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How should I deal with this medical bill?
May 3, 2012 9:11 AM   Subscribe

I recently received an unexpected medical bill in the mail. Should I pay it, or should I ask my parents to pay it?

I am 24 years old in the United States. I am on my parents' health care plan. About three months ago I had an annual checkup at the general practitioner. I had called the insurance company beforehand and was assured that the checkup would be totally free to me. This was the reason I scheduled it.

Just last week, seemingly out of the blue, I received a bill for between $400 to $500 for a medical visit on that date. This amount is about half a biweekly paycheck for me -- it's a lot of money. (Of course, in the grand scheme of things, when medical bills for hospital stays are in the hundreds of thousands, this is nothing... except for me, today, right now, it's not nothing. It's a lot.) I called the insurance company, and eventually I figured out what happened. The doctor at my checkup had a blood draw done at the checkup, which was filed separately as "diagnostic" instead of "preventive, and therefore was not part of the free checkup. Instead, because the deductible had not yet been met, it was entirely uncovered by the health insurance, . Except for a ~10% reduction that the insurance company negotiated, I pay the whole thing, and the insurance company pays zero.

(The insurance company said I should call the doctor and ask them to change the services from "diagnostic" to "preventive." I've done that -- or rather, I called the health care system's customer service line, and they will call the doctor. I have no idea if this will work. Let's assume it will not.)

On some level, I feel as if I went to an autobody shop, got my oil change done for the price I had agreed on upfront (zero!)... and then three months later they've billed me $500 for checking the fluid levels. I never would have agreed to the blood draw if I knew I would be billed this amount. So much for informed consent. (I feel scammed.) Of course: buyer beware, read all the small details, make sure you know what you're getting into, etc. Yes, I've learned my lesson. Hrmph.

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Thanks to my parents, I have had the privilege of never having to worry about a few specific expenses: first, I have never paid medical bills, andd second, I never paid a cent for the rather-expensive college I went to (grants covered 1/3 to 1/2 of it; the rest my parents paid out of pocket). I am lucky for this.

I am not lucky for basically everything else with regard to my parents. The environment I grew up in was hell for a sensitive soon-to-be-gay kid like me: constant arguing and yelling, zero love in the house, emotional abuse, unusual religious restrictions, homophobia, and a father who was warped psychologically in a way I can't easily explain. Two years into college, when I felt unable to do what I had hoped I could in college -- namely, clean my slate and blossom and succeed and leave my upbringing behind -- I broke down and ended up checking myself into the hospital for suicidal thoughts. I spent the next few months in and out of psychiatric wards, the next few years seeing psychiatrist after psychiatrist. This is all relevant mostly because I never paid a cent for what must have been astronomical medical fees. Presumably most of it was paid by the insurance company, but if there was something like 80% coverage, say, that remaining 20% would have been huge.

In the couple years since college I have prided myself on becoming self-sufficient and self-made. I came out of the closet, I worked my ass off at multiple jobs at the same time, I saved up money to buy a car, saved up more money to have a cushion to make a very important cross-country move, packed up that car and made that move, and then through hard work and intelligence and luck and others' help and perseverance I got a single full-time job in the industry of my choice, an industry that more-or-less only exists in this particular city. I'm doing well.

I have only asked for money once in my life from my parents (excluding, and this is notable, college and health expenses, as previously mentioned) -- shortly after college I asked to borrow $1000 to allow me to buy a specific car. I gave them a plan for when I would pay the money back. (This was not the type of "borrowing" in which money is not returned.) They turned me down. I was, to say the least, disappointed.

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Which brings me to right now. The medical bill. As mentioned above, this feels like a LOT of money to me. I am self-sufficient in this city, but I don't make much. I would be able to put the bill on a credit card, and I'd be able to pay it off in a couple of paychecks, but I don't like doing so (I try to pay off my credit card bills in full every month). Further, I've never paid medical bills in the past, and somehow in my head I categorize them as just something that *I* don't have to pay. In addition, because it is a medical bill, I think if I ask my parents to pay for it, they likely will.

