What should I do? ( Medical Related)

[Blown_By_You]

I just had knee surgery. The Doctor told me she could do the procedure either at the local hospital or another private surgery center. I told her I didn't care, just make sure it's in network. I go to another woman's office to actually schedule my knee surgery. I again state, make sure it's in network. "It's in network."

Fast forward two days before my surgery, I get a phone call stating my out of pocket expense for items not covered by my insurance was going to be roughly $1300. The next day, I go to my doctors office to finalize paperwork, get my blood pressure taken and receive a pair of crutches and knee brace. I paid the 1300 bucks and off I went. At the surgery center the receptionist tells me that my insurance will probably mail the check for payment to my home. I'm supposed to endorse the check and drop it off at the surgery center.

A week after my surgery, I get a phone call from insurance stating the procedure was conducted at an out of network facility and that they are rejecting payment; I was told I now owe an additional 10,000 dollars out of pocket. I also had to produce an explanation of benefits for the 1300 charge I put on the card within 24 hours or I would owe that as well.

Now I never authorized the procedure out of network and was specifically told multiple times that it was in fact in network. So I do a little research. The doctor I had seen is part owner of the surgery center where I had my procedure. Upon multiple phone calls to said surgery center, I was told "don't worry about insurance saying you owe the bill. We accept the percentage that they payout and write off the balance. We make more money out of network with write offs than a covered procedure conducted in network. You'll get a check in the mail, just sign it and drop it off to us."

Neither office could explain or answer as to why I was lied to or how the surgery was scheduled at an out of network facility. Mind you, the in network facility it 1.6 miles down the road. Yesterday I got a letter in the mail stating insurance was not going to be sending any payment and I owe the $10,000 plus the $1,300.

I just don't see how any of this bull shit is legal. Sorry about your situation OP. At least you used your brace, my crutches never left my truck and I was billed a hefty amount for them.

This sounds eerily familiar....... Basically the same thing happened to me.. I haven't paid them.. $1500 supposed bill is also sitting right at $10k. I will fight to the bitter end too

 

[hb712]

Sorry, I don't agree. Even if the OP spent the hour or more it would have taken to read the actual agreement he was singing, unless he was a contracts attorney, there is no way he would have fully understood what was written. Might have well have been in Latin. The BS FRAUD in the health care system has to stop. Credit ratings be dammed, I have fought with several medical companies after stupid bills from hospital stays.

Tell the provider you will not accept any charges outside of what the insurance pays unless specifically agreed in writing. Sign nothing while in pain or on pain meds, they have to agree and cannot withhold treatment. If they try to bill you anything outside of insurance allowed charges, decline them as not authorized. Tell any bill collector the same. They eventually give up and move on to some other poor schmuck who will pay because they think they have to. Yes, Obamacare has made this MUCH worse and next year will be worse again as most all HMO/EPO employer health plans have been killed as they are outside of what Obamacare allows. This is going to get very bad. Don't back down and let shysters in the health care field do this and get away with it.

To the OP, call the provider and state in no uncertain terms that the charge was not disclosed to you, you did not authorize it and the charge was not stated on the forms you signed. Blank check forms are not enforceable in any court and they know it. Ask that they reduce the charge to fair market value and you will entertain the idea of making payment on the reduced charge. Otherwise you only feel you can afford $5 a month on a payment plan. So long and you are making an ATTEMPT to pay the medical bill, they cannot report you for past due bills.

Lots of legal advice from someone who obviously should not be giving it. From the beginning, you're alleging an unconscionable contract where there is none. I will not give a lecture on contracts here nor will I offer legal advice. All I will say is that you appear to be stepping way out of your lane.

 

[Montanasvt]

Lol

Same people in this thread have zero issues spending $500 for a short throw shifter for their car, yet bitch about a $100 wrist brace----which I would bet $1000 you didn't actually use for the recommended period of time (2-4 weeks minimum). Lucky you didn't come to my office. I would have ordered an MRI, and then you would really be whining. Why don't you google "wrist pain" and then you can fix the problem yourself for free!!! Good luck bro

Not really whinning...Was making a point that the paper I signed( yes I failed to read it) did not disclose a price at ALL(have copy now)... I have family in the medical field and they disclose that the Item "could " cost if your insurance provider doesn't cover it fully. Therefore, you may want to call or check They made it seem like it was apart of my co-pay.The place I went to was so fast to get me on my way they didn't care about my health. This could have happened to someone who is way less fortunate that I am and cause them much more heart ache than myself. Was just seeing if this happens often.

