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CA Sent Copy of Bill. How Should I Respond?


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I wanted to ask for your kind help once again.


I owe over $5,000 to a hospital mainly for two visits to the Emergency room.


At the time, I did have health insurance. 


But since I never previously had health insurance, I wasn’t familiar with how the rules actually work – deductibles, out of pocket expenses, etc.  So I mistakenly thought most of the bill would be covered by insurance.


I’ve requested and received Explanation of Benefits letters from the insurance company.


However, I don’t really understand the letters. 


I’ve called and talked to the insurance company several times on the phone and they’ve briefly explained the letters.  But I honestly still don’t understand how they’ve calculated what they paid, and how much I’m responsible for.


In any case, the hospital sent the bills to a Collection Agency (CA). 


I received highly valuable advice from this website that was really helpful.


Based on the advice I received here, I sent out debt validation letters for the bills.


The CA has written back and attached a copy of the bills and all the charges.


I’m struggling financially so I haven’t been able to pay the premium anymore and I’ve had to cancel the insurance. 


And I can’t really pay the over $5,000 I’ve been charged.


Although I don’t understand medical terminology, in examining the bills the CA recently sent me, I was able to find two services for which the hospital charged me that they never provided.


I also believe some of the charges are simply outrageous.


I want to dispute the two inaccurate charges and the outrageous amounts. 


And I also want to work out some sort of payment plan for the balance since there is no way I can pay over $5,000.


I’ve contacted the hospital several times, but they are not interested at all in dealing with me and they’ve told me to deal directly with the CA.


Given the dire circumstances, how should I try to resolve this matter? 


It appears I don’t have any good options, but is there a strategy that might produce something less negative than the others?


I would greatly appreciate your thoughts, ideas and advice.  Thank you very much for your kind attention and help!!! 


Thank you!!! 



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Guest usctrojanalum

how much of the bill do the two services you did not receive add up to be? also healthcare is expensive, to say that the price of it is outrageous is not really going to fly. who are you to make that assumption, are you a doctor? work in healthcare? medical biller? you are going to have to prove that the services they rendered are unreasonably more expensive that similar medical providers in your area.

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What was your out of pocket max. for the year per person for your insurance?  Is it 5,000?  Most are 1500, or 2500, and then 5000 per family.  I would look into that.

Ask your insurance company to send you copies of all the things they paid concerning this visit.  You can see what charges the hospital submitted to them, and how much they paid.  It will show they charged one price, but since insurance companies get a discount, it will show they paid another price.  The overage does not reflect what you have to pay.  


It can be confusing, because for some things the insurance will pay all of it if you have met your deductible, or none of it if you have not.  They cover a percentage for certain procedures regardless of deductible.  scrutinize the bill, compare it to what the insurance paid, then you will have a better idea of what is owed.  Make sure they didn't throw the amount the insurance didn't cover due to their discount at you for you to pay.  

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