LIFamilies.com - Long Island, NY


RSS
Articles Business Directory Blog Real Estate Community Forum Shop My Family Contests

Log In Chat Index Search Rules Lingo Create Account

Quick navigation:   

ER visits and bills .....

Posted By Message

LoveBug302
Baby Girl #2 is Here!

Member since 7/11

1652 total posts

Name:

ER visits and bills .....

Has anyone or their child gone to the emergency room and then receive a bill months later, for several hundred dollars because you saw a PA in the ER that did not take your insurance? This is the second time this has happened to me and we have the Empire NYSHIP plan. My 1 year old just got a bill from a creditor today. This is insane. We are in the ER for a reason and don't get to choose who we see. We clearly gave them our insurance info when we check in so I don't understand what the problem is. This is very frustrating. TIA

Posted 1/19/14 9:10 PM
 
Long Island Weddings
Long Island's Largest Bridal Resource

MrsM84
LIF Adult

Member since 2/13

2352 total posts

Name:

ER visits and bills .....

You said this has happened to you already -- what was the result of that 1st instance? Can you call a hospital administrator of billing/insurance? (I'm not even sure if this position or title exists but it sounds legit!)

Posted 1/19/14 9:23 PM
 

2BadSoSad
LIF Adult

Member since 8/12

6790 total posts

Name:

Re: ER visits and bills .....

i could be wrong, but I thought since you were seen through an ER insurance had to cover who you saw? Id definitely fight that.

Posted 1/19/14 10:11 PM
 

BabyBoy
is Skylar Elizabeth

Member since 5/05

4185 total posts

Name:
Tom

ER visits and bills .....

Submit it to your insurance. Depending on your coverage, your deductible should of satisfied your ER visit. Perhaps, this DR. thought he wasn't paid enough or perhaps its coded wrong.

Posted 1/19/14 10:29 PM
 

meganNbobby
Our Family is Complete

Member since 5/05

2774 total posts

Name:
Megan

Re: ER visits and bills .....

Def submit to your insurance, this just happened to me with an ER visit from October, my insurance mailed me a check for the bill

Posted 1/19/14 11:24 PM
 

edfilippi
LIF Adult

Member since 8/12

997 total posts

Name:
Erica

Re: ER visits and bills .....

This just happened to me. My dh went to the ER. I receive a check from my insurance company stating it was out of network and I guess they were reimbursing me. Then 2 days later I get a bill from the hospital for the same amount of money. I thought it was so weird and never happened to me before. Is this the new way of collecting payment?

Posted 1/19/14 11:26 PM
 

luvbuffet
LIF Adult

Member since 7/10

6470 total posts

Name:

Re: ER visits and bills .....

Posted by edfilippi

This just happened to me. My dh went to the ER. I receive a check from my insurance company stating it was out of network and I guess they were reimbursing me. Then 2 days later I get a bill from the hospital for the same amount of money. I thought it was so weird and never happened to me before. Is this the new way of collecting payment?



Do you have ghi ?

Posted 1/19/14 11:43 PM
 

ali120206
2 Boys

Member since 7/06

17483 total posts

Name:

ER visits and bills .....

Was it submitted to insurance? There should be an explanation of benefits stating why it was denied.

We had an issue recently with empire not paying an er doctor and the EOB said that it was out of network but covered if part of an ER visit so I called them and they fixed it immediately and we were just responsible for out er copay.

Posted 1/20/14 7:38 AM
 

PitterPatter11
Baby Boy is Here!

Member since 5/11

7473 total posts

Name:
Momma <3

ER visits and bills .....

Anytime there is an issue with a bill, I call insurance and the hospital billing department to find out more details.

Posted 1/20/14 7:39 AM
 

MrsSpring
I'm a lucky mama

Member since 1/10

7585 total posts

Name:
L

Re: ER visits and bills .....

Posted by edfilippi

This just happened to me. My dh went to the ER. I receive a check from my insurance company stating it was out of network and I guess they were reimbursing me. Then 2 days later I get a bill from the hospital for the same amount of money. I thought it was so weird and never happened to me before. Is this the new way of collecting payment?



same thing just happened to dh. he got a check from the insurance but we didnt even get a bill from the dr yet. hoping the dr is going to bill for the same amount!

op-on your insurance what does it say under er visits? like for ours it says for network Deductible & Coinsurance & for out of network it says In-network Deductible & Coinsurance.

Posted 1/20/14 7:54 AM
 

BlessedMomma
LIF Adult

Member since 12/11

6163 total posts

Name:
Momma Bear

ER visits and bills .....

When a physician is out of network they may bill your insurance on your behalf but a lot of insurances will send you the payment to submit to the physician. Its how a lot of insurances work.

I would call your insurance company and find out exactly what the denial was and what you have to do to appeal. You may need to contact the bikling dept for the ER and you may need to speak with an administrator. Its usually a manager or director of er billing (some hosp have billers for specific dept.) Dont just speak with a random billing person speak with a amanger.

