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Thread: Medical Bills/Insurance

  1. #1
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    Default Medical Bills/Insurance

    I'm really not one to put my business on the www, but I received an unexpected bill this morning for some surgery I had in July 2020. I haven't been able to dig into yet as to why my insurance isn't paying the portion they should have, but what are my options for fighting this? I've never really been in this situation so I'm trying to explore all avenues since I believe my insurance is in the wrong here. I've been expecting a bill in the 3-5K range, but got hit with just over a 13k bill.

  2. #2
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    Who do you have health insurance with

  3. #3
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    At the time of the surgery it was Anthem BC/BS

  4. #4
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    Are you sure it’s a bill?

    There are multiple charges involved in surgery, from the hospital and all their charges and then the doctor and their charges. I don’t think you fight as much as call the doctor and walk through the charges then call the insurance company and walk through the charges and figure out where the mistake is. The dr office can probably tell you more about the charges and how insurance paid than the insurance company can. I wonder if this is the total bill that hasn’t been adjusted for insurance yet?

  5. #5
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    So you can send a copy to me if you’d like and we can look into it. Usually if this is your first bill the provider will have to write it off for timely filing. They have 1 year to file claims or they can be denied. I deal woth insurance daily so let me know if you have any questions.

  6. #6
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    If it is truly a bill, I would look back at your BC/BS - EOB (Explanation of Benefits) from that surgery/procedure and see if any of the bill charges match up to the claims. If not reach out to doctor office for explanation of charges and why not filed on insurance. Then contact insurance company.


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  7. #7
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    You got a max out of pocket I would think
    Gettin old is for pussies! AND MY NEW TRUE people say like Capt. Tom >>>>>>>>>/
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  8. #8
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    It's certainly a bill. I've been watching this and dealing with the hospital since the surgery. For months I had 3-4 K pending with insurance and I owed about 2500. A couple months ago my "owed" part disappeared and around 6k was then showing pending with insurance. Well apparently that ship has sailed and now the hospital wants me to pay 13k. Again, this surgery was in July 2020... over a year ago.

    Blackdog, I may reach out to you next week for some guidance. Thanks.

  9. #9
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    I'd wad it up and toss it, but that's just me

    I had to go to the hospital last summer while at a doctors appt. They saw something on a routine ekg that they thought looked troubling and made me ride the ambulance. I told them I would drive or have my wife carry me but they wouldn't let me. Got an $1,800 bill from ambulance service. Come to find out the girl had the ekg machine all jacked up and hooked up wrong. They can take that bill and shove it
    "They are who we thought they were"

    You can dress a fat chick up, but you cant fix stupid

  10. #10
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    If you just getting it, and its less than a year , you may owe it, but look at the EOB . if its over a yr old, they have to eat it under "timely filing"
    Malo periculosam libertatem quam quietum servitium. -

    I prefer liberty with danger, to peace with slavery.

  11. #11
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    Yall still paying your medical bills?
    I thought we didn't have to do that anymore.

  12. #12
    Join Date
    Jul 2020
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    What’s your max out of packet on your plan? Also yes after one year would be considered beyond timely filing.
    Had a mishap in Utah with youngest , received massive bill two years later. Explained to them I work in hospital Reimbursment as a day job and never received another phone call.


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  13. #13
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    I’m in the same boat. Hospital said my out of pocket was $2800 for my surgery. Then hit me with a 17k bill. I’m not a genius when it comes to this stuff but how does one miss an estimate by that much?


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  14. #14
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    Quote Originally Posted by Timber Ghost View Post
    I’m in the same boat. Hospital said my out of pocket was $2800 for my surgery. Then hit me with a 17k bill. I’m not a genius when it comes to this stuff but how does one miss an estimate by that much?


    Sent from my iPhone using Tapatalk
    Feel free to send me anything as well and we can take a look at it as well. Unless you don’t have insurance then you shouldn’t have been hit with a bill that big unless you went out of network or they are trying to say it’s an excluded procedure

  15. #15
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    Quote Originally Posted by theoldblackdog View Post
    Feel free to send me anything as well and we can take a look at it as well. Unless you don’t have insurance then you shouldn’t have been hit with a bill that big unless you went out of network or they are trying to say it’s an excluded procedure
    When I get back home, I certainly will reach out


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  16. #16
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    I'm dealing with one now from 8/19. Provider didn't file it until 7/21. Insurance only paid a small portion and they billed me the balance. I called and raised hell with provider and asked them what would have happened if insurance wouldn't have covered anything due a 3 month window a provider has to file in. Their response was we would write it off. My response was well write it off and provider said they couldn't since it finally went through insurance almost 2 years later. I'm fighting it and paid them a dollar.
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  17. #17
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    Quote Originally Posted by theoldblackdog View Post
    So you can send a copy to me if you’d like and we can look into it. Usually if this is your first bill the provider will have to write it off for timely filing. They have 1 year to file claims or they can be denied. I deal woth insurance daily so let me know if you have any questions.
    Sent you a PM

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