Surprise bills often come from providers who "were there" for the procedure. I used to get them from anesthesiologists who were not in network but were on call that day. ALWAYS fight that shit. Because YES Dr... I would have postponed my colonoscopy to avoid a surprise $2600 bill. Especially when I ain't exactly choosing this anesthesiologist.
Some doctors also function as contractors with a particular hospital or medical group. They have their own LLC in a totally different city or state (for tax purposes) then send a bill from their LLC to your insurance. When your insurance gets a bill from Dr. Whatever LLC in Arizona but you live in Virginia, yeah it's always out of network even though Dr. Whatever physically lives and works in Virginia.
I'm about to get a big bill for an ambulance ride and emergency room visit. I'll be calling to ask for lump-sum payment discounts. Most providers (in the US) will give you a discount to pay in a lump sum
Wiped out on a bicycle and went to the ER. They told me that they were in network for Blue Cross. At one point in the visit some doctor came in for a total of 30 seconds, looked me over, told the nurse to make sure to get the rocks out of my shoulder and sanitize the skin and left. She was not in network and her part of the bill was $2,200 on top of the ER bill. 1/5 stars. Will not wreck my bike near that hospital again, I will wreck somewhere else in the future.
I recently read a story of a guy the had a medical procedure done and the hospital sent him a bill for $750 because it was processed without insurance. When he called the biller and gave them the insurance information, the bill went up to $1,500. When he asked how much the the insurance paid, they said $1,500 then revealed that the insurance already paid $1,500 and the due was $1,500. With insurance, they raised the bill to $3,000! WTF?!
The fact that it takes this much work on the part of a patient just to get basic healthcare is by design. If you found out you were being outright denied something you had the right to, you could potentially have legal recourse to sue. If they turn the process of receiving the care into a labyrinthian nightmare and you give up, then they can say that you must not have needed it that badly.
Or I could move to one of a bunch of developed English speaking countries, walk in, get treated, walk out, without paying a dime or needing advice on how to navigate shit. Or just fucking not pay. I'm not being serious I just hate this shit so much. "Watch my 5 tips on how to have less medical debt!!" Fuck this country
Unfortunately the no surprises act doesn't cover everything. I had a prior auth on file for several CT scans, the facility was in network, but the radiologist they sent it out to wasn't. I now owe $180 in out of network costs (my in network $6400 annual max was already met). By far not the worst surprise bill but it's some fucking bullshit considering what we pay in premiums and what I already paid out of pocket last year.
Just the regular, periodic payments for the insurance coverage. Called a "premium" for some reason. I'd like to pay the happy hour price instead of the premium price, please.
It was passed a fee years back under Biden. It states that if you receive care at an out of network facility in an emergency or otherwise unavoidable situation that insurance can not deny you care or coverage. I had this happen when an ambulance took me to a hospital and I was immediately sent to surgery to save my life. I’m still fighting it. This is another angle of helping it. I’ve been fighting it for over a year.
Also many towns only have one ER. And you may be out of network.
I had spinal surgery a month ago. I waited for the bill. Instead, I receaved a letter informing me I had already reached my $330 cap for medical spending for this year. So all further doctor visits, fysiotherapy, and other medical needs are free of charge out the year. Yeah, living in Norway ain't so bad always
I had spinal surgery in Washington DC. The surgery itself cost over $10,000. I was told that medicare sometimes does and sometimes doesn't cover this and I wouldn't find out until after the surgery. I paid a $1,200 non refundable deposit, and signed a document saying that depending on how much medicare covered, I might owe more. Medicare covered it all. I still received a bill for $1,200. They said my arrangement had been made with the doctor and this bill was from the hospital, so I did owe it.
Finland here. Couple of years back, a bacteria tried to eat my hand. I was in hospital for 14 days, underwent three surgeries, bill was 700 (14 x 50) euros, which also meant I reached the yearly cap and all the physiotherapy and other care after leaving the hospital was free. There was a surprise though... I was not aware there's a yearly limit. I had never used more than maybe 50 per year for health costs.
Käsi toimii, sillä voi koodata. Kirurgin sanoin "ei siitä koskaan tule yhtä hyvää kun isin ja äidin tekemä". Kyllä tää kelepaa loppuajaks, OYSiin kiitokset.