On top of that, there's another thing to think about: because the deductible is for the whole family, if I pay this bill, I will be paying down the rest of the family's deductible. In other words, it's not purely a matter of "I should be self-sufficient and pay my bills," because by paying *this* bill, I will be effectively be doing them a financial favor, not merely being financially neutral toward them. Because it is a shared deductible, this is profoundly different than, say, my electric bill. I could save them $500 (or whatever) by paying this $500, so (perhaps?) one school of thought could say that they should pay the bill. (I'm reaching here...)

-------

In sum:

I really, REALLY don't want to pay a particular medical bill, because most importantly 1) I am perpetually short on money, and it's half a paycheck, which feels like a LOT to me, and less-importantly-except-on-a-psychological-level 2) in my head I file this as something I "shouldn't" have to pay, because I never have paid medical bills in the past and because the billing itself feels profoundly unfair to me, because I didn't consciously approve the charge. However, I also really, REALLY don't want to ask my parents to pay for it, because I strive to be independent, because I would hate to be "indebted" to them -- I would think they could hold it over me for a very long time.

What to do? Any advice?
posted by anonymous to Work & Money (37 answers total)
 
(The insurance company said I should call the doctor and ask them to change the services from "diagnostic" to "preventive." I've done that -- or rather, I called the health care system's customer service line, and they will call the doctor. I have no idea if this will work. Let's assume it will not.

I actually think it might work. Follow-up with someone in the doctor's office; don't just wait and see if some other bureaucrat with a stack on their desk a mile high gets to it.
posted by ThePinkSuperhero at 9:16 AM on May 3, 2012 [20 favorites]


You're wildly overthinking this. Go back to the info you received: All you need to do is get the doctor's office to recharacterize this charge as preventative instead of diagnostic and the problem will go away. Instead of spending a lot of energy on the dilemma of whether or not to involve your parents, put your energy where it will be most useful: on the billing issue. Call the doctor's office directly if you don't hear back from the insurance line quickly. This may be a completely simple issue that can be cleared up very, very simply.
posted by BlahLaLa at 9:17 AM on May 3, 2012 [24 favorites]


Pay the bill. Call whoever billed you and get on a payment plan.
posted by misanthropicsarah at 9:17 AM on May 3, 2012 [1 favorite]


Call your doctor's office directly and have them re-code the charge. Talk to a human. The folks at my doctor's office are great.
posted by Ruthless Bunny at 9:19 AM on May 3, 2012 [5 favorites]


Seconding ThePinkSuperhero. This is my insurance company's standard advice and so far it has worked.

Note that some services at an annual physical - some blood tests, for example - may not be deemed part of necessary preventive care by your insurance company, and thus they won't cover them as preventive services. A simple office visit without a lot of labs should be OK, though.

Do NOT pay the bill before you make the phone call to find out how the bill was submitted (preventive or not). No need to be out of pocket right away.
posted by Currer Belfry at 9:20 AM on May 3, 2012 [1 favorite]


Definitely wait to see what happens if they refile the claim; doctors' offices generally do want to make health care affordable for their patients and are usually willing to help with this stuff.

If insurance doesn't pay, I would probably ask to split the bill with your parents. Most insurance plans have an overall family deductible, so if you take on the whole bill yourself it does mean you're getting your parents off the hook for paying the deductible later.
posted by something something at 9:20 AM on May 3, 2012


This happens all the time. Whenever somebody talks about the inefficiency and stupidity of government, I have to wonder if they've ever dealt with a health insurance company.

Wait to see what happens with the refile. It may be helpful to you to keep a log with the bill - who you talk to, what they said.

