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Posted 9/19/2018 4:43 PM (GMT 0)
I was quoted by the Rad dpt $290 for my portion of the cost for an f18 scan. I am on original medicare. I paid my $290 at the time of my scan. 6 weeks later, I get a bill for $850. They didn't even show my payment applied. I call the billing dpt. and they blame the Rad. Dpt. The good news is after my call they applied the $290 payment, but won't waiver on the balance. I worry aboutothers are having to deal with this facility and whats my options?
Posted 9/19/2018 5:18 PM (GMT 0)
Have you called the Rad. department yet? They might be able to fix it from their side.

Did you get anything from the Rad people on paper that quoted the $290 price? If yes, send a copy to billing and say, "not me, them."

Sadly it will likely just take a lot of persistence on your part to get it fixed.

I had to deal with things like this for my parents - it was just a lot of work and in one case I contacted a local senior center that had a legal aid service. That lawyer sent a letter to the hospital and the charges were magically changed.
Posted 9/19/2018 5:20 PM (GMT 0)
Have they submitted to Medicare? What did Medicare pay? Do you have a Medicare Supplement plan? What did it pay? Did you gat the upfront quote in writing?
Posted 9/19/2018 6:24 PM (GMT 0)
I'm on original medicare only. All I have, is a voicemail, nothing in writing. I don't have the eob yet, but the statement shows the numbers. Supposedly, the rad dpt mgr is going to call me. That's why I'm looking for ideas.
Posted 9/19/2018 9:09 PM (GMT 0)
Startech,

If you have not already done it, you can set up an online account at:

/www.mymedicare.gov/default.aspx

It is not very timely, and is only as quick as the charges are submitted, then several days to process.

This will tell you how it is broken down. Also, remember that when you ask if Medicare is accepted, remember to ask if they accept "assignment". If they do, they can't charge you anything extra (beyond deductible and your 20%). I have one doc that "accepts" Medicare, but does not accept "assignment", so they want to come after me for the difference that Medicare does not allow.
Posted 9/19/2018 9:17 PM (GMT 0)

Startech said...
I was quoted by the Rad dpt $290 for my portion of the cost for an f18 scan. I am on original medicare. I paid my $290 at the time of my scan. 6 weeks later, I get a bill for $850. They didn't even show my payment applied. I call the billing dpt. and they blame the Rad. Dpt. The good news is after my call they applied the $290 payment, but won't waiver on the balance. I worry aboutothers are having to deal with this facility and whats my options?

Do they accept Medicare assignment? If so, they will have to accept what MC pays, and if you don't have a supplement you will have to pay 20% of what MC says the total allowed bill is. Which presumably should be what the original quoted $290 was. MC may be willing to have a talk with them, if they gave you a false quote. Do you happen to have it in writing? If so, they can't do anything to you. If not, it might be a bigger battle for you.
Posted 9/19/2018 9:19 PM (GMT 0)
How much longer will we allow this extortion racket to continue?????? Can you imagine buying a new car and they refuse to provide a price until you sign that you are financially responsible for it. Then you have to wait for the first statement to know what the new car costs? argghghghhghghhghg

Think of the money spent in the last 20 years, I'll leave it at that
Posted 9/19/2018 9:25 PM (GMT 0)
Hi Startech, I wouldn't get too worried about this billing stuff. Although you only have Medicare it covers most of the expenses. Since you do have PC you may want to get to Medicare Supplement plan next renewal if you can afford it. It'll pay for itself. So for you and everyone else that has to deal with medical billing, here is a little help. In 2016, Congress passed the Medical Debt Relief Act, which provides you with some protection. According to the Act, if an unpaid medical bill goes into collections, the collection agency must notify the consumer that the account was placed in collections. The consumer then has 180 days from the notification to pay the account before the agency is allowed to report it to the credit bureaus. Additionally, once a medical collection has been paid, the medical debt must be removed from the consumer’s credit report within 45 days, according to the legislation. The Federal Trade Commission's website has a link for a free annual credit report and the Consumer Financial Protection Bureau's website offers helpful information about credit and other related topics. Provisions under other federal laws provide the right of an individual to receive a written confirmation of the debt, as well as the right to dispute it and the right to dispute inaccurate information on credit reports. Under the Affordable Care Act some patients are protected from debt collection if they have contacted a non-profit hospital in writing regarding their medical bills and requested options for financial aid to cover medical expenses. So my advice is don't waste too much energy worrying or fighting with these guys.
Here are some helpful sites:
https://www.annualcreditreport.com
Federal Trade Commission Assistance
Report Identify Theft https://identitytheft.gov/
Consumer Protection https://www.ftc.gov/faq/consumer-protection
Credit Reports https://www.consumer.ftc.gov/articles/0070-credit-and-your-consumer-rights
And the Consumer Financial Protection Bureau https://www.consumerfinance.gov/

68 yrs., PSA .012, 8.12.18, 1.42 June 18, 2018 (Lupron 5.21.18 & 8.15.18), 12.7 May 2018, 13.7 Jan. 2018, 2.1 May 2012. SpaceOar 9.6.18, testosterone >7, 8.15.18, Tot Mayo 19 ng .17 testosterone Free 6.18.18, Gleason 3+4=7 involving 15% of the right apex and 15% of the right mid, 3+3=6 prostate cancer involving 5% of the left base. Pathology interpretations by John Hopkins, UNM Cancer, and SF Path 3+4=7 or 4+3=7 MD Anderson Proton Center w/o %. T3 MRI 1.8 lesion left side 5P, Neg. Bone Scan. Prolaris test 3.5 consistent with intermediate and a PTEN test negative. Father PC age 78 RT & ADT now 93 yrs. Neurogenic bladder due to lumbar disk disease and recurrent bladder neck contracture with urinary retention man. 20 years doing catheterizations. TURP & scaring 2003, Finasteride 5 milligrams daily since 2002.
Posted 9/19/2018 9:27 PM (GMT 0)

BillyBob@388 said...