I hope it works out for you but a lot of times videos like this get a complete debunking, especially the part about "who is your compliance contact" bit. They will probably say "no such thing is required and stop getting your information off the Internet". Again, I sure hope I'm wrong but don't walk into this headfirst expecting a miracle.
If they don't have a compliance officer, I guess that's when you escalate to a complaint with CMS (or state insurance commissioner if it's private insurance)
UPDATE! i talked to both the billing company and the insurance company. I was not quit this confrontational yet like in the video. i explained my situation and gave them each the contact info for each other. i even called back and confirmed they reached each other and are aware of the situation. they are going to talk to each other and negotiate out the bill. i have to wait up to 45 days until then. ill let yall know then. it does sound positive tho.
*speaks in Polish* "How much do I pay for this 30+ days of hospital stay? Oh, just for what I ate from the vending machine in the hallway? Great, I'll never recover from this financial fiasco."
It's not really a wonder that you get people believing in nonsense magic words like the sovereign citizens when you get shit like this where they can just lie to you and screw you if you don't know the very real magic words to make them behave themselves
In most legal systems this is simple: they pull this kind of bullshit and you find out later, they pay you back (sometimes with extra for your time), the US is the only western place I can think where they just go 'Ha you fell for it, fuck you'
Except that the medical system isn’t that great - at least not for the majority of people. There’s a lot of other countries that have significantly lower maternal mortality rates (one of the markers of a high quality medical system).
Good medical technology doesn’t make the system good. A good system would make sure their people are healthy prior to concern of their profit, and in other countries it isn’t a profit and especially not at our greedy scale.
WhiteRhino723
Anybody got part one?
TheJackyBear
I can't believe you would have to do this!
Totally broken system
iananimated
You couldn't pay me to live in America.
RawSuger
free market nightmare
OperatorWay
> "...You don't need to argue because the law does that for you..."
If it did, these billing calls wouldn't be necessary.
HeadJamistan
Is this some sort of capitalist video I'm too socialist country citizen to understand? :(
OrkenMork
Then they pull out a form you signed 3 seconds before you were completely out under anesthesia that you have no memory of signing...
BobJones786
Also, this: I've done this and it worked.
HotSauceNCereal
I just don't pay. But what about... Nah. I just don't.
Apeofdeath
I'd better write this down
moistsox
I just ask them for a line by line detailed bill and wait. They have never been able to produce one at my hospital thus can’t prove I owe anything
jargonmon
Surprise bills often come from providers who "were there" for the procedure. I used to get them from anesthesiologists who were not in network but were on call that day. ALWAYS fight that shit. Because YES Dr... I would have postponed my colonoscopy to avoid a surprise $2600 bill. Especially when I ain't exactly choosing this anesthesiologist.
ejw909
Some doctors also function as contractors with a particular hospital or medical group. They have their own LLC in a totally different city or state (for tax purposes) then send a bill from their LLC to your insurance. When your insurance gets a bill from Dr. Whatever LLC in Arizona but you live in Virginia, yeah it's always out of network even though Dr. Whatever physically lives and works in Virginia.
EstoyPoopis
Omg man, that is so incredibly scummy. Fucking dishonest, amoral. That would make me so angry I'd probably be in jail. I'm so sorry, you guys.
Painalschmainal
Nothing can be easy
squillis
I'm about to get a big bill for an ambulance ride and emergency room visit. I'll be calling to ask for lump-sum payment discounts. Most providers (in the US) will give you a discount to pay in a lump sum
JPeterman2
ivel501
Wiped out on a bicycle and went to the ER. They told me that they were in network for Blue Cross. At one point in the visit some doctor came in for a total of 30 seconds, looked me over, told the nurse to make sure to get the rocks out of my shoulder and sanitize the skin and left. She was not in network and her part of the bill was $2,200 on top of the ER bill. 1/5 stars. Will not wreck my bike near that hospital again, I will wreck somewhere else in the future.
BIC777
.
SomeFukinWizard
yea, me too
VindictiveBathToaster
I recently read a story of a guy the had a medical procedure done and the hospital sent him a bill for $750 because it was processed without insurance. When he called the biller and gave them the insurance information, the bill went up to $1,500. When he asked how much the the insurance paid, they said $1,500 then revealed that the insurance already paid $1,500 and the due was $1,500. With insurance, they raised the bill to $3,000! WTF?!