But it sounds like just a paperwork error. Don't stress it. It's a pain in the ass, but totally solvable.
posted by Pogo_Fuzzybutt at 9:23 AM on May 3, 2012 [1 favorite]


a) lose the chip on your shoulder, 2/3rds of this askme is "you need to get therapy" type of baggage unrelated to the problem of the insurance bill.

b) You work both sides, doctors office and insurance. You keep notes on who you talked to and when you talked to them. You need to be persistent in dealing with these folks. It may be a simple coding error, but you have to be responsible for pushing the people to fix it.

It really helps your case, when calling someone back to say "person X, on 29-April, said they would re-code and re-submit this to insurance, today I received a 60-day late bill indicating it has not been recoded nor paid"

- What does the DOCTORs bill say ? (services provided, billed, etc)

- What does the EOB from the INSURANCE FOLKS say ? (EOB - explanation of benefits, a separate letter the insurance folks send you that details what they were billed for, what they covered, etc etc. It often has in bold letters "THIS IS NOT A BILL" on it)

- What does the LAB COMPANY bill say ? (Generally, bloodwork is outsourced to a lab, so they bill insurance/you separately. But, some groups do it all in house)

- What do you know about the insurance policy ?

"technically" preventive care like physicals are "100% covered". Diagnostic things like bloodwork or other lab work are not necessarily covered. BUT there is so much variability in this, with out knowing your policy and the benefits, it's a total crap shoot.
posted by k5.user at 9:26 AM on May 3, 2012 [6 favorites]


Be aware that asking the doctor to re-code doesn't always succeed. I had a Dr's office visit coded as "wellness" (not covered by my insurance) instead of a regular doctor's office visit. I spoke with nurses and the doctor, and eventually ended up in the clinic's standard "revision request" process -- and I was denied. They said, no, I got the wellness checkup, so that's what it was coded as, even though it was exactly the same as other times I've been to the doctor that were coded as something covered by insurance.

But, still go through the process -- it doesn't hurt anything. You will, however, have to start paying the bill now and hope for a refund later, otherwise it'll start messing up your credit. Medical institutions are often happy with "whatever you can afford" -- $5, $10, $20 a month -- especially if you're unemployed, a student, etc., so hopefully you can maintain those payments until the coding is resolved.
posted by AzraelBrown at 9:29 AM on May 3, 2012 [1 favorite]


b) You work both sides, doctors office and insurance. You keep notes on who you talked to and when you talked to them. You need to be persistent in dealing with these folks. It may be a simple coding error, but you have to be responsible for pushing the people to fix it.

This, a thousand times. Early in my career, I fought a $100 charge (at that point, that was a lot of money to me!) that BOTH the doctor's office and the insurance office said I shouldn't have to pay, EVERY time I talked to them, yet both kept billing me for, for almost a year. I finally ended up writing a three-page letter, to both parties, that spelled out all exchanges (thank God I'd kept good notes) and said that this needed to stop. It was taken care of immediately after that. Wouldn't have been, if I hadn't been a pain in the ass.
posted by dlugoczaj at 9:30 AM on May 3, 2012 [1 favorite]


You did the right thing by contacting the insurance company, then the doctor. Give it a couple of weeks at least, then follow up with both.

I take care of my elderly father's insurance questions and stuff like this happens all the time. I call the phone number on the bill, explain the situation, the bill is resubmitted, and lo, the bill is taken care of.

I have had to step in and make sure that he DOESN'T pay any medical bill until I have reviewed it and have talked to the billing office if needed. For reasons I've never figured out, it seems to be standard operating procedure for insurance to pay part of a bill, then send the rest out to see if the patient pays it, even when 100% of the procedures are covered by the insurer's own rules.
posted by apartment dweller at 9:37 AM on May 3, 2012


I think there is a flaw in your reasoning that because the $500 is paying down the family deductible, you are doing them a financial favor. Unless I'm missing something, your parents pay extra every single month for you to be covered under their health insurance, so if you want to figure out who is indebted to whom I really think your parents have already won.

