A friend was unemployed for a bit while his wife was in school and had that issue where self-pay was ridiculously more expensive than the insurance negotiated rate.Quote:
Originally Posted by featuretile
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A friend was unemployed for a bit while his wife was in school and had that issue where self-pay was ridiculously more expensive than the insurance negotiated rate.Quote:
Originally Posted by featuretile
Here's a study that just came out that severe trauma victims survive more if they are transported by helicopter.
So, how long was the helicopter ride (distance)? I work at a doctors' office and just this week we had a patient send us all of his medical bills for his hospitalization to show his expenses to negotiate a discount on our doctor's bill. One of his bills was for helicopter transport from his local hospital to one of our city's hospitals. It was about 50 miles and the bill was $14,000.00. Just wondered how that compares with the distance you were transported?
You said that at first insurance denied the bill saying they only covered local transport and now they're saying the transport company didn't precertify so the bill is denied and you don't have to pay. A couple of suggestions here:
1. Make sure the transport company contracts with your insurance, ie., they're on the preferred provider list. If they aren't, then insurance company can't diictate what is billed or written off and if they bill you, you ARE responsible. If they are on the preferred list, and insurance requires them to precertify services and they didn't, then if insurance says the bill is a write-off - it is.
2. Be very careful about "not paying." In my 16 years at my current job, I've heard lots of patients say "my attorney told me not to pay your bill" - but not once has an attorney taken any steps to undo bad credit reports if we'd turned the patient to collections. The attorney will tell us "cease and desist collections - I represent the patient in a lawsuit/Work Comp case" - no concern whatsoever about the patient's credit. We turn very few patients to collections, but the ones we do turn are usually the ones that don't respond to us.
I'm guessing, without seeing the bills I can't be sure, but it sounds like your insurance tried to deny the bill initially because you didn't "go to the nearest hospital." They might require precertification for non-emergency services (and they don't understand that your services were an emergency - ?), or proof of medical necessity for the emergency transport. If the transportation company does contract with your insurance, they should work this out themselves. But if they try and bill you, by all means notify insurance they did this since it would be a violation of contract. If the air transport doesn't contract with insurance, "walk it through" yourself - ie., call insurance and find out what then need from air transport, call air transport and tell them that insurance needs "x" from you, call insurance to make sure they receive it and are processing the claim - etc. I know it's a pain, but that's a big bill!
Good luck and let us know how it goes. Wish I could help more. The whole system is so frustrating.
FYI - The patient who sent us his medical bills had nearly a half million on his hospital bill alone. They discounted him - he owes $4000 now, which is still a bite, but they have a credit plan for him as well. He'll pay interest but no deadline to pay the whole thing off. He worked last year and is hoping to go back to work again soon. Healthcare providers do discount. Sometimes you have to ask, but private pay patients should not carry the load for insurance!
Not a very good comparison IMHO.Quote:
Originally Posted by Deborajen
You are trying to equate
(a) transport of a (presumably at least somewhat) stabilized patient from one hospital to another hospital, to
(b) emergency airlift of a potentially seriously injured patient from an accident site -- or as near to the accident site as the helicopter can land -- to a trauma center.
There's more at play here than simply mileage. At least in my case, mileage from the crash site to the trauma center (roughly 35 miles) was a very small part of the bill.
Somewhat off topic, but precertification is no guarantee either. My insurance company precertified the PT I had for my hand several years ago and then denied the bill. Denied it on appeal, too. If it had been the size of a bill you have, I might've gone to court over it, but for "only" $1,000 out of pocket it wasn't worth it.
It wasn't intended to be a direct, or rather all-inclusive, comparison. Just curious about the mileage part. But good point and good information.Quote:
Originally Posted by jobob
Oakleaf, also a good point about precertification. Whenever you call an insurance company, they have a recorded disclaimer "this information does not constitute a guarantee of payment." I've seen insurance companies precertify, pay, then come back as much as a year and half later and say - wait, the patient wasn't really eligible for insurance. One particular patient had been a full-time student, but he dropped a class and became part-time. This was a patient who had brain surgery.
No, there are no guarantees. Just suggesting.