RazzaTheBazza
I think you have to be American to relate to this. Brb off to enjoy my free healthcare in my free country.
FlurfMacGurf2
Take me with youuuuuuuuuuuuuuuuu!
TK421isAFK
Dude, you have to be more specific. How are we supposed to know which "free country" you live in, aside from it being Everywhere Except USA?
DifferentColoredSocks
Jelly
Zetor
Please stop. My eurosmugness can only get so high!
Eidodk
Just live in a functioning society where you don't have to pay out of pocket for healthcare. Problem solved.
ZIMISME
No surprises? Don't get healthcare in the USA. Get it literally anywhere else. It might be even better, but it will certainly be cheaper.
doctorId
The fact that it takes this much work on the part of a patient just to get basic healthcare is by design. If you found out you were being outright denied something you had the right to, you could potentially have legal recourse to sue. If they turn the process of receiving the care into a labyrinthian nightmare and you give up, then they can say that you must not have needed it that badly.
Saxytimes
Or I could move to one of a bunch of developed English speaking countries, walk in, get treated, walk out, without paying a dime or needing advice on how to navigate shit. Or just fucking not pay. I'm not being serious I just hate this shit so much. "Watch my 5 tips on how to have less medical debt!!" Fuck this country
someguy7734206
The other English-speaking countries are starting to go down the same path.
Saxytimes
🤬
EstoyPoopis
Ya. This late stage capitalism bullshit needs to be stopped.
tombeithemist
Did a quick look thru OP's posts to find Part I, didn't see. Someone post a link pretty please?
chocobocooki3
Searched around for Sophie Lin but couldn't find her.
Cranbananarama
Not part 1, but I found this: https://www.instagram.com/drsophielin/
RandomStuffsandThings
Unfortunately the no surprises act doesn't cover everything. I had a prior auth on file for several CT scans, the facility was in network, but the radiologist they sent it out to wasn't. I now owe $180 in out of network costs (my in network $6400 annual max was already met). By far not the worst surprise bill but it's some fucking bullshit considering what we pay in premiums and what I already paid out of pocket last year.
EstoyPoopis
What's a premium? Is it like, you pay more so that you pay less, kind of scam?
BeckyLookAtHerButt
Just the regular, periodic payments for the insurance coverage. Called a "premium" for some reason. I'd like to pay the happy hour price instead of the premium price, please.
EstoyPoopis
I see, thanks!
Roune
wtf is this no surprises act?
jamesdking
It was passed a fee years back under Biden. It states that if you receive care at an out of network facility in an emergency or otherwise unavoidable situation that insurance can not deny you care or coverage. I had this happen when an ambulance took me to a hospital and I was immediately sent to surgery to save my life. I’m still fighting it. This is another angle of helping it. I’ve been fighting it for over a year.
Also many towns only have one ER. And you may be out of network.
Roune
Damn sorry you have to deal with that bullshit. Thank you for answering too!
EstoyPoopis
Insanity. I'm sorry.
pr0t34n
It turns this 😱 into this 😐
xETM
surprise!
jamesdking
Prefect diagram.
bigtitsbutnotthesexykind
I had spinal surgery a month ago. I waited for the bill. Instead, I receaved a letter informing me I had already reached my $330 cap for medical spending for this year. So all further doctor visits, fysiotherapy, and other medical needs are free of charge out the year. Yeah, living in Norway ain't so bad always
ArcaneM37
I had spinal surgery in Washington DC. The surgery itself cost over $10,000. I was told that medicare sometimes does and sometimes doesn't cover this and I wouldn't find out until after the surgery. I paid a $1,200 non refundable deposit, and signed a document saying that depending on how much medicare covered, I might owe more. Medicare covered it all. I still received a bill for $1,200. They said my arrangement had been made with the doctor and this bill was from the hospital, so I did owe it.
genepoolboy
Finland here. Couple of years back, a bacteria tried to eat my hand. I was in hospital for 14 days, underwent three surgeries, bill was 700 (14 x 50) euros, which also meant I reached the yearly cap and all the physiotherapy and other care after leaving the hospital was free. There was a surprise though... I was not aware there's a yearly limit. I had never used more than maybe 50 per year for health costs.
bigtitsbutnotthesexykind
toivottavasti olet toipunut täysin
genepoolboy
Käsi toimii, sillä voi koodata. Kirurgin sanoin "ei siitä koskaan tule yhtä hyvää kun isin ja äidin tekemä". Kyllä tää kelepaa loppuajaks, OYSiin kiitokset.
