Medical bill run around

iVillage Member
Registered: 05-28-2014
Medical bill run around
Wed, 05-28-2014 - 5:01pm

Hi Everyone,

In January, I was taken to the ER by ambulance with stroke symptoms. I had the usual tests and plus a CT and an MRI. .I have insurance through my husband's company and we were told by the insurance company everything would be covered but I had a $1000 deductible. The ER visit resulted in me having to see a neurosurgeon, another MRI and physical therapy. Again, I was told by the insurance company I was covered. It wasn't until I went for physical therapy that I was told by the billing office that my insurance company said I had already used my $500 a year outpatient but they would cover some because of a contract they have with the PT place. Of course I was told this after I had already had 3 sessions. Not trusting what was going on, I immediately canceled future appointments. 

I received my first of many medical bills at the end of April. The hospital bill is $22,000.00. The insurance only paid $50 of it plus the $500 outpatient. The bills for the lab work, the ER doctor, radiology, neurosurgeon, ambulance, the secnd MRI and PT were not covered at all. They all wanted their money paid in full in a week. On the hospital bill it said financial aid or charity is available to call with all income information etc. I had it all together and called. They never asked for my incoe information but instead told me what they will accept. It was $500 a month. We can't afford that. The lady said she'd have to talk to her manager and she would get back to me. The manager called me back and said she is only allowed to accept $200 a month at the very least. They'll allow that for 6 months before I'm charged interest. I asked about charity and was told I don't qualify. Mind you, they never asked about income. My friend who works for hospital billng told me I should ask for an itemized bill and ask for a discount for being a self paying patient  since my insurance didn't cover anything. It was a fight just to get that. I did manage to get my bill down to $5000 but they won't take anything less than $200. The other billing places are no better. One offered me a discount but I had to pay it right then and there. I asked her to send me a letter stating that is what is agreed upon and was told that's not policy. I told her my policy is not to make financial agreements over the phone and I'm protecting myself and her company by asking for a letter. Refused. Told me I had to pay them at the very least $100 a month. That is not in our budget with all these medical bills coming in. I just need some time to get everything in order.

I have been told by people to just pay all these bills what I can afford and as long as they're getting something, they can't send me to collections. I sent the hospital $55 dollars and they cashed the check but I received a phone call stating they will only accept $200 minimum. If I don't then they will take legal action. Once again, I asked about the charity program and was told I'm not qualified. I asked them how they knew that since they never bothered to ask for my income info. She said because of my zip code. I was then told I should learn how to live below my means and I'm what is wrong with America. I'm trying to get a hand out. I'm not, I'm trying to pay my debt. I have been trying to appeal to my insurance company and I'm not getting anywhere. They told me if all this had happened before the first of the year, I would've been covered but their policies changed with the new year. We've since dropped them and are now paying out of pocket for insurance that will cover us. My doctor wants another MRI done in July. I was told by the hospital that since I have a bill with them, I can't have an MRI done there. I have to go to a hospital for this that my doctor belongs to. If we paid all these companies what they want, we would be out on the street. I don't know how much more below our means we can get. We use prepaid cells, no cable or satellite, driving clunkers, we have never taken a vacation and we don't have credit cards. 

I guess my question is, can these billing departments legally cash my checks but still send me to collections because I didn't give them what they wanted? I was told by another friend to either file bankruptcy or just let them all go to collections. It'll end up being cheaper that way and the hospitals and doctors lose in the end. 

Avatar for elc11
Community Leader
Registered: 06-16-1998
Wed, 05-28-2014 - 10:19pm

I don't know the answer to whether they can cash your checks and still send you to collections because you're not paying as much as they want. Probably somebody else here can help with that.

I'm curious about how the ins company first said the hospitalization was covered minus $1000 decuctible, then later they said it wasn't covered. It sounds like in the end they told you that your coverage was $500 for outpatient and that's all? What does the policy booklet say? Have you spoken with the HR department at your dh's work? They might be able to help or advocate for you.

For the July MRI, talk to the doctor about getting the test somewhere besides the hospital like a radiology clinic. In my experience they are very good about stating their fees for cash pay and its usually well below the insurance rate. You do have to pay before the procedure but you can then submit to your new ins company for reimbursement/apply to deductible.

