How to contest medical bills??

[Tyme2fish]

The doctors and the medical centers have us by the short hairs and there is no way that I know of to contest their overpriced bills.

Mrs.Tyme fell and hurt her knee and I knew I had to take her to a doctor. We were able to see an orthopedist the day after the fall. She didn't know how bad she was hurt the afternoon of the fall and that is why treatment was delayed for 12 hours.

I did not take her to the ER. Why? Because after performing an X-Ray on the knee they would have said, "You need to see an orthopedist." and charge us $2000.00 for that fine information.

The orthopedist's office took X-Rays that showed a small crack in her kneecap. The doctor suggested a knee brace for 8 weeks. For that "treatment" his knowledge cost us $584.00. The actual X-Rays were an additional $51.00. So far, not that bad. A little high, but he is a specialist. The crappy insurance that I pay for reduced his charge to $296.82 from a "contractual adjustment." Insurance hasn't paid a penny out of pocket but has reduced what I owe the doctor. Pretty good racket, isn't it.

The orthopedist's bill states:Closed treatment of patellar fracture,without manipulation $584.00
Knee x-ray;three views $51.00
Contractual adjustment form Insurance; -$323.89

This afternoon, I receive in the mail a charge for $36.00 from a radiology center/doctor. I've already been charged for X-Rays by the original doctor. Where the heck does this second bill come from? The X-Rays were performed in the original doctor's office. Does he just rent out the X-ray room? Why does doctor A and then doctor B charge me for the same service. I consider this double billing and will be making some phone calls tomorrow to figure out what's going on.

Oh, the brace was an additional $84.00 from the brace company. The male nurse at the doctor's office put it on Mrs.Tyme's knee and gave us absolutely no instructions on how to adjust it,attach it,etc. NOTHING!! NO INFORMATION!! This is a brace with Velcro fasteners that can be removed if needed for bathing,etc. It's partially our fault for not asking about it, but we were both in a little bit of shock and then relief about the facts of her injury. I consider it the doctor's office responsibility to inform the patient on how an apparatus is to be used. I thusly informed the doctor of that on our follow up appointment. At that visit, the doctor then took time to show us how the brace could be adjusted,tightened,loosened,etc. but only after I had complained to him.

I realize we're not talking about great sums of money,but IT'S MY MONEY, AND I NEED IT NOW!!!!

Original treatment was on 9/21/2012 and I get a bill dated 10/29/2012 from this second doctor?? What can I expect next month from some other third or fourth party interest?

[RoadToad]

I'd say the way to contest it is to call the office that sent and ask, "WTF?"

That second bill is most likely for the radiologist. The first x-ray charge was for taking the x-ray, developing it, the film itself (if they didn't do it all digitally, which not all places do yet), the tech, etc. The second bill was for "reading" it. Yes, the orthopod read it right there, and was probably right on the mark, and gave you his diagnosis based on what he saw, but the "official" reading of any x-ray, CT scan, MRI, or any such radiological study, the version that actually goes on the permanent record, has to come from a radiologist.

[SLP]

First, sorry to hear about your wife hurting herself.

Yes, it is the radiologist, they always have a trained radiologist x-rays examine them. Basically pretty standard procedure, I have had numerous x-rays, C-scans, and MRI's and even if the specialist looks at them himself, they still are always read by an actual radiologist.

You're right though, it is expensive. Even for something simple it usually isn't cheap. Personally I have a very large deductible, so I am in the same boat as you, and often end up having to pay much of the bill myself. But do check and make sure of your deductible, because once that is satisfied you should be liable for much less. Also if you are close to your deductible and she will need any more procedures, try and have them done this calendar year so as to save some money.

[DJD]

It ***** man. I went through it with my insurance as well. My X-ray bill responsibility was close to $400. I received another bill or two later like you and it pissed me off. I called my insurance and demanded to know how long I was gonna get shafted. Naturally she talked a lot and told me nothing. I really do not like being involved with insurance companies and the racket they run.
You guys are lucky she isn't hurt so bad that she had to be hospitalized. Sometimes I guess you have to count your blessings.

[GeoFisher]

It ***** man. I went through it with my insurance as well. My X-ray bill responsibility was close to $400. I received another bill or two later like you and it pissed me off. I called my insurance and demanded to know how long I was gonna get shafted. Naturally she talked a lot and told me nothing. I really do not like being involved with insurance companies and the racket they run.
You guys are lucky she isn't hurt so bad that she had to be hospitalized. Sometimes I guess you have to count your blessings.

Insurance companies pay claims............that is all............providers charge.

