Billed for amount that insurer says I am not responsible for

[Notgivingup]

Hey guys. I received a bill from Chesapeake Urology for about $3k, but my insurer, Medica, says I am not responsible for this amount. It looks like I am being billed for an amount that Medica would not pay and that Medica says I should not be responsible for. Anyone have a similar experience?

Today I sent an email to Danielle at Chesapeake Urology explaining the situation, with the relevant documents from Medica (copy of the bill, claim statement from Medica, letter from me explaining the situation). I'll let you know what the final outcome is. I hope it's just a billing error.

[Agfa13]

Only 3K???
Sounds like the billing was done before the dust settled, so just wait it out.

[Txagq8]

When it comes to medical bills, I find the best advice ever came from Nancy Reagan.

Just say no.

I’ve dealt with premature twins, 2 shoulder surgeries, a nearly impossible to diagnose auto immune disorder, you name it. Five hernias, all in different locations.

Wait at least 6 months for the dust to settle.

If you can figure out the # of the debt collection agency, block it on your phone. Shred any mail they send or write “Refused” on it and send it back.

After six months, call your insurance carrier, get an explanation of benefits, ask them how much you should pay, and send the hospital/clinic/doctor that amount. No more, no less.

If medical stuff impacts a credit score, I’ve never seen it.

Most hospitals have enough dirty laundry they don’t want aired as part of discovery so they aren’t going to sue for a puddly co-pay.

I’m not suggesting anyone not pay their just debts. But having paid and then had the insurance pay and try to get the appropriate amount refunded....I learned my lesson.

Early on....just say no.

[Notgivingup]

Sounds like great advice. Thank you.

[WhiteCane]

I I am 32 but my body got messed up enough that I have Medicare/Pennsylvania State Medicaid… I got a bill for 2846 or something around there? I was told it was a co-pay and there was really nothing I can do about it… I paid it off in four payments… If I wouldn’t have paid it off like that, it would have been the amount due at the time of surgery… I put it into Medicaid to see if they would pick anything up but the surgery was in Maryland and Medicaid is for Pennsylvania unless it’s a necessary procedure well on vacation… We shall see……

[Notgivingup]

So I sent an email to Danielle. She sent me an email telling me to contact the patient accounting department. But my email to patient accounting was returned unsent; people outside their organization are not allowed to send emails to the patient accounting department. Really? I put a hard copy of my letter along with supporting documents in the good old mail.

[adamwalker2019]

Frankly speaking, It's very sad story, man.I don't even know what I can recommend you. Maybe you should take a lawyer.

[DaveKell]

Given that over the years I’ve had 22 major surgeries, my wife has become an expert at parsing medical bills. On my first surgery she found 7 thousand dollars of improper billing. For every procedure since she has found discrepancies that were corrected in our favor. She currently has one provider being audited by Aetna. Never assume the doctor’s billing department has capable people!

[Hrc714]

When Cramer was with UMD, I was overbilled by UMD and went with the "wait it out" plan. Once they sent to collections I paid the bill to maintain credit score. Then when it was finally determined that I over paid, it was like pulling teeth to get my refund. Good on Dr C for breaking away.

[Hrc714]

If you consider billing errors based on incompetence to be random, the odds of your 22 surgeries all being over billing is 4,194,304 to 1. I think it is very competent, but not very ethical.