Hospital billing



  • In January 2007 I had to have radiation therapy for a cancerous tumor. It was administered over the course of four weeks.  Every weekday I would drive down to the hospital, check into the Radiation Oncology clinic, change into a gown, then get led to the radiation room. There they'd spend five minutes positioning my body, two minutes shooting X-rays into me, and then send me home. I was usually in the hospital less then half an hour each day.

    A few weeks later the hospital sent me a $650 bill (a $50 copay for each visit in January). A couple weeks later they sent another $450 bill for copays in February.

    My brain wasn't very sharp after four weeks of radiation on top of ongoing chemotherapy. But eventually I got around to paying the bills. I didn't want to confuse them so I wrote two checks, $650 and $450. But I sent them together with the bill stubs all in one envelope.

    A few months later I got a call from a collection agency. They said I was delinquent $450 to the hospital. I double checked the service date, double checked that my checks had been cashed, and sent the collection agency copies of the cancelled checks from my bank.

    A month later I got another call from the collection agency. The hospital still says I'm delinquent! So I call the hospital billing department to see if they had not, in fact, gotten money from the check they cashed.

    The billing person looks at my records and says that I still owe $450 (six months past due now) on my radiation therapy bill. But oh-by-the-way, I have a $450 credit on my other radiation therapy bill. In my radiochemobrain confusion, I had written the account number from the $650 bill on both checks.

    Okay, maybe that's my fault. I wasn't really expecting to have different account numbers for two bills for the same exact service separated only by calendar month. But wouldn't it have been nice to check whether I had an outstanding positive balance before sending a collection agency after me?

    The funny thing is, if I had just buckled and paid another $450 to settle the account, I doubt the hospital would have ever sent a reimbursement agency to track me down and give me back the other $450 I overpaid.



  • Thanks to ammoQ that lets me know how to write things

    I wanted only to say that I love being in Italy since you don't have to pay for healthcare (or, at least, not too much). However we have a lot of taxes.

    Anyway good luck.



  • Did at least things get solved? Did they cancel out your debt with your credit and call off the collection agency?



  • @AlpineR said:

    I doubt the hospital would have ever sent a reimbursement agency to track me down and give me back the other $450 I overpaid.
    Yup, funny how they always forget, isn't it?

     



  • My cable company did the exact same thing to me. They shot me with x-rays. No wait, they just have the same WTF billing system that your hospital has.

    I pay my cable bill online, so when I got a $35 bill after they had a technician out to fix a problem with my line I paid for it the same way I pay all my cable bills: On my bank's web site I typed 35 into the Amount text field and selected my cable company from the dropdown menu

    The following month I received my cable bill, but it had a separate section detailing the $35 charge that they claimed I still owed. The worst part of it was that the girl from the cable company with whom I spoke seemed really put out that I didn't go through all the trouble of figuring out that they wanted me to pay for this particular bill in a completely different way than every other bill from them.



  • @AlpineR said:

    The funny thing is, if I had just buckled and paid another $450 to settle the account, I doubt the hospital would have ever sent a reimbursement agency to track me down and give me back the other $450 I overpaid.
    I've overpaid bills on several occasions (e.g., paid for a whole month of cable service, then canceled part way through the month) and received checks for the amount of the overpayment every time.  I'm sure they'd rather dillegently repay overpayments than face a lawsuit when they get caught not doing so.

     

    See also: http://www.bash.org/?127039

     

    At any rate, it is really sad that this is considered acceptable customer service these days.  You'd think, rather than sending a collection agency after you, they'd at the very least ask for authorization to transfer your overpayment from the overpaid account to the dellinquent one.  Or just use a single account. 




  •  @AlpineR said:

    Okay, maybe that's my fault. I wasn't really expecting to have different account numbers for two bills for the same exact service separated only by calendar month. But wouldn't it have been nice to check whether I had an outstanding positive balance before sending a collection agency after me?

     Same thing happened with my wife.  She was diagnosed with an AVM, and was referred to a neurologist(sp?).  She visited him twice.  Once in November 2006, once in December 2006.  She received two bills with two separate account numbers.   Luckily I caught it when filling out the checks so we didn't have to deal with what you dealt with.



  • @merreborn said:

    I'm sure they'd rather dillegently repay overpayments than face a lawsuit when they get caught not doing so.
     

    I think it depends on the company.  Phone companies and power companies seem to treat (me at least) well in this regard, on the other hand, I've had a delinquent $0 balance from a cable company I never was never even a customer of.  



  • @merreborn said:

    See also: http://www.bash.org/?127039
    hehehe nice one



  • @arty said:

    I think it depends on the company.  Phone companies and power companies seem to treat (me at least) well in this regard,

     

    I once paid way too much for my cellphone bill (4321€ instead of 43.21€) and the company promptly contacted me and told me the necessary steps to reclaim my money.



  • A friend of mine had a problem with the billing department of his hospital recently, as well.  After an emergency appendectomy, he was left with a bill of about $8,000 (I don't know how much insurance covered, but it wasn't much).  He arranged with the billing department to do monthly payments of $500 or so.  After a few months, he got a new job and moved to another state, and continued paying his monthly amount.  About a month into his new job, he started getting harrassed (and I mean harrassed) -- hourly phone calls, door knocking at late hours, threats of arrest, etc. -- by a collection agency.  Also note that he never got a paper notice about the delinquient payments, the collection agency was the one to notify him. Apparently, the person he talked to at the billing department didn't file all the correct papers, so while he didn't get delinquient notice papers because he wasn't technically behind on payments, the person who calls the collections people only saw a remaining balance.

