My daughter died. Our story aired a year later. Another year later, so around 2 years after my daughter's death, I received a hospital bill for a little over $3,000, for her initial few weeks of ICU care. I never acknowledged it. I couldn't bring myself to call the hospital to setup a payment plan, say my daughters name in the same sentence as a dollar amount again. We haven't heard a peep since.
Here I was thinking I was the only one with insane insurance stories...
The closest experience I can think of to this was when I was a sophomore in college in 2006. In short order, I had a seizure, was taken to a local Trauma ICU, and hours later flown to a Level 1 facility in another part of the state.
The hospital where I stayed billed us without issue, but the Trauma center decided it was the right thing to do when it sent the unadjusted bill to me at my college address. Oh, and the medical transport people who flew me around the state of NJ? Nothing.
Just super.
I also could talk about how earlier this year I spent 23 days in the ICU for an infection related to the same condition, and how an event from April-May still isn't settled as far as insurance goes, but I'm stressed enough at this point.
Score 1 for PTSD!
It occurs to me that I've surely met the deductible and OOP limit for the year, so that might explain why we've been so slow to see things get resolved.
To top off this cavalcade of awfulness, the person who hired me into my current job lost her fight with pancreatic cancer last week.
I'm sorry for your loss. Losing a child is a horrible experience and you never really get over it; time moves on but the emptiness persists. I wish you and your family well.
To the hospital systems and insurance companies, the confusion is a feature, not a bug. They assume most patients and their families will just knuckle under and pay what they're told they owe.
Since the health care sector is one of the largest political donors, elected officials have little incentive to fix anything, so they nibble at the edges and call it reform.
Absolutely. I work in HIT for small to medium size practices. We all know how badly insurance is treating us as patients, but what’s not as well known is how much they squeeze medical providers (example [1]). Hospitals and networks have the weight to navigate insurance, but small independent offices don’t and are also getting absolutely fucked over. In addition to staffing issues, rising operational costs, excessive demand, slow turn around in receipts, rising complexity in software and regulatory compliance, a lot of local doctors are selling to networks and hospitals or just straight up closing doors. Large entities absorb all the same problems primarily by economies of scale which can result in poor individual care, increased out of pocket costs, amongst other things.
> local doctors are selling to networks and hospitals
My primary care physician did this a couple of years ago. He still works at the practice and I still see him. When I asked him why he sold, he said he wants to do what he loves - practice medicine - not spend most of his time working with insurance companies.
The worst part is all my records from years of visiting him did not transfer to the new system. It’s as if I’ve been seeing him for 2 years instead of 10 because no one can access my old test results and records. So much for continuity of care. Now I download all documents in their portal and save locally.
There’s a major dental insurance carrier that finds it perfectly acceptable to “pay” dental offices with prepaid debit/credit cards. Think Greendot, Mastercard, or Visa prepaid cards.
I’m fairly certain my dentistry firm is fighting back in ways I’m not comfortable sharing because I don’t know any facts and would just be speculating, but I do hope they’re sticking it to them.
Another technique is to pass the burden of proof onto the consumer. The hospital creates a new charge, and it is up to the patient to prove it should have been covered by insurance. For example, showing something like meeting your yearly out-of-pocket is a difficult task.
Sometimes it's up to the consumer to connect the two departments, insurance and the hospital billing, on the phone at the same time. Seems simple but the wait time between the two parties is high, and either one of them will drop off mysteriously.
If the bill is in dispute for too long, you will be sent to collections, and have your credit score degrade.
It’s not donations. It’s the fact that the largest employer in nearly every congressional district is a healthcare system. Heard this from a guy who worked on the ACA.
We simply need a sort of statute of limitations for B2C transactions.
- Your employer can incorrectly pay you for a long time and then demand the money back.
- A hospital bill can come (afaik) anytime in the future
- You can dispute charges, the provider can fail to provide customer service, but your credit score is negatively affected.
Etc.
We need bills that focus on favoring the "little guy" in the fight so that wealth, dominance, and power are mitigated in justice.
EDIT: actually the bit about employer overpay being for "Decades" and demand back was not entirely true, depends on the state, ranges from weeks to 15 years according to my googling.
A lot of health plans consider any bill presented more than a year from the date of service forfeited. Medical billing is notoriously slow, opaque, and fragmented. On the insurance side they tend to be super slow in payment running 120 days behind forcing the hospital to de facto provide vendor credit to insurance companies that are way better capitalized than they are.
What baffles me are these people who constantly show up to defend the US health care system, when there is clearly a plethora of real end user testimony showing how detrimental it is to the health of most United States citizens.