Posted 1/20/14 7:55 AM
 

LIMomma
LIF Adolescent

Member since 6/12

523 total posts

Name:
Momma

Re: ER visits and bills .....

This frosts me. This is called balanced billing and it really really should be ILLEGAL. If you are seen by an out of network doctor in an in network setting, you are covered. If your insurance coverage pays a bill and then you recieve a bill afterwards for the "balance" (this is after all your deductibles have been paid) than you should QUESTION, QUESTION, and QUESTION again. In most cases (i'll caveat with most because there's 10 million insurance plans out there) when a physician recieves payment from and cashes a check for service, even if its not the whole amount it is considered payment in full.

* Call the hospital and your insurance company.
* If you can not get the help you are looking for (ie, you should not have been balance billed) then start writing letters - return receipt, registered.

I've posted this before but this can become a full time job if you have a life threatening injury (like we were faced with) you don't think question the entire staff of support that have come to save your loved ones life. You dont think to ask when you are asking for them to do everything they can to ask -oh by the way are you enrolled in my insurance. And once you are able to breathe and the recovery road is set and you get home and you wade through mail you realize the bills. Our first one back was for $105,000 because the insurance company did not allow for surgery more than 24 hrs (and my DH surgery was 27 hrs), they paid $1,500 and told us we were responsible for the rest....that's what put us on the the road for understanding and reviewing and fighting (and winning).

Any questions please PM me. I'm happy to help.

ARTICLE

Organization to help with Balanced Billing in NYS

NYS Insurance FAQ on Insurance in Emergency Situations

Message edited 1/20/2014 8:31:20 AM.

Posted 1/20/14 8:17 AM
 

sunnyflies
LIF Adult

Member since 9/09

1757 total posts

Name:

ER visits and bills .....

My hospital was on the front page for what turned out to be an out of net work doctor there billing ten grand for a quick ER visit during which he did nothing. He'd been at the hospital at the time for another patient and was called down to look at this person for some reason. No one thought to ask if he was in or out of network as the visit took place in the ER. And, he did not disclose the fact which I think was horrible.

The people were fighting it, I do not know the outcome. But, shortly thereafter I was billed by the same hospital $2500 for a blood test that is usually covered. I made a stink and the doctor who looked at my results called me and said it would be dropped, that I shouldn't have been billed. So it seems that we have to be vigilant and always ask questions.

Posted 1/20/14 1:29 PM
 

edfilippi
LIF Adult

Member since 8/12

997 total posts

Name:
Erica

Re: ER visits and bills .....

Posted by luvbuffet

Posted by edfilippi

This just happened to me. My dh went to the ER. I receive a check from my insurance company stating it was out of network and I guess they were reimbursing me. Then 2 days later I get a bill from the hospital for the same amount of money. I thought it was so weird and never happened to me before. Is this the new way of collecting payment?



Do you have ghi ?



Yes

Posted 1/20/14 9:35 PM
 

jessnbrian
Only God knows His plan for us

Member since 4/13

7238 total posts

Name:
Jessica

Re: ER visits and bills .....

Posted by 2BadSoSad

i could be wrong, but I thought since you were seen through an ER insurance had to cover who you saw? Id definitely fight that.



Not true at all.


Happens all the time; speak with the hospitals billing dept, tell them you can't afford the whole thing but can afford $100 (if you can)... Negotiate it down, most of the time they don't get any money, so if you are willing to pay something they are usually able to reduce it greatly. DH was in the ER twice in one day a few years back, he had NO insurance and it negotiated a $2500 bill down to $200.

Posted 1/20/14 9:53 PM
 

jessnbrian
Only God knows His plan for us

Member since 4/13

7238 total posts

Name:
Jessica

Re: ER visits and bills .....

Posted by edfilippi

Posted by luvbuffet

Posted by edfilippi

This just happened to me. My dh went to the ER. I receive a check from my insurance company stating it was out of network and I guess they were reimbursing me. Then 2 days later I get a bill from the hospital for the same amount of money. I thought it was so weird and never happened to me before. Is this the new way of collecting payment?



Do you have ghi ?



Yes



Very often insurance companies send patients the check if it's an out of network provider becAuse TECHNICALLY they are supposed to collect the $$$ upfront.

Posted 1/20/14 9:54 PM
 

jessnbrian
Only God knows His plan for us

Member since 4/13

7238 total posts

Name:
Jessica

ER visits and bills .....

Please also remember that almost every single insurance company requires you to basically call either while you are in the waiting room or within one day of the visit.

Posted 1/20/14 9:55 PM
 

ElizaRags35
My 2 Girls

Member since 2/09

20494 total posts

Name:
Me

Re: ER visits and bills .....

Posted by jessnbrian

Posted by 2BadSoSad

i could be wrong, but I thought since you were seen through an ER insurance had to cover who you saw? Id definitely fight that.



