Payments on Medical Bills - Question

[Shugness]

I'm asking this for a coworker - her husband had a minor biking accident that hurt his shoulder and eventually led to rotor cuff surgery in December. He has been getting a lot of bills from the hospital, physical therapy center, surgery center, etc. He has insurance but it wasn't the greatest so he's responsible for what's left over.

Anyways - he owes $1600 to the clinic/center that actually did the surgery. My coworker and her husband were told they could apply for a Care Credit card account where they could finance that $1600 over the next 18 months interest free.

Long story short on that - not that this makes any sense but essentially he is now being told that he can only finance that $1600 for 6 months and it has to be paid off within that time frame.

Under normal circumstances they could pay $266 a month, but like I said this is not the only bill from this surgery that he owes right now, just happens to be the largest one.

My coworker has told the doctors office they could pay $100 a month right now (then pay more when the smaller ones are paid off) but no more. The doctors office is saying if its not paid off within 90 days (unless its put on the 6 month card) that they will turn it over to a collection agency and take them to court and have a judgement filed, wages garnished - whatever.

It seems foolish to waste time and money taking someone to court when they are paying you a significiant payment each month - they may get their money sooner but its going to cost to accomplish that. And I can't see a judge garnishing someones wages that is making payments.

So I think the doctors office is bluffing. I have heard before on medical bills as long as you pay a certain amount every month (which the amounts have varied, but it was under $100 in all those incidences) that they have to take your payments and can't turn it over to a collection agency.

I'm sure this may very from state to state, but I'm talking North Carolina in this case, but I'd be interested to hear how that all works in other areas too. Also, does it vary depending on how much is owed and who it is owed to - for example does a hospital have to work with you more than a private doctors office does?

TIA

[KimE]

I live in Washington State and when I was a single parent I always had to make payments and I was never told you have so many months to pay, in fact my friends that work credit/collections have always told me as long and you make a payment EVERY month, no matter how small they can not file a jusgement or send you to collections. I have never had an issue and there were time I could only pay $10.00 on a $400.00 bill a month and was never questioned. But I also never missed a payment.

Kim

[Gumbeaux]

If your coworker and her husband are in a difficult financial situation, I would work on getting the hospital to reduce the amount of money owed first.

[blazedog]

There is no requirement that any creditor HAS to accept less than what they are contractually allowed.

As a practical matter, many doctors would accept a payment schedule -- when they send a bill to collection, they in effect either pay the collection agency a large percentage or sell the debt for a percentage of face value.

However, there is every reason why a doctor's office would not do this since they would have significant accounting expenses in terms of billing and accounting for payments -- as well as the risk that the full amount might never be paid.

My sense is that a doctor's office/clinic that has ties to a third party finance company is one that has pretty firm regulations and not much discretion -- I would assume that the doctors are employees of a corporation and don't have much impact on the administration.

From what I have read, doctor's offices are tightening up credit and billing practices -- many of them will not perform services unless the co-payment is paid in full prior to your seeing the doctor.

This person might want to speak to the insurance company -- maybe they have some clout with the clinic.

[hollysmom]

While this is no means a pleasant solution, can your friend take a second job and work to pay these bills off by increasing their income? I would guess that hubby would be home to watch the kiddos (if they have any).

SSM

[Jessnc]

I don't have any expertise in the medical billing area, but I can lend insight into my current situation.

I wanted to set up a payment plan with my hospital for my surgery bill. The first option was to pay off the bill in 6 months, which I could no way, no how ever do, so the hospital then told me that my only other option was to open an AccessOne Med card, which is like Care Credit - a credit card for medical bills. I found this interesting because my sister went to the same hospital for an ER visit and they told her she just had to pay a minimum of $30 a month on a $1,500 bill :rolleyes:. If I do not make my interest free payment every month (it will take 12 months to pay off the bill by making the interest free payment) the interest accrues monthly. I didn't realize this - I thought if I was short one month I could compensate the next without paying interest...duh - what was I thinking...

I am embarrassed to admit it, but extremely thankful that I qualified for a 100% discount on two hospital bills from a different hospital. Maybe your friend can look into any financial assistance offered by the hospital.

As far as my doctor's bills, the surgeon required that I pay in advance, which I did, and I am now making payments to the anesthesiologist. They asked me what I could afford to pay, I told them $50/month which would have me paid off in about 11 months. No problems there.

I also arranged for payments on my ultrasound and they had no problem with $40/month.

Medical bills stink. I hope they can find a resolution for this.

[Shugness]

My coworker is 50 so she doesn't have any kids at home, but on her days off she's been helping her son and his wife by watching their kids - I gather their financial situation isn't all that great so they've become very dependant on my coworker and her husband (the father of the son). So essentially she's unable to get another job due to her volunteer work of babysitting. Plus good luck in this job market finding anything.

