The American healthcare system is built to extract money as it's first priority, not necessarily patient care ☹though it's understandable why people think it's the opposite.
@@Joe-- it's actually to determine a possible way to diagnose you for a lifelong subscription illness with several accompanying prescriptions. Chronic profit extraction triage.
@@mikezupancic2182 Irrelevant to the point that the US healthcare system is lacking compared to other developed countries. The problem is insurance US companies themselves in conjunction with the system.
@Joe until obamacare, the US health system was #1 in the workd in many categories of care, including cancer survival and even time to be seen by a doctor. Statistically you got seen quicker in the US than anywhere else in the world.
I went to a hospital once for a few stitches. I got 3 bills. 1. I got it and paid it 2. I got the bill, but it didn’t have my insurance attached. So it was higher than it would have been. I told them my insurance, the total was reduced by 90% and I paid my share 3. They didn’t have my address and sent it straight to debt collectors. When I asked the hospital, they blamed for not giving them any contact information. When I pointed out they got the other two bills to me just fine, they couldn’t give me an answer
They tried doing that to me about a year and a half ago when I had to go into the hospital for pancreatitis with no insurance (was covered under Maryland Medicaid because I have no income and are living on an inheritance). Sent me 3 bills... 2 were marked 'paid in full by MediCaid'... the other was marked "Not covered by insurance" but the insurance they tried to bill it to was the insurance I had another 18 months beforehand and dropped because it was too expensive to keep. When I called them back, they tried that "I'd given them no information for billing!" and I called them out on it, reminding them that I had been working with a social worker based in the hospital in question who I had given my home address, my e-mail address, my cell phone number, and even the names/numbers of 3 relatives. They changed their tune real quick and rebilled the service to MediCaid and I ended up only having to pay 30 dollars for that service.
For me the scariest thing is. Apparently they can send you straight to collections, and if a lawyer can't find a remedy what hope do the rest of us have? I hope your credit score never notices.
More and more of us are tired of this system and just don't care. Home ownership is out of the question for years to come, and I can buy any used vehicle cash. I don't need credit for anything other then high income jobs extremely rarely and services like internet that don't really care regardless of score. I can't think of a single time I have used my credit in my 25 years of life. I luckily have a grandfather who has loaned me 3k for a car down payment once. I guess that one I would have used credit for MAYBE. Anyway, my point is I don't care and they can send what ever they want to collections. They can't even call me lol. I don't have a phone number by choice. My job uses messenger. I'm sure many MANY people like me also wouldn't even notice for years if they had something outstanding.
@@FeedMeSalt I agree. After a death of a near relative, I asked the hospital to consolidate the bills, so I wouldn't have to write five different checks for bills from each stay. I was paying the hospital 500 a month, plus paying several doctors. The hospital said sure, so I wrote one check, included all the different bills in the envelope and sent it off. The next month they sent two of the bills to collections. I told the collection agency, no dice, I'm not paying you. I would have paid off the hospital, but not after they sent the bills to collections, so they just lost out. It's been over twenty years, and my credit is great. But I remember telling the collection agency do your worst. I already had a car, credit cards, and a house. Didn't need credit.
@@TheKatyMadison I'm of the same sentiment as you and the previous commenter. However, the ushering in of social credit scoring is going to start adjusting our price on things depending on our credit. That's what I fear this issue is. A see what we can get from this guy type billing
Who has to pay to go to the doctors. Only one G30 nation that doesn’t have universal healthcare. The wealthiest most powerful country in the history of the world. Can’t figure out how to tax the wealthy so you can have universal healthcare. One time I had to pay for parking. It was $7. That’s the most I’ve ever paid
@gcanada3005 the other countries that have the insurance you are referring to pay for those services largely on middle class to foot the bill. NOT the wealthy.
One tip for dealing with a vertigo attack is to sit in a corner, so you can feel the floor and two walls (3 different planes at 90 degrees from each other). Your proprioception will then help your brain resolve the difference in signals from your eyes and ears, and can still help if even you close your eyes. Hopefully you won't need to use this trick, but I wanted to put it out there for anyone who might find it useful.
This beats when I went to a hospital for a simple stress test when I turned 50. I asked how much it costs. "Oh, we 'd have no way of knowing that." How many of these do you do? "Hundreds a year." Yet you can't tell me? "No idea." YET - ten minutes after, they had an (inflated) itemized bill printing out.
The US health system always leaves me scratching my head. It reminds me of websites that want to sell you something but will not tell you until you have ordered it and clicked pay.
Always get an itemized bill. Tell those debt collectors you are officially challenging your bill and they are not allowed to report to the credit agencies while you are disputing the bill.
This actually is more common than a lot of people realize. My neighbors do Medical Billing and Coding from their home office, and they have at least two medical facilities that they do billing for that have zero bookeeping ability in their office - which just blows my mind. BTW - I had an incident with a small urgent care facility several years ago that was almost exactly the same scenario as this!
I concur with you, having worked at an HCA facility billing office and see this very often. one of the causes is it needs to be coded by a medical coder for the billing department to apply the charge.
Did medical billing for 29 yrs. Before practices went to Electronic Medical Records, this was not nearly as much of an issue.The Dr marked the paper with what was done, and you paid either your copay or deductible, or just cash if no insurance. But you have to understand that every single thing they do has a procedure code, and that code is what determines the $ (both what they charge and what insurance "allows"). With Electronic Medical Records, they can't tell you those amounts bc the system generates everything. Also, if you need an MRI, CT Scan, etc... always ask for the "cash price" if you have a high deductible. In our cases, we would have had to pay almost 3x more than the "cash price" was if we had it go through insurance. It all sucks for sure!
Once suffered from ( and had been diagnosed with vertigo). Was with my wife in Walmart when an episode hit. Managed to get outside door and was leaning on their trash bin while I asked my wife to bring the car. Lady comes by and asks if I need help. I explained the situation and that I was waiting for my car. She apparently went inside and told a manager that there was a drunk outside leaning on their trash bin. Two guys came out and tried to forcibly drag me inside out of sight of incoming customers. Luckily my wife arrived with my car.
My local emergency room is like that. Not only that, but when I asked for an itemized bill they said they didn't do that. When I finally got one I found they charged for many things I didn't get or they didn't do. They have a standard ER bill and only add things to it but never subtract what they don't use. The time spent with the billing department was time-consuming and very frustrating and didn't end until I told her to go get all the things they were billing me for that I didn't get.
Yes, just like when you are treated by the E.R. or admitted and they supply you will a drinking cup...it comes in a package of maybe 15 items that satisfy all sorts of stays or examinations except for the one you are there for and the patient is paying for things never needed nor used except for one item, the drink cup. Very draconian.
I'm a retired Marine, retired in 97, and have "free medical care for life" given my twenty plus years of service. I've dealt with this same idea for almost thirty years, even though I've only had to actually pay when I've gotten service that isn't covered by my "tricare for life" medical coverage that has morphed into "medicare" because government wants everyone to be under their umbrella so they have complete control of our health "services". I've watched this "arrive" over the past thirty years since retirement. I often got told, "we don't know" even when there isn't supposed to be any possible charge. I've had multiple sclerosis since my "classified experimental anthrax vaccine" going to the gulf in 89, and been in various shot and infusion therapies for thirty plus years. "Multiple sclerosis" is a description of the neurological injuries, not a description of the cause of the damage, still "unknown".
Hate to tell you but they know exactly what caused your issue and will not tell you. Look up squalene. It is a vaccine enhancing drug only approved for animals but they used it in humans for that experiment. You likely had a very high fever for many days.
I've never been to an urgent care, but when receiving medical services, the cost has ALWAYS been a mystery. Sometimes I don't know for 9-10 months how much a medical service cost.
@@tekkigizmo they precisely know how much they charge to non covered patient. They take what treatment costs and multiply it by the insurance discount. Because that is important: The guy working at the insurance needs to negotiate large discounts and the hospital needs to operate. So to offer huge discounts, the hospital just inflates the base cost.
My son had emergency surgery at an in-network hospital with in network doctors and I was still getting bills for over two years. Nobody at the hospital or my insurance company could tell me how much I owed or when the bills would stop.
Hey Steve love the video. I had a local Dr. office turn in about 15 different bills to collection. They never sent me a total bill of what I owed. It was for several visits. All of those collection bills hit my credit. I had signed up for Credit Karma and I disputed all of those bills. They were all removed. The best part is All of those bills never got paid!
I went for a regular check-up (required so I didn't have to pay a surcharge on my insurance. or better - so I got a discount) in September last year, everything except one blood test was covered. I finally got the bill from my provider last week. Yes, April 11 the following year - SIX MONTHS LATER! New York has a law on the books that requires medical facilities to provide a schedule of costs if requested.
If you had said "no, I don't have insurance" they would have sent you a bill that you could have paid. The health system is MESSED UP!! How much they charge depends more on who is paying than what they did for you.
I've lived in places in which our uninsured bill was not discounted, but very high because we had to make up for Medicaid underpayments. Much of the population were on Medicaid, and that ended up keeping the system on the edge of bankruptcy.
My wife went through something similar. Called the Dr every couple weeks for several months trying to get a bill so she could pay it and they kept telling her to wait. Then they sent her to collections. When she complained they had the nerve to tell her she should have called! She's had detailed records of each call, who she spoke with etc and let them have it.
