I haven't talked much about my situation for fear of someone I know reading it, or for fear of causing myself troubles on my impending bankruptcy. Now I'm pissed and I need to tell someone...
My wife has been ill for more than a year. Not the kind of illness that makes her look sick, but it she's not well and needs expert advice and treatment that a doctor without special experience can't give her. (Imagine someone with early signs of MS or something like that.)
Earlier in the year we visited a notionally recognized "clinic" that is actually a large not-for-profit research, school and care facility that most people have heard of. We've been driving a few hundred miles to be seen there every once in a while and our last visit generated a $13,000 bill.
My insurance company (probably the nations largest legal organized crime group) happily declared $4,000 of the bill as "Reasonable and Customary" and paid just over $3,000 of the claim after decucting my deductable and co-insurance. The remaining $11,000 was declared my responsibility.
Needless to say, we've been operating on a tight margin in my household and depending on credit to get by. We've been meeting our obligations and paying our bills but not making any real progress toward paying off loans either. With my wife's illness and the added expenses, we've spent months spending more than our income and using up most of our available credit. Today I'm not paying my non-secured creditors and bankruptcy is imminent.
Among the things I tried was negotiating with the clinic to see if I could get a discount. I started by asking a very pointed question and got everything but the truth or a straight reply.
"You regularly provide services at a discount for large insurance companies. As an individual customer, why are you not willing to provide those services at a discount to me?"
The answers I received seldom addressed the original question, and frequently turned to arguments about how I knowlingly accepted thier services and agreed to pay anything the insurance company would not.
I never tried to disagree, because I did agree to pay the bill. Still, I kept pushig for a straight answer. "Why are you unwilling to provide service to me at a discount when you routinely do so for large insurance companies?"
"You're not required to provide me a discount and I DID agree to pay for your services -- even though the charges were never discussed." " I can only conclude that you feel I'm not worthy of a discount and you don't want to give me a discount -- why?"
Early in the process, representatives would tell me "There is no discount for anyone -- everyone pays the same price. We can't give you a discount -- it never happens." This, despite the fact I know it isn't true, and have previous bills from another insurance comany where a discount had been applied.
I pressed on with my complaint and talked to new people at higher levels. At another level, I was offered a 5% discount to make me feel better. It was progress, but not very satisfying. As I pushed higher with more phone calls, I was soon offered a 10% discount. All of this despite the original person who told me "it can't be done -- never happens."
Shortly after my visit, my insurance company entered in to a contract with the clinic so patients could be seen "in network" and get a higher level of benefits. It was too late to help me, but it did give me a benchmark of 25% because I was told that that's the biggest discount they give to anyone. Even still, they wouldn't consider giving me a 25% discount for even a moment.
Ultimately I was encouraged to submit a request for finincial assistance. The clinic is not-for-profit and has programs and grants to help people in need. I submitted all of the information they requested and I even showed that my disposable income was a negative number!
To my pleasant suprise, I got a letter back from the clinic awarding me more than a $7,000 discount! This meant that I owed less than $4,000 of the original bill (because insurance had already paid $3,000) and they would accept payments for the balance. I praised them and blessed they day they helped me and I was generally hapy with them and life in general.
I've also been after the insurance company. Of the things I could do, was to be sure that the limits they applied to my claim agreed with the contract they signed a month later with the insurance company. I was sure I had them because 30-cents on the dollar was way lower than the 25% discount the clinic assured me they had negotiated. I didn't expect to win, but I did expect to be a pain in the butt for them and it brought me a little bit of satisfaction.
Today I learned my appeal to the insurance company was granted and they agreed to re-price my claim using the contracted rates! I couldn't have been more suprised -- until I read the details.
To my supreme suprise, the discount negotiated with the insurance company would have been LARGER than the discount they offered to me as charity! I can't believe my eyes! My hardship discount took more than $7,000 off of the bill but the insurance company discount would have been more than $8,000. How's that for charity?
The bill they sent me for $13,000 would have been $5,000 for the insurance company and $6,000 for me as charity due to negative disposable income.
I am so pissed...
I can't tell you how bad I felt at the prospect of the clinic getting paid nothing if they were included in my bankruptcy. They were so generous with me, it hardly seemed fair to treat them so badly in return. I aganized over how to reaffirm the debt or pay them off before I file -- anything to avoid screwing them over and making me a crook.
