May 2011 Moms

anyone else have problem with LO hospital bill?

I just wanted to see if anyone else is in the same boat or can give me some advice!

My DD was put in the NICU for 3 days because she had a slight temperature at birth. They ran blood tests and nothing was wrong with her but they still wanted to monitor her.

I had pregregistered at my hospital and had to pay a deductible of $270. I have been getting Explanation of Benefits letters from my insurance company with large numbers! About a month ago I got a bill for $6,000 for my DD NICU stay. Turns out the doctors in the NICU are out of network doctors for my insurance.....this was not known to me in the hospital. My insurance company kindly gave me a check for $2,500 to help pay towards the hospital bill. They told me to write a letter to the hospital along with the check asking them to accept it as payment in full since I did not have a choice in doctors and was unaware that the doctors provided were out of network.

Today I get a bill for the remaining balance $3884 and no acknowledgment of my letter. I called the hospital but their computer system is down so they weren't able to look up my account. I would really like to fight this somehow. Does anyone know if there is any legal action that I could take or am I just wasting my time? When they call me back I'm going to play the "I have no money" card and see where that goes but I don't know what else I could do. We have the money to pay it but I really don't want to!!

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Re: anyone else have problem with LO hospital bill?

  • imageTMILLER45:

    I had pregregistered at my hospital and had to pay a deductible of $270. I have been getting Explanation of Benefits letters from my insurance company with large numbers! About a month ago I got a bill for $6,000 for my DD NICU stay. Turns out the doctors in the NICU are out of network doctors for my insurance.....this was not known to me in the hospital. My insurance company kindly gave me a check for $2,500 to help pay towards the hospital bill. They told me to write a letter to the hospital along with the check asking them to accept it as payment in full since I did not have a choice in doctors and was unaware that the doctors provided were out of network.

    That is exactly what you need to do.  A few years ago I was hospitalized and brought to the hospital in an ambulance.  I was billed about $500 for the ambulance and it was not covered by my insurance..  I called the ambulance company and asked them what I should do, and they suggested calling my insurance company and fighting it.

    I talked to a rep at my insurance company and explained that since I was unconscious at the time I was unable to ensure that the ambulance company was covered by my insurance ("I need an ambulance, can you make sure it is covered by Blue Cross?  Thanks, I'm going to pass out now!").  They agreed and dropped the charges.  I was surprised at how simple it all was.

    You might have to push harder since you are dealing with the hospital, but I strongly encourage you to ask, and push if you need to.  The last thing on any new mommy's mind is, "Are these NICU docs covered on my insurance?"  I think it's pretty LAME that they're not covered, but that's a rant for another day.

    GL!! 

     

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  • Thank you so much for your advice. I am going to keep pushing because I just think what they did was wrong. So all the other doctors in the hospital take GHI insurance just not the NICU? WTF!
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  • I think if you push hard enough you can get them to budge.  Don't be afraid to talk to a higher up and be tough if you have to.  One thing I've found that that seems to help is asking them a question that might make them feel uncomfortable.  Sometimes these awkward questions fluster the person you are asking and they are more included to do what you want out of embarrassment.  Hey, I didn't say you had to play nice!

    For me in my situation it was something like, "I don't understand how I was to communicate to the ambulance company that they had to be covered by BCBS when I was in respiratory distress and had to be intibated.  Do you think that was very fair?" I purposefully put TMI in there to make the insurance rep feel awkward... It worked and I didn't have to pay.  

    Anyway, I am ranting.  I hope you can get the charges dropped! 

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  • lol I like that idea. First I'll kill them with kindness....if that doesn't get the job done then I will have to get my *** on!
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  • If the NICU docs were out of network and there was no way for you to know that at the time that's just bad luck. You know some docs are in network some are out of network, that's just how health insurance work, so why do you want to fight this? You do owe this money, I'm not trying to to be a smart a** here, I'm sincerely asking why are you trying to get out of it? what you can do is negotiate with the hospital letting them know you had no idea the docs were out of network that it is a hefty sum of money and you can't pay it in full, or any for that matter. Most hospital have charity programs, based on your income and household number, you might end up not paying anything at all. Now, they're always two types of bills:the hospital is one and the docs is a separate one, if it's the hospital charges you might be able to apply for the financial help, if it's the docs that usually is harder to do, you didn't specified which one it is. What I'm telling you is based on my knowledge working in the field and my personal experience with the bills from L&D I didn't have insurance at the time of delivery, my bill was nearly 25k!
  • It's the doctor billing us. I know it's a case of bad luck but if I can try and save $3,000 I'm going to do it. I can't imagine paying 25k!! That's crazy!
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