I'm sorry you have this unexpected medical bill and that your relationship with your parents is far from perfect. And, I really do think you can get this medical bill taken care of through your doctor's office. But you are 24 years old, and part of being an adult is paying bills you don't want to pay. I think it will be much better for your maturity and your psyche in the long run if you just pay the bill, if it comes to that.

You will be so much happier once you lower your expectations for what other people and the world owe you.
posted by ohsnapdragon at 9:38 AM on May 3, 2012 [12 favorites]


You are an employed adult. Work with the doctor's office and insurance company to get the bill to go away, and if it doesn't, pay it yourself.

I spent a fair amount of time unemployed a while back, and I felt guilty every time I went to the doctor because my parents had to pay for it. Now that I have a job (and make about the same as you do), I pay for these things myself. It sucks (I just dropped $75 bucks yesterday for a month of Rx drugs), but the fact that I CAN pay my own way counts for a lot.

It's time to grow up. You're lucky you can.
posted by phunniemee at 9:46 AM on May 3, 2012 [1 favorite]


Congrats on "becoming self-sufficient and self-made" at a young age! Part of that is taking care of this bill yourself.

lets break this down how you do this:
-call the doctors office, ask to make an appointment with one of the admin staff to talk about your situation, face to face. dress professionally for the appointment. (you're making a deal for 500 dollars here.) while at this appointment get a direct line and email to your person. Also ask for a timeline/deadline for when they will be able to change this by.

-notify your insurance of your intent to pay and also of the office's intent to change the classification. Ask if you can wait on this until a week after the re-classification date. establish a payment plan to go into effect AFTER this change would have been made (this signals your intent to pay, makes them more willing to work with you)

-tell your parents in a polite e-mail what happened, that this is going towards the deductible and that you're taking care of it

there, now you have a plan to reduce your cost (hopefully to nothing) and if that doesn't work soften the blow of a large bill.

the thing to remember here is that this is a further step in being a self sufficient adult. self sufficient means you can take care of ALL your needs. WHENEVER they need to be taken care of not just when you were expecting them. part of being an adult is being polite and through in that process even when you feel it's unjust or you're frustrated by the situation.
posted by FatRabbit at 9:53 AM on May 3, 2012


Of course, you should wait until you hear back from the doctor's office before taking action. However, if it turns out that you do need to make the payment then you can ask your parents for help. Or, you can pay it off at full and struggle for a few weeks financially.

If you need help from your parents then ASK for help rather than demanding that they help. They have provided you with all of your basic needs (if not more) for years as a kid. So, they don't owe you anything even if you have a shared deductible. No, your parents were not emotionally the most supportive and I'm sorry to hear that having experience in that department myself.

But, they helped you out financially throughout your life so far. If you talk to them, don't make it sound like a demand just because you and the family share a deductible. It's not their responsibility to pay this off. They would be doing something incredibly kind if they did help you out with this. Ask them for help by telling them that you NEED help since you are not financially well off. Tell them that you will pay them back, you have a job after all.

My parents always ask me if I need help financially and tell me that if I ever do need help to let them know. But, I decide to struggle financially instead. I think of myself as an adult, I have a job, and I know that struggling to pave my own way will be difficult. After all, I'm only 21 years old, but knowing that I can take care of my bills is truly rewarding. But, do what feels right for you. If you do ask for help and they agree to help, then at least offer to pay them back. Good luck!
posted by livinglearning at 9:55 AM on May 3, 2012


Whenever I have a hospital visit or some such, I generally ignore the first wave of medical bills which typically arrive before the payed/owed statement from the insurance company. Amazingly enough, the second wave of bills is much lower. If your doctor misfiled something in a way that has you paying a lot of money that the insurance company should be paying (an remember, they've already soaked up a huge wad of money for this service) have your doctor resubmit the claim categorized appropriately.

After that, you'll probably be long term happier if you pay off whatever is left, if anything, but do it after that.