Do they accept Medicare assignment? If so, they will have to accept what MC pays, and if you don't have a supplement you will have to pay 20% of what MC says the total allowed bill is. Which presumably should be what the original quoted $290 was. MC may be willing to have a talk with them, if they gave you a false quote. Do you happen to have it in writing? If so, they can't do anything to you. If not, it might be a bigger battle for you.

BB, that is correct if they accept Medicare "assignment". Some docs (two of mine in particular) file with Medicare, which then files with my supplement, to cover what MC says is the allowable cost. BUT then they bill the patient for the rest of the original charged amount. This is allowed to be done by MC. They can't stop it unless the facility is registered with them as accepting "assignment".

There is a tool on the mymedicare.gov site that lets you find docs / facilities. It will tell you if the doc / facility accepts Medicare (shows as a ?) or Medicare "assignment" (don't remember, maybe a checkmark).

The background issue is who else is involved in the bill. There may be 2 out of 20 of a particular specialist who don't accept assignment while all the rest do. I feel like I'm going off to war with each doctor's visit.
Posted 9/20/2018 1:51 AM (GMT 0)
Faunleroy...maybe not the new car...but look what we pay for computers...and then...
Posted 9/20/2018 2:02 AM (GMT 0)
I never worry about a med bill until I receive an explanation of benefits.
Posted 9/20/2018 2:13 AM (GMT 0)
Exactly. The bill means nothing.
Posted 9/20/2018 2:30 AM (GMT 0)
Yesterday my wife complained to me about a co-pay the clinic made her pay. She thought it was too high. I told her I'd check with my company's insurance admin.

Today the health plan sent her a refund check for overpayment of a co-pay.

Now, do I still have to call the company's insurance admin?
Posted 9/20/2018 1:23 PM (GMT 0)
Thanks for all of the info and support. The thing that burns me, is I was considering a free trial for the same scan in DC. Travel and a room all covered. I could've made a mini vacation out of it, but decided to support MD Anderson San Antonio. A new addition to San Antonio with a new machine. Pfft, in reality they are just riding the coat tails of MDA Houston. It's not the money to me, but rather the principal. I'm positive I'm not the first to experience this, but now I have a mission. I'll be the last.
Posted 9/20/2018 1:48 PM (GMT 0)

142 said...

BillyBob@388 said...

Do they accept Medicare assignment? If so, they will have to accept what MC pays, and if you don't have a supplement you will have to pay 20% of what MC says the total allowed bill is. Which presumably should be what the original quoted $290 was. MC may be willing to have a talk with them, if they gave you a false quote. Do you happen to have it in writing? If so, they can't do anything to you. If not, it might be a bigger battle for you.

BB, that is correct if they accept Medicare "assignment". Some docs (two of mine in particular) file with Medicare, which then files with my supplement, to cover what MC says is the allowable cost. BUT then they bill the patient for the rest of the original charged amount. This is allowed to be done by MC. They can't stop it unless the facility is registered with them as accepting "assignment".

There is a tool on the mymedicare.gov site that lets you find docs / facilities. It will tell you if the doc / facility accepts Medicare (shows as a ?) or Medicare "assignment" (don't remember, maybe a checkmark).

The background issue is who else is involved in the bill. There may be 2 out of 20 of a particular specialist who don't accept assignment while all the rest do. I feel like I'm going off to war with each doctor's visit.

Good info. I have one doc who does not accept assignment. I have to pay the full amount when I leave his office, but then they send the info to MC and my supplement who later send me a check. But so far he has always billed only what MC will pay, so the check they(and the supplement folks) send me covers the full amount. But it sounds like he does not have to do that? It's low risk since I have gone to him for years(dermatologist) and his charges are usually between one and a few hundred $. But my next appointment is a year away, and I plan to switch to a doc who accepts assignment.
Posted 9/20/2018 4:25 PM (GMT 0)
Before you okay any new and expensive treatment, ask that they get "pre-approval" for your insurance company. You can also ask "how much is my out of pocket expense for this treatment" ??

Also, the window for changing your Medicare plan opens pretty soon. You my find that a Medicare Advantage plan (there are many) might work better in your situation..

Another thing I always ask myself...Will having this expensive scan or treatment allow me to live any longer or better than if I just skip it ? Will my treatment plan be in a significant way by this scan or treatment ?
Posted 9/26/2018 2:38 PM (GMT 0)
Good advice Fairwind and all. Just to update, I never heard from the Rad Dpt. Mgr.. So I left a few messages to no avail. I then called the billing dpt. back and got what seems to be a sympathetic rep..

Ruh Roh, it gets worse. The additional $600 billed is just for the f-18 injection. The Scan for some reason was denied by MC, but the f-18 injection was approved. So, they are appealing to MC. The rep. says my total 20% responsibility could exceed $1600., but since the voicemail (in which I still have) was left by a benefits coordinator estimated $290, I may not be responsible for the balance. And that she would put my acct. on hold so it does not go to collections. They still have not applied my payment to my acct., although the rep. acknowledges she see's it.

Pfft-Right...I'm relaxing.
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