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medical ins question - already in chapter 13

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    medical ins question - already in chapter 13

    fell off my mountain bike, was rushed to hospital, and got a bill for $16,000.

    they didn't ask for insurance card at ER for some reason, nor ID actually.

    was sent a bill for 16k, but since they don't think i have insurance, they were giving me a discount of 75%, asking me to pay $4k.

    i called them and got the insurance situation sorted out, my insurer, blue shield then paid them close to $9k.

    a month later i got another bill from the ER, this time for the co-pay of $950.

    how does this make sense in way that they only wanted 4k, got 9k, now the want another 950 from me...

    i am already in a pretty tight budget with chapter 13 payment and all, not sure if i can afford this.


    I hate to even venture an opinion because of the date it is, and the news that has been going on all month..... However, here goes....

    I am self-insured, at least until July 2014, with a high-risk, high-deductible policy, with an HSA. I talked to my doctor about what I could do. [There is a lot of back-story to this that I won't go into now.] He told me that there are three different levels of payment for the physician:

    1. Patient Pay. This is what I am with a high deductible of $3,500.00. To qualify with my doctor, I had to write on our letterhead, that we were indigent and could not pay any higher fees. This was for the Government audits that come around.

    2. Insurance Payment. This is the level that most people are paying. Their insurance picks up the majority and the patient pays to co-pay, whatever that is.

    3. Medicare and/or Medicaid. The next level of payment--whether above or below that of 'Insurance Payment'--I don't know.

    I do know that doctors and facilities are bailing out of servicing Medicare and/or Medicaid right and left. That is because they are not, or will not be compensated. No, they are not being greedy, but they have families to support and bills to pay also.

    And those pricing levels were well in place by the Federal Government well before this current president took office.

    So you have experienced some of the three tiers of payment schedules...

    I do hope you are healing well and will be back to full health before long.
    Last edited by AngelinaCat; 10-31-2013, 07:12 PM.
    "To go bravely forward is to invite a miracle."

    "Worry is the darkroom where negatives are formed."


      Once they knew you had insurance, they billed BC and per their contract with BC accepted the assignement for the procedure.
      Nothing out of the ordinary occured.
      Call the hosiptal and see if you acn negoiate a discount on the copay or, setup monthly payment arrangements.

      As an ex.-last year my wife was hospitalized for 10 days with a raging infection caused by a kidney stone. We got the EOB and the hospital biiled BC $57K, they accepted $28K. Our responsibility was $3800. We called and asked about a discount and they took $700 off if we could pay that day.Cash, check or credit card. I took a check to the business office that afternoon.
      Just explain your situation and I'm sure they'll work with you.


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