ExTechOp
Onnistuminen kuitenkin, mikäli toinen vaihtoehto olisi ollut poikki ranteesta tai ylempää…
genepoolboy
Joo se eka oli hätäleikkaus, verenmyrkytys oli just lähös. Veikkaan että vielä 80-luvulla olis lähteny ranteesta käsi.
CatPlanetQueen9000
hey guess who just got a surprise bill for a supposedly completely covered procedure?
ME!!!! this showed up just in time!
TurtleByrdThey
doot
WillCorrectInaccuraciesForFood
Recommend to read up on the act before applying this video to your situation, to make sure the situation qualifies https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/publications/avoid-surprise-healthcare-expenses
MoopsyLD
Please post the details here as a follow up
Snooj
I hope it works out for you but a lot of times videos like this get a complete debunking, especially the part about "who is your compliance contact" bit. They will probably say "no such thing is required and stop getting your information off the Internet". Again, I sure hope I'm wrong but don't walk into this headfirst expecting a miracle.
HelpfulCorn
This one seems legit except maybe that part, unlike that other one that always goes around.
TakeAChillPill16
If they don't have a compliance officer, I guess that's when you escalate to a complaint with CMS (or state insurance commissioner if it's private insurance)
Snooj
From what I remember, most of them don't have "compliance officers" because that's not a real thing.
CatPlanetQueen9000
UPDATE! i talked to both the billing company and the insurance company. I was not quit this confrontational yet like in the video. i explained my situation and gave them each the contact info for each other. i even called back and confirmed they reached each other and are aware of the situation. they are going to talk to each other and negotiate out the bill. i have to wait up to 45 days until then. ill let yall know then. it does sound positive tho.
MadamPuddifoot
Just stumbled across this, what a great update! Hope it saves you big bucks!
CatPlanetQueen9000
@MoopsyLD @TurtleByrdThey
MoopsyLD
Nice!
TheLastSpaceman
What a shithole of a country
iktome99
And now that there is unlimited dark money in politics it will never get better
RazzaTheBazza
Such a shithole
somuchproblemo
Yes, but our fountain sodas are the size of water towers.
InnerBushman
*speaks in Polish* "How much do I pay for this 30+ days of hospital stay? Oh, just for what I ate from the vending machine in the hallway? Great, I'll never recover from this financial fiasco."
Hmuda
rUSA is so cooked.
agonarch
It's not really a wonder that you get people believing in nonsense magic words like the sovereign citizens when you get shit like this where they can just lie to you and screw you if you don't know the very real magic words to make them behave themselves
In most legal systems this is simple: they pull this kind of bullshit and you find out later, they pay you back (sometimes with extra for your time), the US is the only western place I can think where they just go 'Ha you fell for it, fuck you'
[deleted]
[deleted]
theworldcouldbeflat
So are you Endorsing the Pedophile President here, because most people would have killed him by now.
TheLastSpaceman
You know you still have lynching laws, right?
req4adream99
Except that the medical system isn’t that great - at least not for the majority of people. There’s a lot of other countries that have significantly lower maternal mortality rates (one of the markers of a high quality medical system).
MilkShotsMoo
Good medical technology doesn’t make the system good. A good system would make sure their people are healthy prior to concern of their profit, and in other countries it isn’t a profit and especially not at our greedy scale.
friendsofsandwiches
I dunno man, still seems kinda shitty compared to other countries.
glovelyday
You don't know shit. How we pay for it sucks, the distribution is terrible, but, if you can afford it the medical care is the best un the world.
somuchproblemo
So, so stupid. Dear god.
glovelyday
Don't fret, if you study more you can get smarter.
jumpbus360
But guns! And eagles! And we all know you can't have FREEDUMB without guns and eagles.
3654798521
and they even do a Hawk voice over for the Eagle....
theworldcouldbeflat
FudgeLicense
jumpbus360
And that's why eagles need guns. Protection from those violent, foreign, gangs of geese. Also, that is both awesome and hilarious.
theworldcouldbeflat
The deadly "cobra-chicken".