Anyone who wants to feel more mature by paying bills that they don't exactly owe, please send me your address. This self-esteem boost is just one of the many services I offer.
posted by Kid Charlemagne at 9:56 AM on May 3, 2012


1) You are only saving your parents money by paying this if they actually go on to hit their deductible.

2) Health insurance plans are weird on this. Some plans cover routine preventative office visits, but don't actually cover the associated labwork. Some plans (like the one I have now) are even weirder -- they'll cover preventative labwork, but only so long as the actual labwork results come back normal. If a lab test shows a problem (like, say, low Vitamin D), that particular test gets recoded as "diagnostic" and now falls under your deductible. Under some plans, it isn't possible to know what tests are covered until you actually get the test results back.

3) I agree with everyone saying to deal with this through insurance and the doctor's office. It could still potentially be covered.

4) This isn't the only unexpected bill you're going to have to deal with. Personally, I found my stress levels on this kind of thing went way, way, WAY down once I had an emergency fund in the bank. If you don't want to ask your parents for money ever again, I think building up an emergency fund would be a really good way to make that possible.
posted by pie ninja at 9:58 AM on May 3, 2012


Maybe this is just me, but I did not read OP's question as expecting the world to owe her/him anything. I read it as "I feel guilty about having recieved a lot of care free (to me) in the past and so should I pay this bill without challenging it?

To which I strongly second BlahLaLa's advice. You are wildly overthinking this, it doesn't matter what happened in the past, what matters is they may have made a billing error. It happens ALL THE TIME and you shouldn't think they're trying to screw you, it was probably just a mistake. Try to get it cleared up. There is no reason you should pay if you don't have to. If you can't get the bill covered by insurance, then yes suck it up and, if you want to maintain your independence, pay it yourself. No big deal.

I don't quite see what in OP's question elicited this wave of resentment at perceived entitlement. This is just a routine annoyance of life as an adult getting medical care that we have to figure out and asking on AskMeFi for help doesn't seem out of line.

Re: ethnomethodologist
Sure as a healthy 24 year old OP probably doesn't NEED to do an annual physical, but there's no harm in doing one if your insurance covers it, assuming they don't routinely order a million unneccessary tests. Especially given that OP has a psych history. If they aren't seeing a therapist of some sort, the annual primary care checkup is presumably also the annual psych check up.

Oh and seconding FatRabbit that it would be polite to inform your parents that you'll take care of the bill if, in fact, you do have to pay.
posted by Wretch729 at 9:58 AM on May 3, 2012


-call the doctors office, ask to make an appointment with one of the admin staff to talk about your situation, face to face. dress professionally for the appointment.

No, don't do this. This is a Level 1 phone issue, not an in-person issue.
posted by ThePinkSuperhero at 10:00 AM on May 3, 2012 [7 favorites]


I'm going to n-th that you keep contacting your doctor's office to get the tests re-billed as preventive. They should be pretty open to this, if they weren't checking for a specific disease tied to a symptom/complaint that you came in with, which it doesn't sound to be the case.

Also, you might want to review the bills you've received and check whether the insurer discount was applied correctly. Typically, lab work has a discount rate of between 75% and 90% - it's very common for the uninsured/no discount rate for a blood test to be $100 or $120, and after insurer-negotiated discounts the actual allowed amount is only $10-12. That discounted rate is what you should be paying even if you haven't hit the deductible for the year yet. If you're seeing only a 10% discount rate, it's probably worth asking your insurer what the deal is--was the lab out-of-network, or what? $500 seems way, way out of line with what you would be paying for basic blood work with insurer discounts.
posted by iminurmefi at 10:00 AM on May 3, 2012


I ... don't want to pay a particular medical bill, because 1) I am perpetually short on money, and it's half a paycheck

Since when is that a valid reason for a grownup to push a financial obligation off onto someone else (even if that someone else is their parents)?

... and 2) in my head I file this as something I "shouldn't" have to pay, because I never have paid medical bills in the past and because the billing itself feels profoundly unfair to me, because I didn't consciously approve the charge.

