flying, I could take a medical vacation in jolly olde England! :-D:-D

 

As to them not knowing how much you owe until it gets run through the insurance company, that is absolutely true. They do not. They can tell you the retail cost, but that is not what you will end up paying. Your insurance company has a discount, which automatically cuts the cost of service by 40-50%, then your portion is your deductible and/or co-insurance, depending on your coverage. For instance, my co-pay is $30 for an office visit, then I have an annual deductible of $1,000, then I have to pay 20% of the total cost up to a $5,000 maximum.

No, they do not know off the top of their head what coverage the person standing in front of them has. And honestly, even if they were looking at a copy of your insurance card, they have no way of knowing what plan you're covered under, how much it pays, or how much you will owe. The only information available to the person sitting at the desk is the company you are covered under and any co-pay amount, because that is all the information available on your insurance card. Your doctor has no way of knowing until they submit their claim to your insurance company how much, if anything, will be left for you to pay.

As an example, the total hospital bill for my recent surgery was $9,518.45. Between the insurance adjustment for their discount and the portion of that total they paid, my bill was for $465.10. But had I asked at the hospital the day I had surgery how much I owe, they would have told me $9,518.45, because they don't know what insurance will pay until they submit a claim.

I can't speak to the coverage under health care reform, because it does not affect me. I was not aware until this post, however, that you are considered a child since you are in school and still covered under your parents' insurance, which also makes a huge difference in how things are handled.

Typically when you visit the doctor, you pay your co-pay when you are there, and then after the insurance company works it out with the doctor's billing office, you find out how much you owe. This typically takes a minimum of 30 days, but often several months. I started physical therapy on December 4, and finished on February 22, going twice a week. I got my FIRST bill on February 27. My surgery was October 30. I got the bill from the hospital on January 6.

 

Sgt. Tibs, around here, there are two prices for many things. Healthcare, auto glass replacement, body work... There is the lower price if you pay cash, and a much higher price if you have insurance.

Sounds bad, but just wait until the gubment gets more involved. :cry

 

That would actually be a welcome change! Around here, if you don't have insurance, you get charged the original amount. So if I didn't have insurance, my hospital bill would have been $9,518.45. And while they will technically make payment arrangements, their maximum time to pay off the bill is 24 months.

The 12-day hospital stay I had at the beginning of 2011 without insurance left me with a bill for just over $33,000...which they gave me 24 months to pay. I failed. rolleyes

 

Think we will just have to agree to disagree on this one Sgt. Tibs.

:cool

 

We can do that, but I'm not sure what we're disagreeing about. I simply said I would welcome having a discounted price if I paid cash, as opposed to the insurance company getting a 40-50% discount for the same service which is not available to me as an individual.

Of my $9,500-ish hospital bill, the insurance discount was just shy of $5,000, whereas if I had to pay it on my own it would've been $9,500-ish without the discount. I would love the five grand discount for paying cash! The hospital obviously doesn't have a problem with eating that cost, since they do it for an insurance company.

 

Ahh, sorry Sgt. Tibs, I mis read. :-D

Just my opinion, but that is one reason insurance is so high. Companies learn how to max out the payments, and many people don't care, as they don't actually pay for it.

OT, but I would vote for this guy in 2016!! And makes some good points about health care and how to pay for it.

http://www.youtube.com/watch?v=GOuM1etgKUc

Long, but worth a watch IMHO.

 

that's why Im waiting for the insurance to send me an "Explaination of benifets"

THats what Im figureing out, that instead of saying, "we dont know" they gave me their opinion, for some reason, to a serious question.

I said that? I am too old to be covered by my parents and I have my insurance, income, home, pet cat.....car.....problems...gym membership....genes,(radiation is a bitch:-D)

Ive never had a bill from a MD come so late, but it seems it is very possible
thanks for the info

 

You did not say in so many words, no. But this phrase, "who had to deal with my insurance(thru my dad's employer)", as well as you talking about being referred to a doctor by your school nurse, leaves the impression that you are probably in high school or college, and under the age of 25, since you cannot be older than that and still covered under your dad's insurance he gets through his employer. I apologize if there are some special circumstances under which you are considered an adult while still having insurance coverage under a family plan that your parent's employer provides.

 

Personally, I am glad we have the NHS. I have easily dis-locatable kneecaps and as a result I pay a very painful trip to A&E once every few years. If I was in the US this would have cost a ton by now on my parent's insurance (and now on my own as I am over 21) just in A&E bills.

It's interesting to note, however, how our current "government" is attempting to destroy the NHS from the inside (along with the police, coastguard, and other critical services) by cutting too deep in the wrong places.

Absolutely. But who is now getting cut? The doctors and nurses.

