NFT: Medical Bill Question

Do you have an out of pocket max? If so, did you already hit it?

Sometimes you get billed like this bc the provider never submitted it to your insurance company.

Either way I’d check with your insurance first and then the provider.

Any time you get a lawyer involved it’s been my experience you essentially double your problem. There’s the problem you bring to the lawyer and then there’s the lawyer. So, two problems. Again, just my experience. With the medical malpractice you sometimes really have no choice because the bills are so high and then there’s times when you just can’t believe the doctors should get away with gross negligence. One thing you can count on is that the insurance company will do everything they can to screw you.

Gosh darn, I’m sorry. The older I get the more frequently I hear these stories about peoples lives and health being ruined by medical mistakes and a lot of stories about people being ruined financially by health problems and malpractice. It shouldn’t be this way. Sorry and best of luck to you.

Most often times they're not. They're called "complications". You sign a consent form that thoroughly goes through them. Oftentimes you can literally do everything perfectly as a surgeon and get a less than ideal result. It's an art, not a science. Not everything is in your control. Example, you do a total knee implant and have a blood clot form. You never see it coming and you manage it as fast and as efficiently as you can. I've had friends have patients die from elective surgical cases from pulmonary emboli and there was no way anyone could see it coming.

Also, physicians that continually do bad work, get litigated, often, quickly dropped by their insurance carrier and have to leave the profession. So, you know, your surgeon cannot charge your insurance for ninety days after surgery, it's called globalization of charges. The hospital, likely can but being the really, really squeaky wheel can help, and, at the very least, get the amount reduced markedly. I'm sorry for what you and Mrs are going through. I've been an ortho surgeon for thirty seven years, done thousands and thousands of cases, never been litigated (ever), knock on wood, and truly anguish when even small things aren't going well. Most surgeons do. Some because they're good people, some because they don't want to get dropped by their carrier and then cannot practice in the hospital/surgical center and usually both.

after asking the hospital for a detailed bill breakdown. One thing to check is that the charges are considered "Usual and Customary" for the procedure performed by the doctor. As far as charges by the hospital -- check with the hospital -- they usually have an office of patient relations that can act as an ombudsman for complaints and work directly with the billing department to iron out billing mistakes.

Also, many hospitals have a form you can request for consideration of hardship or other petition for forgiveness of debt for charitable purposes.

See link below for an interesting article on hospital pricing in CT. Good luck!

Story re creating medical pricing charges at hospitals - ( New Window )

From what you’re saying- doubtful you’re on the hook for that.

Something like that sounds like it would be included with the initial surgical bill. I would pay nothing until the insurance carrier processes the bill.