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Old 09-26-2012, 07:58 AM
 
68 posts, read 303,970 times
Reputation: 65

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About a couple of months ago my wife had UTI pains in the middle of night ... so I took her to East Cooper Emergency. They wrote her a prescription and also gave her one pill while she was there.

We have decent insurance ... and the hospital filed and we paid the difference. Closed case ... right?

Well ... About a month ago we received a letter in the mail (with no return address on the envelop). It was from an outfit called Mount Pleasant Emergency Physicians. It was a bill with one line item ... no explanation ... just says "office visit" and the bill was for close to $1000.00. There was no information about them filing with the insurance company.

I called the number listed and got a after hours message saying that the doctors bill separately. The whole thing smells fishy. No-return-address-envelopes ... one-line description of services ... nothing filed with insurance.

Anybody know?

On a side note ... that one antibiotic pill they gave her in the emergency room ... they billed the insurance company $94.00 ! for a single pill !

Thanks !
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Old 09-26-2012, 08:40 AM
 
Location: Summerville, SC
1,321 posts, read 2,146,726 times
Reputation: 444
RE: Your bill... I would keep calling during business hours and tell them to file with your insurance. It DOES sound fishy. That is one way to find out.

RE: $94 for one pill... Healthcare costs today are out of line. I saw similar costs after I had surgery last winter. What really annoys me is when the hospital / anesthesiologist bill doesn't give specifics or line items telling you the breakdown of their bill. Someone I know was in the hospital, and the hospital billed the insurance $125 for 2 Tylenol caplets.
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Old 09-26-2012, 08:42 AM
 
3,256 posts, read 4,597,351 times
Reputation: 675
Can you call your insurance company and ask what they think?
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Old 09-26-2012, 09:30 AM
 
68 posts, read 303,970 times
Reputation: 65
Quote:
Originally Posted by Robynn View Post
Can you call your insurance company and ask what they think?
The folks who answer the phones at Blue Cross ... are so low in the totem pole that they probably ask permission before they need to use the rest room.
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Old 09-26-2012, 09:40 AM
 
Location: Mount Pleasant, SC
1,541 posts, read 2,356,433 times
Reputation: 368
It does sound strange to me too. My son broke his leg during our transition from military to civilian, so we were cash patients for that experience (doesn't it figure you go three months your entire life without coverage and thats when you need it most). Having been under the umbrella of military insurance our entire adult lives we had no idea how hospital billing and costs worked. We received separate bills for just about everything you can imagine, similar to what you have now. The difference is everything was well documented.
One thing that really shocked me was the mark up they charge the insurance companies. We didn't ask for charge reductions, but every line item was discounted nearly 50% for cash payment. When we asked about it they told us it was normal to have different charges for individuals vs. individuals. It was all still insanely expensive, but I guess thats how they get around those in network discounts that insurance companies get?
Anyway, I got off topic. My point was it's normal to be billed separately by the doctor who sees you in the ER, but in your case it sounds very suspicious. I would call your insurance company and see what they say. They will know if they already paid for doctor services.
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Old 09-26-2012, 10:38 AM
 
68 posts, read 303,970 times
Reputation: 65
Quote:
Originally Posted by roxanneself View Post
It does sound strange to me too. My son broke his leg during our transition from military to civilian, so we were cash patients for that experience (doesn't it figure you go three months your entire life without coverage and thats when you need it most). Having been under the umbrella of military insurance our entire adult lives we had no idea how hospital billing and costs worked. We received separate bills for just about everything you can imagine, similar to what you have now. The difference is everything was well documented.
One thing that really shocked me was the mark up they charge the insurance companies. We didn't ask for charge reductions, but every line item was discounted nearly 50% for cash payment. When we asked about it they told us it was normal to have different charges for individuals vs. individuals. It was all still insanely expensive, but I guess thats how they get around those in network discounts that insurance companies get?
Anyway, I got off topic. My point was it's normal to be billed separately by the doctor who sees you in the ER, but in your case it sounds very suspicious. I would call your insurance company and see what they say. They will know if they already paid for doctor services.
Thank you !
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Old 09-27-2012, 06:28 AM
 
Location: Summerville, SC
662 posts, read 1,256,488 times
Reputation: 135
I would file it with your insurance company too. It will be interesting to hear about the final outcome. And, our health care costs are insane!
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Old 09-27-2012, 06:37 AM
 
857 posts, read 1,143,593 times
Reputation: 448
It's pretty standard practice for physicians to bill separately; you will always see separate bills for the radiologist who reads your films, the surgeon, etc.

What sounds fishy to me is the lack of documentation in the bill you received, and the fact there is no insurance information. I'd maybe try calling East Cooper billing to get verification on the name of the group who sent you the bill.

Interesting I just googled Mt Pleasant Emergency Physicians along with a few variations and no group with this name comes up in Mt Pl SC. Hmmmm.
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Old 09-27-2012, 06:40 AM
 
Location: Meggett, SC
10,814 posts, read 9,635,069 times
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Quote:
Originally Posted by 1lisat View Post
I would file it with your insurance company too. It will be interesting to hear about the final outcome. And, our health care costs are insane!
I think the costs would be significantly less if this wasn't in the emergency room. That alone can cause an enormous cost difference.

That said - for the OP. You can get the information from your EOB and/or insurance company on who they paid to and how much you are responsible for as the patient.
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Old 09-27-2012, 02:36 PM
 
435 posts, read 753,365 times
Reputation: 75
Do you know why the bill is so high? That's because hospitals only get 4 cents out of every dollar they billed. We don't have a cost issue, we have a single issue is that most Americans don't pay their healthcare bills! Btw, we can fix these if hospitals do not even have to stabilize patients who do not have an insurance or cannot pay. Yes, I'm sick of the health care debt. Simply by not treating patients who cannot pay, we will control our healthcare cost. We either have universal healthcare that TAX people who do not have a insurance or simply toss them out of the hospital. It is a failing business model and eventually these will be the two only choices that we have to make.

Quote:
Originally Posted by vulcanman View Post
About a couple of months ago my wife had UTI pains in the middle of night ... so I took her to East Cooper Emergency. They wrote her a prescription and also gave her one pill while she was there.

We have decent insurance ... and the hospital filed and we paid the difference. Closed case ... right?

Well ... About a month ago we received a letter in the mail (with no return address on the envelop). It was from an outfit called Mount Pleasant Emergency Physicians. It was a bill with one line item ... no explanation ... just says "office visit" and the bill was for close to $1000.00. There was no information about them filing with the insurance company.

I called the number listed and got a after hours message saying that the doctors bill separately. The whole thing smells fishy. No-return-address-envelopes ... one-line description of services ... nothing filed with insurance.

Anybody know?

On a side note ... that one antibiotic pill they gave her in the emergency room ... they billed the insurance company $94.00 ! for a single pill !

Thanks !
Rate this post positively Quick reply to this message
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