Again...you feel cheated and ripped off, so that's a reason your parents should pay instead?

You're an adult with a full-time job. You shouldn't go running to your parents to pay your bills unless it's an eat-dogfood-for-a-month situation. It sucks that you're short on funds, and it sucks that you feel like you shouldn't have to owe this money in the first place, but those are both your problems to deal with.
posted by drlith at 10:03 AM on May 3, 2012 [4 favorites]


I came here to echo what others have said: call your doctor. I've had to deal with insurance billing screwups a million times, and the doctor's office has always been much more helpful than the insurance company - which makes sense, it's in the doctor's interest to sort out the billing so that they can get paid. It is very likely that the doctor's office will help you. Please don't rely on any direct communication between the insurance company and the doctor's office actually happening.

So my advice is, don't freak out about how to pay the bill, approach it as a billing mistake that can be corrected. This will help you stay calm in talking to the doctor and insurance company: your attitude will be, "So there's this unfortunate mistake with the billing that needs to be corrected," not "OMG I can't pay this bill the world is ending!"
posted by medusa at 10:06 AM on May 3, 2012


Yeah, jump through the hoops to try to get the doctor's office to recode it, but if they won't, pay it. I do not understand how "I'm trying to be an adult" and "I feel like I shouldn't have to pay things I don't want to and haven't paid in the past" is even internally logical. You're lucky stuff got paid as long as it did, and you do acknowledge that. I mean, you literally said, "but I don't want credit card debt." Who does? People don't always have credit card debt because they buy too many video games and shoes - people have credit card debt largely *because* of things like this. And car repairs. And other unexpected, adult purchases that kind of suck and feel unfair (and be, indeed, be unfair).

Since you're still on your folks' insurance, they're already covering you more than I would consider normal for an "adult," so I'd suck up the mental "but I'm paying *their* deductible" thing.

It does sound like the doctor's office was screwy, though, so hopefully you get that worked out and no one besides the insurance pays anything. And I think the reason you're getting this knee jerk "that is not adult behavior" reaction from several people, including me, is the sense that you can do this with minimal actual impact on your life (credit card debt for a few months is extremely low impact), you just don't want to. If the sum of money were huge, or you were unemployed or something, I think the reaction would lean more toward, "Even adults have to ask for help sometimes." Asking for help with major bills isn't necessarily childish, but asking or demanding for something just because you simply don't want to do it isn't most people's idea of "adult."
posted by wending my way at 10:11 AM on May 3, 2012


Most of your reasoning re your upbringing, and the fact that you are not used to paying medical bills, and the fact that you just don't wanna, I think are totally irrelevent to the question. Once you're grown your folks don't owe you anything, nor should they still be on the hook for doing the "hard stuff", just because they always did when you were a kid. You're not a kid any more, doing your own hard stuff is part of being an adult.

Not that I don't sympathise about the unexpected bill, $500 is a lot to most people and seems like a fortune when you don't make very much. It sucks that medical care is so freaking expensive.

I would definitely try to have your doctor's office resubmit the bill as preventative care... this is not an unusual request and there is a very good chance you can get it paid unless it just doesn't qualify.

But assuming you're stuck with it, and considering it will go towards the family deductible, it wouldn't hurt to politely ask your parents if they would mind helping you out by paying a portion of it. But you have to be cool about it if they decline.

Don't put it on your credit card unless you absolutely have to. Most offices will let you make payments direct to them and most don't charge interest. $50 a month would be acceptable to most medical providers on a $500 bill.
posted by Serene Empress Dork at 10:24 AM on May 3, 2012


NEVER pay an unexpected and not-sense-making bill for health care until you have gone through every possible step of an appeals process with your insurer, and (if all appeals processes have been exhausted), negotiated directly with the care provider for a lower rate.

