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Estimated Hospital Charges


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I happen to go into emergency for blood pressure related illness two days ago. After being treated i was taken to finance dept by one of the nurses and i signed paperwork.

I was returned a copy which showed only estimated charges for hospital visits. This is their writing

 

ER SERVICES ONLY ESTIMATE OF CHARGES

 

1) PACKAGE PRICE = $1200 offer valid until 7/xx/13 @ 7:40p

 

2) PAYMENT PLAN= $400 DOWN PAYMENT TOWARDS FULL COMPACT RATE ; $100 X 12 MONTHS

 

3) 120 POLICY EXPLAINTED-REFFERRED TO COLLECTIONS IF PAYMENT OR ARRANGEMENT NOT MADE

Estimate of RESPONSIBILITY: $1600 ; COMPACT RATE LEVEL= 1, 2, 3, 4,5+ CT 123  ;; my compact rate level is circled 5+

 

Other procedures may be performed during your procedure by the doctor/medical personnel that may not be included in this estimate; You will be responsible for this additional cost.

 

Understands that this is an estimate only and represents the average charge for similar services previously provided to our patients. Your actual costs may be higher or lower than amount quoted.

 

I have read, understand the contents of and received a copy this Estimate of Charges;  signed by patient & date & Witness (hospital finance dept signature).

 

 

 

 

Has anyone had experience settling or negotiating with hospital for an EMERGENCY VISIT. they r providing me with a 24 hr deadline to settle or take their offer even before an ITEMIZED BILL is being issued.

Also, this is just their estimate & they are asking to get as much money as possible in and within the 24 hr period. Basically i refused paying anything right now!@!!!!!!!!

 

I want to find out ways of settling this with the hospital. I do think a $50 or less payment over a 12 months period is a very viable option for me,(settling for $600 for an ESTIMATED TOTAL BILL OF $1600).  do i get it all in writing, what else should i demand/ask for in a settling agreement for this.  In their estimate of charges they also HIGHLIGHT that costs may be HIGHER OR LOWER!!!!!! i guess wait until a final bill is drafted or make payment arrangements.

 

what made them think i belonged in the 5+ compact rate level versus anything else? does anyone know how that is determined?

 

This is a PRIVATE HOSPITAL not a county or clinic/URGENT CARE KINDA PLACE.

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It's awfully early in the process, but if you call the finance department in the hospital, you may be able to work out a payment plan.  I'm not sure they would settle for less, but you might want to try and ask for a hardship type deal.  

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so if i were to debate there r two  hospital to be within 5 mi north & 5 mi south of my location which hospital by law would they take me to? If i preferred one over the other would you think Shelley that they would listen to me?

 

Mind you i m in a state of emergency that i do not exactly have the will or the stature of wanting an argument with the ambulance driver? is that something the Parameds GOOGLE on their systems to c where might be the right place to go? i am seriously curious how they decide on it.

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Also consider that one hospital charges twice what the other charges (yes, it really happens ... this exposed on TV the other day with even higher ratios), then which would they take you to.  What if the one that charges more and provides a kickback to the ambulance service (yes, it really happens).

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as the crow flies energinzer, as the crow flies.  The ambulance service goes to the closest hospital from your service area.  That hospital can be a private, or non-profit, or county hospital, ift depends on what your emergency is, and what their trauma rating is.  For instance, if you were involved in a MVA, and there were 2 hospitals.  One hospital had a trauma rating of a level 2, and the other a level 3, they would take you to the level 2 hospital because of the nature of your emergency.  Level 2 hospitals are more equipped to handle most emergencies.  If your emergency was medical, like chest pain for instance, if the private hospital was certified for chest pain, and the other was not, they would take you to the private hospital.  If it was an emergency that both hospitals were qualified to handle, it is the closest one as the crow flies.  You don't get a choice.These were national laws put into place to prevent  EMTALA violations, or (hospital dumping)  It is a good law, so many big hospitals get patients dumped on them with patients that have no insurance, or are under-insured.  It helps "spread the wealth"

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Also consider that one hospital charges twice what the other charges (yes, it really happens ... this exposed on TV the other day with even higher ratios), then which would they take you to.  What if the one that charges more and provides a kickback to the ambulance service (yes, it really happens).