Best of luck in getting this straightened out.

iVillage Member
Registered: 11-28-1999
Thu, 05-29-2014 - 11:05am

The first thing to do is to get a copy of your health insurance plan and read it carefully to see exactly what is covered.  I have really never heard of health insurance that only covers $500 per year for outpatient services--what are you paying for coverage?  If that is true, then you might as well not even have insurance.  I pay for my own insurance and a cheap plan costs $500 per month.  All hospitals have to devote a certain amount of money toward "free care."  It is not charity.  I have never heard of someone being told they did not qualify for free care because of their zip code--generally you have to fill out an application with your income.  If you own a home, I don't know if you would still qualify.  I would call back the hospital billing office and say that you want to be sent an application--normally on the back of your hospital bill, they have a number to call for free care.

Depending on your other financial circumstances and income, it actually might be better just to go bankrupt, but you should consult a lawyer about that.  If the hospital bill alone is $22,000 and you have a bunch of other bills too, is this a debt that you realistically are going to be able to pay?  Although hospitals will give out free care, that won't cover any of the doctor's bills.  The fact that people say they wont' take less than a certain amoutn is really b.s.  Believe me, they will take whatever you will give them.  I don't think there is any rule that they won't send the bill to a collection agency if you are just paying a small amount, but so what?  Even if they sue you and get a judgment, they still can't get blood out of a stone.  Maybe the next time someone calls, tell them that if their requested payments are too high, you might just have to go bankrupt and they will get nothing, so maybe they should work with you.  You would think they would be more sympathetic to a sick person.

As far as the person who said that you are what is wrong with America, I would write a letter to the president of the hospital asking if that is how they train their employees to insult their patients.  I do not think they would want that bad publicity.

iVillage Member
Registered: 05-09-2010
Thu, 05-29-2014 - 11:09am

I can tell you from personal experience that the "pay only what you can and they have to accept it" for a hospital bill is totally false. You must call the hospital accounting office and explain your situation. Make payment arrangements. They are not a financial institution and do not have to accept your offer or make arrangements- but most gladly will. You may even get them to help you appeal the decision from your insurance company since you were told services were covered prior to your treatments. Just do not ignore their letters and their calls. Talk to someone!

Community Leader
Registered: 08-25-2006
Thu, 05-29-2014 - 2:19pm

First, I second what Music said about that employee that insulted you.  These hospital foundations are there for a reason.  It is inappropriate and uncalled for.  I am mad just thinking about it!  

I have my own ER insanely high bill, but I had no issue requesting the financial assistance form.  In fact, if approved (varies from 0 to 100%), it is good for 6 months.  

I don't know about the bills that are separate from the hospital, but here we only have one hospital, so generally as long as you send something every month, you are okay.  But like another poster said, still make sure and keep the communication open.  

My dermotoligist office tightened up their policies this year and she told me that they are really supposed to get everything collected in 90 days.  BUT, ultimately, they took my smaller payments (still $50 a month though).  So yea, I got a letter and a phone call, but they still took my money and did not send me to collections.  Of course, when I went to make an appointment, my file was flagged and they wanted to make sure I was paid in full before coming back in.  

I think the key for many places is the consistent, monthly payment, without missing a month.  

Wish I had something more helpful to offer.  All I can really say is to keep on with the insurance company, send everyone at least a few bucks every month, don't miss a month, and DON'T commit to a payment you cannot afford.  AND, keep on with the financial assistance thing.  I just don't get that at all!!  

Lastly, be honest with your Dr. about the cost.  My example is minor, but my dermatoligst froze off a bunch of spots and did not charge me.  Whether she would have had I said anything?  I don't know.  But I did and she didn't charge me.   Of course, you won't get an MRI for free, but the Dr. does have some pull.  I was honest at my PT  a couple summers ago and it was the Dr. that said "keep making her appointments as long as she can make payments."  

Enough babling out of me.  Keep us posted!  These kind of stories are very helpful to the readers.

Serenity CL making a marriage work

iVillage Member
Registered: 07-27-2009
Thu, 05-29-2014 - 2:54pm

My 2₵…I would stop communicating with the companies by phone and only submit my requests for information and financial support in writing. Mail them with return receipt requested so you have proof that they have received the documents. Write down times and dates that you do talk to them on the phone and what the conversations were, with whom, and what their ID/badge number was. I would also continue to pay what I could every month without fail. If they do end up taking you to court, you will have proof of the requests for information, the application for financial consideration, and proof that you were making an effort to pay them, but they have refused to acknowledge your requests for assistance. I don’t know for sure if this would be the “legal” way to handle it necessarily, but it would keep me from worrying about “he said, she said” if it comes down to litigation. Basically; documentation, documentation, documentation.


