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  1. #1
    null Jonny's Avatar
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    Default $4000 Bill for MRI / Dr. Appointment

    So, about a month ago I went to my family physician for knee problems, which I believed were due to my gait. She then referred me to a physician specializing in sports medicine. I told him that I thought the pain was due to my gait, but he suggested I get an MRI of the knee to be safe. I go get the MRI, it comes back perfectly fine. He then refers me to a podiatrist, whom I have yet to visit.

    Today I open up a bill for 4,000 dollars; apparently my insurance company rejected the MRI and all the doctor visits after the first one. If I had known that I would have to pay more than a copay for any of this, I simply wouldn't have done it... end of story. Nobody during the entire process lead me to believe that I would have to pay anything above the copay...

    Is there anything I can do about this? I cannot afford this bill at this time, and I feel this was a major injustice. Yes, I was stupid for not making certain that it would be paid by contacting the insurance myself, but I was under the assumption that they didn't order MRIs and such without knowing whether it would be paid for.

    I'm really distressed about this... Seriously, I just wouldn't have had it done. Why did they do this to me?
    [SIGPIC][/SIGPIC]

  2. #2
    RETIRED CzeCze's Avatar
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    Wow, that sucks. And they did it because doctors/hospitals/insurance companies don't really have your best (monetary) interests at heart and ultimately kick responsibility/blame back on you.

    I had an ex who had a similar issue but in a bigger scale - she had to have emergency heart surgery and stayed in ICU for a few days - she found out her employer had switched insurance providers on her and she was left with the entire bill. They swore they had sent her the new insurance card and information but she never did (we lived together at the time and I was at the hospital when she gave her insurance card, she really did not receive the new card from what I know).

    The final bill was welll over $100,000 no joke. And she pretty much was living right along the poverty line at the time.

    She was incredibly passive about the whole thing but the hospital had its own negotiating process and gave her a lawyer. She didn't even bother showing up for the session and wouldn't have called her lawyer back except for my pushing (this was one the big reasons I was glad to break up with her - her utter lack of practicality and just the odd counter-intuitive things she would do and say sometimes) and they negotiated it down. It still ended up being tens of thousands of dollars.

    If I were you I'd contact the hospital/doctor as well as your insurance company. Your insurance company will probably not care but hospitals/doctors want to collect some money as opposed to none. You can try to negotiate the fees. If you went to a hospital, they may have an ombudsperson. In addition to negotiating it down you might be able to get an interest free payment plan so it's not as much of a hardship.

    Also, I know anecdotally of a man who responded to his dental bill thusly, "I don't have the money to pay you so it's a waste of time for you to keep asking". Not sure what happened with the bill.

    Good luck!
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  3. #3
    @.~*virinaĉo*~.@ Totenkindly's Avatar
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    Quote Originally Posted by CzeCze
    If I were you I'd contact the hospital/doctor as well as your insurance company. Your insurance company will probably not care but hospitals/doctors want to collect some money as opposed to none. You can try to negotiate the fees. If you went to a hospital, they may have an ombudsperson. In addition to negotiating it down you might be able to get an interest free payment plan so it's not as much of a hardship.
    We have a kid with special-health needs and we went through this crap all the time.

    Talk to the hospital/doctor, and also talk to the insurance company.
    Find out why it was rejected.
    See if your doctor can bill it differently/justify it differently, and then see if it goes through.

    It's definitely true the hospital wants at least some money, even if you cannot pay all of it.

    As another side note, hospital services and doctor visits are also routinely OVERCHARGED in order to receive the maximum amounts they can get from the insurance companies, and then typically if the insurance doesn't pay all of it, they just write off the rest. Still, this case is a little different because they rejected everything; that makes it sound like the insurance company doesn't think the test was justified and/or some sort of procedure was not followed. (With some companies, you have to get pre-approval for tests that expensive.)

    But definitely you sending someone a check is your last resort. Don't do that up front. Contact the docs and the insurance company first, to see why it was rejected and what can be done, and to make sure you understand and follow your insurance company's procedures for getting services covered.