 

That would be a slippery slope for them to climb, If the other hospital (they can hear the EMS Traffic on the dispatch radio) were to call them out, they would have huge fines. I do believe before EMTALA this was common practice, but not so much anymore.  There are times when some hospitals may be overwhelmed, and have to go on divert, but most do not divert ER patients, they stabilize, then transfer to another hospital that has room.

 

 

http://www.emtala.com/

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The general rule is that the ambulance must take you to the closest available, appropriate hospital.  Available means they can accept you.  Appropriate means medically appropriate - for example a cardiac case would go to the closest hospital with a cardiac emergency capability.

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First of all where the ambulance took you will not be a very good defense if this goes to court.

 

First Do you have insurance? If you have medicaid, the hospital better send a true bill and not an estimate to your insurance.  There is also a provision to medicare and medicaid that states the hospital must accept what medicaid pays as payment in full and they cannot balance forward and send you a bill for the extra. 

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I have the county hospital insurance which covers emergencies and would cost me less than $100 including ambulance visit?

However, since i was in a private hospital with a 5+ rating emergency i was taken i guess to the nearest ER which will nearly cost me $2000 excluding ambulance. 

Ambulance alone approximately is $850 to $1200. County hospital would have been nearly 15 miles but fully covered.

 

BTO429 i was provided with contact info for Medicaid to apply, but no i do not have medicaid or any other private insurance. i was hoping that i would be a AMBULANCE TRANSFER FROM the private hospital to the county Hospital once my condition was stablizied & if they found it necessary to have further evaluation or ongoing monitoring for my condition. Well, it never actually came to that and i was discharged from hospital after 5 hours of stay. (2 hours included just paperwork).lol. with an estimated charges of $1600.

 

Thanks shellieh98 for the wonderful explanation. That makes good sense.

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So i received a call from Medicaid based assistance office of my Hospital i visited. They called and asked me eligibility info such as

 

a) full name

B) Members of Household

c) Legal Status
d) Any children under 18

e) Income

 

Based on the income provided, i was told if i would only be eligible if based on members of my household i would have to make less than $275/month in texas for a three member household (2 adults & 1 child under 18).  However,

 

Medicaid office will be sending me an application for Financial Aid assistance which i need to fill out completely and enclose a check of $100 as payment & if approved i will owe nothing more. Did not tell me whether it was charity based or goverment provided assistance/private foundation assistance. 

 

DEVELOPING......

 

will let you know as it goes forward

 

I find this to be very interesting/pertient information for what "OBAMACARE" would look like ? Everyone becoming eligible for financial aid assistance and hospitals/doctors bear the brunt of this expense!!!!!!

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When Obama care kicks in they will start building more jails for those whom cannot afford to pay for insurance. I am 100% against the government telling us that we have to have insurance. It just goes to show you whop has the biggest hand in the making of this law, insurance, big insurance. it is a free country and if I don't want to buy a product I should not be forced to buy it.

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Hi folks

this is a complaint i found researching on Central financial control. It seems like the LVNV of Medical HealthCare related collection practices. It is also known as TenetHealthCare headquartered in Anaheim, CA. What i am getting at is I have received a collection letter from Central Financial Control & to the best of my knowledge & belief, i do not show any addresses listed in Anaheim, CA for if you ever wanted to correspond with them but their address is in Alabama, and i did DV them within the first 30 days and Central financial Control followed up with a letter stating it will be reported to the Credit Bureaus. Remember, i was returned a certified letter that was sent to the address listed on their collection letter.

 

Now r there more than two violations here.

 

Central Financial Control
P.O. Box 66044
Anaheim, CA 92806-6040

 
 
Complaint Type: Billing or Collection Issues
Product/Service: Collection agency
Model Name/Number:
Amount in Dispute: $1257.00

Complaint

Posted: 12/20/2012

Summary: Deceptive collections practices.

Resolution Sought: Delete the negative information placed on my credit report

Detail: Central Financial Control placed a collection account on my credit report for a health bill of Coral Gables Hospital that is still in dispute with my Insurance Company (BlueAdvantage Administrators of Arkansas), I have explained them and Coral Gables Hospital the situation and they inescropously placed the bill for collection anyways damaging my credit report. Trying to solve this problem I have contacted Central Financial Control and offered them to pay the bill and request a refund from my insurer, and in exchange they will immediately remove the account from my credit report. I spoke to a guy named Allan who assured me that immediately after the payment is processed they remove the negative information from the report. I have and they have the recording from the conversation. Ten days after the payment, they just have updated the collection record on my report to show Paid, settled. This is just inadmissible and I'm demanding them to comply with their promise of removing the collection record of my report before I proceed with the next action to get this solved.