Steve!! About 8 years ago I had the same symptoms you described, maybe even worse. After 5 days in the hospital the final verdict was "maybe?" I had Vertigo! If so Vertigo has to be the most painful miserable health issue I have ever had! I couldnt even open my eyes or move without getting nauseas. I had nothing left to throw up! I was lying on the filthy floor in the ER waiting room because they didnt have a room and I could even set up in a chair. Pretty sure folks thought I was a junkie that need a fix! I was in the hospital for 5 days!
I went to urgent care once, it's called A&E where I live. It was the middle of the night and I was 3 sheets to the wind, they opened the eye department for me and proceeded to remove a piece of metal from my eye, Doc wondered if I needed anaesthetic considering how much I'd had to drink but he numbed my eye removed the metal and I was good to go with an eye patch "Thanks Doc" All on the NHS no charge.
@@johnp139 Between £1,600-£2,800 that's about $1,924-$3,472 per year if I was working, but remember I don't need to worry about whether someone or somewhere is in network, whether my insurance covers this procedure, I don't have out of pocket expenses, or co-pays or deductibles, I don't have an insurance excess, I don't need to shop around every year to get the best deal or rely on my employer for healthcare especially if I'm unable to work for an extended period, and it doesn't matter if I'm in work or out of work I still get the same cover and if I'm not working for some reason I'm still covered. If I need an ambulance or air ambulance I'm still covered.
NHS is having issues right now with a Nurses strike this week and months long waits for a max 5 minute visit with a GP. Seems that you can only get decent medical attention at an A&E (ER in the US). GMB (ITV) had a long story about that yesterday.
Steve I had Vertigo a few months back and it was one of the worst experiences I ever had. I spent over 24 hours in the hospital so they could make sure I wasn't having a stroke. I could only lay in a bed on my left side the entire time until it passed. If I even slightly moved my head in any other direction I would immediately get sick. I feel for ya dude
Hey Steve the Affordable Care Act does have a section 45 CFR §180.50 that requires all "hospitals" (not sure what the act defines as hospital) to have transparency in common procedures cost. My local hospital has it but they have it well hidden on their website. I have good google-fu abilities so I was able to find it but I bet most people can't. I have noticed they don't follow it unless you call them out then they will adjust your bill to their published prices. So just everyone be aware that those price list went into effect a year or two ago so if your hospital doesn't have it turn them in. My reading doesn't show much teeth to that part of the law but it might make for some interesting discussion with their billing people. It sounds like they might use Athena Net for the practice management as I think they do this kind of thing.
The problem with their "published price list" is that is the maximum they can charge non-insured, non-Medicare/Medicaid patients. Each insurance company has different "allowable charges" for each billing code and each provider. Medicare/Medicaid have completely different allowable charges that even vary within a state. (They can charge different amounts in NYC and Poughkeepsie from the same provider) Another issue is billing procedures. Say you break your finger and go to get it splinted. The provider will bill for "finger splitting, one each," then bill for the doctor or PA who splinted it as they may be working for a different company 9n contract. Then if they took an x-ray, they bill you separately for that. Also, they bill you for the person in Australia who read the x-ray because it was the middle of the night in Poughkeepsie and no one was on-site to read it. It can get even worse for Medicare/Medicaid as some providers have Medicare billing agents who bill for the "finger splitting, one each" and, if successfully paid, will go back and bill for each item used in the splint kit to see if they can squeeze a bit more money out of the system. I have frequently said that "if I ever turn to the dark side, it would be Medicare/Medicaid fraud!"
Yes the negotiated rates with insurances companies will always be lower (45-60%)-yes that low- than cash pay rates- which further places uninsured & underinsured individuals into debt. The system is designed to be complex and exasperating. Also very few states have recently begun placing caps on the finance charges (apr) and fees additionally added.
One thing for sure that is needed in the definitions sections is the meaning of "tranparency" just so that everyone understands what and who that applies to.
Whenever I hear about medical health care and insurance, I tell about my motorized wheelchair. On the open market my chair costs $15,000. Because of insurance that same chair costs $60,000. 4x as much because it was a prescribed durable medical device.
Back in the day... 80's? 90's? it was cheaper to pay cash, they'd give you 50% off for the "administration" savings. Then I just filled out the insurance form and get reimbursed! This is back when "master medical" was the standard... Medical debts are not part of your credit report.
There is actually a simple maneuver (epley maneuver) that can treat vertigo by moving around the liquids and possibly small objects in the ear from pressing against the sensitive elements that help with proprioception (the sense of movement and position). An ER Doctor can usually easily preform the maneuver. It does depend on what type of vertigo you have though.
When my second child was born I asked about payment and was told that someone would talk to me before we left the hospital. When we were leaving I asked again and was told I would be billed. Called multiple times over the first few months and was told I would get a bill. Six years later I was sued by the hospital for not paying them.
For what it’s worth I went through that. went to the ED and they diagnosed vertigo. Found out several years later it was actually a stroke. Please Make sure you get an MRI to be safe.
Yes, definitely. My nephew, who we thought was perfectly healthy, had two strokes close together. He's in his early 50,s. He survived, but is permanently disabled now.
I have had similar experiences with immediate care, however, they did bill me and I was able to pay without issue. I had bought a house to move for a steal and got injured a few times in thr dismantling of it... Mainly stitches, a bad burn, foreign object in the eye, and a crush injury.. I am so grateful for the clinic I went to that they will have my business for all future immediate care. On my last visit they just said "hi Jeff, what did you do this time..." It was cheaper than my normal doc office and way cheaper than the ER...
Lol! My wife's friend's husband hurt himself so many times redoing their house the local er staff knows him by name. They joke they will rename the place after him. After he sliced open his leg with a chainsaw (he's a combo of clumsy and no common sense) he finally decided to let pros handle the more challenging aspects of the work.
@@jplum7708 I was on a timeline. The owner who was selling me the house gave me 30 days to prep the house for the move from his property to mine. Our contact stipulated that if not completed he could at his discretion have the house bulldozed and I would only get a portion of my payment in return. It was a $400k house I got for $30k plus moving costs of $45k.... I couldn't fail, too little time...
Sadly, this is pretty common because the final cost is only determined after your insurance company has negotiated with the care facility. Totally unique, worldwide, if I'm not mistaken. Luckily I always know exactly how much to pay each time for my medical care; zero. Which is nice, not gonna lie. And I pay it gladly, with a smile on my face!
Yes. If a client uses insurance, it is hard for me to tell you what your cost will be for that first visit. Now, I can tell you what my self pay rate is, but if you pay that then I will own you money afterwards. I'd rather not collect and then give back. So I say, I am waiting on insurance. But I would never send something straight to collections.
Usually, the "negotiated amount" applies even when you (the patient) is paying through your deductible. I.e. if they submit it to insurance for $500 and insurance says "no, you can only charge $200 for that", that applies whether insurance is paying it, or if you are. And if they charge you the higher amount anyway, they can get in trouble with the insurance company.
Sometimes accounting has to do the books a couple times because the finance department needs to figure out how many additional charges for random services need to be added to your bill in order to remain on target with the money they need to make.
Happy Friday, Steve! I have bouts of vertigo, usually situational. For instance, I can't work under my car - I like to change their oil, etc, but going under the car, flat on my back, gives me vertigo to the point of nausea. I need a garage with a lift.
Welcome to the US medical system. It’s completely broken, but a lot of people make a pile of money from the system “working” the way it does. So don’t expect it to change soon. The most common problem with medical billing is when their Random Number Generator goes down. You can’t generate a bill without a Random Number …
Don’t pay them anything until you get a letter from your insurance indicating how much they pay, zero perhaps, and you owe 229.00. Then wait for the bill on paper from the mail. If they match send them a check or go online and pay them. If their bill doesn’t match the insurance amount, call the insurance and have them dispute the bill… don’t pay them anything until the bill matches the insurance amount.
Insurance doesn't dispute the bill for you. But you don't have to pay more than the EOB. If they are in network then they are free to bill the insurance any amount they want. Even a billion gazillion dollars, but the insurance will just reduce the amount to the contracted price. Like you said they can bill you a different account than what the insurance allowed. In that case you can dispute it and go to court if they hurt your credit history. I'm not advocating for the system we have now, but it can be profitable for those that have the means.
He's right. They have negotiated rates with the various insurance companies. They bill something crazy. Insurance tells them how much they have to pay and the rest they are contractually obligated to waive. What your probably seeing is a ride to get you to pay the whole amount before it gets submitted to insurance. Then they can pretend it was a mistake.
@@Omego2K it might be, but honestly, if that was what they asked for before having it reduced by the insurance company, it's quite possibly too high. I've rarely seen a medical bill that didn't ask for some amount larger than insurance will pay.
Unfortunately, on occasion, I’ve had vertigo and has the same symptoms you referred to. Felt like the whole room was spinning at times. Nausea, throwing up, etc. In my case, I just went downstairs to bed, lay down and just close my eyes as best as I could, and just laid still. It put me out of commission for about 2 to 3 days before I completely recovered. Admittedly, I probably should’ve went to the doctor/hospital but I didn’t. It’s been over a year now since I’ve had that attack.
Hi Steve. You're not alone in your plight. Many small hospitals and clinics do not do the billing themselves.They usually have a billing agency do that for them. I was surprised that this occurred within a matter of a few weeks. Most of the time it takes months if not longer just for you to receive the bill, let alone be sent to a billing agency. A couple of times, my wife who is a nurse at a rural hospital, has had a couple of bills sent to collections, one, because they took their time trying to figure out why she was charges the full amount and two, the never sent anything to the insurance company. We have had on several occasions not been billed for over a year. Go figure.
