General Question

andrew's avatar

How do I deal with my exorbitant medical expense?

Asked by andrew (15766 points ) March 30th, 2007
I had to go to the ER a few weeks ago because I was dehydrated. I stayed for a few hours, received a couple bags of IV saline, some anti-nausea medicine, and a potassium pill. They did an x-ray and a flu test. Cedars-Sinai billed insurance >$6000; Blue Shield is billing me $1500. Do I have any recourse to drive the amount down? Whom do I talk to?
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19 Answers

gailcalled's avatar
BS has a customer service line; brace yourself; dial, put phone on speaker while you wait, find a project to do; eventually you might get a customer service rep. (You could try pressing "O" during the voice prompts to get you to a human faster.) Write down name, date, time, conversation...
gailcalled's avatar
Anything relating to med. Insurance is a NIGHTMARE. You should also call Cedars-Sinai, ask for the ombudman and get a breakdown of the costs. That potassium pill probably cost you $200. However, your time may be worth more than you could possibly save.
gailcalled's avatar
And there is the issue of the deductible on your specific policy. Mama Calder suggests next time you drink your water every few hours and throw in a packet of that powdered enzyme Emergen-C (a better version of Gatorade) or whatever it is called from the health food store
gailcalled's avatar
*Ombudsman, I meant.
sarahsugs's avatar
I had a high medical bill a couple years ago and I called customer service at my insurance company (Blue Cross) and explained that I was student with no income and asked if there was anything at all they could do to help me out. It turned out they had a financial aid program and I managed to get the fee reduced significantly. They definitely don't advertise that sort of thing, so you will have to ask and be aggressive until you talk to the right person. Good luck!
Iwaswondering's avatar
If it's a hospital expense, there is sometimes a fund available to assist with bill payments in special situations. The patient (or former patient) needs to ask, and will be interviewed. The situation will be presented to a committee, and sometimes there will be a reduction granted.
Iwaswondering's avatar
Oops-- I wasn't ready to send off that reply. If I can throw in my rant for a moment, I think affordable health care is a crisis in the U.S. at this point. Often, we don't realize until we are directly affected. I think we all need to make our voices heard politically in regard to this issue. (I'm reminding myself about this, too.)
Tennis5tar's avatar
It's when I read stuff like this I feel very fortunate to live in England where we have the National Health Service... Almost makes you feel better knowing you don't have medical bills to deal with!
gailcalled's avatar
I have been writing and emailing the powers-that-be in relationship to the Med. D RX program for foks over 65. No one listens; my family practioner spents 1/3 of his time trying to sort out insurance issues. At present I am getting PT for lower back problems. Medicare limits me to 17-20 one-half hour sessions/year. So whether I am rehabbed or not, out I go. Doc originally suggested 3X weekly but since I have a treadmill and heating pad at home and am a compliant patient, I am stretching it out to 2X weekly. I will still run out of sessions before my lower back is mended. And I shudder to think what might happen should I injure another part before Jan. 2008. Tough luck for me.
gailcalled's avatar
I get Medicare A (Doc), Medicare B (some hospitalization) Med D for some drugs after deductible is met, and pay for an AARP medigap policy. The paperwork involving this leaves my office looking as tho the Collier brothers live there. And the older one gets, the more complicated and incomprehensible the system becomes. Fortunately, I still have most of my marbles and can do my own advocacy..but it ain't fun, particularly when one is feeling not so hot!
gailcalled's avatar
It takes a huge amount of work to get the system to bend, change, compromise or act in a marginally humane way. So, everyone...exercise, eat your greens, meditate and don't get old.
gailcalled's avatar
Last point - all the Medicare fees come out of Social Security, leaving folks w. no extra resources eating cat food and selling pencils on Main St. Iwaswondering is correct; the health care system here is beyond fixing, I fear.
b's avatar
Take a close look at your policy. Usually you have a co-pay for emergency room visits. A few months ago I went to the ER, and only had to pay my $75 co-pay. If there is no co-pay clause, see if the insurance co will take payments.
occ's avatar
The insurance companies send bills like these because they assume that no one has the patience to fight them on it. Call the hotline and ask immediately for a supervisor or manager--refuse to speak to the folks at the bottom of the totem pole who answer your call--if you insist on speaking to a manager you have a much better chance of reimbursement. Persistence really will pay off. Ask them for an EOB (Explanation of Benefits) that will break down exactly what you are being charged and why--and then fight them on each section. And let us know what works so we can use your tactics in the future!
andrew's avatar
Isn't it also an issue of why the hospital charged $6000 in the first place?
sfgal's avatar
yeah, you should get your insurance to fight the hospital on that. and ask the hospital for an itemized list of exactly what they charged you for--6,000 seems really over the top.
hossman's avatar
I wonder what the wait would have been for that service under a nationalized health care program?
rowenaz's avatar

Call the hospital and ask them to lower what you owe. I hear SO MANY people do it, with results. Then, cut a deal, which is that you'll pay $25 a month until you pay it off. This sounds crazy, and I don't know where you are, but if you are making a "good faith" effort to pay each month, they can't bother you at all. I don't know if this is state by state, but here they can't touch your credit if you don't pay. I'm not saying don't pay, I'm saying you should find out what the repercussions are, and make the good faith effort to do so. One month before I had my baby, my insurance changed (surprise!) leaving me with an exorbitant co-pay of several thousand dollars. I did cut a deal, and pay $50 a month....

nerfmissile's avatar

Ah, unbridled capitalism at its finest. Healthcare in the USA is such a monster at this point that no one wants to deal with it. It’s kind of like Cloverfield but without an army. Better to pretend the problem doesn’t exist and hope the monster dies from neglect or boredom before it eats all of Manhattan?

If you are over the age of 40 or have any chronic illnesses or conditions that might make you appear slightly imperfect/not the immortal and flawless product of a Nazi breeding program to the insurance companies, then your best bet is to move to a civilized country that believes in taking care of its citizens instead of exploiting them—such as Canada, Cuba or most of Europe. Last time I checked, though, they’re harder to get into than the Chinese import market. Barring that, try voting for a candidate that doesn’t believe that 21st century medicine is best addressed with Frontier Capitalism (self-help manuals, some booze, a package of gauze and a good sharp knife).

One of the possible benefits of globalism, in theory, is that we get to vote with our feet. Hey, I hear the Mexican industry of reasonably inexpensive border clinics is booming…

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