 

[jcthorne]

Lots of legal advice from someone who obviously should not be giving it. From the beginning, you're alleging an unconscionable contract where there is none. I will not give a lecture on contracts here nor will I offer legal advice. All I will say is that you appear to be stepping way out of your lane.

Fine, you pay what they say you owe, I will pay what I agreed to. Nothing more. Until we all start refusing to pay rediculus and fraudulent charges just because they play hide and seek with the billing, this will only get worse. And just FYI, yes, I have been through this situation and it was resolved in my favor. They still do it as most will not fight it.

 

[hb712]

Fine, you pay what they say you owe, I will pay what I agreed to. Nothing more. Until we all start refusing to pay rediculus and fraudulent charges just because they play hide and seek with the billing, this will only get worse. And just FYI, yes, I have been through this situation and it was resolved in my favor. They still do it as most will not fight it.

I don't care what situation you have been through; you're legal advice is wrong. You should refrain from offering this type of advice to others based on a flawed understanding, predicated by limited personal experience and nothing more. What you manage(d) to negotiate with a company has nothing to do with the potential legal obligations of others.

Whether the charges are ridiculous is entirely subjective, but your accusation of fraud is baseless. Next time you should offer an experiential analysis, but certainly that should be it. You have neither the training nor expertise to offer the advice you did. For some reason, people cannot seem to stop themselves from offering legal advice that could harm others.

 

[allister]

It's a rip off, all of it. I remember when my wrist hurt one time and I didn't have insurance. I knew it had a cyst, and although I watched Youtube Videos on how to break them, I decided I'd rather leave it to a medical expert. I called to make an appointment, was told it would be $140ish to see the doctor and that he could indeed drain my cyst for me. So I made the appointment, went and the doctor basically told me that he could drain it but he wasn't going to and that if I gave it a few more weeks it would go away on it's own. My problem was the stupid cyst was pressing on a nerve causing a ton of pain, and I wasn't waiting another minute to have it removed. I couldn't even bend my wrist because of the pain.

I was livid, I didn't pay $140 to be told to f-off. So I basically flipped out, threatened to contact the attorney general and better business bureau because I wasn't paying money to a doctor who was too lazy to help me, and it actually worked. I think they actually just ripped up my paperwork and pretended like I was never there.

For the record I came home and smashed a book onto it so it popped inside of my wrist. Instant relief.

 

[kirks5oh]

It's a rip off, all of it. I remember when my wrist hurt one time and I didn't have insurance. I knew it had a cyst, and although I watched Youtube Videos on how to break them, I decided I'd rather leave it to a medical expert. I called to make an appointment, was told it would be $140ish to see the doctor and that he could indeed drain my cyst for me. So I made the appointment, went and the doctor basically told me that he could drain it but he wasn't going to and that if I gave it a few more weeks it would go away on it's own. My problem was the stupid cyst was pressing on a nerve causing a ton of pain, and I wasn't waiting another minute to have it removed. I couldn't even bend my wrist because of the pain.

I was livid, I didn't pay $140 to be told to f-off. So I basically flipped out, threatened to contact the attorney general and better business bureau because I wasn't paying money to a doctor who was too lazy to help me, and it actually worked. I think they actually just ripped up my paperwork and pretended like I was never there.

For the record I came home and smashed a book onto it so it popped inside of my wrist. Instant relief.

Again, someone who hasn't a clue. You didn't have insurance. How the **** would you expect to have the cyst removed surgically ($3000), or with a needle ($250), when you clearly weren't going to pay?

You wouldn't tow your car into a shop, ask them to diagnose your car for $140, and then threaten to sue them because they won't fix it for free when they tell you it needs $3000 of work, would you? You went to a hand specialist, who told you that you have a ganglion cyst that is pushing on your ulnar nerve, for $140. Knowing there was zero chance of you paying for a $3000+ surgery, and not wanting to hit the ulnar nerve with a needle, he gave you conservative advice---it will likely go away with no treatment. Guess what? That expertise costs $140. Don't like it? Get insurance. Or don't go to the dr. I would have stuck you with the bill and sicked the collectors on you.