Not true at all.


Happens all the time; speak with the hospitals billing dept, tell them you can't afford the whole thing but can afford $100 (if you can)... Negotiate it down, most of the time they don't get any money, so if you are willing to pay something they are usually able to reduce it greatly. DH was in the ER twice in one day a few years back, he had NO insurance and it negotiated a $2500 bill down to $200.



This didn't happen to me when I had an issue w/ my insurance. I was technically covered, the insurance paid $500 of a $2500 bill. Due to some circumstances with my former employer, my insurance had been canceled retroactively to 2-3 days BEFORE my ER visit (whole other story Chat Icon ) and the insurance company took back the $500. I tried so hard to negotiate with the billing dept. and even said I'd pay the same $500 the insurance company paid which they had accepted with no problems. They flat out refused and said it was only accepted b/c they have an agreement with the insurance company. I told them I couldn't afford $2500 and they said I could submit my W2 from the year before along with copies of paystubs to prove I couldn't afford the bill and maybe they'd discount or else they were sending the bill to collections, which they did. I ended up negotiating with the collections agency and paid $1800 of the $2500 which was ridiculous but it was that or it affecting my credit.

Never again will I go to that hospital b/c I know that if there is a billing issue, they will not be any help to me.

Posted 1/20/14 10:14 PM
 

jessnbrian
Only God knows His plan for us

Member since 4/13

7238 total posts

Name:
Jessica

ER visits and bills .....

Wow!!! That surprises me entirely! This was at Franklin general as part of nslij.... I received one of the bills years later and was furious. I simply made it clear to the person I was speaking with that I knew what they were doing as I work in the industry (I've been in health care for over 10 years) and that unless they were willing to work with us the could send us to collections, they weren't going to see a dime, and that I would let every media and news outlet that would listen to me know what they did to patients without coverage.

Posted 1/20/14 10:20 PM
 

PrincessP
Big sister!!!!!!!!!!

Member since 12/05

17450 total posts

Name:

Re: ER visits and bills .....

I've seen this happen with hospital anesthesiologist s.

Posted 1/20/14 10:47 PM
 

rojerono
Happiest.

Member since 8/06

13803 total posts

Name:
Jeannie

Re: ER visits and bills .....

This happened to me last year with Noah at Good Sam. I got a bill directly from the doctor. I called the doctor's office and told them I was NOT paying them. I called my insurance company and told THEM I was not paying. They worked it out. :)

Posted 1/21/14 10:25 AM
 

lucamon
LIF Adult

Member since 6/09

1133 total posts

Name:
Samantha

ER visits and bills .....

Yes, this happened to us. DS needed a plastic surgeon to stitch up his face. My local hospital didn't have one on staff so they called one from Stony Brook and she did not take insurance. She billed us thousands. Don't pay the bill. Call the hospital and your insurance. The doctor can bill through the hospital. You hospital takes insurance.

Posted 1/21/14 1:05 PM
 

butterfly20
Party of 5 - 2015

Member since 4/06

7390 total posts

Name:

Re: ER visits and bills .....

we have high deductible plan...

when dd ended up in ped ER - it was a $1,500 bill for us- after insurance discount and they ran no labs.

Posted 1/21/14 4:39 PM
 

sfp0701
Liam's Mommy!

Member since 1/07

9764 total posts

Name:
Tricia

Re: ER visits and bills .....

I have had this happen to me during extended hospital stays. I don't know what to tell you except that it sucks. You do have the right to ask for someone in network but, if you are in the hospital.. who does that?

I am trying to remember but, I think doctors negotiated a little bit.

Posted 1/21/14 6:22 PM
 
 

Potentially Related Topics:

Topic Posted By Started Replies Forum
Did anyone tally up their medical bills for taxes yet? LisaW 2/28/06 16 Infertility
Spinoff to Credit Cards....paying monthly bills w/card? btrflygrl 2/7/06 22 Families Helping Families ™
Anyone please care to share their Keyspan/LIPA bills with me? krashnburn 11/30/05 15 Home
Do your hubbies go to all your MD visits? MrsM 9/4/05 24 Pregnancy
What do you do if you don't have enough $$ for ALL your bills? btrflygrl 8/29/05 39 Families Helping Families ™
Spinoff... Who pays bills. june262004 7/24/05 35 Families Helping Families ™
 
Quick navigation:   
Currently 111269 users on the LIFamilies.com Chat
New Businesses
1 More Rep
Carleton Hall of East Islip
J&A Building Services
LaraMae Health Coaching
Sonic Wellness
Julbaby Photography LLC
Ideal Uniforms
Teresa Geraghty Photography
Camelot Dream Homes
Long Island Wedding Boutique
MB Febus- Rodan & Fields
Camp Harbor
Market America-Shop.com
ACM Basement Waterproofing
Travel Tom

      Follow LIWeddings on Facebook

      Follow LIFamilies on Twitter
Long Island Bridal Shows