Baylor Hospital Scam

[benenglish]

... So I had to go back to them, and try and get about 2000 dollars back.
It took 4 phone calls, I got told everything from, I have no idea what you're talking about, to, you must be mistaken that's not how insurance works.
I finally had to go down to the hospital show them the billing, walk them through how I was billed by who when. And they finally figured out I knew what I was talking about before they cut me a check.

This is why when I have been forced to pay prior to receiving services I use a credit card. I want to be able to dispute the charges. I anticipate time frame problems; credit card companies don't like getting disputes on charges that are several months old. I'll deal with that if I ever have to fight on this issue again. Still, it gives me some leverage to be able to tell the hospital "Now that you've charged that card, be advised that I will not hesitate to dispute that charge if y'all screw up the insurance."

I once visited a doctor while on a business trip. I had injured my foot moving some equipment. As an accidental injury, insurance paid everything. There should be no co-pay.

The front office staff put the wrong codes on the paperwork and demanded a $20 co-pay. We got on a conference call with the insurance company, figured out the problem, and the office manager refused to change anything. They threatened to call the police if I didn't pay. I paid with a credit card and disputed it that evening.

The most insane, surreal thing about that visit? Because the coding on the paperwork that reached the doctor did not say anything about treatment for an injury, he didn't even look at the foot. In order to have something to bill the insurance company for, he launched into a 10-minute canned speech about the prevention of sexually transmitted diseases then told his nurse to provide me the number of a specialist in town for the foot.

I was gobsmacked. I came there for an injured foot and, out of nowhere, he just started rattling off a memorized speech on a totally different topic.

Insurance weirdness spawns treatment insanity.

 

[TX69]

Thanks for the CC reminder!

Sent from my SAMSUNG-SGH-I337 using Tapatalk

 

[Mic]

If the hospital files as a business its THEIR problem NOT mine or anyone else's......Basic economics.

Basic free market would be "If you don't want to pay for our services up front, go screw yourself."
The only reason it's not that way is because of all kinds of laws interfering with our medical care and everybody uses insurance or probably doesn't pay and then they have a bitch of a time collecting afterwards.
So.... they are trying to collect ahead and........I guess that IS your problem, caused by POS people and a POS system.

 

[kabob]

If they're asking for a copay upfront, that's not dictated by Baylor, that's the insurance company asking. I don't know how many of you guys work in health care or have had to deal with insurance companies but if you don't follow their exact guidelines to the letter, they simply deny the claim.

<--- Baylor employee and someone who's had serious health issues off and on the last 10 years.

 

[Tejano Scott]

And then when you go somewhere else, you find the same problems because nearly all hospitals are dealing with the same issues.

Of course, you're both right that we're dealing with basic economics. There are, for example, people rich enough to simply pay cash for everything. Scott, I assume you know this but to everyone else - Have you seen the entire floors set aside for rich clients at large hospitals? Most people haven't because, for obvious reasons, hospitals don't mass-market those services. They can still be an eye-opening experience. If you're rich enough to pay the freight you get a separate check-in roughly like checking into a hotel, furnishings and service also comparable to a high-end hotel, and no hassles. You never have to rub shoulders with the little people.

So, yeah, basic economics provides choices if you can pay for them. For the bottom 99%, those choices are mostly an illusion because they don't exist in any meaningful way. There may be minor differences in procedures or policies but it's basically all the same. Those minor differences may be important enough to cause some small percentage of patients to choose one facility over another, granted, but those patients aren't numerous enough to impact the way hospitals, overall, do business.

There's the bottom. There's insurance-paid. And there's the top. The free market in the U.S.A. really doesn't slice up health care service levels any more finely than that. The few doctors who have opted out of dealing with insurance and require full payment from their patients are the exceptions that prove the rule.

Scott - How far have I missed the mark on this one?

More accurate than most would like to admit.

As for TX69's basic economics response, the problem with that theory is a little federal law known as EMTALA (huge nightmare for Hospitals). Do you really think those costs don't get passed on to innocent consumers who pay their bills (like you)? Of course they do. Very few businesses or industries I can think of are required to give away goods and services at the same rate as hospitals.

 

[Brains]

Knew that EMTALA existed, just didn't know what it was called. Thanks for that little tidbit.

 

[Tejano Scott]

I've seen the stats long ago about the impact EMTALA had on medical costs, it's staggering. I get to hear a dozen times a day "your charges are outrageous". It's always so humorous hearing that statement made as if there are cheap places to go get healthcare. I always like asking them "as compared to what?" I've sat through some high level conversations/depositions regarding hospital Chargemasters (look this term up if you want to really understand hospital charges), and it would blow you away the losses that get discussed and passed on via inflated charges. At the end of the day, every hospital knows what every other hospital in town charges for the same procedure and they generally are in line with everyone else (since they all face the same losses). These are the types of losses that you just can't mitigate like businesses in other industries do.

I'm sure we all know, Obamacare is NOT going to fix this problem. Unfortunately for me, I really need to shut my mouth at this point.

Good luck OP. Prayers for positive results and a speedy recovery for the wife.

 

[TX69]

I've seen the stats long ago about the impact EMTALA had on medical costs, it's staggering. I get to hear a dozen times a day "your charges are outrageous". It's always so humorous hearing that statement made as if there are cheap places to go get healthcare. I always like asking them "as compared to what?" I've sat through some high level conversations/depositions regarding hospital Chargemasters (look this term up if you want to really understand hospital charges), and it would blow you away the losses that get discussed and passed on via inflated charges. At the end of the day, every hospital knows what every other hospital in town charges for the same procedure and they generally are in line with everyone else (since they all face the same losses). These are the types of losses that you just can't mitigate like businesses in other industries do.

I'm sure we all know, Obamacare is NOT going to fix this problem. Unfortunately for me, I really need to shut my mouth at this point.

Good luck OP. Prayers for positive results and a speedy recovery for the wife.

Appreciate the well wishes to my wife and to everyone here thank you.

Ths thread and your responses did help a lot. My wife was able to win the battle over the upfront payment and she/we will not pay until we see an itemized bill. She had to go up the ladder three rungs to get to a person that could make a decisoon but it worked. She had a civil argument with them at Baylor and then at the end said Okay. I'll call my surgeon and explain why we are canceling and hung up. While she was on the phone with insurance the lady from Baylor called back and said there will not be upfront charges. She then made the lady say that there will be no problems when we get to admittance.

Wife gets extra points for sticking to her guns! I'll let you guys know how the service goes from the hospital staff or whomever else.

 

[Tejano Scott]

Awesome results!

 

[Rangerscott]

I don't have insurance so it's a big down payment for anything before they'll do any test/procedure. My intestines are all screwed up and paid a good penny just for a doc to "assume" I have IBS. Who knows what's really wrong with me. I'd rather be dealing with ya'lls problems and have procedures done and fighting over who owes what than wondering how I'm gonna feel tomorrow.

 

[CJ7nvrstk]

Wife is going in for surgery which has been planned for months. Yesterday she gets a call that they want $500 BEFORE she has the procedure. Ihave had her take voice mail if they call back and I will return the call. She has full boat insurance and no money until services rendered.

FWIW, these insurance companies don't always pay their bills in a timely manner and it could be they are on the hook for a good bit of coin with Baylor so Baylor is just trying to make sure they get something. It is standard to ask for money before the surgery.