The wonders of private health care. I had similar issues with dizziness in the morning, so I decided to see a doctor the following day. At about 5AM I woke up with a buzzing in my ear, and I drove to Accident and Emergency in a panic, I felt fine apart from the buzzing. After a few attempts, the doctor removed the insect from my ear, I phoned work to explain the situation and that I might be late, and carried on with my day. There was no charge for this treatment. The higher tax I pay is much less than the cost of private insurance, especially when they use debt collection agencies.
Steve, Imagine being told by your health insurance company (high deductable plan) that its covered, and 2 months later getting a collection call telling you to pay 10k!!!! NEVER receiving a statement prior with the balance due.
I don't know if this will be of help, but if you're still suffering from vertigo still, have you looked up an exercise called "The Epley Maneuver"? It's basically a means to "reset" the otoliths in your ear canals. Those are the little "stones" in your ear that help you with balance.
I had a $58 medical bill haunt me for 4yrs that no one would accept payment on or knew what it was for but kept sending me to the next billing company then another etc.....our medical/insurance system is just completely stupid
My wife had several vertigo issues. Finally found the right doc. It was a sodium issue. As long as she stay at about 1500mg or less(prefer less) she has no issues. 2-3 days of 2000 or more she gets vertigo.
Totally understand your frustration. The reason they don't know, as I understand it, is that there is no, uniform, standard rate for providing medical services. What they charge depends on where you are, what insurance you have, whether the services were in or out of network, and something called the charge master- which can vary from hospital to hospital. And yes, again AFAIK, this is all perfectly legal- but it has drawn the attention of federal and state legislators and some have passed laws against "surprise billing." Two people receiving the exact same treatment, for the exact same problem, performed at the exact same hospital can (and have) received wildly differing bills depending on the factors I listed previoiusly. The only reason I know this stuff at all is because my sister and I had to take care of our parents (now deceased) so I had to learn it in self defense.
Something it seems that's being ignored here is that stuff which happens after the fact (such as lab tests) will often have unknown total costs until they're done, well after your visit. So, the lack of proper billing by them is a giant screwup (which I've gone through before myself), but the lack of clarity on cost does make sense due to the timeline and external services which may be involved.
Ive been doing medical billing for almost 20 years. This video absolutely cracked me up! Sorry you had the misfortune to get sick in the USA, Steve. The whole system is horribly screwed
Hey Steve. I have worked in medical care for 30 years and one thing I do know is that ICD-10 codes needs to be determined for accurate billing for medical services. I worked for the last several years in LTC coding for Medicare and Medicaid/other insurances billing. This involves reading the “doctor” notes and determining any diagnoses/procedures that were provided. So it takes at least as long as getting those notes to determine the correct coding. Over the years, this coding has gotten more complicated and there are persons certified for this service to the providers. I suspect the coder may be a third party(some work at home) or at least is not in the same building. Glad your feeling better! We love your sow and watch all the time Gail and Greg in Missoula Montana 😸
I had a similar experience with a provider. They were the insurance and the provider. They took a copay and said nothing of a deductible. I got a bill a month later and didn't understand. They said there wasn't any way to know. They setup a 90 day payment plan and I forgot about it having never received a statement or instructions to pay. 45 days later I got a collections call. I told them that happened and informed them I never received the payment info. They apologized and I called the provider directly. Then called the collector and provided them the confirmation number. They made note of it. Later I got a call from them informing me they had seen a pattern of this behavior from the health provider and were no longer going to be collecting on their behalf. 😂
Had pneumonia one year, went to urgent care. They kept me waiting four HOURS. My son was coughing with bronchitus next to me. I complained repeatedly that I'd been there so long but didn't want to leave because someone MIGHT help. Now, I understand more urgent cases coming in but that length of time was ridiculous. They made me PROMISE to come back (I didn't) because they felt there was more there that they thought they saw. I got my meds for both myself and my son. I NEVER got a bill.
I've worked as a programmer of hospital billing for years, so I can shed a little light on this matter. Typically hospital services are rendered into invoices by a job that runs monthly. HOWEVER in a good system, there's always a way to perform billing on the spot and finalize the bill, once the case is closed (i.e. upon patient's release). This hospital seems to have a broken system in place.
Quite a few years ago, we got a notification from our insurance company that they were denying coverage for lab tests from (Hospital) Laboratory. Unusual for our insurance, but the amount was small enough it wasn't worth it to argue about it. So we paid it. Awhile later, we got a notice that the insurance company had gotten a bill from (Hospital Initials) Laboratory Services- same date, same tests. And this time, the insurance is going to pay it! So we called our insurance company to alert them to the fraud. It took some talking to explain that we were asking them to NOT pay a bill. One CSR said "No one has ever asked that before." Never got info on how they dealt with the crooked hospital.
Steve, I’ve been a nurse for 27 years. Of course I’ve been a patient more than I can count. What you said was totally correct by the way. In health care the charges are inconsistent across the board. They can and do make up their own charges. Their goal is to get as much as they possibly can. Often times urgent cares have a nurse practitioner or PA. A doctor never sees you but you pay for a doctor in your bill because they review your chart or are consulted. Most often they have a contracted doctor that oversees the care but never sees patients. They can give you estimates and take copays but that’s about it. The healthcare providers will not finish with your chart until sometime later. That’s when billing will determine the charges based on the codes. Even if your insurance would have paid you still might have had to pay out of pocket for charges your insurance will not pay because it was 1 not covered or 2 the provider is out-of-network. Facilities often did that with me and I had to pay way more than what my insurance paid. You can argue all day long but they will just turn you over to collections. One of my biggest gripes is billing in healthcare but only in America. For example, there was a car accident along a highway near the hospital I was working with (I’m an ER nurse). The vehicle sustained minor damage with no intrusion (meaning the interior of the car was intact with nothing pushed inside such as an engine) and the occupants had no sign of injury and tried to refuse medical care at the scene. But because of the nature of the accident the emergency personnel felt it would be necessary to transport them to our facility for evaluation. Out of the 3 occupants of the vehicle only 1 finally consented to be transported by ambulance the others said that they would go by private car. The ambulance notified us of one patient they were carrying and because the accident occurred at 70mph a high rate of speed trauma activation was made. Anything over 25 mph goes into a list to determine trauma activation. A list mind you, not singular. Because the activated trauma we had to call in a limited trauma team. Surgeon, lab, x-ray tech, of course the ER team. The patient arrives we evaluate her and in 5 minutes she is discharged. Both the ER doctor and surgeon agreed they could go on their way but if anything changes can come back to the ER. The patient received a bill for almost $20,000. Almost $15,000 which was for trauma activation. You can research this and find this is common practice. Absurd right. Of course the ladies insurance covered the bill but she came back to the hospital to complain. Some hospitals charge more for trauma activation than that depending on the level of activation. Thankfully this was limited trauma activation and not a full trauma activation. Just food for thought about our healthcare system in the US.
Yep! I have had that happen to me more than once. One time I had insurance but a very high deductible - I wanted some blood work done but I wanted to know the cost first. I was told they had no way to tell me the cost. I was told to have the lab work done then it would be sent to my insurance and after that I would be billed. More or less the same as you went through. In my case I wanted the lab work done for my own curiosity. In the end, I did NOT have the labs done since I had no idea what the cost might be. I am currently living in the Philippines. I have had lab work done here. It is VERY reasonable and you are given the price before the lab work is done. Philippines vs USA.... Crazy, ha.
Ok as a mechanic I'm now the car doctor I cannot tell you how much for the brakes and shocks, but you'll be billed later. Thank you for your business. Sincerely medical mechanic.
I was in a car accident that gave me what ended up being severe chronic whiplash. I have these muscle groups firing underneath my right scapula that cause constant tightness in my shoulder area and neck area causing constant pain. I was referred to a doctor that could measure these muscle firings and possibly prescribe a cure. Contacted the hospital to make sure that these tests would be covered under insurance. I contacted them twice with the same question. They said it was no problem it would be covered by insurance. The first time I contacted them I asked if they were sure. They said it was okay to go. I had my reservations. So I contacted them a second time to make sure. They said that it was all good to go. I went in to have my first reading done on my muscle grouping... I informed the person putting the electrodes on that they were in the wrong area. I tried to guide them to the right area but they insisted that they were correct in their placement. The test result came back with normal muscle action. I insisted on a second test with a different person and they placed the electrodes in the correct place revealing that the muscle grouping was indeed firing abnormally at a high rate. Causing my spasms and neck pain. When they filed with insurance, my insurance denied it because it was not covered. Mother fucker I asked you to check if it was covered.. and you didn't do it. I ended up paying $1,100 out of pocket for someone to tell me something I already knew. And they had no inkling of what to do about the pain. 15 years later I am still living with the pain. Constant headaches. There are times in which the muscles in my scapula are so tight that even heat from a heating pad and a "therocane" device massaging the muscles doesn't help. I just end up taking fistfuls of muscle relaxant and a washing them down with a bit of alcoholic drink just so I can sleep at night without being woken up with the pain. There was a lawsuit. There was payment. But it will never replace The lifelong pain that I will endure until my death. I just want the pain to be over. Preferably sooner than later.
I have found that it is better to go to a hospital er than to go to an urgent care. Had the same thing happen to me in Indiana only I got billed for a CT scan from the urgent care and they don’t even have a CT machine.