I believe she is going to try and apply for another regular credit card that has low interest rate and just make payments on it - she's just upset she went through the process of applying for this one per that doctors office recommendation only to find out in the end they're not accepting the terms in which she really needs (even though they said they did initially). And as you know, too many credit inquires hurts your credit, so here's two inquires in a short time.

I was just really surprised at how the doctors office mislead her and then isn't working with her anymore than that, threatens to take them to court. I just more so wanted to know if they were bluffing or not.

[mbrogier]

I've made monthly payments to hospitals only to have the hospital turn my account over to collections. We're talking $50k, not $3k, though.

You do need to be sure that the insurance company has paid all that they are going to pay. 2 months isn't usually enough time for everyone to have filed from the surgeons, hospital, anesthesiologist, labs, etc. with all the right codes and all and get paid.

You're not responsible for the "retail" amount when you have insurance. The insurance has a contracted amount with each preferred provider (as long as you are in network). You are responsible for any amount left over after the insurance company pays on the contracted amount---say you are responsible for 20% or haven't met your yearly deductible. ---Many people don't know this fact and overpay by thousands. Some doctors don't make it clear what is really owed and keep the extra money.

It used to be medical stuff couldn't be turned over to collections or put on your credit, but that is no longer true. Medical costs is the #1 cause of debt and bankruptcy in the US. Rob and I are drowning in medical debt, but there isn't much we can do.

It costs a fortune to be sick in America.

[Shugness]

Funny you should say that - I had a colonoscopy in October and I got a bill almost immediately from the hospital for like $2100. I figured it hadn't been settled by the insurance yet and ignored it. Then two months later got the same statement - then I started worrying, thinking maybe my insurance had denied the claim - I am only 25 so they may have reason to think it wasn't necessarily based simply off that, but I was having bad issues that made me and my doctor suspect I might have Chrons or somthing else wrong with me instead of IBS. I called the hospital to ask them and they said they never received anything back, that it would have been sent to me if it was denied. Not that I believed that completely. But I called BCBS, my insurance company, and they had NOT received anything from the hospital - she put me on hold and called them up - got the ladies voicemail. She left her a very detailed message telling her where to send the bill.

When my insurance did get the bill, they settled with them for $1200.

That made me wonder, is this something unethical the hospital was trying to pull? Get me to pay the whole $2100, because they'd make $900 more off me? I wouldn't have thought that initially but the lady with the insurance company said it happens all the time, them not getting the invoices from the hosptials.

The other thing - I called the hospital for three days straight, several times a day and kept getting the lady who was responsible for my bills voicemail. It was very annoying - I hate leaving messages because I want to talk to them when its a good time for me, not have them call me back when I'm in a meeting or at lunch. I just got the impression that all phone calls were routed to voicemail and they'd return calls on their time. Maybe not, but it did cross my mind.

Oh, and by the way, the gastrointerologist (sp?) who done my procedure told me I could make payments to him on what I owed - he was really cool about it but I only owed him like $400. I did have to pay $150 up front, which was half my deductible.

[LaraW]

Funny you should say that - I had a colonoscopy in October and I got a bill almost immediately from the hospital for like $2100. I figured it hadn't been settled by the insurance yet and ignored it. Then two months later got the same statement - then I started worrying, thinking maybe my insurance had denied the claim - I am only 25 so they may have reason to think it wasn't necessarily based simply off that, but I was having bad issues that made me and my doctor suspect I might have Chrons or somthing else wrong with me instead of IBS. I called the hospital to ask them and they said they never received anything back, that it would have been sent to me if it was denied. Not that I believed that completely. But I called BCBS, my insurance company, and they had NOT received anything from the hospital - she put me on hold and called them up - got the ladies voicemail. She left her a very detailed message telling her where to send the bill.

When my insurance did get the bill, they settled with them for $1200.

That made me wonder, is this something unethical the hospital was trying to pull? Get me to pay the whole $2100, because they'd make $900 more off me? I wouldn't have thought that initially but the lady with the insurance company said it happens all the time, them not getting the invoices from the hosptials.

The other thing - I called the hospital for three days straight, several times a day and kept getting the lady who was responsible for my bills voicemail. It was very annoying - I hate leaving messages because I want to talk to them when its a good time for me, not have them call me back when I'm in a meeting or at lunch. I just got the impression that all phone calls were routed to voicemail and they'd return calls on their time. Maybe not, but it did cross my mind.

Oh, and by the way, the gastrointerologist (sp?) who done my procedure told me I could make payments to him on what I owed - he was really cool about it but I only owed him like $400. I did have to pay $150 up front, which was half my deductible.