Company's Response

Posted: 12/21/2012

Summary: Since the patient was duly notified of the outstanding debt prior to it being reported, a deletion is not warranted. Our office does not accept payments for deletion of items

Response: Thank you for bringing customer’s complaint to our attention. Due to concerns expressed, our office has thoroughly reviewed the above listed account. The aforementioned account results from services rendered to him by our client. At the time of service he was provided with the Conditions of Services (COS) which is the contract between our client and him and outlined his financial responsibility for any charges incurred resulting from medical services rendered by our client. Customer’s insurance carrier, BlueCross BlueShield, processed the claim and denied payment leaving him with the patient responsibility of $5,471.00. If he does not agree with the denial and/or the amount assigned by his insurance carrier, he needs to contact his insurance carrier directly. Notices were sent to him to advise him of the outstanding balance. Specifically on August 14, 2012, a letter was sent to advise the account was sent to collections and on October 17, 2012 a warning letter was sent to notify Mr. Gonez of credit bureau reporting. As neither a response nor contact was received, on November 21, 2012, this office reported the account in question to the credit reporting agencies (CRAs). Patient payments totaling $4,221.76 have been received. Our records show this account was settled after it was reported to the credit reporting agencies and it is accurately reporting on his credit profile as settled.

Consumer's Rebuttal

Posted: 01/01/2013

There are many inaccuracies in this letter: 1- BlueCross and BlueShield was never the insurer, which is BlueAdvantage Administrators of Arkansas, a plan administrator for the Walmart Health Insurance Plan. 2-The reason of the declination was the terrible billing services of your client, in case they don't know, if you submit a bill for a procedure involving a diagnostic code "asyntomatic varicose vein", it will always be considered by most of the insurance carriers a cosmetic procedure and will be not covered. 3-I always kept your client informed and I'm still in a dispute with the plan administrator. Such mentioned letter sent,as you said, were never received by me, you can show me an evidence that I did. 4-I realized that you have reported this to the mayor CRAs when I applied for a credit and was denied, never beacuse you or your client informed me. 5- Your Agency lied to me when I found out of this situation and call you to get a solution, as I explained before, I was told that right after they receive the payment, they remove the negative information, which never occurred. If you can't solve this, I will continue fighting my rights with the FTC and eventually seek legal

Company's Final Response

Posted: 01/14/2013

The first issue brought to attention is that consumer states BlueCross BlueShield was never his insurance carrier. Please note the patient’s home plan is in fact Blue Advantage Administrators of Arkansas. However, the services took place at a Florida facility and therefore, the claim must be submitted to the local plan which is BlueCross BlueShield of Florida. This information is listed on the back of the patient’s insurance card. In reference to the facility’s billing practice; it is the responsibility of the treating physician to diagnosis and code the patient’s treatment. Questions regarding the diagnosis or coding of the claim need to be addressed directly with the treating physician. The facility does not employ physicians. As previously stated, notices were sent to consumer to advise him the account was sent to collections. Specifically on August 14, 2012, a letter was sent to advise the account was sent to collections and on October 17, 2012 a warning letter was sent to notify consumer of credit bureau reporting. Please note consumer was aware of the outstanding account. On August 27, 2012 he initiated an online inquiry through the facility online portal

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the reason for this posting by me in two places is to show y it will always make sense to be dealing directly with the OC have the collection agency recall by the OC and expect collection agency to get into violations before ever making or agreeing to a payment either having recorded conversations or verbal.

Thats why its best example also to show " if it aint in writing, then it never happened"....lol

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Like I told you before,

Willful blindness, also known as conscious avoidance, is a judicially-made doctrine that expands the definition of knowledge to include closing one's eyes to the high probability a fact exists.

 

They know the fdcpa requirements, but provide an address that does not exist or they return your mail, making them blind to the facts that exist. They can claim they did not know because the did not receive your mail. But you show the court that the intentionally make it impossible, with an address that is erroneous, for you to acceert your rights under the fdcpa. They are trying to avoid the fdcpa.

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