    This was further worsened by occurring during a holiday weekend, in which the billing department was only staffed by temps who did not know how to verify that he was not delinquient and to call off the dogs.

    I would not wish that on my worst enemy. 



  • @Zecc said:

    Did at least things get solved? Did they cancel out your debt with your credit and call off the collection agency?

    Yeah, the hospital billing person was actually helpful and got the bill/balance issue fixed. The whole thing shows up on my credit report as an overdue medical bill with zero balance. I don't think my credit rating should be marred by such an innocent mixup. But since I'm still dealing with the cancer part I don't really care. 



  • @ammoQ said:

    @arty said:

    I think it depends on the company.  Phone companies and power companies seem to treat (me at least) well in this regard,

     

    I once paid way too much for my cellphone bill (4321€ instead of 43.21€) and the company promptly contacted me and told me the necessary steps to reclaim my money.

    When I went from PAYG to 18-month contract, I didn't know that the carrier had set-up my billing to automatically charge my credit card each month. So when I checked my balance online, I paid it in full, using my CC on their site. Turns out that they did the charge that same day, so I ended up paying twice my bill. Of course, this was given as credit for next month, so I didn't really have any problem with this.

    But TRWTF is that the mobile carrier actually let me pay the bill, given that they already knew I was on the automatic charge system!



  • My fun time was when I went into an emergency room after a skiing accident which screwed up my knee. Aside from waiting 8 hours only to be told by the doctor to go see an orthopedic surgeon, I eventually received a bill that had line items for X-Rays - something that I definitely did not have. I called up the hospital to query the bill, and they said "Yes, X-Rays of your hand. For that nasty hand injury you had". I pointed out that I was there for a knee injury, and to send me a new bill when they got it right. 12 months later I finally got the correct bill. I suspect that something fell off their accounting system after 12 months of non-payment and they finally bothered to issue the correct bill.



  • You know, given the number of hospital billing stories that are out there, I seriously wonder how much of the cost of health care is in administration (or more directly, the overhead of billing)



  • @WeatherGod said:

    You know, given the number of hospital billing stories that are out there, I seriously wonder how much of the cost of health care is in administration (or more directly, the overhead of billing)

    Given the horror stories on seen occasionally on here about the MUMPs system, I wonder how much those support costs are adding to it.

    [url=http://en.wikipedia.org/wiki/MUMPS]MUMPS programming language[/url]


    [url=http://thedailywtf.com/Articles/A_Case_of_the_MUMPS.aspx]A case of the MUMPS[/url]


    [url=http://thedailywtf.com/Articles/Avoiding-MUMPS--Arcadius.aspx]Avoiding MUMPS[/url]

    But something is fishy, given that the per capita spending on health care is amongst the highest in the world, but the quality is typically reported as being no where near the highest.



  • I can't speak to specific numbers, but I have read that it's a significant chunk (in the US). And of course, the real money is in billing the insurance companies, since they pay the largest share. If you're a health care provider, you can actually outsource your billing to a company that specializing in filing insurance claims. They know just which procedure and diagnosis codes to use, in the cases where two or more roughly equivalent codes could be used, to ensure maximum pay-out.

    There are even schools to train medical coders. Where there is room for a middle-man like that, you can be sure there is a great deal of inefficiency.



  • @dgvid said:

    I can't speak to specific numbers, but I have read that it's a significant chunk (in the US). And of course, the real money is in billing the insurance companies, since they pay the largest share. If you're a health care provider, you can actually outsource your billing to a company that specializing in filing insurance claims. They know just which procedure and diagnosis codes to use, in the cases where two or more roughly equivalent codes could be used, to ensure maximum pay-out.

    There are even schools to train medical coders. Where there is room for a middle-man like that, you can be sure there is a great deal of inefficiency.

    I did medical coding for a short while several years ago.  It's actually an interesting system.  Most of the codes and standards are actually set by Medicare, though.  The private insurance companies just follow them because it keeps things simpler, especially when dealing with insurance that is supplemental to Medicare.  Since CMS is the single largest healthcare provider in the US (accounting for about 1/3rd of all health care expenditures), everyone else conforms to the standards set by the Federal government.



  • This thread reminded me of my funnest billing experience.

    In college, almost every day for a year, I came home to the rapid, hysterical babbling of a woman with a THICK southern (US) accent on my answering machine. I could not make out hardly any of her words. I played it for my friends and they couldn't make heads or tails of it either. It was funny at first but after a year it was just annoying. Finally, in one of the messages I was able to understand a toll-free phone number, so I called it.

    I was immediately put on hold without any indication of who I was calling. I was on hold for at least an hour (left it on speaker phone while I was watching a movie).

    Finally, someone picked up. It was another woman with a southern accent but I could understand her this time. She was very rude and berated me for owing all kinds of money. She had my full name and phone number but she had the wrong social security number (thank GOD). I asked who she represented: Capital One -- the "no hassle" card™.

    I just started laughing my ass off. I was being harassed like crazy for a year by the "no hassle" credit card company, and I didn't even have a Capital One card.

    The woman didn't appreciate my laughter and refused to believe it was all a mistake so I eventually hung up. Turned out OK because I moved far away soon after and never heard from them again.


Log in to reply
 

Looks like your connection to What the Daily WTF? was lost, please wait while we try to reconnect.