If anyone is SHAFTING you my friend, it is the provider and the clinics.......not the insurance co. In fact, I bet the negotiated rates actually save you some smack......

The best solution is to tell them YOU ARE PAYING all of it.......That is what I do with my HSA.

[waterdog101]

I have 3 friends that I work with, and in the last 5 months, sickness has bankrupted all 3. one was ready to retire, and had to have surgery and get the treatments for prostrate cancer. a week in uk with insurance, and he told me it bankrupted him. the other 2 were in 2 different wrecks, air lifted to uk and one had to stay for 3 weeks, and the other has been there for over a month, and still critical. all 3 had insurance, worked all their lives, and their world turned upside down over night. if your healthy be thankful, life is uncertain. here today gone tomorrow.

[Tyme2fish]

I'd say the way to contest it is to call the office that sent and ask, "WTF?"

That second bill is most likely for the radiologist. The first x-ray charge was for taking the x-ray, developing it, the film itself (if they didn't do it all digitally, which not all places do yet), the tech, etc. The second bill was for "reading" it. Yes, the orthopod read it right there, and was probably right on the mark, and gave you his diagnosis based on what he saw, but the "official" reading of any x-ray, CT scan, MRI, or any such radiological study, the version that actually goes on the permanent record, has to come from a radiologist.

I'm sure you're correct but it still galls me that both doctors can charge for reading the x-ray. If doctor A is not "qualified and certified" and a radiologist has to read it, then when why can doctor A even charge me?

Second, I never gave authority for doctor B to do anything. I guess I signed away all rights when I signed 43 separate forms to get Mrs.Tyme seen by the doctor. Still makes me mad.

[Tyme2fish]

I'll call the radiologist in the morning. If they state that yes indeed they are required to read any x-ray, then I'll demand a complete diagnostic report and evaluation of the x-ray followed up by a written and signed letter and said report from doctor B.

[waterdog101]

I'll call the radiologist in the morning. If they state that yes indeed they are required to read any x-ray, then I'll demand a complete diagnostic report and evaluation of the x-ray followed up by a written and signed letter and said report from doctor B.

tyme, read this. you think Doctors that will do some of these things, would let other Doctor friends come in your room, and look at a sick person, so they to could charge them also, and add to their bank account. you've heard the old saying, people helping people. what about Doctor helping Doctor.http://www.kentucky.com/2012/09/06/2...-needless.html

[SLP]

I'll call the radiologist in the morning. If they state that yes indeed they are required to read any x-ray, then I'll demand a complete diagnostic report and evaluation of the x-ray followed up by a written and signed letter and said report from doctor B.

My two cents, take it for what it is worth (.02)

If you are trying to get them to maybe credit you the charge, you might be better off just containing your original doctor. He was the one who ordered the x-rays. The radiologist just did what he was authorized to do and only charged you $36, which really is pretty reasonable. Your original doctor made the bulk of the money, and he would have more room to offer you a credit if you explained to him you feel overcharged. Also make sure to point out that you have not met your deductible and will be paying the entire bill out of pocket, and would appreciate if he was able to work with you in any way.

I hope you are able to get a credit off you bill, good luck.

[SLP]

I have 3 friends that I work with, and in the last 5 months, sickness has bankrupted all 3. one was ready to retire, and had to have surgery and get the treatments for prostrate cancer. a week in uk with insurance, and he told me it bankrupted him. the other 2 were in 2 different wrecks, air lifted to uk and one had to stay for 3 weeks, and the other has been there for over a month, and still critical. all 3 had insurance, worked all their lives, and their world turned upside down over night. if your healthy be thankful, life is uncertain. here today gone tomorrow.

That is just horrible. Did their insurance cover the bulk of the bills after they met their deductible?

We really need to do something about the rising cost of health care in this country. People should work hard their entire lives and then lose everything just because they get sick. What a shame, I really feel bad for your friends.

[Tyme2fish]

O.K.,I've calmed down a little bit. I never received an E.O.B. (Explanation of benefits) from my insurance carrier. I had to go on-line and see the EOB. Turns out the radiologist billed for the second set of x-rays before getting a response from the insurance carrier. Insurance states I only owe them $2.88 out of the $36.00 he charged to read the x-ray. They tacked on $35.00 for the second set of x-rays and billed me prior to receiving EOB. I'm more than willing to pay them $2.88 for the first set and will await an EOB for the second set.

Hopefully our visit on 11/06/2012 will be the last visit to the doctor and she will probably have to have some rehab visits as she hasn't bent her knee in 8 weeks. Those ligaments,etc are probably all tightened up by now.