Medical bill question (1 Viewer)

[staphory]

Last week I got a bill in the mail from Rush Medical Group. I saw them for a check up in February.
The bill was for $1147.00. My insurance paid for the doctor visit but not for lab work.
I tried to call the clinic I went to and nobody answered the phone. I decided to call Aetna.
The Aetna rep said that the problem was pass through billing and that is not allowed. Essentially, they billed two lines as if I saw the doctor and he did the lab work himself. They know doctors don’t do that. The rep asked me to give her the number to the billing department and told me that she would call and explain it to them.
On Monday she called me back. She got nowhere with the person she spoke to. She said it was obvious that person did not understand and the lady said she would transfer the call to her supervisor then simply hung up the phone. The rep called back but they didn’t answer.
The rep told me that I’m not responsible for that bill and all the billing department needs to do is bill Aetna properly and it will be paid. I filed an appeal with Aetna because the rep advised me to.
Any advice from SR members will be appreciated.

 

[whoah whoah]

No idea if you are responsible or not. Worst case scenario if you don't pay it they hit your credit. However, keep detailed notes of who you talk to and when both with insurance and the lab. You can also send a certified letter explaining that according to your insurance company you don't owe the amount and why. However, patience is probably all you need...

 

[DadsDream]

Get Aetna to send the Rush Medical Group a letter stating what you are and are not responsible for and have them CC you as well.
When Rush hits you up again, call Aetna again and tell them you're being contacted by Rush to pay a bill that Aetna has said you are not responsible for.
Aetna will then send them a letter telling Rush not to call you again and telling you not to talk to Rush again.
Kick back and let them fight it out.

At least, it worked for me with a hospital and United Health Care. When the hospital threatened my credit, I sent that to United too. Got an apology letter from the hospital. Mistake. Sorry. Oops.

 

[Mr. Sparkle]

No idea if you are responsible or not. Worst case scenario if you don't pay it they hit your credit. However, keep detailed notes of who you talk to and when both with insurance and the lab. You can also send a certified letter explaining that according to your insurance company you don't owe the amount and why. However, patience is probably all you need...

Unpaid medical bills dont hit your credit until they are 6 months past due, so take your time to get it fixed.

Credit Agencies To Ease Up On Medical Debt Reporting

I almost always wait at least 60 days before paying because it takes so long to process that the first bill is often wrong anyway.

 

[baarbogast]

Do you have an explanation of benefits letter from Aetna? Normally it will tell you what they paid and what you owe.

If it is 3 month old, you should have it already.

 

[FullMonte]

You don't mention where they (or you) are located...but if they are close enough, it's probably worth your time to go over to sit down with someone at Rush Medical and see if you can get it resolved.

 

[mt15]

When I had surgery the first bill was way, way wrong, I didn’t even have to do more than glance at it to see it was off by a factor of 10 x more than I should owe. I tried calling the billing office of the hospital, and got nowhere (and I’m a manager for them, lol). So I called the insurance company. Got a nice lady who took a quick look and said “they can’t bill it that way.” She called them and straightened it out. Hopefully you will have similar luck.

 

[Saint_Ward]

If they're doing some sort of pass through billing, contact your doctor's office to help out with this. I"m a bit confused if your doctor took your blood and sent it to the clinic, or if you went to the clinic. If you went to the clinic, odd that it would be a pass through bill.. meaning, the lab charges the doctor, the doctor charges you and gets a little profit... it should have just been a regular bill.

I'm having similar fun... our 16 yr old got billed as an adult for blood work, so it was denied. But, getting the right person to fix it.. that's the rub.

Pass-Through Billing Generally Not Permitted

 

[staphory]

If they're doing some sort of pass through billing, contact your doctor's office to help out with this. I"m a bit confused if your doctor took your blood and sent it to the clinic, or if you went to the clinic. If you went to the clinic, odd that it would be a pass through bill.. meaning, the lab charges the doctor, the doctor charges you and gets a little profit... it should have just been a regular bill.

I'm having similar fun... our 16 yr old got billed as an adult for blood work, so it was denied. But, getting the right person to fix it.. that's the rub.

Pass-Through Billing Generally Not Permitted

The doctor works for Rush Medical Group at a clinic owned by Rush Medical Group. When you give blood for lab work, you go down the hallway to the “lab”. A technician draws the blood and I think they send that to the lab in Meridian. I believe all work is done entirely by Rush employees at Rush owned facilities. The issue is that billing shows that the lab work is done by the doctor.
Two separate lines on the bill but both read the same.

 

[soupcan dan]

my lovely wife's chemo bills have been billed as " miscellaneous chemo", for up to $5,000 per. Some covered , some deemed "experimental". 60 days aint nearly enough to clean this shirt.