It is crazy to me that this is the first time you have had to go through this. I had the same exact problem more than 20 years ago. It is insane to have no idea what you're getting into with health care. I once went into an emergency room on a Sunday because I had a tick in the middle of my back that I couldn't reach when I was traveling, I could not find an open urgent care. I asked the hospital how much it would cost because I could only afford a couple hundred bucks, and they said don't worry about it. We're here to help people. It shouldn't be more than $250. Months later I got a $1,500 bill.
Hate to say it, but that's fairly common. Billing in the medical industry is not standardized. The cost of services rendered is not the same for everyone. If you are with Insurance company A on plan 23, you pay a different amount for the same services than someone with insurance company C on plan 51. If you're uninsured, then you get the base rate, which is usually inflated in order to give insurance companies "discounts". However, that's not always the case. Sometimes, uninsured people pay less than insured people due to the negotiated prices specific to various insurance plans. Then, throw in variables: just because your insurance claims to cover it doesn't mean it'll be approved. They don't know in advance what the insurance company will approve and what it won't. For that matter, it could get denied due to a paperwork error, but it costs the medical facility too much to fight it, so they instead bill you the extra and let you battle it out with your insurance company.
Frustrating, isn't it? I have been dealing with this now for years. Makes my blood pressure go through the roof, and then I have to go through it again after being treated for high blood pressure.
Almost as bizarre as the $120 bill I got for speaking with a doc for almost exactly 5 minutes over the phone. He ordered some tests while chatting and send me the lab order, all during that time.
Where I live there are NO Doctors in ANY Urgent Care clinics.. however they DO have a list of services and cost. But, there are"add on" that they don't tell you.
That is crazy, my experience with my last medical treatment, was quite different. The last time I received medical treatment was about 13 years ago, and I went to an Urgent Care type facility and got 22 stitches in my scalp. Before they started, I requested, and they gave me an approximate price, and then upon completion I paid $300 for the entire process. Overall I was pretty pleased with the entire process. I figured it probably would have cost me several thousand if I'd gone to the emergency room.
Ugh. I'm a physician and work in an urgent care. There is so much wrong with our system. We have plenty of people with high deductible plans who choose to play cash. And I can tell you exactly how much it will cost if you're paying cash. Our system is burning to the ground, but not fast enough.
Good rant. Yes, I have been there when they screw-up and decline my insurance or failed to charge my insurance (They were not sure) and sent us an $8,000+ bill. Thank goodness my UNION Healthcare Trust took care of contacting the various billing businesses once I spoke with them and reduced it to about $1,600.
I believe they wait to see what kind of limit to the charges are imposed by the insurer. Even if the deductable is not met many companies have worked out charge limits. These are leveraged by the size of the company. Between the insurers, state an federal regulations, doctors are having hard time not drowning paper work. Everyone knows the medical field needs to be regulated , but the added amount of paper work and dumb regulations make it difficult. As to no doctor they are probably only using a nurse practitioner or physicians assistant to make more money. Depends on Michigan's laws on whether an MD needs to be present.
I used to be a maintenance supervisor for a company that had 25 locations. We were on national account for our lubricating oils. I ordered the oil from our local distributor, they delivered the oil with no idea how much we were paying. A week or so I'd get a bill from the oil company for my oil and pay it. The distributor explained they sent the oil company a statement of what they delivered to the oil company, the oil company would bill us and send the distributor money for the oil and a commission. I'd order the oil with no idea how much it was and the business who delivered it had no idea what I was paying.
The urgent care I went to recently made me give like a hundred dollar deposit before they would even see me. Complete opposite. This country has become so bizarre it blows my mind.
I was told it was based on the negotiated price with the different insurance companies. Even though I have a very high deductible, it depended upon my insurance company with the cost was for the service.
Two things, one, although it’s not the burden of your rant, look up Benign paroxysmal positional vertigo. It’s one of those, “it sucks to get old” things. My wife has it, and had a doctor perform the Epley Maneuever on her for it. She’s learned to do it for herself, and it sorts it out, every time. Number two, re: the insane ‘we don’t know how much you owe us” thing. It’s the insurance billing, of course. Who do you think funded all the backlash against Obamacare and any talk of socialized medicine? It’s the insurance companies, who have created such an arcane system that no one can follow what they are doing, and just how much money they are bilking us all out of. They do their best to scare the simple minded away from actually fixing the problem, which would mean taking control of the medical system away from them, and making the care more comprehensible to both the patients and the medical community itself.
GREAT. Just was at UrgentCare two weeks ago under similar circumstances...got crutches, a knee brace, and also had NO CLUE as to the cost. Now I wait...
My son did his back in really bad, in a lot of pain and couldn't walk upright, had to wait a few days for a MRI scan. After the doctors examined the scan, they used a computer controlled robot to inject into the nerve running next to the spinal cord. When I asked him how much, he said, nothing, bulk billed. We are in Australia.
11:38 There used to be a restaurant in the Upper Montclair, NJ area that sent the bill to you a few days layer, after they figured out how much the meal cost them to make.
I have had similar experience. Administrative medical cost have skyrocket. It went to collections. I told them “I think you have broken the law by sending this to collections.” It got resolved.
I really thought you as a lawyer would’ve loved this one. They have separate contracts with each insurance company saying that they will provide care according to the billing schedule of the insurance company provides. Now the insurance company does all the advertising and sends people to the “approved“ provider. And they agreed not to charge the individual more than or less than the exact amount on the billing schedule. And then both companies agree on the write off portion. I’m sure the consideration part of that contract Hass to do with making sure that there are people only go to the provider
Frontier screwed me years ago. I had their bundle deal with home phone and dish network. The home phone worked 10% of the time (we are in the country). Constantly would pick up the handset with no dial tone or anything. Useless. Called frontier and told them we no longer want the home phone and would continue to use dish network. They said no problem and they said I would receive one final bill from them and from then all future bills would come from dish network. Frontier bill came and I paid it. Dish network bills came and I paid them. Then 6 months later I get a notice from frontier that I had an outstanding bill and if not paid I would be sent to collections. I called them and they explained there was a small additional bill that came after the final billing cycle. So I paid it over the phone and they said no collection action would be taken. A month later a deliquent note was placed on my credit history from frontier. Called their management and they would do nothing about it. Contacted the credit reporting agencies and they made a case with frontier but they would not change it. Its off my credit at this point but I will never do business with frontier again.
I go to an Urgent Care that doubles as a Primary Care Doctor. It's my first doctor that I've seen on a regular basis besides grade school. I'm 27 years old; I got in a bad financial situation and filed Bankruptcy. My health insurance kicked back a pretty sizable bill, I of course had to include it in my Bankruptcy. They have refused to let me be seen by my Doctor. It's been 3 months, I can't even get my medication refilled. My attorney sent them a letter and they still insist I pay them. It's an absolute shame! Even today I'm pleading my case trying to be seen.
In Australia, we have a different way of treating people in need. A year ago, my shoulder was severely dislocated at my home. After calling 000 (your 911) the process started - all free. My problem has been trying to get them to charge my private health provider. Failure.
I recall an incident where a woman(?) went to a clinic/hospital/ER/care facility, checked in (told them she was there and why) was directed to the waiting room with everyone else, waited there for like 5-6 hours, then just got up and left. (Not sure if it was cause she felt better, or had things to do.) A few weeks later she got a bill in the mail for $500(?) from the facility. Even though she never saw anyone except the receptionist at the check in desk. Their explanation why she owed money? Well she may not have been "seen" by a nurse or doctor, but they were "told" why she was there, and they had triaged her as someone who could wait until after other more critical cases, and she need to pay for their time in deciding she could wait.
Imagine someone having to go through this who is young, not an attorney, working multiple part-time jobs and trying to care for kids at the same time.
The American healthcare system is built to extract money as it's first priority, not necessarily patient care ☹though it's understandable why people think it's the opposite.
@@Joe-- it's actually to determine a possible way to diagnose you for a lifelong subscription illness with several accompanying prescriptions. Chronic profit extraction triage.
Imagine being smart enough to understand that insurance companies have negotiated rates. It's literally only been like that for what, 50+ years?
@@mikezupancic2182 Irrelevant to the point that the US healthcare system is lacking compared to other developed countries. The problem is insurance US companies themselves in conjunction with the system.
@Joe until obamacare, the US health system was #1 in the workd in many categories of care, including cancer survival and even time to be seen by a doctor. Statistically you got seen quicker in the US than anywhere else in the world.
I went to a hospital once for a few stitches. I got 3 bills.
1. I got it and paid it
2. I got the bill, but it didn’t have my insurance attached. So it was higher than it would have been. I told them my insurance, the total was reduced by 90% and I paid my share
3. They didn’t have my address and sent it straight to debt collectors. When I asked the hospital, they blamed for not giving them any contact information. When I pointed out they got the other two bills to me just fine, they couldn’t give me an answer
They tried doing that to me about a year and a half ago when I had to go into the hospital for pancreatitis with no insurance (was covered under Maryland Medicaid because I have no income and are living on an inheritance).
Sent me 3 bills... 2 were marked 'paid in full by MediCaid'... the other was marked "Not covered by insurance" but the insurance they tried to bill it to was the insurance I had another 18 months beforehand and dropped because it was too expensive to keep.
When I called them back, they tried that "I'd given them no information for billing!" and I called them out on it, reminding them that I had been working with a social worker based in the hospital in question who I had given my home address, my e-mail address, my cell phone number, and even the names/numbers of 3 relatives.
