I work in healthcare and believe there should be standardization. I had to be readmitted for a medical problem, the result of a procedure gone bad and ended up with a hospital acquired condition. The result, a $110,000 hospital bill. After insurance, the physician agreed to write-off the balance. The hospital added insult to injury and pursued collections. Government payers do not reimburse for negligence nor is the beneficiary responsible.
Another issue. . . this has happened to me on a couple of occasions. In this instance, I had a MRI, received the insurance EOB and paid the balance. That should have been the end of it. Two plus years later I receive a notice for the balance, which should have been the contractual allowance. When I called the collection agency all they knew was that the MRI business had closed and turned my balance over to them as bad debt. They were able to see both the insurance and my payment. However, since they didn't have the insurance EOB, they suggested that I contact the insurance company and obtain a copy. Why is it the consumers responsibility to chase down information, it feels like I am doing their job. There should be standards for turning over collections to a agency. If the provider is going to send a bill to bad debt, they should have to supply a file the with all the information. In this case, the claim and itemization (1500 and/or UB) the insurance EOB and/or COB and all notes pertaining to the claim. Maybe having to provide all the required documentation would allow the provider review the claim to determine whether the balance is the patient's responsibility.
Deb27804
1I work in healthcare and believe there should be standardization. I had to be readmitted for a medical problem, the result of a procedure gone bad and ended up with a hospital acquired condition. The result, a $110,000 hospital bill. After insurance, the physician agreed to write-off the balance. The hospital added insult to injury and pursued collections. Government payers do not reimburse for negligence nor is the beneficiary responsible. Another issue. . . this has happened to me on a couple of occasions. In this instance, I had a MRI, received the insurance EOB and paid the balance. That should have been the end of it. Two plus years later I receive a notice for the balance, which should have been the contractual allowance. When I called the collection agency all they knew was that the MRI business had closed and turned my balance over to them as bad debt. They were able to see both the insurance and my payment. However, since they didn't have the insurance EOB, they suggested that I contact the insurance company and obtain a copy. Why is it the consumers responsibility to chase down information, it feels like I am doing their job. There should be standards for turning over collections to a agency. If the provider is going to send a bill to bad debt, they should have to supply a file the with all the information. In this case, the claim and itemization (1500 and/or UB) the insurance EOB and/or COB and all notes pertaining to the claim. Maybe having to provide all the required documentation would allow the provider review the claim to determine whether the balance is the patient's responsibility.
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