Medical Bill Changed after the visit. Any recourse?

[justsomeguy]

What is the name of your state? Texas

I recently fell and hurt my back, after it was reccomended I get an MRI ($395 for the suggestion). I elected to go ahead and do it after I got the price. Another $1589, which they wouldn't do unless I pre-paid. I Said Ok, I'll go ahead and do it. I paid in full.

Now, a month later they are trying to collect an additional $700 I never agreed to pay, or knew anything about.

I know there is probably nothing I can do here, but what's to stop them from making it $7000, or $70,000 since they didn't mention any of it till after the fact, and I never agreed to it??

My insurance doesn't kick in till $5000.

Thanks for any advice.

[moburkes]

The first question is, what is the additional $700 for?

[ecmst12]

My guess is the $1500 is the facility charge and the $700 is the radiologist's interpretation charge. Two bills for tests like this is normal and the facility would only be able to quote you THEIR bill, not the radiologist's bill.

[moburkes]

Originally Posted by ecmst12

My guess is the $1500 is the facility charge and the $700 is the radiologist's interpretation charge. Two bills for tests like this is normal and the facility would only be able to quote you THEIR bill, not the radiologist's bill.

That's what I was thinking, but I couldn't think of the word "interpretation". I was going to say the cost for the doc to read the results. Yours sounds much better.

[justsomeguy]

It just erks me that we made it perfectly clear that I was doing this as a self pay and this was very expensive for me. I was leary about doing it at all.

This leaves me with two possible "interpretations" of my own. The Doctor, the nurses, and the cashiers all knew I was having a hard time paying for this and this was tight for me so;

either

A. They were ignorant of their own procedures and how their billing works,

or

B. They just didn't care enough to bother bringing it up, none of them.

Either way, not someone I want to work with anymore, or trust my health to. I'll let them know my family will never be back. I'm guessing that's going to be the best I can do.

[justsomeguy]

Originally Posted by ecmst12

My guess is the $1500 is the facility charge and the $700 is the radiologist's interpretation charge. Two bills for tests like this is normal and the facility would only be able to quote you THEIR bill, not the radiologist's bill.

Wouldn't they need some kind of written approval or authorization from me to force me to pay for this though? I never agreed to it.

[justalayman]

I'm betting you did agree to it somewhere. Most releases state that there may be additional charges from (things like this).

B. They just didn't care enough to bother bringing it up, none of them.

They most likely knew of the situation and either forgot to tell you or just didn;t really care. Even if they did not know the actual charge, they should have warned you of the additional charge from outsiders. It is the courteous thing to do.

[Ladynred]

Wouldn't they need some kind of written approval or authorization from me to force me to pay for this though? I never agreed to it.

You agreed to the procedure, that was all that was required. Who do you think READS your MRI, CT Scans, XRays.. the radiology fairy ??

DOCTORS, in general, are not trained radiologists, they can look at a study and understand what they're looking at, or looking for, but they don't have the specialty training that radiologists do.

[seagoing]

I believe patients are not given enough information to the total expenses for a procedure as the poster mentioned.I have a similiar story.My Dr told me I needed a sonogram of my liver.They TOLD me I needed to go to the hospital to have it done.At the hosp.I asked the admitting clerk if they participitated in my ins.I showed her inmy ins. booklet the hosp.was listed and to confirm.I even explained if there was a problem I would go elsewhere to a hosp.that took my ins.Ive had probs.in the past etc I explained.Yes they participated,I may even have the co-pay waived,not to worry.Great.A month passes,I get $250 dollar radiologist bill.Guess what ,this Dr.THEY sent my sonogram to doesn't take my ins.Then comes thehosp.bill $1124.I inquire.Seems the procedure I had done ,could habvebeen done at at Dr.office.Its not a procedure that warrented me to go to the hosp.Now how would I know that.The Dr.office told me to go to the hosp.So I had to ,yes,ASSume they knew what they were talking about,Im just a dumb retired fireman.While I was being admitted,I spoke plenty of how I couldn't afford to pay a huge bill and usually I have a $15 dollar co-pay.Yet I was assured there would be little if any out of pocket.I have written to the hosp.administrator and await any help he may give.My point,until you get a letter after the fact,you dont know the price.It should be like an auto shop.Tell me upfront what it cost,if you need an ouside guy to do the alignment ,the shop tells you.I had no idea a radiologist would beinvolved like the OP.Hospitals and Dr.offices dont give you the skinny upfront.

