Bite Me, Medical Establishment

The BBQ Pit
1

I’m so pissed. Do I have any recourse?

Last month, my husband had an operation for a hernia and a hydrocele. At the time, we had no insurance. His condition had been diagnosed in Nepal as just a hydrocele, which we were told was not dangerous. It had, however, become uncomfortable, so we decided to see a doctor, pay out of pocket and see if there was anything he could do.

The doctor said he could asparate it, and then we could have the surgury later when our insurance kicked in. When he tried to asperate it, however, he discovered that there was also a hernia and said we would have to get the surgury right away. We asked him about the costs. After talking to the surgeon and the clinic where the procedure would be performed, he told us it would be $1,300 for the clnic fee and $500 for the surgeon.

We scraped up the money and hubby had his surgury. We paid the bill the same day. Nothing was said about extra charges and as far as we were concerned, we had paid the bill in full.

This week, I get a bill from the clinic. They are charging us an additional $1,300 plus $380 in “additional charges” that are not explained. I called them and they told me that they quoted the doctor the $1,300 price based on him doing only the hydrocele, and that the other $1,300 was for the hernia. I never did get an explaination of the additional $380. She also told me that all prices are only estimates, and that the doctor should have told us that. Well, he didn’t.

I’ve put in a call to the doctor’s office but they haven’t gotten back to me yet. I hate to be a jerk with the guy since he did work with us to get a discount, but I don’t think it’s fair that we were quoted one price and are now being charged more than double. We haven’t got any money, and we planned very carefully in order to be able to afford the original $1,300 and the $500 for the surgeon. I couldn’t pay this new bill if I wanted to (which I don’t). I am very concerned that the clinic will turn this over to collections and ruin my credit rating.

Is there anything I can do if they refuse to change their bill?

2

Aarrgghh. I wish I had a cite for you, Lucky, but I can’t remember where or when I read/heard/saw this…

I recently heard about someone who makes a living deciphering medical bills. You bring him the bill, he tracks down all the costs, usually saves the patient %20 of the total bill, and collects 10% of the savings.

(Here’s where it gets really hazy, so don’t quote this word for word; I’m only dredging up some examples I can remember):

If you take the bill to the hospital’s billing department, you will find that the hospital is charging $17.50 for a piece of surgical gauze and $22.50 for gloves - that’s where that extra $380 comes from.

If you can find something on the net about “medical billing” or “hopital billing errors”, you might be able to start from there and fight the extra charges.

Good luck :slight_smile:

3

I had a similar experience when I had back surgery. The long and short of it is this: The insurance company refused to pay about $8,000 of my bill for the assisting surgeon, as they felt an intern could have assited rather then another surgeon. I got a bill and almost shit my pants- I was only 20, trying to recoup from a spinal fusion, and looking at many years of debt to pay off this unexpected bill.

In an unbelivable act of kindness and support, my doctors office tried to recover the money (from the ins), and when they failed to, they wrote it off. Sent me a letter saying I had a 0 balance. They didn’t even know the bill had been generated until I called them about it.

Give the office a chance to explain before getting to freaked out. Good luck!

Zette

4

{hijack}

Lucky, could you send me an e-mail? I have a question for you (unrelated to this thread). Thanks!

{/hijack}

Esprix

5

Thanks for the advice, guys. I’m supposed to call the doctor at 11:30 today and discuss it with him directly. I’ll keep you posted.

6

Lucky- get an itemized copy of your bill.

Believe it or not, my hospital (which is great and gives wonderful care) routinely overbills patients, and says it is the patient’s responsibility to disprove or dispute the errors.

Once, they charged me 2-3 times for each day of my stay- 11/5/00 $500; 11/5/00 $500; etc. It was RIGHT THERE ON THE BILL, but they said they would have to research it. I have also been charged for being seen by a doctor I’ve never met. GRRRRR…

It was eventually worked out, but you need to be an informed consumer and check everything yourself. BTW, it isn’t too hard, don’t rush to pay someone else to check your bill when you don’t have the $ in the first place!

Good luck.

7

A friend of mine works in a hospital and got ticked off at some of the things patients were being billed for. As a Medical Assistant, he does various medical procedures and uses supplies the patient is charged for via a charge ticket on the packet.