 

being someone who has had a issue with reading large blocks of words, I have nothing but sympathy for you to take things out of context, or perhaps it was my fault for not providing a detailed timeline of events of the tangent to the OPs main topic.
-have you ever heard of a K-12 nurse giving a referral to deal with insurance? I havent. I never even knew that school nurses were actually nurses, I thought they were just cafeteria workers?
-the only reason I was still under my parents plan when I was in the coma was because I was 21yos, no job and in med school. then I aged off and had to get insurance thru my school.
I also had said a clues throughout this thread, I'lll list then because I am procrastinating doing legit work, I do appreciate insight into this problem, although this thread is more of a *itch session about healthcare:wave

The same phrase says some rather key info about when this occurred:

I didnt say that was 9 years ago, I thought other things I had said in this thread made that clear I wasnt on my Dad's insurance:
such as
-

I would have been the best son if when I was younger, I understood/cared things I did cost my parents money.

I have a doctor in St Louis, he's a "Neuro-Ophthalmologist", the surgeon who did both my double vision surgeries and prescribed prism glasses.
he retired
I found a new Neuro-Ophthalmologist who took my insurance in KC, where I live.
Because I have student health insurance, I get a deduction off my deductible if I first go to my school health center and get a referral.[/QUOTE]

yeah, the whole issue about a neuro-opthalmologist is about getting double vision from my head injury-->coma

dang, I dont know what else to write, guess I better make some new threads or *gasp* do something productive.
:zzz

 

Good god, but you're argumentative, aren't you?

 

yes and no...as I said in the post

 

Just wait until 2014. Then the excrement will hit the rotating device in the US. :-D

 

what do you mean?

 

Obamacare hits full force.

 

The numbers are disputed. I have seen that it may cost a family of 4 around $20K a year, but that may actually start in 2016. But, in 2014

http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act

So, if you don't have an acceptable plan, you get to pay for your health care, and pay a tax.

Now, not trying to get political here, but how many times have you seen an estimate of a cost from the gubment be accurate? Seems to me they always cost a lot more when it gets down to paying the bill. :-D

 

Actually, I think that is 2016 and beyond. But we get to start paying the IRS for the privilege in 2014.

 

thanks for the info and I dont think you got political, I just like emotionless facts.

This healthcare issue makes me think of having to pre-pay the IRS for stocks/etc, based on what I paid last year,...which is pretty much like walking into a store and giving them money based on what I spent last time I was in the store...then when I check out ,I might get some back...
something like that

arent the federal employees/ie congress exempt from all that BS? that have the greatest health plan on top of their 6 figure salaries and no boss/accountability

I dont get why we have a univeral healthcare plan, if we dont have universal car insurance or anything else

what was said as an into to the movie, Idiocracy:
As the 21st century began, human evolution was at a turning point. Natural selection, the process by which the strongest, the smartest, the fastest, reproduced in greater numbers than the rest, a process which had once favored the noblest traits of man, now began to favor different traits. Most science fiction of the day predicted a future that was more civilized and more intelligent. But as time went on, things seemed to be heading in the opposite direction. A dumbing down.
How did this happen? Evolution does not necessarily reward intelligence. With no natural predators to thin the herd, it began to simply reward those who reproduced the most, and left the intelligent to become an endangered species.


http://www.youtube.com/watch?v=icmRCixQrx8


why are americans so fat? oh because people can stop eating...it's called addiction,...

why dieting is so hard to do, dieting is literally drug rehab and you are going cold turkey, in most cases

but can be expected from mankind? we dont adhere to the basics that got us to where we are today...ie, natural selection....no one dies, in fact worse then that, the worst genes are being passed on faster than the best genes and the best genes have to care for the worst genes(Ie people who have an education/drive/accomplish things with their lives) are taking care of teens with kids, drug addicts, hobos.


and a huge population of people who do nothing but sit in a cell and get 3 meals a day and suck money out of my pocket(prison system)
I watch this show called Deadly women and Deadly sins, about people who kill others in devious ways and sometimes get caught.....but even after they kill families of people, they are sentenced to 5years-LIFE WHY? why are they in jail where we pay for them and not just killed?

now with addicts running around, Food addicts/fat people are addicts, but they look like fat people. the herd is taking care of them instead of moving for.......
huh? oh I can't finish my thoughts, Im too busy watching the Kardashians, MTV, aMerican idol and other REALITY TV while stuffing my face with ring dings and ...mmmmmmmmmmmm...

hmm microwave popcorn..this is safe, hmmm diet MT DEW and addiction free amphetamines...let me unbuckle my belt on my elastic sweat pants and watch
"sum TV"..

 

I just blame the low information voters, and the gimmedats. :-D

Ore more simply: “When the people find that they can vote themselves money that will herald the end of the republic.”

― Benjamin Franklin