They changed their tune real quick and rebilled the service to MediCaid and I ended up only having to pay 30 dollars for that service.
This is typical for hospitals. The left hand doesn't know what the right hand is doing.
For me the scariest thing is. Apparently they can send you straight to collections, and if a lawyer can't find a remedy what hope do the rest of us have?
I hope your credit score never notices.
Remedy: sue the collections reporting systems for libel. Bill went to collections without arriving; thing does not belong on credit history.
More and more of us are tired of this system and just don't care.
Home ownership is out of the question for years to come, and I can buy any used vehicle cash.
I don't need credit for anything other then high income jobs extremely rarely and services like internet that don't really care regardless of score.
I can't think of a single time I have used my credit in my 25 years of life.
I luckily have a grandfather who has loaned me 3k for a car down payment once. I guess that one I would have used credit for MAYBE.
Anyway, my point is I don't care and they can send what ever they want to collections. They can't even call me lol. I don't have a phone number by choice.
My job uses messenger.
I'm sure many MANY people like me also wouldn't even notice for years if they had something outstanding.
@@FeedMeSalt I agree. After a death of a near relative, I asked the hospital to consolidate the bills, so I wouldn't have to write five different checks for bills from each stay. I was paying the hospital 500 a month, plus paying several doctors. The hospital said sure, so I wrote one check, included all the different bills in the envelope and sent it off. The next month they sent two of the bills to collections. I told the collection agency, no dice, I'm not paying you. I would have paid off the hospital, but not after they sent the bills to collections, so they just lost out. It's been over twenty years, and my credit is great. But I remember telling the collection agency do your worst. I already had a car, credit cards, and a house. Didn't need credit.
@@TheKatyMadison I'm of the same sentiment as you and the previous commenter. However, the ushering in of social credit scoring is going to start adjusting our price on things depending on our credit. That's what I fear this issue is. A see what we can get from this guy type billing
You are in the correct vocation to have them all explain that to a judge.
I thought a federal law requires disclosure of prices up front. Am I wrong?
You should have gone in person to pay the bill whilst wearing your "I sue people for fun" shirt. Pretty sure they wouldn't over charge at that point.
He's one lawyer. They have dozens.
Who has to pay to go to the doctors. Only one G30 nation that doesn’t have universal healthcare. The wealthiest most powerful country in the history of the world. Can’t figure out how to tax the wealthy so you can have universal healthcare. One time I had to pay for parking. It was $7. That’s the most I’ve ever paid
@gcanada3005 the other countries that have the insurance you are referring to pay for those services largely on middle class to foot the bill. NOT the wealthy.
They don't know because the insurance company hasn't told them how much they can charge you yet.
One tip for dealing with a vertigo attack is to sit in a corner, so you can feel the floor and two walls (3 different planes at 90 degrees from each other). Your proprioception will then help your brain resolve the difference in signals from your eyes and ears, and can still help if even you close your eyes. Hopefully you won't need to use this trick, but I wanted to put it out there for anyone who might find it useful.
Drinking large amounts of hard liquor quickly gives me vertigo. That technique does not work.
This beats when I went to a hospital for a simple stress test when I turned 50. I asked how much it costs. "Oh, we 'd have no way of knowing that." How many of these do you do? "Hundreds a year." Yet you can't tell me? "No idea." YET - ten minutes after, they had an (inflated) itemized bill printing out.
The US health system always leaves me scratching my head. It reminds me of websites that want to sell you something but will not tell you until you have ordered it and clicked pay.
Always get an itemized bill. Tell those debt collectors you are officially challenging your bill and they are not allowed to report to the credit agencies while you are disputing the bill.
Best comment here! Perhaps when you insist on an itemized bill the total owing may decrease?
This actually is more common than a lot of people realize. My neighbors do Medical Billing and Coding from their home office, and they have at least two medical facilities that they do billing for that have zero bookeeping ability in their office - which just blows my mind. BTW - I had an incident with a small urgent care facility several years ago that was almost exactly the same scenario as this!
I concur with you, having worked at an HCA facility billing office and see this very often. one of the causes is it needs to be coded by a medical coder for the billing department to apply the charge.
Did medical billing for 29 yrs. Before practices went to Electronic Medical Records, this was not nearly as much of an issue.The Dr marked the paper with what was done, and you paid either your copay or deductible, or just cash if no insurance. But you have to understand that every single thing they do has a procedure code, and that code is what determines the $ (both what they charge and what insurance "allows"). With Electronic Medical Records, they can't tell you those amounts bc the system generates everything. Also, if you need an MRI, CT Scan, etc... always ask for the "cash price" if you have a high deductible. In our cases, we would have had to pay almost 3x more than the "cash price" was if we had it go through insurance. It all sucks for sure!
Sounds like the people who established medical coding are either stupid or were being malicious.
Once suffered from ( and had been diagnosed with vertigo). Was with my wife in Walmart when an episode hit. Managed to get outside door and was leaning on their trash bin while I asked my wife to bring the car. Lady comes by and asks if I need help. I explained the situation and that I was waiting for my car. She apparently went inside and told a manager that there was a drunk outside leaning on their trash bin. Two guys came out and tried to forcibly drag me inside out of sight of incoming customers. Luckily my wife arrived with my car.
My local emergency room is like that. Not only that, but when I asked for an itemized bill they said they didn't do that. When I finally got one I found they charged for many things I didn't get or they didn't do. They have a standard ER bill and only add things to it but never subtract what they don't use. The time spent with the billing department was time-consuming and very frustrating and didn't end until I told her to go get all the things they were billing me for that I didn't get.
Yes, just like when you are treated by the E.R. or admitted and they supply you will a drinking cup...it comes in a package of maybe 15 items that satisfy all sorts of stays or examinations except for the one you are there for and the patient is paying for things never needed nor used except for one item, the drink cup. Very draconian.
@@Garth2011 Yes. Also charged me for an IV which they brought in because I was "slightly dehydrated" which I refused. That was a huge amount.
I'm a retired Marine, retired in 97, and have "free medical care for life" given my twenty plus years of service. I've dealt with this same idea for almost thirty years, even though I've only had to actually pay when I've gotten service that isn't covered by my "tricare for life" medical coverage that has morphed into "medicare" because government wants everyone to be under their umbrella so they have complete control of our health "services". I've watched this "arrive" over the past thirty years since retirement. I often got told, "we don't know" even when there isn't supposed to be any possible charge. I've had multiple sclerosis since my "classified experimental anthrax vaccine" going to the gulf in 89, and been in various shot and infusion therapies for thirty plus years. "Multiple sclerosis" is a description of the neurological injuries, not a description of the cause of the damage, still "unknown".
Hate to tell you but they know exactly what caused your issue and will not tell you. Look up squalene. It is a vaccine enhancing drug only approved for animals but they used it in humans for that experiment. You likely had a very high fever for many days.
Uh Rah Marine -- Retired Squid here (20 yr, ret in 98) -- similar story, different day; Seen changes in VA but depends on region.
I've never been to an urgent care, but when receiving medical services, the cost has ALWAYS been a mystery. Sometimes I don't know for 9-10 months how much a medical service cost.
Yeah neither did they, they just threw numbers out there until something stuck.
@@tekkigizmo they precisely know how much they charge to non covered patient.
They take what treatment costs and multiply it by the insurance discount.
Because that is important: The guy working at the insurance needs to negotiate large discounts and the hospital needs to operate.
So to offer huge discounts, the hospital just inflates the base cost.
My son had emergency surgery at an in-network hospital with in network doctors and I was still getting bills for over two years. Nobody at the hospital or my insurance company could tell me how much I owed or when the bills would stop.
@@sarowie What a way to run a healthcare system.
@@PrinceAlberts Hope you and your son are doing well now..
Hey Steve love the video. I had a local Dr. office turn in about 15 different bills to collection. They never sent me a total bill of what I owed. It was for several visits. All of those collection bills hit my credit. I had signed up for Credit Karma and I disputed all of those bills. They were all removed. The best part is All of those bills never got paid!
I went for a regular check-up (required so I didn't have to pay a surcharge on my insurance. or better - so I got a discount) in September last year, everything except one blood test was covered. I finally got the bill from my provider last week. Yes, April 11 the following year - SIX MONTHS LATER!
New York has a law on the books that requires medical facilities to provide a schedule of costs if requested.
If you had said "no, I don't have insurance" they would have sent you a bill that you could have paid. The health system is MESSED UP!! How much they charge depends more on who is paying than what they did for you.
I've lived in places in which our uninsured bill was not discounted, but very high because we had to make up for Medicaid underpayments. Much of the population were on Medicaid, and that ended up keeping the system on the edge of bankruptcy.
Never heard Steve so nicely agitated. I like it!
Funny funny , my world is like yours some days! Have a better day as soon as you can!
Love your off the wall stories!
My wife went through something similar. Called the Dr every couple weeks for several months trying to get a bill so she could pay it and they kept telling her to wait. Then they sent her to collections. When she complained they had the nerve to tell her she should have called! She's had detailed records of each call, who she spoke with etc and let them have it.
This channel is a gem! I appreciate you sharing this with us!
Reminds me of "We have to pass the bill to find out what's in it."
