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  • TX69

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    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.
     

    benenglish

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    I've run into this more and more where the healthcare provider doesn't care about the insurance, they want some money up front. If I call my insurance company, they'll tell me in no uncertain terms to pay nothing before care is provided so that they can get the bill, pay their amount, negotiate any overcharges, then tell me what to pay. Hospitals don't want to go along with that.

    Before my mom died, I took her to a couple of hospitals that were downright nasty about it. The person checking my mom into the hospital had nothing to do with insurance, just check-in. Therefore, that person had a script to go by that said to get a payment for a certain amount before completing the paperwork. Period. No negotiations.

    I've had to butt heads over this issue more than once.
     

    TX69

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    Wonder who made the call?

    Baylor did.

    Happens all the time, surg. Center wants to get paid.

    Of all of the surgeries that I have had I have never been called or paid upfront. The scams they run to get others to pay their losses from previous dead-beats is not our problem. Anyone here ever been screwed by a hospital AFTER a visit? Did they try to extort HUGE sums of money and try to screw you financially? They are getting nothing upfront. No pay until services rendered.
     

    benenglish

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    Anyone here ever been screwed by a hospital AFTER a visit?
    Probably everybody.

    Did they try to extort HUGE sums of money and try to screw you financially?
    As in charging $20 for an aspirin? As in charging $500 for some doctor that no one ever heard of or talked to who supposedly took 10 seconds to walk in and out of the room while the patient was asleep?

    Oh, yeah.
     

    Sapper740

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    I've had two major surgeries done at Baylor and both times they discussed the total cost of the surgery, how much was going to be paid by my insurance and how much I would be on the hook for. They were professional and courteous and although they requested that I pay my portion upfront, never suggested that it was mandatory. When I received my EOBs from United Health Care it reflected accurately what had been discussed with Baylor and there were no surprises. My surgeries were both pre-Obamcare though which may something to do with the OP's experience.
     

    TX69

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    I've had two major surgeries done at Baylor and both times they discussed the total cost of the surgery, how much was going to be paid by my insurance and how much I would be on the hook for. They were professional and courteous and although they requested that I pay my portion upfront, never suggested that it was mandatory. When I received my EOBs from United Health Care it reflected accurately what had been discussed with Baylor and there were no surprises. My surgeries were both pre-Obamcare though which may something to do with the OP's experience.

    Great news as we also have United Health Care. Since Baylor has started to push this off track I sure hope it doesn't get worse. I will be there from start to finish to make sure I record everything. When they squeeze in bogus charges I will report them. They've stung me twice and had to report them each time.
     

    mitchntx

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    My wife used to work intake at an ER and her instructions were to get money upfront if at all possible.

    And she was incented to do so. She received a quarterly bonus check of a percentage she collected at intake.
     

    Brains

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    Wife just gave birth to our new son, and while in the recovery room here comes some doofus in a cheap suit trying to get me to cut him a check or give him a credit card. Uh, no. Go away. He was doing his best to be as pushy and persistent as he could be without outright pissing people off.
     

    Tejano Scott

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    The scams they run to get others to pay their losses from previous dead-beats is not our problem.

    I'm a hospital attorney, so I'm biased. Dead beats not paying for their services is everyone's problem. Like it or not. If people steal from grocery store, those losses get passed on. Basic economics.

    Im im not sure I'd call this a scam as much as I'd question the registrar/patient access person who usually read from a script (as others pointed out).. Full coverage insurance, with no copay or deductibles, is becoming increasingly rare. So they are probably assuming a copay/deduct is owed. We know what happens when people assume.

    Id is recommend calling the doctors office of who is going to perform the surgery. Tell them you are running into issues with facility demanding copays you do not legally owe. See if they can intervene on your behalf. The doctor is the middle man with most financial incentive to fix this (before u go elsewhere).
     

    tx_transplant

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    Tejano Scott hit the nail on the head. In years prior, I was a patient access/registration/insurance verification person. At least in our facility, what would happen is that when a procedure was scheduled, the insurance verifiers would contact the insurance carrier. The carrier would give a best estimate of what the patient would owe out of pocket. That information would go to the call center folks, who would contact the patient and request payment of a percentage of the out of pocket. Often times, the patient was put in touch with a financial caseworker that would work out a payment plan.
    Unfortunately, a combination of non paying patients, rising costs, and lower reimbursements has led many places to begin doing this.
     

    TX69

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    I'm a hospital attorney, so I'm biased. Dead beats not paying for their services is everyone's problem. Like it or not. If people steal from grocery store, those losses get passed on. Basic economics.

    Im im not sure I'd call this a scam as much as I'd question the registrar/patient access person who usually read from a script (as others pointed out).. Full coverage insurance, with no copay or deductibles, is becoming increasingly rare. So they are probably assuming a copay/deduct is owed. We know what happens when people assume.

    Id is recommend calling the doctors office of who is going to perform the surgery. Tell them you are running into issues with facility demanding copays you do not legally owe. See if they can intervene on your behalf. The doctor is the middle man with most financial incentive to fix this (before u go elsewhere).

    If the hospital files as a business its THEIR problem NOT mine or anyone else's. The businesses inability to collect is their problem. The fact that the business has to raise their prices is a part of THEIR business and one that ALL businesses must go through. Raise the prices so much and people like us will go elsewhere. They asked us where we wanted to have this done and we could have chosen somehwere else. If hospitals or their "incentive employee's" harass us enough we just might. Don't think it has an affect until people start sharing their stories using social media.

    Basic economics.
     

    benenglish

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    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?
     

    tango5seven

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    My stepdaughter had that whachacallit surgery for endometriosis. We shopped hosiptals. Baylor estimated our part would be like 8 grand. A small "boutique" hospital quoted $1200 out of pocket.

    This was just the hospital part of course, doctor fees and gas passer extra.




    Sent from Cheyenne Mountain to confuse the NSA
     

    scap99

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    Wait until you get the bill from the pathologist....I didn't ask them to send my gall bladder out for testing. Either give it to me or throw it in the trash, it's broken...
     

    mosin

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    They **** us on the prices period.

    pretty much... I went back in september for the first time in years. I had been knocked out sick for two weeks. Finally went into the ER. I had an hour long wait, then spoke to the dr. for about 5 minutes at the most. "you have the flu, not much we can do. Drink water take some musinex"

    $600 bill.
     

    stdreb27

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    I had a major surgery a few years ago. Went to do the pre-checkin the day before.

    Paid them what was left on my deductible. The problem was they didn't bill first. One of the other interested parties did. 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.

    Never again.

    Then my wife got pregnant, and her baby catching doctor pulled the same crap. I went in there talked to her head of business and this lady looked me in the eye and told me I was full of crap (in acceptable business speak). I would have to pay my deductible to them. Prior to them billing my insurance company

    Of course my wife thought I was being completely unreasonable did not understand the risk that we would be exposing ourselves to and told me in pregnant lady terms I was full of crap.
    I told my wife, you have x saved up in your account, you deal with it.

    Fortunately they billed first and it was a non issue.
    But never again.
     
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