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I don't have health insurance, I belong to a Christian healthcare sharing ministry so I am considered "self pay" when I need healthcare.
I had surgery and a hospital stay 3 months ago and it has been like pulling teeth to get all the providers to send me the itemized bills so I can get them paid. Some just sent statements or emails demanding payments and I had to call to request the actual bill. I still don't have a bill from the unknown ambulance company or from the specialist who provided follow-up care and did x-rays (2 visits so far).
The great thing is that I got top notch care at the hospital and from the surgeon, without insurance. Without even asking, the hospital adjusted my bill a ridiculous amount for being self pay (wondering if they just use Medicare/Medicaid adjustment levels). And since they quickly sent me the itemized bill with the adjustment amount, they have already been paid in full.
Location: East of Seattle since 1992, 615' Elevation, Zone 8b - originally from SF Bay Area
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The last couple of years dealing with some serious health issues, I got bills though January only.
In some cases 2-3 bills for one visit, for example ER bill, ER Doctor bill, lab bill. After that my annual maximum out-of-pocket was met ($2,000) so I never got any more. The rest of the years the insurance paid everything.
I'm not really asking about whether the bill is paid or not, do you actually get itemized bills or do those only go to insurance companies now?
I just find it amazing that the patient has to ask for the bills.
Yes I always get itemized bills and statements but the timing seems to vary based on the provider.
For a simple, straightforward claim for a single office visit I don't usually get a statement, I get a bill requesting my payment of the portion my insurance has determined they don't cover, and I'll get that after my insurer has already paid their part. It can take a while.
If it was a more complicated claim involving several visits or procedures over a period of time, I'll often get an itemized statement earlier on showing what they've submitted to my insurance. Then, as insurance pays their portion I'll get bills requesting my payment of the deductibles or portions insurance wouldn't cover. If the provider had to re-submit a charge to my insurance (happens fairly often) it can delay when I see an actual bill.
Of course the vast majority of health care I get isn't "self-paying". The charges are submitted to my insurer at the time of service. I have never had coverage through a health ministry either.
Last edited by Parnassia; 12-10-2020 at 01:39 PM..
I don't have health insurance, I belong to a Christian healthcare sharing ministry so I am considered "self pay" when I need healthcare.
I had surgery and a hospital stay 3 months ago and it has been like pulling teeth to get all the providers to send me the itemized bills so I can get them paid. Some just sent statements or emails demanding payments and I had to call to request the actual bill. I still don't have a bill from the unknown ambulance company or from the specialist who provided follow-up care and did x-rays (2 visits so far).
The great thing is that I got top notch care at the hospital and from the surgeon, without insurance. Without even asking, the hospital adjusted my bill a ridiculous amount for being self pay (wondering if they just use Medicare/Medicaid adjustment levels). And since they quickly sent me the itemized bill with the adjustment amount, they have already been paid in full.
You should consider filing for the hospital's charity care to see if you qualify unless you're sure you make too much to even be worth your time applying. You'd be surprised how many people do qualify when they think they would not. The "trick" is to show all of your money going out.
My hub had tonsil cancer in August 2009. He had insurance thankfully but with 3 hospital stays for chemo, another one for an infection plus 33 radiation treatments left us owing $75,000. He didn't work for 7 months. He was getting unemployment which wasn't much compared to what he made delivering new cars.
When I applied, I copied every receipt when money went out. Every house related bill, groceries, medications, doctor bills, gas in my car and other car related bills including that I spent close to $10,000 putting a new motor in my 2002 SUV. You wouldn't believe the size of our application with all of those print outs, it was over an inch thick! It worked though. They wrote off the whole $75,000 balance.
Even though we qualified for charity care with Thomas Jefferson in Philly, my local hospital wanted me to redo it for their bill for my daughters ER bill. I don't recall what lame excuse they gave me. You'd think if one hospital system deemed you a charity case that the letter would be enough.
As to your question, I personally never see one bill through out the year unless the insurance company is taking a long time to send the payment.
My hub recently switched his GP, he's not happy with the new one either. They send a bill within 2 days of him being seen. He will pay them in full and they'll send another saying he still owes money some how. What threw him over the edge was they sent one for like 35 cents which is less then the postage they paid to mail it.
Thanks, I don't need charity care, I belong to the sharing ministry and we give a set amount each month and then "share" the bills. I just have been having trouble getting all the original bills with the codes, descriptions, date of service, location so they can be correctly entered into the system.
My original bills were $350,000 and were automatically adjusted by the hospital to a fraction of that, which we'll be able to pay in full.
I don't understand why they bill so high when no one will actually be charged that amount, not insurance companies, medicare, medicaid or even self pay like me.
Location: East of Seattle since 1992, 615' Elevation, Zone 8b - originally from SF Bay Area
44,687 posts, read 81,491,960 times
Reputation: 57948
Quote:
Originally Posted by KaraG
Thanks, I don't need charity care, I belong to the sharing ministry and we give a set amount each month and then "share" the bills. I just have been having trouble getting all the original bills with the codes, descriptions, date of service, location so they can be correctly entered into the system.
My original bills were $350,000 and were automatically adjusted by the hospital to a fraction of that, which we'll be able to pay in full.
I don't understand why they bill so high when no one will actually be charged that amount, not insurance companies, medicare, medicaid or even self pay like me.
They operate like scammers, telemarketers, and car sales people. They hope that some percentage however small of rich but naive people will receive their huge bill and just pay it.
I don't understand why they bill so high when no one will actually be charged that amount, not insurance companies, medicare, medicaid or even self pay like me.
Because it preserves their rate structure. Kind of like the rack rate hotels post that nobody ever pays, or the MSRP on cars that only fools pay, or some made up "regular retail price" that they sue to create that perpetual sales price, or....
Imagine if they lowered their posted prices to what they actual anticipate being paid; next year every insurance company, government or welfare program or private pays will expect a price lower than the posted price. So by saying they charge $4,000 even though they average only $2,000 payment for that procedure, everyone thinks they are getting some big whoop discount.
And, they hope someone pays the amount. They know that there are those of us who have enough money to do so and can't be bothered wasting time or energy trying to negotiate a lower rate. And, those rates also enable us to finagle the system to essentially have zero deductible insurance at the same premium rate everyone else pays just for a high deductible plan.
Nope; never gotten a bill my entire life and I'm 75 years old with the expected number of hospitalizations for things like pneumonia, artificial stapes replacement, one old school, cut open and go digging, and one arthroscopic knee ligament repairs, three eye surgeries, even an elective vasectomy and never once saw a bill for any of those.
Never see a bill for my routine, twice yearly GP visits with the requisite blood work and any related specialist referrals, consults or treatments either.
BUT : - - - I'm Canadian.
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and never once saw a bill for any of those. 