Steve!! About 8 years ago I had the same symptoms you described, maybe even worse. After 5 days in the hospital the final verdict was "maybe?" I had Vertigo! If so Vertigo has to be the most painful miserable health issue I have ever had! I couldnt even open my eyes or move without getting nauseas. I had nothing left to throw up! I was lying on the filthy floor in the ER waiting room because they didnt have a room and I could even set up in a chair. Pretty sure folks thought I was a junkie that need a fix!
I was in the hospital for 5 days!
I went to urgent care once, it's called A&E where I live. It was the middle of the night and I was 3 sheets to the wind, they opened the eye department for me and proceeded to remove a piece of metal from my eye, Doc wondered if I needed anaesthetic considering how much I'd had to drink but he numbed my eye removed the metal and I was good to go with an eye patch "Thanks Doc" All on the NHS no charge.
How much have you paid in taxes for all of that?
@@johnp139 Between £1,600-£2,800 that's about $1,924-$3,472 per year if I was working, but remember I don't need to worry about whether someone or somewhere is in network, whether my insurance covers this procedure, I don't have out of pocket expenses, or co-pays or deductibles, I don't have an insurance excess, I don't need to shop around every year to get the best deal or rely on my employer for healthcare especially if I'm unable to work for an extended period, and it doesn't matter if I'm in work or out of work I still get the same cover and if I'm not working for some reason I'm still covered. If I need an ambulance or air ambulance I'm still covered.
NHS is having issues right now with a Nurses strike this week and months long waits for a max 5 minute visit with a GP. Seems that you can only get decent medical attention at an A&E (ER in the US). GMB (ITV) had a long story about that yesterday.
Steve I had Vertigo a few months back and it was one of the worst experiences I ever had. I spent over 24 hours in the hospital so they could make sure I wasn't having a stroke. I could only lay in a bed on my left side the entire time until it passed. If I even slightly moved my head in any other direction I would immediately get sick.
I feel for ya dude
Hey Steve the Affordable Care Act does have a section 45 CFR §180.50 that requires all "hospitals" (not sure what the act defines as hospital) to have transparency in common procedures cost. My local hospital has it but they have it well hidden on their website. I have good google-fu abilities so I was able to find it but I bet most people can't. I have noticed they don't follow it unless you call them out then they will adjust your bill to their published prices. So just everyone be aware that those price list went into effect a year or two ago so if your hospital doesn't have it turn them in. My reading doesn't show much teeth to that part of the law but it might make for some interesting discussion with their billing people. It sounds like they might use Athena Net for the practice management as I think they do this kind of thing.
The problem with their "published price list" is that is the maximum they can charge non-insured, non-Medicare/Medicaid patients. Each insurance company has different "allowable charges" for each billing code and each provider. Medicare/Medicaid have completely different allowable charges that even vary within a state. (They can charge different amounts in NYC and Poughkeepsie from the same provider)
Another issue is billing procedures. Say you break your finger and go to get it splinted. The provider will bill for "finger splitting, one each," then bill for the doctor or PA who splinted it as they may be working for a different company 9n contract. Then if they took an x-ray, they bill you separately for that. Also, they bill you for the person in Australia who read the x-ray because it was the middle of the night in Poughkeepsie and no one was on-site to read it.
It can get even worse for Medicare/Medicaid as some providers have Medicare billing agents who bill for the "finger splitting, one each" and, if successfully paid, will go back and bill for each item used in the splint kit to see if they can squeeze a bit more money out of the system.
I have frequently said that "if I ever turn to the dark side, it would be Medicare/Medicaid fraud!"
Yes the negotiated rates with insurances companies will always be lower (45-60%)-yes that low- than cash pay rates- which further places uninsured & underinsured individuals into debt. The system is designed to be complex and exasperating. Also very few states have recently begun placing caps on the finance charges (apr) and fees additionally added.
One thing for sure that is needed in the definitions sections is the meaning of "tranparency" just so that everyone understands what and who that applies to.
Whenever I hear about medical health care and insurance, I tell about my motorized wheelchair. On the open market my chair costs $15,000. Because of insurance that same chair costs $60,000. 4x as much because it was a prescribed durable medical device.
Back in the day... 80's? 90's? it was cheaper to pay cash, they'd give you 50% off for the "administration" savings. Then I just filled out the insurance form and get reimbursed! This is back when "master medical" was the standard...
Medical debts are not part of your credit report.
There is actually a simple maneuver (epley maneuver) that can treat vertigo by moving around the liquids and possibly small objects in the ear from pressing against the sensitive elements that help with proprioception (the sense of movement and position). An ER Doctor can usually easily preform the maneuver. It does depend on what type of vertigo you have though.
When my second child was born I asked about payment and was told that someone would talk to me before we left the hospital. When we were leaving I asked again and was told I would be billed. Called multiple times over the first few months and was told I would get a bill. Six years later I was sued by the hospital for not paying them.
For what it’s worth I went through that. went to the ED and they diagnosed vertigo. Found out several years later it was actually a stroke. Please Make sure you get an MRI to be safe.
Yes, definitely. My nephew, who we thought was perfectly healthy, had two strokes close together. He's in his early 50,s. He survived, but is permanently disabled now.
I have had similar experiences with immediate care, however, they did bill me and I was able to pay without issue. I had bought a house to move for a steal and got injured a few times in thr dismantling of it... Mainly stitches, a bad burn, foreign object in the eye, and a crush injury.. I am so grateful for the clinic I went to that they will have my business for all future immediate care. On my last visit they just said "hi Jeff, what did you do this time..." It was cheaper than my normal doc office and way cheaper than the ER...
Lol! My wife's friend's husband hurt himself so many times redoing their house the local er staff knows him by name. They joke they will rename the place after him. After he sliced open his leg with a chainsaw (he's a combo of clumsy and no common sense) he finally decided to let pros handle the more challenging aspects of the work.
@@jplum7708 I was on a timeline. The owner who was selling me the house gave me 30 days to prep the house for the move from his property to mine. Our contact stipulated that if not completed he could at his discretion have the house bulldozed and I would only get a portion of my payment in return. It was a $400k house I got for $30k plus moving costs of $45k.... I couldn't fail, too little time...
Sounds like you found an interesting deal. Glad you didn't have any major injuries and things worked out. I wish you well on your future endeavors.
Sadly, this is pretty common because the final cost is only determined after your insurance company has negotiated with the care facility. Totally unique, worldwide, if I'm not mistaken. Luckily I always know exactly how much to pay each time for my medical care; zero. Which is nice, not gonna lie. And I pay it gladly, with a smile on my face!
Yes. If a client uses insurance, it is hard for me to tell you what your cost will be for that first visit. Now, I can tell you what my self pay rate is, but if you pay that then I will own you money afterwards. I'd rather not collect and then give back. So I say, I am waiting on insurance. But I would never send something straight to collections.
The last time I went to an urgent care (eye injury), I had to pay for them to tell me that they could not treat me and that I should go to an ER.
Another complaint, instead of one itemized bill you can understand, you get 16 different bills for one visit with all kinds of random charges.
having vertigo is no picnic , glad you recovered so quickly
Usually, the "negotiated amount" applies even when you (the patient) is paying through your deductible. I.e. if they submit it to insurance for $500 and insurance says "no, you can only charge $200 for that", that applies whether insurance is paying it, or if you are. And if they charge you the higher amount anyway, they can get in trouble with the insurance company.
Sometimes accounting has to do the books a couple times because the finance department needs to figure out how many additional charges for random services need to be added to your bill in order to remain on target with the money they need to make.
Happy Friday, Steve! I have bouts of vertigo, usually situational. For instance, I can't work under my car - I like to change their oil, etc, but going under the car, flat on my back, gives me vertigo to the point of nausea. I need a garage with a lift.
Welcome to the US medical system. It’s completely broken, but a lot of people make a pile of money from the system “working” the way it does. So don’t expect it to change soon.
The most common problem with medical billing is when their Random Number Generator goes down. You can’t generate a bill without a Random Number …
Healthcare billing is a scam. Talk about adding stress to a sick person and making things worse. It gives me vertigo.
Don’t pay them anything until you get a letter from your insurance indicating how much they pay, zero perhaps, and you owe 229.00. Then wait for the bill on paper from the mail. If they match send them a check or go online and pay them. If their bill doesn’t match the insurance amount, call the insurance and have them dispute the bill… don’t pay them anything until the bill matches the insurance amount.
Insurance doesn't dispute the bill for you. But you don't have to pay more than the EOB. If they are in network then they are free to bill the insurance any amount they want. Even a billion gazillion dollars, but the insurance will just reduce the amount to the contracted price. Like you said they can bill you a different account than what the insurance allowed. In that case you can dispute it and go to court if they hurt your credit history. I'm not advocating for the system we have now, but it can be profitable for those that have the means.
He's right. They have negotiated rates with the various insurance companies. They bill something crazy. Insurance tells them how much they have to pay and the rest they are contractually obligated to waive. What your probably seeing is a ride to get you to pay the whole amount before it gets submitted to insurance. Then they can pretend it was a mistake.
@@michaelallen1432 229 bucks might be the right amount. That's actually small
@@Omego2K it might be, but honestly, if that was what they asked for before having it reduced by the insurance company, it's quite possibly too high. I've rarely seen a medical bill that didn't ask for some amount larger than insurance will pay.
@@michaelallen1432 either way it's ultra simple to double check the EOB online
"They bring out the paddles and zap me back to life...." 😊 Nice rant. Regards.