[justsomeguy]

Originally Posted by seagoing

I believe patients are not given enough information to the total expenses for a procedure as the poster mentioned.I have a similiar story.My Dr told me I needed a sonogram of my liver.They TOLD me I needed to go to the hospital to have it done.At the hosp.I asked the admitting clerk if they participitated in my ins.I showed her inmy ins. booklet the hosp.was listed and to confirm.I even explained if there was a problem I would go elsewhere to a hosp.that took my ins.Ive had probs.in the past etc I explained.Yes they participated,I may even have the co-pay waived,not to worry.Great.A month passes,I get $250 dollar radiologist bill.Guess what ,this Dr.THEY sent my sonogram to doesn't take my ins.Then comes thehosp.bill $1124.I inquire.Seems the procedure I had done ,could habvebeen done at at Dr.office.Its not a procedure that warrented me to go to the hosp.Now how would I know that.The Dr.office told me to go to the hosp.So I had to ,yes,ASSume they knew what they were talking about,Im just a dumb retired fireman.While I was being admitted,I spoke plenty of how I couldn't afford to pay a huge bill and usually I have a $15 dollar co-pay.Yet I was assured there would be little if any out of pocket.I have written to the hosp.administrator and await any help he may give.My point,until you get a letter after the fact,you dont know the price.It should be like an auto shop.Tell me upfront what it cost,if you need an ouside guy to do the alignment ,the shop tells you.I had no idea a radiologist would beinvolved like the OP.Hospitals and Dr.offices dont give you the skinny upfront.

This is the problem with the entire medical industry. It exists outside of the free enterprise system. You don't get prices written down ahead of time and they just bill you whatever and whenever they want.

In the future I'm going to just go in and pay cash as John Doe. I'm guessing they won't take me anyway though.

[justsomeguy]

Originally Posted by Ladynred

You agreed to the procedure, that was all that was required. Who do you think READS your MRI, CT Scans, XRays.. the radiology fairy ??

DOCTORS, in general, are not trained radiologists, they can look at a study and understand what they're looking at, or looking for, but they don't have the specialty training that radiologists do.

This is absolutley a ridiculous statement. Who do i think reads all those things? I have no idea, why would I??? Who do I think reads the Flux capaciter emmissions that come out of an MRI, (as far as I know I'm gonnna get a bill for that too). I have no idea, because I do not know anything about MRI's or Radiology, I am a patient, I am not a doctor, a nurse, or an admitting clerk who regularly schedules people and informs them of what is to come regarding MRI's!

Your statement had it been aptly put would have been who did the doctor, nurses, scheduling agent, and admitting agent think was goig to read the MRI? The radiology fairy?? They must of, otherwise they should have mentioned it to the patient that there will be additional charges.

[lealea1005]

I don't see that you answered moburkes question. Who, exactly, is the $700 bill from? The hospital? Radiologist? AND... what is the description of the services rendered?

It is not the scheduling person, the nurse, the tech or your prescribing Physician's responsibility to guess at what other charges you may incur once you leave their office. Ultimately, it is YOUR responsibility to pay for any services rendered to you.

[justsomeguy]

Originally Posted by lealea1005

I don't see that you answered moburkes question. Who, exactly, is the $700 bill from? The hospital? Radiologist? AND... what is the description of the services rendered?

It is not the scheduling person, the nurse, the tech or your prescribing Physician's responsibility to guess at what other charges you may incur once you leave their office. Ultimately, it is YOUR responsibility to pay for any services rendered to you.

There were actually 2 bills, the $700 was an error, which is why I abandoned this post. I requested and received a fax statement saying I owe the "hospital" nothing more. (they were trying to bill me for the insurance rate, rather than the self pay rate)

Then I just got a call from a collection agency yesterday (first i've heard of it) for the $300 radiologists bill. Bitter... I reposted here.

Granted, I'm just going to pay it, but.. the point is, all those people did not have to "guess" that there "WOULD BE" another charge, they knew that (even if they didn't know the amount, but i'm guessing it's pretty standard), they could have mentioned "A" charge, even if they didn't know what it was.

Specifically they might want to make it a policy to mention not possible, but GURANTEED additional charges when you're dealing with self pay individuals. It just seems like common courtesy, common sence and professionalisim to me.