Well, now I feel differently. They should be ashamed of themselves! Who's screwing who...
My wife has been ill for more than a year. Not the kind of illness that makes her look sick, but it she's not well and needs expert advice and treatment that a doctor without special experience can't give her. (Imagine someone with early signs of MS or something like that.)
Earlier in the year we visited a notionally recognized "clinic" that is actually a large not-for-profit research, school and care facility that most people have heard of. We've been driving a few hundred miles to be seen there every once in a while and our last visit generated a $13,000 bill.
My insurance company (probably the nations largest legal organized crime group) happily declared $4,000 of the bill as "Reasonable and Customary" and paid just over $3,000 of the claim after decucting my deductable and co-insurance. The remaining $11,000 was declared my responsibility.
Needless to say, we've been operating on a tight margin in my household and depending on credit to get by. We've been meeting our obligations and paying our bills but not making any real progress toward paying off loans either. With my wife's illness and the added expenses, we've spent months spending more than our income and using up most of our available credit. Today I'm not paying my non-secured creditors and bankruptcy is imminent.
Among the things I tried was negotiating with the clinic to see if I could get a discount. I started by asking a very pointed question and got everything but the truth or a straight reply.
"You regularly provide services at a discount for large insurance companies. As an individual customer, why are you not willing to provide those services at a discount to me?"
The answers I received seldom addressed the original question, and frequently turned to arguments about how I knowlingly accepted thier services and agreed to pay anything the insurance company would not.
I never tried to disagree, because I did agree to pay the bill. Still, I kept pushig for a straight answer. "Why are you unwilling to provide service to me at a discount when you routinely do so for large insurance companies?"
"You're not required to provide me a discount and I DID agree to pay for your services -- even though the charges were never discussed." " I can only conclude that you feel I'm not worthy of a discount and you don't want to give me a discount -- why?"
Early in the process, representatives would tell me "There is no discount for anyone -- everyone pays the same price. We can't give you a discount -- it never happens." This, despite the fact I know it isn't true, and have previous bills from another insurance comany where a discount had been applied.
I pressed on with my complaint and talked to new people at higher levels. At another level, I was offered a 5% discount to make me feel better. It was progress, but not very satisfying. As I pushed higher with more phone calls, I was soon offered a 10% discount. All of this despite the original person who told me "it can't be done -- never happens."
Shortly after my visit, my insurance company entered in to a contract with the clinic so patients could be seen "in network" and get a higher level of benefits. It was too late to help me, but it did give me a benchmark of 25% because I was told that that's the biggest discount they give to anyone. Even still, they wouldn't consider giving me a 25% discount for even a moment.
Ultimately I was encouraged to submit a request for finincial assistance. The clinic is not-for-profit and has programs and grants to help people in need. I submitted all of the information they requested and I even showed that my disposable income was a negative number!
To my pleasant suprise, I got a letter back from the clinic awarding me more than a $7,000 discount! This meant that I owed less than $4,000 of the original bill (because insurance had already paid $3,000) and they would accept payments for the balance. I praised them and blessed they day they helped me and I was generally hapy with them and life in general.
I've also been after the insurance company. Of the things I could do, was to be sure that the limits they applied to my claim agreed with the contract they signed a month later with the insurance company. I was sure I had them because 30-cents on the dollar was way lower than the 25% discount the clinic assured me they had negotiated. I didn't expect to win, but I did expect to be a pain in the butt for them and it brought me a little bit of satisfaction.
Today I learned my appeal to the insurance company was granted and they agreed to re-price my claim using the contracted rates! I couldn't have been more suprised -- until I read the details.
To my supreme suprise, the discount negotiated with the insurance company would have been LARGER than the discount they offered to me as charity! I can't believe my eyes! My hardship discount took more than $7,000 off of the bill but the insurance company discount would have been more than $8,000. How's that for charity?
The bill they sent me for $13,000 would have been $5,000 for the insurance company and $6,000 for me as charity due to negative disposable income.
I am so pissed...
I can't tell you how bad I felt at the prospect of the clinic getting paid nothing if they were included in my bankruptcy. They were so generous with me, it hardly seemed fair to treat them so badly in return. I aganized over how to reaffirm the debt or pay them off before I file -- anything to avoid screwing them over and making me a crook.
Well, now I feel differently. They should be ashamed of themselves! Who's screwing who...
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