If anyone made a mistake and got the wrong stuff, once it was opened, the patient was charged for it. Like a catheter of the wrong type or size. Sometimes if the person dropped sterile stuff, new stuff was obtained and charged to the patient. The hospital could easily take many things back that are reusable and sterilize and repack them, as was their common practice with supplies which sat on a shelf too long or were found to have been opened by accident.

Once it hit a patient’s room though, whether used or not, the patient go charged for it.

So he started pocketing the charge tickets until he was sure everything was used. The items that were not and could be resterilized, he shipped back and tore up the ticket. Items damaged or dropped by staff that could not be used, he marked the ticket ‘defective - no charge,’ and items brought in and used but turned out to be the wrong things, he either shipped back for sterilization or threw out and ripped up the ticket.

He’s almost been fired over that, but he keeps on doing it, only less obviously now.

8

OK, so I just called the doctor’s office. In his typical brusk manner, the doctor told me to call the administrator of the clinic. He said he would call him also. The doctor did not deny telling us that the cost would be $1,300, and he did not fathom a guess as to why were were charged more money.

So, I called the administrator, who treated me like low-life pond scum. After mentioning numerous times that the clinic was the epitome of good-heartedness, having given us a substantial discount, he went on to explain the extra charges.

He said that the doctor performed both a hydrocele and a hernia operation. I knew that. That was what my husband went in for. He then said that when our doctor negotiated the price, he told them he was only doing a hydrocele, which would have been $1,300. However, since the doctor did both procedures, the cost was more. He also said that the $380 charge was for an implant the doctor used in the hernia operation. The doctor never mentioned any sort of implant to us (I think we need to find a new doctor).

Anyway, I told the administrator that there had been no change in plans–the operation was supposed to be hernia and hydrocele from the begining, and our doctor told us the price would be $1,300. He said our doctor fucked up and we are basically SOL and have to pay the bill. He then went on to remind me that we, having had no insurance, represent the scum of the earth and that we are lucky they even bothered to provide services rather than letting my husband die in the street as he so clearly deserved. I guess the medical establishment doesn’t like to be paid cash immediately after procedures anymore.

So now I will wait and see if my doctor does call the clinic and what comes of that.

If our doctor did fuck up and quoted us the wrong price, I don’t quite know what to do. On the one hand, I feel he did try to help us and I don’t wnat to screw him out of money if he made an honest mistake. On the other hand, we discussed the fees with him on several occasions and he knew we had no money and that the cost was a very important factor to us. Besides that, we don’t have the money to pay (of course, if the INS would get off it’s ass and issue my husband the work permit he is entitled to we wouldn’t be in this position—but that’s a whole other story).

Oh, bummer. Actually it’s good news. It’s just that I already typed out the whole miserable story. Oh well—

The doctor’s office just called me and said it is all taken care of. I expressed surprise, telling them that the administrator did not seem to me like he was willing to budge. The doctor’s office told me that he was, in fact, quite a jerk with them as well, but that my doctor gave him holy hell, and he caved.

Yeah Dr. Bush!

If only everything in life were this easy.

9

Lucky, I sure hope that the clinic administrator didn’t say those things to you, or even intimate them, or you may have a real grievance to file.

Wait until everything is resolved, then nail this prick with the AMA, a local admin board, or whoever. And enjoy!

I hope your doctor has it taken care of, it’s nice to hear about someone who was willing to go to bat for you.

10

I understand your frustration completely. Scum sucking doctors and the stupidity of the medical staff who is unable to comprehend that if you have no health insurance…you probably don’t have much extra money.
I had a asshole doc who decided that he should do $300 dollars worth of tests that I didn’t really need. No insurance…full time student. Total bill was almost $1000 for a simple cyst on my back.
I had to let it go to collections. If the people are nice and work with you…you can settle for about 30% of the bill, but you have to have the cash right then. Also you can write a consumer disclaimer to put on your credit report explaining what happened. I learned about that last night when a lady called about one of those bills. It had not hit my credit report or collections for almost 3 years.
Also if the collection person or the acct person is an asshole…just deal with a sup or a manager. The doctor generally has nothing to do with the billing.
Contact Equifax credit reporting service for more info on your rights regarding your credit report.
I can post the three # for the reporting services when I get home for anyone to call and get info on their credit report.