This was an expensive lesson I learned when I was pregnant with my first child. I was out of town, and was in a hotel room by myself and at 29-30 weeks along I was having regular contractions and was totally freaked out. I went into the hospital and got hooked up to a monitor, had some other things done to determine whether or not I was in labor (I wasn't). When I got the bill from the hospital, I just paid it. It wasn't until I got the bills after my daughter was born that I realized I had overpaid by about $200. I never was able to get my money back, despite constant phone calls, etc.

Luckily it was only $200, it could have easily been 10 times that. It still makes me mad, and I remember talking with DH about how much "extra" money hospitals must make by billing people who don't know any better and just pay their bills.

:mad::mad::mad:

[LakeMartinGal]

You're not responsible for the "retail" amount when you have insurance. The insurance has a contracted amount with each preferred provider (as long as you are in network). You are responsible for any amount left over after the insurance company pays on the contracted amount---say you are responsible for 20% or haven't met your yearly deductible. ---Many people don't know this fact and overpay by thousands. Some doctors don't make it clear what is really owed and keep the extra money.
This is not always the case, unfortunately. The EOB should state if you have a contracted rate. On our insurance, we are responsible for the charge over the 'reasonable and customary' rate. (BCBS) We used to have Humana, and it stated clearly what the 'Humana negotiated rate' was...

[blazedog]

This is not always the case, unfortunately. The EOB should state if you have a contracted rate. On our insurance, we are responsible for the charge over the 'reasonable and customary' rate. (BCBS) We used to have Humana, and it stated clearly what the 'Humana negotiated rate' was...

This generally comes into play when people go out of network since the insurance company only agrees to pay x% of the "usual and customary" rates. There was a major lawsuit brought by (I think) either NY or California against the insurance companies because the "usual & customary" rates were set so low so that a person going out of network would see a small percentage of actual charges covered.

For most people, it comes into play with dental insurance quite a bit since if one goes out of network (which is most of the time with a dentist), one's dentist generally charges above the low rate deemed usual and customary.

Most people do make sure their doctor is in the network. However, it is also critical to be SUPER vigilant to make sure that everything else is in the network -- the laboratory used by the doctor for instance could be out of network.

Also, one should make sure that the doctor is prescribing drugs which are in your plan's formulary as I have found that often a doctor will prescribe something that isn't in my formulary -- with a higher deductible or a proprietary drug when the generic is just as effective and significantly less expensive.

And of course if any kind of procedure outside the standard is recommended, make sure to get pre-approved AND keep notes of who is approving in case there is some question about it.

[Jessnc]

Most people do make sure their doctor is in the network. However, it is also critical to be SUPER vigilant to make sure that everything else is in the network -- the laboratory used by the doctor for instance could be out of network.


I am dealing with this right now. The laboratory that my Dr.'s office uses is not in network. The insurance company said they were going to mail me a check to cover the expenses but they are really giving me the run around. I would have never thought that the laboratory wouldn't be in network. It really is a hassle to deal with.

[Gumbeaux]

Most people do make sure their doctor is in the network. However, it is also critical to be SUPER vigilant to make sure that everything else is in the network -- the laboratory used by the doctor for instance could be out of network.

I let my guard down one time and didn't do this. I went to a doctor who was in network and he sent me to a sleep clinic that was in network. The sleep clinic told me I needed to buy a bunch of equipment from any of the places on a printed form that they handed me. I bought about $1,000 worth of stuff from a place that wasn't in network. I had to make numerous phone calls to the insurance company and argue with them to get them to pay.

[Shugness]

When I was 18 I made my first appointment with a gynecologist - I was working full time and about two weeks before my appointment my work told us they had changed insurance companies spur of the moment. We were told that this insurance wasn't accepted at the main hosptial system just then, but they were signing a contract with them the next week.

I called this gynecologist office and asked them if they accepted this insurance - the lady told me on the phone, not right then but would be accepting it when the hospital system signed their contract. They weren't affliated with that hospital system but were going to follow their lead essentially, so yes, by time I came in for my appointment they would be accepting that insurance.

I went in for the appointment and when I went to check out, the woman behind the desk presented me with a $600 bill :eek: - I told her "no, no I owe only a $50 co-pay". She told me they didn't accept my insurance!!! I told her I called and was told they did - and she says "Well who did you talk to?". Of course I didn't write their name down. Apparently something changed and they didn't sign that contract - so it was a learning experience for me to make sure I always ask when I arrive if they still accept my insurance. I kind of think they should let you know then and there whether they do or not, but you can't count on them. It'd be nice if they'd tell you "We're not in your network so you realize you'll be responsible for X% of this bill today, correct?" - its definately not something you want to argue about after its all said and done.

Ultimately though the new insurance company agreed to pay the gynecologist all that was owed to them, but told me very sternly they wouldn't do that again. :o