Unfortunately, on occasion, I’ve had vertigo and has the same symptoms you referred to. Felt like the whole room was spinning at times. Nausea, throwing up, etc. In my case, I just went downstairs to bed, lay down and just close my eyes as best as I could, and just laid still. It put me out of commission for about 2 to 3 days before I completely recovered. Admittedly, I probably should’ve went to the doctor/hospital but I didn’t. It’s been over a year now since I’ve had that attack.
Hi Steve. You're not alone in your plight. Many small hospitals and clinics do not do the billing themselves.They usually have a billing agency do that for them. I was surprised that this occurred within a matter of a few weeks. Most of the time it takes months if not longer just for you to receive the bill, let alone be sent to a billing agency. A couple of times, my wife who is a nurse at a rural hospital, has had a couple of bills sent to collections, one, because they took their time trying to figure out why she was charges the full amount and two, the never sent anything to the insurance company. We have had on several occasions not been billed for over a year. Go figure.
The wonders of private health care.
I had similar issues with dizziness in the morning, so I decided to see a doctor the following day.
At about 5AM I woke up with a buzzing in my ear, and I drove to Accident and Emergency in a panic, I felt fine apart from the buzzing.
After a few attempts, the doctor removed the insect from my ear, I phoned work to explain the situation and that I might be late, and carried on with my day.
There was no charge for this treatment.
The higher tax I pay is much less than the cost of private insurance, especially when they use debt collection agencies.
Steve, Imagine being told by your health insurance company (high deductable plan) that its covered, and 2 months later getting a collection call telling you to pay 10k!!!! NEVER receiving a statement prior with the balance due.
This has been my experience with many medical visits. I thought the clear pricing act was supposed to help with this.
I don't know if this will be of help, but if you're still suffering from vertigo still, have you looked up an exercise called "The Epley Maneuver"? It's basically a means to "reset" the otoliths in your ear canals. Those are the little "stones" in your ear that help you with balance.
I had a $58 medical bill haunt me for 4yrs that no one would accept payment on or knew what it was for but kept sending me to the next billing company then another etc.....our medical/insurance system is just completely stupid
My wife had several vertigo issues. Finally found the right doc. It was a sodium issue. As long as she stay at about 1500mg or less(prefer less) she has no issues. 2-3 days of 2000 or more she gets vertigo.
Totally understand your frustration. The reason they don't know, as I understand it, is that there is no, uniform, standard rate for providing medical services. What they charge depends on where you are, what insurance you have, whether the services were in or out of network, and something called the charge master- which can vary from hospital to hospital. And yes, again AFAIK, this is all perfectly legal- but it has drawn the attention of federal and state legislators and some have passed laws against "surprise billing." Two people receiving the exact same treatment, for the exact same problem, performed at the exact same hospital can (and have) received wildly differing bills depending on the factors I listed previoiusly. The only reason I know this stuff at all is because my sister and I had to take care of our parents (now deceased) so I had to learn it in self defense.
Something it seems that's being ignored here is that stuff which happens after the fact (such as lab tests) will often have unknown total costs until they're done, well after your visit. So, the lack of proper billing by them is a giant screwup (which I've gone through before myself), but the lack of clarity on cost does make sense due to the timeline and external services which may be involved.
Ive been doing medical billing for almost 20 years. This video absolutely cracked me up! Sorry you had the misfortune to get sick in the USA, Steve. The whole system is horribly screwed
Hey Steve. I have worked in medical care for 30 years and one thing I do know is that ICD-10 codes needs to be determined for accurate billing for medical services. I worked for the last several years in LTC coding for Medicare and Medicaid/other insurances billing. This involves reading the “doctor” notes and determining any diagnoses/procedures that were provided. So it takes at least as long as getting those notes to determine the correct coding. Over the years, this coding has gotten more complicated and there are persons certified for this service to the providers. I suspect the coder may be a third party(some work at home) or at least is not in the same building.
Glad your feeling better!
We love your sow and watch all the time
Gail and Greg in Missoula Montana 😸
Every time I’ve gone to an urgent care I have regretted it.
I've never been to one, and sure won't go now.
I had a similar experience with a provider. They were the insurance and the provider. They took a copay and said nothing of a deductible. I got a bill a month later and didn't understand. They said there wasn't any way to know. They setup a 90 day payment plan and I forgot about it having never received a statement or instructions to pay. 45 days later I got a collections call. I told them that happened and informed them I never received the payment info. They apologized and I called the provider directly. Then called the collector and provided them the confirmation number. They made note of it. Later I got a call from them informing me they had seen a pattern of this behavior from the health provider and were no longer going to be collecting on their behalf. 😂
That'll teach the provider to not double dip!
Had pneumonia one year, went to urgent care. They kept me waiting four HOURS. My son was coughing with bronchitus next to me. I complained repeatedly that I'd been there so long but didn't want to leave because someone MIGHT help. Now, I understand more urgent cases coming in but that length of time was ridiculous. They made me PROMISE to come back (I didn't) because they felt there was more there that they thought they saw. I got my meds for both myself and my son. I NEVER got a bill.
Our healthcare system at "work"! Yeah, it's fubar!
Oh the stories I could tell! 😆 [Chronic illness AND I worked in healthcare for years!]
I've worked as a programmer of hospital billing for years, so I can shed a little light on this matter.
Typically hospital services are rendered into invoices by a job that runs monthly.
HOWEVER in a good system, there's always a way to perform billing on the spot and finalize the bill, once the case is closed (i.e. upon patient's release).
This hospital seems to have a broken system in place.
Quite a few years ago, we got a notification from our insurance company that they were denying coverage for lab tests from (Hospital) Laboratory. Unusual for our insurance, but the amount was small enough it wasn't worth it to argue about it. So we paid it.
Awhile later, we got a notice that the insurance company had gotten a bill from (Hospital Initials) Laboratory Services- same date, same tests. And this time, the insurance is going to pay it! So we called our insurance company to alert them to the fraud. It took some talking to explain that we were asking them to NOT pay a bill. One CSR said "No one has ever asked that before." Never got info on how they dealt with the crooked hospital.
Glad you’re feeling better Steve
Steve, I’ve been a nurse for 27 years. Of course I’ve been a patient more than I can count. What you said was totally correct by the way. In health care the charges are inconsistent across the board. They can and do make up their own charges. Their goal is to get as much as they possibly can. Often times urgent cares have a nurse practitioner or PA. A doctor never sees you but you pay for a doctor in your bill because they review your chart or are consulted. Most often they have a contracted doctor that oversees the care but never sees patients. They can give you estimates and take copays but that’s about it. The healthcare providers will not finish with your chart until sometime later. That’s when billing will determine the charges based on the codes. Even if your insurance would have paid you still might have had to pay out of pocket for charges your insurance will not pay because it was 1 not covered or 2 the provider is out-of-network. Facilities often did that with me and I had to pay way more than what my insurance paid. You can argue all day long but they will just turn you over to collections. One of my biggest gripes is billing in healthcare but only in America. For example, there was a car accident along a highway near the hospital I was working with (I’m an ER nurse). The vehicle sustained minor damage with no intrusion (meaning the interior of the car was intact with nothing pushed inside such as an engine) and the occupants had no sign of injury and tried to refuse medical care at the scene. But because of the nature of the accident the emergency personnel felt it would be necessary to transport them to our facility for evaluation. Out of the 3 occupants of the vehicle only 1 finally consented to be transported by ambulance the others said that they would go by private car. The ambulance notified us of one patient they were carrying and because the accident occurred at 70mph a high rate of speed trauma activation was made. Anything over 25 mph goes into a list to determine trauma activation. A list mind you, not singular. Because the activated trauma we had to call in a limited trauma team. Surgeon, lab, x-ray tech, of course the ER team. The patient arrives we evaluate her and in 5 minutes she is discharged. Both the ER doctor and surgeon agreed they could go on their way but if anything changes can come back to the ER. The patient received a bill for almost $20,000. Almost $15,000 which was for trauma activation. You can research this and find this is common practice. Absurd right. Of course the ladies insurance covered the bill but she came back to the hospital to complain. Some hospitals charge more for trauma activation than that depending on the level of activation. Thankfully this was limited trauma activation and not a full trauma activation. Just food for thought about our healthcare system in the US.
Yep! I have had that happen to me more than once. One time I had insurance but a very high deductible - I wanted some blood work done but I wanted to know the cost first. I was told they had no way to tell me the cost. I was told to have the lab work done then it would be sent to my insurance and after that I would be billed. More or less the same as you went through. In my case I wanted the lab work done for my own curiosity. In the end, I did NOT have the labs done since I had no idea what the cost might be. I am currently living in the Philippines. I have had lab work done here. It is VERY reasonable and you are given the price before the lab work is done. Philippines vs USA.... Crazy, ha.
Ok as a mechanic I'm now the car doctor I cannot tell you how much for the brakes and shocks, but you'll be billed later. Thank you for your business. Sincerely medical mechanic.
I was in a car accident that gave me what ended up being severe chronic whiplash.
I have these muscle groups firing underneath my right scapula that cause constant tightness in my shoulder area and neck area causing constant pain.
I was referred to a doctor that could measure these muscle firings and possibly prescribe a cure.
Contacted the hospital to make sure that these tests would be covered under insurance. I contacted them twice with the same question. They said it was no problem it would be covered by insurance.
The first time I contacted them I asked if they were sure.
They said it was okay to go.
I had my reservations. So I contacted them a second time to make sure.
They said that it was all good to go.
