Medical bill help.
October 18, 2011 9:04 AM Subscribe
How can my folks find out what this medical bill is for?
My folks are Canadian citizens who own a house in Florida and spend a few months a year there. Earlier this year, my father paid out of pocket to have some medical tests done at a clinic near their Florida residence. My father was told (and unfortunately, he does not have it in writing) that the procedure and related lab tests, etc, would set him back about $3,000.00. He paid about this amount in full the day of the procedure. He was surprised about a month later to receive another invoice from the clinic for over $4,000.00! He phoned the clinic to get some clarification and was given none. The staff member he spoke to told him, quite rudely, to just pay it. He wrote a very polite letter asking for an explanation for the additional charges and has received nothing in response.
Right now he is simply refusing to pay it until he gets an explanation. For the record, my parents are very fiscally responsible. They own their homes and vehicles outright, have no consumer debt, and ALWAYS pay their bills on time. $4,000.00 will not break them by any means. Dad's attitude is "If they can give me an explanation about why I owe this money, I will pay it."
How can they best go about resolving this issue? And what are the ramifications of not paying the bill?
My folks are Canadian citizens who own a house in Florida and spend a few months a year there. Earlier this year, my father paid out of pocket to have some medical tests done at a clinic near their Florida residence. My father was told (and unfortunately, he does not have it in writing) that the procedure and related lab tests, etc, would set him back about $3,000.00. He paid about this amount in full the day of the procedure. He was surprised about a month later to receive another invoice from the clinic for over $4,000.00! He phoned the clinic to get some clarification and was given none. The staff member he spoke to told him, quite rudely, to just pay it. He wrote a very polite letter asking for an explanation for the additional charges and has received nothing in response.
Right now he is simply refusing to pay it until he gets an explanation. For the record, my parents are very fiscally responsible. They own their homes and vehicles outright, have no consumer debt, and ALWAYS pay their bills on time. $4,000.00 will not break them by any means. Dad's attitude is "If they can give me an explanation about why I owe this money, I will pay it."
How can they best go about resolving this issue? And what are the ramifications of not paying the bill?
Does he have a receipt for the amount he has already paid?
posted by mr_roboto at 9:16 AM on October 18, 2011
posted by mr_roboto at 9:16 AM on October 18, 2011
If the bill lists a CPT or ICD-9 code he might at least be able to see if they're billing him for something that actually happened.
Anecdotally I have heard of situations like this before, where patients are misled about billing. It appears to be a regrettably common part of the health care system.
posted by Wretch729 at 9:22 AM on October 18, 2011
Anecdotally I have heard of situations like this before, where patients are misled about billing. It appears to be a regrettably common part of the health care system.
posted by Wretch729 at 9:22 AM on October 18, 2011
It might be possible that the first $3,000 was not applied to his account somehow. It certainly seems more plausible that $3,000 worth of tests would turn into $4,000 rather than $7,000.
posted by grouse at 9:25 AM on October 18, 2011
posted by grouse at 9:25 AM on October 18, 2011
what are the ramifications of not paying the bill?
It'll go to a collections agency, which will have even less inclination to discuss whether the bill is justified, and be marked on his credit report. The collections agency could conceivably go to court and place a lien on your parents' house. TedW's link is a good summary of the controlling federal law.
The problem your father faces is that he doesn't have any written confirmation that his payment settled the bill, but under the Florida Patient's Bill of Rights:
posted by holgate at 9:27 AM on October 18, 2011 [1 favorite]
It'll go to a collections agency, which will have even less inclination to discuss whether the bill is justified, and be marked on his credit report. The collections agency could conceivably go to court and place a lien on your parents' house. TedW's link is a good summary of the controlling federal law.
The problem your father faces is that he doesn't have any written confirmation that his payment settled the bill, but under the Florida Patient's Bill of Rights:
A patient has the right to receive a copy of an itemized bill upon request. A patient has a right to be given an explanation of charges upon request.If he's inclined, it might be worth paying a lawyer to see if a nastygram makes the clinic more communicative. FWIW, Florida, with its high proportion of retirees (mainly Medicare recipients) is considered a hotbed of billing abuse, to the extent that a sub-industry has grown up to check bills for errors. As a cash payer -- meaning that the clinic isn't dealing with equally stroppy insurers -- your father may be being treated as easy pickings.
posted by holgate at 9:27 AM on October 18, 2011 [1 favorite]
If you have questions about the CPT or ICD-9 codes you can memail me.
posted by Apoch at 9:39 AM on October 18, 2011
posted by Apoch at 9:39 AM on October 18, 2011
He definitely needs to contest the bill. Medical providers, in my experience, are some of the worst when it comes to getting their billing correct. We once went round-and-round with a local lab for tests they claimed were not paid for, two years after the date of service. We had, of course, paid for the tests at the time of service. Luckily, we had the receipt and faxed it to them and then double-checked by phone with the billing office. They acknowledged the error and sent us an updated bill with a 0 balance.
Until six months later, when we started getting bills from the lab for the same damned charge.
Repeat the faxing and calling.
You father needs to ask for a detailed invoice for the $4000 charge. This is another thing some providers are getting bad at...lack of detail on their bills. Especially bills where there is no insurance company involved.
If he can't get what he needs directly, I'd seriously consider having a lawyer send a letter to this provider demanding the records.
posted by Thorzdad at 11:00 AM on October 18, 2011 [1 favorite]
Until six months later, when we started getting bills from the lab for the same damned charge.
Repeat the faxing and calling.
You father needs to ask for a detailed invoice for the $4000 charge. This is another thing some providers are getting bad at...lack of detail on their bills. Especially bills where there is no insurance company involved.
If he can't get what he needs directly, I'd seriously consider having a lawyer send a letter to this provider demanding the records.
posted by Thorzdad at 11:00 AM on October 18, 2011 [1 favorite]
I can imagine a number of ways this could have happened... tests can turn into more tests that don't require your presence. Clinics can do a facilities/testing/nursing fee while the doctors have their own practice that bills separately, etc. If it's not resolved quickly, I'd definitely start looking for lawyers because these systems are way beyond merely complicated. On a positive note, it's probably not deliberate malfeasance, just some sort of mistake or communication error.
posted by pjaust at 12:42 PM on October 18, 2011
posted by pjaust at 12:42 PM on October 18, 2011
I can imagine a number of ways this could have happened... tests can turn into more tests that don't require your presence.
Tests which don't require your presence aren't going to cost $4000, though, since you're talking about blood (and possibly urine) tests. Tests which cost thousands of dollars would be things like MRIs.
The first step is obviously for the OP's father to insist upon an itemized bill so he can see exactly what is going on.
posted by Justinian at 1:13 PM on October 18, 2011
Tests which don't require your presence aren't going to cost $4000, though, since you're talking about blood (and possibly urine) tests. Tests which cost thousands of dollars would be things like MRIs.
The first step is obviously for the OP's father to insist upon an itemized bill so he can see exactly what is going on.
posted by Justinian at 1:13 PM on October 18, 2011
IANAL but FWIW Florida is a hotbed of medical fraud (information I know to be true based on my job in a very large insurance company's claims department).
posted by tr33hggr at 1:17 PM on October 18, 2011 [1 favorite]
posted by tr33hggr at 1:17 PM on October 18, 2011 [1 favorite]
This thread is closed to new comments.
posted by TedW at 9:09 AM on October 18, 2011