The recoding will probably work. If it doesn't work, you enter a formal dispute with the insurer. If that doesn't work, then you negotiate with the doctor's office; at the very least, they should discount your bill to what they would actually get from the insurer (which is likely to be at most 80% of the bill's face value).
posted by Sidhedevil at 10:41 AM on May 3, 2012 [4 favorites]


I would hate to be "indebted" to them -- I would think they could hold it over me for a very long time.

Look, IF the doctor refuses to change the coding (and I agree with others it's highly likely this is the easy fix), you are going to end up owing someone. You could pay off this debt in a year at $40 a month, a far preferable scenario to owing some amorphous moral debt to your folks indefinitely.

Also, refile medical expenses in your head as something you are responsible for. The way you characterize this is almost bizarre for a person in his mid-twenties. It is really great that you are still able to be on your parents' insurance plan, but pressing that advantage to suggest they should pay your out-of-pocket expenses really does smack of entitlement. It's clear from the rest of your post that you really, really don't want to be that way, that you see yourself as self-sufficient. So BE the way you see yourself.

One other consideration is that there may come a time (this isn't it) when you really need emergency financial help from your parents. You don't want to dilute the urgency of such a future need with non-vital requests now.
posted by torticat at 10:43 AM on May 3, 2012 [1 favorite]


Just another voice chiming in to say that this kind of thing happens all the time, and it is highly likely the recoding will take care of it completely. As others have said, do not pay the bill until you have exhausted all possibilities and, as the insurance company instructed you, call the doctor's office directly. Do not rely upon some customer service line to handle this. Then follow up to make sure it's been resolved.

As for all that other stuff, you investing a lot of time, energy, and worry into something that probably isn't even an issue. If you do end up responsible for a balance, pay it yourself since it seems you can with a little financial maneuvering and remember that medical expenses are tax deductible if they account for either 7 or 10% of your income. I don't remember the exact percentage because the increase from 7 to 10 is one of the changes eventually being implemented with Obama's health care bill, I think in 2013, but again, fuzzy on those exact details.
posted by katemcd at 10:55 AM on May 3, 2012


Don't stress about paying it immediately. The doctor's office made the mistake here. Doctor's offices are used to billing errors, and they are used to it taking months and months to get cleared up. As long as you are in communication with them they aren't going to screw up your credit. I've had this sort of stuff drag on for almost a year - it's a not insignificant part of why health care is so damn expensive in the first place.

Also, if the doctor won't recode (which he probably will, so this is a moot point) see if you can find out from the insurance company what the contracted rate would be on lab work. With my insurance company, it's an 80% discount, or more. Then offer to settle with the doctor / lab for the contracted rate, as that is all they should have been paid for that particular service in the first place.
posted by COD at 11:02 AM on May 3, 2012


n'thing don't pay until you've exhausted all possible avenues of appeal. The Doctor's office would like to get paid, and they are much more likely to get paid if they re-code and bill your insurance. In fact, your doctor's office pays people to do nothing, NOTHING, but find the most advantageous way to code each encounter - they are coding black-belt ninjas and can help you.
posted by Ausamor at 11:15 AM on May 3, 2012


If you aren't able to make the charge go away, I agree that the best thing to do is a payment plan with the doctor's office, not putting it on your credit card. Do not put it on your credit card. Your doctor's office will not charge you the exorbitant interest a credit card will.

This was not an issue of you having to pay for something you didn't consent to. You asked if getting a physical exam at the doctor would be free, your insurance company said yes, and it was free! Having additional testing done was not part of your question. If you had had an x-ray, or an EKG, or a CT scan, would you feel differently, like you shouldn't have to pay for it? Was there some reason you thought the blood work would be included as a part of the 'exam'? I recommend always telling your doctor if you are short on money and are going to have to pay the bill yourself, because there are things they can do to reduce your costs related to how they bill for things (as you've seen) and how they order things as well.