I went in to have my first reading done on my muscle grouping... I informed the person putting the electrodes on that they were in the wrong area. I tried to guide them to the right area but they insisted that they were correct in their placement.
The test result came back with normal muscle action.
I insisted on a second test with a different person and they placed the electrodes in the correct place revealing that the muscle grouping was indeed firing abnormally at a high rate. Causing my spasms and neck pain.
When they filed with insurance, my insurance denied it because it was not covered. Mother fucker I asked you to check if it was covered.. and you didn't do it.
I ended up paying $1,100 out of pocket for someone to tell me something I already knew. And they had no inkling of what to do about the pain.
15 years later I am still living with the pain. Constant headaches. There are times in which the muscles in my scapula are so tight that even heat from a heating pad and a "therocane" device massaging the muscles doesn't help. I just end up taking fistfuls of muscle relaxant and a washing them down with a bit of alcoholic drink just so I can sleep at night without being woken up with the pain.
There was a lawsuit. There was payment. But it will never replace The lifelong pain that I will endure until my death.
I just want the pain to be over. Preferably sooner than later.
Thank you Federal Government and third party payer.
I have found that it is better to go to a hospital er than to go to an urgent care. Had the same thing happen to me in Indiana only I got billed for a CT scan from the urgent care and they don’t even have a CT machine.
I love to rant and rave. And as a corollary, I love those who also rant and rave. Keep 'em coming, Steve :)
It is crazy to me that this is the first time you have had to go through this. I had the same exact problem more than 20 years ago. It is insane to have no idea what you're getting into with health care. I once went into an emergency room on a Sunday because I had a tick in the middle of my back that I couldn't reach when I was traveling, I could not find an open urgent care. I asked the hospital how much it would cost because I could only afford a couple hundred bucks, and they said don't worry about it. We're here to help people. It shouldn't be more than $250. Months later I got a $1,500 bill.
Hate to say it, but that's fairly common. Billing in the medical industry is not standardized. The cost of services rendered is not the same for everyone. If you are with Insurance company A on plan 23, you pay a different amount for the same services than someone with insurance company C on plan 51. If you're uninsured, then you get the base rate, which is usually inflated in order to give insurance companies "discounts". However, that's not always the case. Sometimes, uninsured people pay less than insured people due to the negotiated prices specific to various insurance plans. Then, throw in variables: just because your insurance claims to cover it doesn't mean it'll be approved. They don't know in advance what the insurance company will approve and what it won't. For that matter, it could get denied due to a paperwork error, but it costs the medical facility too much to fight it, so they instead bill you the extra and let you battle it out with your insurance company.
Frustrating, isn't it? I have been dealing with this now for years. Makes my blood pressure go through the roof, and then I have to go through it again after being treated for high blood pressure.
Almost as bizarre as the $120 bill I got for speaking with a doc for almost exactly 5 minutes over the phone. He ordered some tests while chatting and send me the lab order, all during that time.
Where I live there are NO Doctors in ANY Urgent Care clinics.. however they DO have a list of services and cost. But, there are"add on" that they don't tell you.
."that would involve some kind of magic" along with hand gestures that rival Scotty Kilmer! Pure gold.😄
The gentleman tried to pay his bill manually. Interesting legal journey of a legal mind, documented.
That is crazy, my experience with my last medical treatment, was quite different. The last time I received medical treatment was about 13 years ago, and I went to an Urgent Care type facility and got 22 stitches in my scalp. Before they started, I requested, and they gave me an approximate price, and then upon completion I paid $300 for the entire process. Overall I was pretty pleased with the entire process. I figured it probably would have cost me several thousand if I'd gone to the emergency room.
Ugh. I'm a physician and work in an urgent care. There is so much wrong with our system. We have plenty of people with high deductible plans who choose to play cash. And I can tell you exactly how much it will cost if you're paying cash. Our system is burning to the ground, but not fast enough.
Btw, federal law now requires that medical facilities list their prices
Good rant. Yes, I have been there when they screw-up and decline my insurance or failed to charge my insurance (They were not sure) and sent us an $8,000+ bill. Thank goodness my UNION Healthcare Trust took care of contacting the various billing businesses once I spoke with them and reduced it to about $1,600.
I believe they wait to see what kind of limit to the charges are imposed by the insurer. Even if the deductable is not met many companies have worked out charge limits. These are leveraged by the size of the company. Between the insurers, state an federal regulations, doctors are having hard time not drowning paper work. Everyone knows the medical field needs to be regulated , but the added amount of paper work and dumb regulations make it difficult. As to no doctor they are probably only using a nurse practitioner or physicians assistant to make more money. Depends on Michigan's laws on whether an MD needs to be present.
I used to be a maintenance supervisor for a company that had 25 locations. We were on national account for our lubricating oils. I ordered the oil from our local distributor, they delivered the oil with no idea how much we were paying. A week or so I'd get a bill from the oil company for my oil and pay it. The distributor explained they sent the oil company a statement of what they delivered to the oil company, the oil company would bill us and send the distributor money for the oil and a commission. I'd order the oil with no idea how much it was and the business who delivered it had no idea what I was paying.
The urgent care I went to recently made me give like a hundred dollar deposit before they would even see me. Complete opposite. This country has become so bizarre it blows my mind.
I was told it was based on the negotiated price with the different insurance companies. Even though I have a very high deductible, it depended upon my insurance company with the cost was for the service.
Two things, one, although it’s not the burden of your rant, look up Benign paroxysmal positional vertigo. It’s one of those, “it sucks to get old” things. My wife has it, and had a doctor perform the Epley Maneuever on her for it. She’s learned to do it for herself, and it sorts it out, every time. Number two, re: the insane ‘we don’t know how much you owe us” thing. It’s the insurance billing, of course. Who do you think funded all the backlash against Obamacare and any talk of socialized medicine? It’s the insurance companies, who have created such an arcane system that no one can follow what they are doing, and just how much money they are bilking us all out of. They do their best to scare the simple minded away from actually fixing the problem, which would mean taking control of the medical system away from them, and making the care more comprehensible to both the patients and the medical community itself.
GREAT. Just was at UrgentCare two weeks ago under similar circumstances...got crutches, a knee brace, and also had NO CLUE as to the cost. Now I wait...
Ironically, dealing with this billing made Steve's head spin. 😄
My son did his back in really bad, in a lot of pain and couldn't walk upright, had to wait a few days for a MRI scan. After the doctors examined the scan, they used a computer controlled robot to inject into the nerve running next to the spinal cord. When I asked him how much, he said, nothing, bulk billed. We are in Australia.
I love Friday's videos.
11:38 There used to be a restaurant in the Upper Montclair, NJ area that sent the bill to you a few days layer, after they figured out how much the meal cost them to make.
I have had similar experience. Administrative medical cost have skyrocket. It went to collections. I told them “I think you have broken the law by sending this to collections.” It got resolved.
I really thought you as a lawyer would’ve loved this one. They have separate contracts with each insurance company saying that they will provide care according to the billing schedule of the insurance company provides. Now the insurance company does all the advertising and sends people to the “approved“ provider. And they agreed not to charge the individual more than or less than the exact amount on the billing schedule. And then both companies agree on the write off portion. I’m sure the consideration part of that contract Hass to do with making sure that there are people only go to the provider
Frontier screwed me years ago. I had their bundle deal with home phone and dish network. The home phone worked 10% of the time (we are in the country). Constantly would pick up the handset with no dial tone or anything. Useless. Called frontier and told them we no longer want the home phone and would continue to use dish network. They said no problem and they said I would receive one final bill from them and from then all future bills would come from dish network. Frontier bill came and I paid it. Dish network bills came and I paid them. Then 6 months later I get a notice from frontier that I had an outstanding bill and if not paid I would be sent to collections. I called them and they explained there was a small additional bill that came after the final billing cycle. So I paid it over the phone and they said no collection action would be taken. A month later a deliquent note was placed on my credit history from frontier. Called their management and they would do nothing about it. Contacted the credit reporting agencies and they made a case with frontier but they would not change it. Its off my credit at this point but I will never do business with frontier again.
What a wonderful health system you have in America.
Around here, you never get a bill from the medical offices. They always just send it to collections if there is a balance remaining.
I go to an Urgent Care that doubles as a Primary Care Doctor. It's my first doctor that I've seen on a regular basis besides grade school. I'm 27 years old; I got in a bad financial situation and filed Bankruptcy. My health insurance kicked back a pretty sizable bill, I of course had to include it in my Bankruptcy. They have refused to let me be seen by my Doctor. It's been 3 months, I can't even get my medication refilled. My attorney sent them a letter and they still insist I pay them. It's an absolute shame! Even today I'm pleading my case trying to be seen.
In Australia, we have a different way of treating people in need. A year ago, my shoulder was severely dislocated at my home. After calling 000 (your 911) the process started - all free. My problem has been trying to get them to charge my private health provider. Failure.
I recall an incident where a woman(?) went to a clinic/hospital/ER/care facility, checked in (told them she was there and why) was directed to the waiting room with everyone else, waited there for like 5-6 hours, then just got up and left. (Not sure if it was cause she felt better, or had things to do.)
A few weeks later she got a bill in the mail for $500(?) from the facility. Even though she never saw anyone except the receptionist at the check in desk.
Their explanation why she owed money? Well she may not have been "seen" by a nurse or doctor, but they were "told" why she was there, and they had triaged her as someone who could wait until after other more critical cases, and she need to pay for their time in deciding she could wait.