    EDIT: I would also not depend on the doctors to tell you all this up front. They could be training new people; often they do not know the specific rules for a particular company and/or policy (since companies offer more than one type of plan and usually tailor their plans to employers) until they've worked with that specific company and plan; and they are dealing with many, many patients during the day. There's a lot of data going back and forth and it's likely no one is completely on top of it. More importantly, they are not the ones footing the bill, you are the one who will be left holding the bag if things don't pan out. So it ends up being your responsibility in the end, regardless, since it is your bank account that will get hit unless you look out for yourself.
    "Hey Capa -- We're only stardust." ~ "Sunshine"

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  4. #4
    Senior Member ceecee's Avatar
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    Quote Originally Posted by Jonnyboy View Post
    So, about a month ago I went to my family physician for knee problems, which I believed were due to my gait. She then referred me to a physician specializing in sports medicine. I told him that I thought the pain was due to my gait, but he suggested I get an MRI of the knee to be safe. I go get the MRI, it comes back perfectly fine. He then refers me to a podiatrist, whom I have yet to visit.

    Today I open up a bill for 4,000 dollars; apparently my insurance company rejected the MRI and all the doctor visits after the first one. If I had known that I would have to pay more than a copay for any of this, I simply wouldn't have done it... end of story. Nobody during the entire process lead me to believe that I would have to pay anything above the copay...

    Is there anything I can do about this? I cannot afford this bill at this time, and I feel this was a major injustice. Yes, I was stupid for not making certain that it would be paid by contacting the insurance myself, but I was under the assumption that they didn't order MRIs and such without knowing whether it would be paid for.

    I'm really distressed about this... Seriously, I just wouldn't have had it done. Why did they do this to me?
    I'm very surprised they even proceeded with the MRI without authorization from the insurance company as it was not in an emergency capacity. I would contact the insurance company first and see what can be done. You can also negotiate it down with the hospital or facility that did the MRI. They have employees that deal expressly with these issues.
    I like to rock n' roll all night and *part* of every day. I usually have errands... I can only rock from like 1-3.

  5. #5
    Senior Member Shimmy's Avatar
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    You should definitely get a lawyer('s opinion) on the case. This is quite an outrage.
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  6. #6
    No moss growing on me Giggly's Avatar
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    If you ask a doctor how much a procedure or lab done by someone else other than themselves costs, they'll often say "I don't know", because they truly DON'T know.

    After having gone through the same thing you did once, I now have been an expert on what these things costs. lol

    Anyways, the billing department of place where you got it done will negotiate in some way with you. Good luck.

  7. #7
    Senior Member ThatsWhatHeSaid's Avatar
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    Maybe call the referring doctor too and ask for some advice on how to handle this.

  8. #8
    Senior Member Mal12345's Avatar
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    Quote Originally Posted by Jennifer View Post

    But definitely you sending someone a check is your last resort. Don't do that up front.
    This is especially important for winning your case. Even if you give the hospital one thin dime toward the bill, they will take that as a commitment to pay the rest of it. A lot of people will screw themselves over by sending in a small payment and then afterward deciding to fight the debt. But it is just impossible to win at that point.
    "Everyone has a plan till they get punched in the mouth." Mike Tyson
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  9. #9
    Senior Member Wanderer's Avatar
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    Fight fight FIGHT.

    Unfortunately the devil is in the details. Get a lawyer and go over every sentence of your insurance agreement.
    I have a sinking feeling though, because some insurance companies are incredibly weaselly. [For example, I'm not allowed to go to the ER unless I call my primary health provider and obtain a referral first; doesn't matter if I'm unconscious and unable to call, or if the emergency is great enough that I can't wait 20 minutes on hold. If I didn't call ahead of time, the entire bill is mine. Non-negotiable. Hopefully your insurance isn't anything like mine.]

    If your insurance doesn't cover referrals, or if they classify the MRI as something that was not "medically necessary" then you're kinda screwed unless you have a doctor who's willing to testify that it was, in fact a medical necessity. No matter what you're looking at a lot of time on the phone and possibly a legal battle. Don't give in without a fight.

  10. #10
    Senior Member INTP's Avatar
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    im glad i dont live in USA. the bill would had been more like 50€ here in public hospital(because its founded by government) and if you dont have a job you dont have to pay anything. this whole getting in financial trouble because of health issues sounds like some 3rd world country thing lol.

    if you would get like 10000 bill from hospital because your life was in danger due to acute medical condition and you were broke as fuck(barely can afford food and rent an apartment) and end up not paying the bill, could you go to jail for this?
    "Where wisdom reigns, there is no conflict between thinking and feeling."
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