As a side note, this highlights how stupid our medical system is. The insurance company is flat out telling you how to get this covered - so why don't they just cover it, if they think it is something that should be covered? Having blood work done is always 'diagnostic' - meaning you make a diagnosis based on the results, so the distinction between 'diagnostic' and 'preventative' seems very artificial! (i.e. you get a cholesterol level checked and it's normal, does that mean it was 'preventative'? You get a cholesterol level checked and it's high, does that mean it was 'diagnostic'?)
posted by treehorn+bunny at 12:16 PM on May 3, 2012


Dude, medical bills (and car repairs) are why I'm in credit card debt. If you don't catch a break from the doctor's office, just put it on a credit card and pay it off over a few months.
posted by ablazingsaddle at 12:31 PM on May 3, 2012


I agree with all the practical advice you are getting about the steps you need to take to remedy the situation (get it recoded, see about a payment plan if necessary, etc.).

Regarding this:

the billing itself feels profoundly unfair to me, because I didn't consciously approve the charge.

...I hope this does not come off as flip (because I don't mean it to be, sincerely), but: welcome to the for-profit healthcare system in America. Millions of people are billed every year (both small amounts and massive, bankruptcy-level amounts) for medical charges they don't "consciously" approve. What you are seeing is a tiny glimpse of how the system treats virtually everyone, in which medical care is a commodity for profit, rather than a service for people. It is very frequently an enormous hassle, and dealing with it is (unfortunately) one of the downsides of being a self-sufficient adult in the U.S. at this point in history.
posted by scody at 12:36 PM on May 3, 2012 [3 favorites]


The entire middle part of your question is irrelevant and shows some really... interesting... thinking. If you are unable to get the bill resolved by speaking with your doctor/doctor's office/insurance, then you should pay it. You can just about always negotiate a lower base or monthly payments. No one scammed you. You got a service that wasn't free, and none of your reasoning gets you off the hook for that.

I sympathise because I've had some medical debt myself, but this is quite mountain/molehill.
posted by sm1tten at 1:11 PM on May 3, 2012


It might be an error on the part of the doctor's office--one that they're more than willing to change with only a phone call. But you'll never know unless you make the call.

The same thing happened to me a couple of weeks ago: I got angry that my doctor's office sent a bill after I'd already paid my co-pay. But I had new insurance that's confusing to me, so I assumed they were right. WRONG. On a whim I called them, and they admitted their error and cleared the bill.

Do NOT pay without calling first to ask for what you want.
posted by ImproviseOrDie at 1:41 PM on May 3, 2012 [1 favorite]


The doctor's office re-coding thing should work. Same thing happened to me recently, they accidentally did not put my appt down as preventative (which is free on my plan). Then what happened is I paid the co-pay, and without me even saying anything (I assumed my plan must have changed), I got a refund in the mail from my dr's office.

Which is to say this sort of thing happens often and I am betting your dr's office will be cool about it.
posted by manicure12 at 1:55 PM on May 3, 2012 [1 favorite]


If the issue is not resolved by following the excellent recommendations above, look at it this way: the only reason that you have any coverage is the new ACA requirements. This does not cost your parents anything. If not for the ACA, you would be on your own with respect to medical insurance, and probably uninsured.

Every medical office will accept a payment plan if you cannot afford the entire amount in one payment.
posted by yclipse at 2:27 PM on May 3, 2012


If you can't get it covered from your doctor's office, you should absolutely be the one to pay it. You talk about self-sufficiency and guess what - here it is.

In general, the kind of attitude where you want your parents to help you out of *spite* because you don't want to make their lives easier... is not going to help you live a healthy adult life. Pay the bill because it was your care, you're an adult with a job, and it's the right thing to do. Don't drag it into the internal drama you have going on w/r/t your parents as - beyond this thought process where your healthcare is somehow connected to them - it's totally unrelated.

You can absolutely pay it off in installments rather than putting it on a credit card. Just pay the medical office what you would have put on the card each month.
posted by sonika at 7:22 PM on May 3, 2012


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