Additionally, I would mail/email everyone up the chain (President, CEO, Chairman of the Board, Manager, Supervisor, etc.) from the woman who said that about you living below your means. You are not your debt. Medical crisis happens and does not define you as a person or your financial situation. They are two separate issues. She has no right to verbally berate you. Take it to the top and let them know that you are not satisfied with the actions and attitudes of their employees/representatives.

JenAaron.jpg picture by jen2075

Community Leader
Registered: 01-03-2004
Thu, 05-29-2014 - 8:32pm

Two things immediately:

1)It sounds like they offered you a settlement on your bill: from $22K to $5K. Please be very clear if they consider that a "settlement." Why? Because you will pay income taxes on the $17K you don't pay. If you have a tax preparer, take this question to them.

Note: You've gotten all the 'charity' you're going to get from the hospital if they are writing off 75% of your bill. They will not be interested in giving you additional charity discounts regardless of your income. And while 'redlining' is illegal in the banking world, i.e. they determine by zip code whether you live in a low income neighborhood and deny you financing; I'm not sure it's ilegal in the collection business. (Might be something to check into with the new federal office of consumer protection.)

2)Yes, they can and will still take you to collections if they receive less than the desired minimum. It may make it harder for them to make a case to a judge in a courtroom, but it won't stop them from suing you and garnishing a paycheck or bank account either. Keep in mind, they can threaten to take you to court all day long to scare you into paying more but until you are served with court papers for an actual appearance, it's hot air. By the way, if you are sued, make sure you attend the hearing and present your side of the story. If you don't appear, the judge won't have any choice but to judge for the hospital. If you are served with papers for court, follow the instructions on these to file an appeal. 

Finally, never agree to a payment you truly can't make. Also, don't make "one time" payments in an effort to get a collector off the phone. They will expect you to make that a regular payment month after month if you do. (Which is why don't like to put anything in writing.) If you want something in writing, send them a letter stating the terms you can pay to them via certified mail. Keep a copy for your file. That way you can show you attempted to negotiate the debt payment.

Personally, if you're working at all, I wouldn't file bankruptcy on $5K. It will cost you $1,500 to hire a BK attorney. Might as well put that toward the bill.

I agree with Music that you need to examine your original medical insurance policy. The way you describe what it paid it sounds more like it was a medical discount plan which is NOT insurance. You may have bought something falsely represented to you as insurance.

Good luck.

Avatar for demecafe
iVillage Member
Registered: 04-08-2008
Fri, 05-30-2014 - 3:54pm

Are you sure they said outpatient and not out of network? It sounds more like you reached your max with out of network coverage. Did you check with the doctors prior to going to see if they accepted your insurance plan? I know for me it means a huge difference. Even with ER visits, which cost me $35, if the doctor that sees me is NOT in my plan, he is thus out of network and I end up having to pay the bulk of his fee. That's something to consider/look into with your insurance. 

When my son was a few days over one, he entered the hospital and ended up needing emergency brain surgery. The doctor in our plan was on vacation, so his partner had to do the surgery. His partner was not in our plan. We got a bill for $22,000 - from the surgeon (the hospital bill was upwards of $100k). We were in the hospital for a month, between the surgery and then recovery. THE DAY we came home I got a phone call from the surgeon's office asking for payment. I hadn't even gotten through the mail from being away for a month! When I said that I just got home/released today, I was told, "We saved your child's life, we didn't have to. You need to pay us." I was flabergasted. I called back after getting off the phone and asked to speak to the office manager, which turned out to be the very woman who said that awful thing to me. So I can totally see what was said to you happening. I'm sorry. :(

We've done payment plans with our pediatric dentist. When I got the recent $300 bill, I called and asked if it would be ok if I sent 3 payments.  I find if you're upfront they'll cooperate more than just sending them payments. I had also asked prior if they accepted payments so I had that knowledge when I called after I got the bill (they bill the insurance when the service is done then bill us when they hear back). Anyway, definitely do not just pay them whatever — call them, tell them that you can afford to send x amount. If they say no, then I'd be honest and ask what you can do then. But I agree with everyone to get certain things in writing. 

GL to you!! 


iVillage Member
Registered: 11-28-1999
Sat, 05-31-2014 - 10:07am

I agree with you on asking the doctor, but that works out better if you can ask ahead of time.  I need a root canal and found out that the cheap dental insurance I switched to is cheap for a reason--it only covers basic things like cleaning, X-rays and fillings.  So I told the dentist that I have no insurance and can't really afford to pay--she took off 25% and said that she usually doesn't do payment plans but she would do it.  I had another root canal from her before when I had insurance so maybe she gave me a break cause I was already a patient.