How long a delay before billed?

NancyD

I had my reconstruction surgery in late January 2010. Because of contract negotiations, the hospital was "out-of network" for a few weeks that included my surgery period. They have since signed a contrac and are back in-network. The billing to my insurance company showed on the insurance website, and I can see that they did not pay them the total amount and surprise, surprise! it says I am responsible for about $42,000 which is even more than the out-of-network percentage.

About two months after the surgery, someone from the hospital's financial office called me and asked if I would like to set up a payment plan. I told them payment for what? I had not received any kind of bill from the hospital. I only knew about the $$ from the EOB posted on my insurer's website. I said I wouldn't even discuss it until I had an itemized bill from them to see what I was paying for.

It is now seven months after my surgery and there's been no big bill. I've received a couple of smaller bills for tests or labs, but nothing for my hospital stay. How long could this go? I don't dare call them for fear of waking a sleeping dog. But I have other financial obligations...child in college...have to change living arrangements. How soon (or how long) did it take the hospital to bill you for surgery?

BTW, this was a different hospital than the one I used for my mastectomy. That was settled and paid for within a 2-3 month period. 

lovemygarden

I had my BMX in early February and received the hospital's bill only 2 weeks later! But I am self-pay (no insurance) so it may be that they send those out ASAP. I'd assume that the delays are caused on the insurance (aka Bureaucratic Nightmare) company's end, in your case.

I received all of my surgery-related bills (hospital, doctors, pathologies, attending Rxs, etc) within the 60 days after my surgery was done. They all want their $$$$$$$$$$$$ as fast as someone will write the checks .....

lovemygarden

The tax-deduction-year factor can definitely be a biggie! That was the reason why I asked for a somewhat lower monthly payment amount than I could have made; I already had such a huge medical-expense deduction from the other (pay in full as incurred) providers for this tax year, I wanted to be able to spread as much of those expenses as possible into my 2011 tax return also. The hospital bill is the only one I can do that with.

After January 1st I will probably raise the amount of my monthly repayment so that it will all be paid up in 2011 and thus I'll get the max use out of it during that tax year.

NancyD

I never seem to have enough to make an itemized tax deduction work...even with medical bills of the last 2-1/2 years. My coverage has been that good. Don't own a home, yet, so there's no deduction there. Give a few hundred to charity, but that's not going to take me over the top. So I'm not worried which year it falls into. If I have to pay that much, it will be enough in itself to make itemization work.

I've thought about the possibility of losing the right to appeal, but I haven't even received a copy of the EOB in the mail. I only found out about it poking around there.

The thing that makes me angry is I checked with my insurer three times before I went in...once for precertification, and then twice after the dispute spilled over into the new year and the status of the hospital was in question. Each time, I was assured verbally that I would be covered. Dang, I should have asked for it in writing. So I'm angry at myself, too.

lauri

re medical expense deduction - don't forget that you can ONLY deduct the amount that EXCEEDS 7.5% of your AGI for the year -- so you have to watch both your expenses AND your income when you have a choice about what year to pay your medical bills. 

If by chance you have long-term care insurance, the premiums can be added to your medical expenses (but see the IRS regulations on dollar amount depending on age)  I was actually able to take medical deduction the year I was in treatment, largely because of big bills ,mileage and parking,LTC premiums and reduced income.

DiDel

Nancy

I would not call or say a peep!! Sounds like you should have been covered. Obviously you would not have gone out of network and paid $42000 at any hospital no matter how good they are! That's crazy, hopefully someone realized what you initially saw was incorrect and have since corrected it that is why you haven't seen a bill or EOB. I saw nothing from my surgeries because I had met my out of pocket maximum by the time I went into surgery.

I wouldn't worry about it until you get an actual bill, then if you do I'd get an attorney that specializes in insurance claims.

Good luck!

Diane 

NancyD

I won't worry another bit, expecially considering the hospital has been paid @$43,000 already. The insurance didn't reject their entire bill, just half of it.