Maybe HN isn't the best site to discuss this on, I'm guessing most of you work for some large tech sector business that offers good insurance. But most of the world is not made up of tech workers.
I think it's very common for Americans with decent insurance to not want universal healthcare, and be afraid they'll pay waaaaay more in tax. They think the system is fine as it is, because they've never put it to the test.
Then they have some catastrophic incident (car crash, cancer, heart attack, etc. etc.) and they're bankrupt in a few years and become very, very strong proponents of universal healthcare.
I think it's exceptionally hard for people to understand the system until it personally impacts their life in a very big way.
I'm not sure what to do about it. Maybe as a start every health insurance provider should be forced to provide facts about customers with the same insurance who had catastrophic events and how that worked out for them over 3-5 years.
It's easy to maintain an unfair political system, as long as your base of support is better off than some underclass. It makes them feel valued and special, all while your hand's in their pocket.
Why should I care about Bob's healthcare problems, I am healthy and have a good job, I'm currently comfortable.
(Observe the recent death of Joe the Plumber, and his family's immediate followup was starting a fundraiser to pay for his accrued medical bills. All for a man who spent his rather low-profile and sad political career campaigning, among other things, against healthcare reform.)
If you have a good job and don’t have any chronic medical conditions and have never been hospitalized and no one you care about has experienced those things the US medical-industrial complex is fine.
Healthy Americans want the payroll deductions for health insurance employee contribution, Medicare, Social Security, income tax to be as small as possible. When we get sick or injured we want no wait highest quality maximum intervention medical care and low co-pays.
There's a lot of willful denial of reality when it comes to health care, but even when that doesn't happen, a lot of discussions just end up being people explaining how things work to others.
The Veterans Health Administration is a huge sprawling thing. A lot of people aren't aware it exists.
Every interaction I have involves checking out, standing before a sign that says, "all fees must be paid at time of service." I pay then, then months later get more bills to be paid well after the time of service.
As far as I can tell, this is the correct way to handle this? I haven’t paid attention to any medical bills sent in the mail since I started working 15 years ago (I generally pay what they ask at the point of service), and I’ve never noticed any consequences (no denial of service anywhere, has never shown up in any way on my credit report, etc) — as far as my experience has shown, any bills sent after the fact are completely optional to pay.
I think you're interpreting this wrong: they aren't saying that all fees will be presented to you at time of service. They mean any fees which are presented to you at time of service need to be paid, but that isn't all the fees.
The worst experience I've had is one where I interacted with a provider, I paid my co-pay, they billed my insurance, my insurance paid the remainder, and it seemed to be done. Roughly a year later, the insurance company audited the bill, determined that the provider coded something wrong, and (somehow) took back their money. So the provider turned around and billed me 18 months later.
I called the provider, who had no clue what had happened. The insurance company finally told me that they reversed the charges, and told me I was not responsible for the bill, and the provider had to generate a correct bill. That was the last I heard of it, and I'm still expecting a several thousand dollar bill to show up in the mail..
Wow! That is quite a ride. You know there's a problem when an organization has to hire a billing coder in order to decipher what to bill patients. The whole thing just seems sad
Imo one part of the confusion and complexity is pricing. There is no standardized pricing. Many countries with government run healthcare systems solve this by not showing patients the prices and standardizing the price they pay to doctors etc. in the US you have the hospitals / health care providers, insurance companies, and patients all negotiating with each other. Some state governments tried to mandate a defined list of services and costs, but I don’t think it worked. Each provider categorizes things slightly differently. Also it seems the insurance companies and providers are fighting it out around what to pay, leaving the patient in the middle also trying to negotiate. It’s all very exhausting.
Mixing profit with healthcare is bound to lead to trouble. Patients got no choice but to accept the abuses of the system when they are sick. Like agreeing to things under duress.
That sounds like the unintended consequence is you'd be billed the day of service the full cost and you can submit the claim to your insurance for reimbursement.
Readit News
> https://www.npr.org/sections/health-shots/2022/09/22/1121612...
My daughter died. Our story aired a year later. Another year later, so around 2 years after my daughter's death, I received a hospital bill for a little over $3,000, for her initial few weeks of ICU care. I never acknowledged it. I couldn't bring myself to call the hospital to setup a payment plan, say my daughters name in the same sentence as a dollar amount again. We haven't heard a peep since.
The closest experience I can think of to this was when I was a sophomore in college in 2006. In short order, I had a seizure, was taken to a local Trauma ICU, and hours later flown to a Level 1 facility in another part of the state.
