vegas

My daughter recently injured her thumb at school. She was complaining that she thought she had broken it. I went to pick her up whilst my wife called blue cross blue shield of texas to get the name of a ppo hospital that was an in network hospital. I took her there and after an xray it turned out to be a strain which they put a brace on. So I thought that was that.

2 weeks later i have received a bill from the hospital for $700 which has been reduced by our insurance to $350. Also a bill for $350 from the doctor which is not covered. After talking to our insurance it turns out the hospital is ppo but the doctor working in it is not so we are liable for all his charges . Its absolutely incredible that you have to ask the doctor in a ppo hospital if he is also ppo if not to tell him to go away. :curse:

Jerseygirl

Annoying isn't it? Last year my insurance refused to pay over $200 for a blood test they deemed unnecessary. So when my doctor sends blood to be tested do I have to call the insurance company and ask if every single test is approved? Then call my doctor to tell him what tests he can request?

I have to say this is the first problem we've had...our insurance company is usually pretty good.

neil

Our insurance (Oxford) was pretty good earlier this year when my wife went to see a specialist (in network); then we got a notice saying the insurance wouldn't cover a decent sum of money. Anyway, it turned out that even though she went to see a doctor in network, the doctor that read the results of the tests was not and the whole bill had been put under that doctor's name. The insurance paid it because it wasn't our fault that this happened.

franc11s

SIMPLY fight it. Most people DO NOT and just pay iit. You called BCBS so it's NOT your fault. Stick to your guns and they will write it off. They do that ALL the time.

Friggin healthcare..... $700 for a sprained finger... $10 for the Dr, $5 for the nurse, $25 for the bandage and the rest to liability insurance for the hospital...........

katesbackagain

I intend to contest my latest bill. I recently had 2 wisdom teeth removed. I went to a regular dentist, who took x-rays the old fashioned way, one tooth at a time, then they referred me to an oral surgeon, who then did another x-ray (full mouth at once), then I got a nice bill from my insurance company. Both dentists were within the network. My insurance is supposed to pay for 90% of all my treatment/visits and my share of the bill was $95, there's was...........$65. Either I'm being shafted deliberately or someone in their accounting dept needs to be strung up by their pubes until they learn how to add up correctly. :curse:

Jerseygirl

Could be that you're only allowed one x-ray per year.

Duncan Roberts

Definitely fight things. We'd be about a grand worse off this year if we hadn't fought a few charges for me and my wife.

Mallory

The trick to that is not to go to an emergency room, unless it's an emergency. Make an apt with an orthopaedic doctor. They will take x-rays in the office, put on the splint and all bills will be under one roof - with less waiting time.

Brit3964

As the others say, fight it and DON'T pay it. I had the same thing happen in 2001. Went for a hernia op, was very careful to check everything was in network only to find the anethetist wasn't. I didn't pay it and eventually they wrote it off. You'll keep getting the same bill each month though until they give up.

For all of the NHS's faults, you don't get these kind of problems in Old Blighty.

katesbackagain

I thought that might be the case, but that bill was for the first x-ray I had. I asked the oral surgeon if I could just get it from the dentist and bring that to show them, and they said no, they had to do a full-mouth one.

Giantaxe

I agree with the advice to fight nonsense like this. Insurance companies assume that a lot of people won't and therefore reject stuff on the flimsiest pretence.

Duncan Roberts

Actually, most of the time it's been incorrectly billed and the denial is perfectly reasonable based on the claim submitted. I've had outpatient stuff billed as inpatient, my subscriber number wrong on the claim, tests sent to the wrong lab, claims billed under the wrong doctor, all kinds of stuff.

Bob

We got a bill a couple of days ago...for someone else...our address, my name, bar the middle initial...I know it ain't for me as I haven't had any work done on my knee...and I have both legs.

Trying to sort that out is a little weird

Silly Sod

Next time go to the emergency room, say you are undocumented and then pay them 5 dollars a month! Seems to be what the rest of america does lol

scrubbedexpat097

Excellent advise