The hospital where I stayed billed us without issue, but the Trauma center decided it was the right thing to do when it sent the unadjusted bill to me at my college address. Oh, and the medical transport people who flew me around the state of NJ? Nothing.
Just super.
I also could talk about how earlier this year I spent 23 days in the ICU for an infection related to the same condition, and how an event from April-May still isn't settled as far as insurance goes, but I'm stressed enough at this point.
Score 1 for PTSD!
It occurs to me that I've surely met the deductible and OOP limit for the year, so that might explain why we've been so slow to see things get resolved.
To top off this cavalcade of awfulness, the person who hired me into my current job lost her fight with pancreatic cancer last week.
2023 sucks.
Good. But just to be safe, you should check your credit report from time to time to make sure they didn't send your account to collections.
Since the health care sector is one of the largest political donors, elected officials have little incentive to fix anything, so they nibble at the edges and call it reform.
[1] https://www.npr.org/sections/health-shots/2023/08/15/1193754...
My primary care physician did this a couple of years ago. He still works at the practice and I still see him. When I asked him why he sold, he said he wants to do what he loves - practice medicine - not spend most of his time working with insurance companies.
The worst part is all my records from years of visiting him did not transfer to the new system. It’s as if I’ve been seeing him for 2 years instead of 10 because no one can access my old test results and records. So much for continuity of care. Now I download all documents in their portal and save locally.
There’s a major dental insurance carrier that finds it perfectly acceptable to “pay” dental offices with prepaid debit/credit cards. Think Greendot, Mastercard, or Visa prepaid cards.
I’m fairly certain my dentistry firm is fighting back in ways I’m not comfortable sharing because I don’t know any facts and would just be speculating, but I do hope they’re sticking it to them.
Sometimes it's up to the consumer to connect the two departments, insurance and the hospital billing, on the phone at the same time. Seems simple but the wait time between the two parties is high, and either one of them will drop off mysteriously.
If the bill is in dispute for too long, you will be sent to collections, and have your credit score degrade.
https://hedgehoglibrarian.com/2023/08/14/executive-function-...
In the same way that tourists bring tourists dollars, sick people bring government dollars.
You pay politicians, and you get the outcomes you want.
Every other country in the world calls it bribery.
This is, unfortunately, not true for the majority of "democratic" countries.
They call it "lobby". They avoid to call it "conflict of interest".
- Your employer can incorrectly pay you for a long time and then demand the money back.
- A hospital bill can come (afaik) anytime in the future
- You can dispute charges, the provider can fail to provide customer service, but your credit score is negatively affected.
Etc.
We need bills that focus on favoring the "little guy" in the fight so that wealth, dominance, and power are mitigated in justice.
EDIT: actually the bit about employer overpay being for "Decades" and demand back was not entirely true, depends on the state, ranges from weeks to 15 years according to my googling.
Maybe HN isn't the best site to discuss this on, I'm guessing most of you work for some large tech sector business that offers good insurance. But most of the world is not made up of tech workers.
Then they have some catastrophic incident (car crash, cancer, heart attack, etc. etc.) and they're bankrupt in a few years and become very, very strong proponents of universal healthcare.
I think it's exceptionally hard for people to understand the system until it personally impacts their life in a very big way.
I'm not sure what to do about it. Maybe as a start every health insurance provider should be forced to provide facts about customers with the same insurance who had catastrophic events and how that worked out for them over 3-5 years.
Why should I care about Bob's healthcare problems, I am healthy and have a good job, I'm currently comfortable.
(Observe the recent death of Joe the Plumber, and his family's immediate followup was starting a fundraiser to pay for his accrued medical bills. All for a man who spent his rather low-profile and sad political career campaigning, among other things, against healthcare reform.)
Healthy Americans want the payroll deductions for health insurance employee contribution, Medicare, Social Security, income tax to be as small as possible. When we get sick or injured we want no wait highest quality maximum intervention medical care and low co-pays.
The Veterans Health Administration is a huge sprawling thing. A lot of people aren't aware it exists.
> people who constantly show up to defend the US health care system
that you're claiming exist? I don't see any of them.
Deleted Comment
I called the provider, who had no clue what had happened. The insurance company finally told me that they reversed the charges, and told me I was not responsible for the bill, and the provider had to generate a correct bill. That was the last I heard of it, and I'm still expecting a several thousand dollar bill to show up in the mail..
Mixing profit with healthcare is bound to lead to trouble. Patients got no choice but to accept the abuses of the system when they are sick. Like agreeing to things under duress.
I was thinking we should use the proposition system here in CA to get this through- who wouldn't vote for it.