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johnnyburns527 Asked June 2016

How do I dispute certain medical bills?

Hi Everyone,


I am responsible for caring for my elderly relative, who is sick and in need of constant attention. As of late, the medical bills and procedures have significantly increased. Unfortunately, I am getting incredibly fatigued and frustrated. On top of all of this, I believe the medical bills of the individual are incorrect and more than what they should be.


I really don't have the time or energy to solve this. I was wondering if anyone knew of a respected company that could accurately find these mistakes and save me much need money.


Thanks

UncleDave Jun 2016
At DisputeBills they work on a 30% contingency payment plan, so if they saved you 100% of the $30,000 you would owe Disputebills $9,000

mscoulter Jun 2016
There's a company in NY that does it called Medwise Billing. I believe they only handle NY cases but they have a website and I know the CEO personally. She is very astute and will work hard for you. PM me if you need more info.

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JoAnn29 Jun 2016
I know this is all confusing. It is hard reading these statements. Call ur local Office of the Aging and see if there is someone there who can take u thru the billing process. Really hard to explain here. Better having someone to sit down with you. What it comes down to is it doesn't matter what is billed by the provider, Medicare will only allow what they cover less the 20% the patient is responsible for if they don't have supplemental.

Veronica91 Jun 2016
If you are unsure of procedures performed ask the hospital for an itemized bill.
if you have medicare and a PPO the insurance will send you periodic statements. ours comes every month with a summary at the end of the year. It only tells you what was billed, what approved, what Medicare paid and your responsibility.
Your responsibility is what you should be billed by the provider and have to pay.
Read your insurance manual carefully and be aware of the co-pays that are expected often at the time of service.
If you are unfortunate to be private pay (or very rich) you can negotiate the price for procedures before anything is done both with the provider and facility. Paying upfront if you can will save you significant amounts of cash. Last year my medical bills amounted to almost a million dollars but we were billed about $3000 that was for three months in hospital and numerous expensive procedures.

JoAnn29 Jun 2016
When you get a bill from a provider it will show what they billed. It will show what Medicare paid and then what the supplimental paid. You will also she Medicare adjustments that should agree to what the supplimental statement says the patient may owe. Be aware that not all providers take Medicare or some supplimentals. In this case, the patient is responsible for payment. I would question the need for certain "procedures". Just because it is recommended doesn't mean you have to have it done.

JoAnn29 Jun 2016
I agree with Christine73. If the person is on Medicare, you will get a statement from them. Then you will get a statement from the supplimental. This statement will show what medicare paid and what the supplimental picked up. The balance is paid by the patient unless on Medicaid. I wait for the bill and make sure everything agrees. Medicare does not make mistakes and they will tell u that. What u need to make sure is that the supplimental is billed by the provider. This is the only problem I have had. Copays, and until met, deductables by the patient. When it comes to procedures, you may hve to shop around. Every hospital charges different.

Midkid58 Jun 2016
This may be too late to help you--but any time we have a "procedure" of any kind, I start a new file. In it I place:
A: all information given to me (or hubby) by the drs' offices/original dx/and xrays or scans
B: all bills as they come in
C: all payment statements as they come in--and then I cross reference those with the original bill---I ALWAYS find errors, always
D: a "calling list" the place I called, the time., date, to whom I spoke, what we spoke about, what they are going to do, what I am going to do and I GET THEIR NAMES!
E: a finalized bill when all the dust has settled.

Plus I will hold on to this for a few years.

Hubby had a liver transplant 10 years go, chemo afterwards for 84 weeks, a stroke, a terrible motorcycle accident, and all the dr visits, hospital visits, etc along with those. Without my enormous notebook of information, we'd be out much more money. I found countless incidents of double billing--improper billing. outrageous billing--since we were private pay out of plan for most of this, we still paid almost $200,000 over time. You betcha I squeezed every penny til it hurt.

I started doing this with a child's simple tonsillectomy. I do it for all things now, even our boring yearly exams. With 5 kids, I couldn't keep track of who'd had what done--and with the transplant--no way could I have carried that info in my brain.

I do not know of anyone who would WILLINGLY take on this task. You'd probably pay more than you owed to unsnarl someone else's medical bills.
Start afresh and don't do more than a couple of hours per day. It's daunting, but doable.

johnnyburns527 Jun 2016
I did some research over the weekend and actually found some companies that answer the exact question I previously asked. If anyone is interested, visit DisputeBills CoPatient sites I personally recommend DB because they have a success rate that exceeds 70%.

Bottom line is that I have finally found a specific company that can do this time consuming work for myself and help me finally save me money!

ferris1 Jun 2016
Where do you live? In Sun City, AZ there are a dozen companies who will be glad to manage money and sort out medical issues, however, you will pay a lot of money for these services. But, you know your limits. If you suspect one provider is over charging, then halt the visits until you can get records (assuming you have MPOA). You are in control of providers. Just because a doctor wants to see a patient every three months, doesn't mean you have to go. Remember, a person with dementia has a terminal illness and will never get any better. There is nothing you can do to halt this horrible disease.

UncleDave Jun 2016
The diffuglty I have encounter is the insurance rejecting coverage {correctly} but the hospital billing us for meds not actually delivered. OTC meds ordered by the hospital staff from our home med list, not administered but billed by hospital. Billing office off site and having no itemized statement, sent me back to patient rep at hospital. Advice the med is on the statement so I am sol.

Christine73 Jun 2016
One more: some insurance companies offer the kind of bill auditing services you're asking about. Ask your insurance company if they offer it. If they don't, they may know a company that does. Good luck!

Christine73 Jun 2016
Sorry, I don't "company" what was billed. I *compare what was billed.

Christine73 Jun 2016
Here's what I do. I don't pay ANY medical bill until I see the EOB from the insurance company. When I get the EOB, I company what I was billed with what the insurance company says I SHOULD have been billed. If there's a discrepancy, I call the provider, inform them, and ask them to make an adjustment. If they want to see the EOB, I send them a copy, but they usually don't.

It may not seem this answers your question, but I think it addresses the spirit of your question which is: I need to get this done and I'm too tired for a hassle.

The best way to avoid fighting with providers is to call the insurance company and let them know, "on x date I was billed x amount by x provider." They will be able to tell you if you were billed what you should have been, of if you were billed too much. Providers have to bill the contract rate. I hope this helps.

UncleDave Jun 2016
johnnyburns527
YES YES I also wish there was someone or some company that would dispute medical bills

I was hospitalized recently, and they ordered all of my daily meds from an old list. Two were ones I never received at the hospital. I have since learned they can charge at will for non-prescription meds.

Thomas0611 Jun 2016
Get a calendar or planner book and write down every medical event on the date it occurred. Get a three hole punch and a quality three hole notebook, and file every statement chronilogically on the date it occurred. Many times the medical provider submits the insurance claim multiple times with minor updates and/or clarifications to satisfy the insurance company. You can understand this better with everything filled by date medical service received. If you have supplemental insurance, they cannot submit their insurance claim until the primary insurance claim is settled. A third party "billing helper" agent would bill you more than they would help you. If you think any billing is fraudulent, it is your responsibility to report this to the insurance people. We all realize the complexity of medical billing, but it is reality that each of us must deal with. Realize that much of the medical billing is not paid by insurance or the insured, rather it is "written off" by the medical provider. Don't pay anything until considerable time has passed and you understand the billing issue completely. Eventually, you must discuss issues with the billing clerks to gain understanding. Having the documentation in order will be a minimum requirement.

Eyerishlass Jun 2016
Oh how I wish there was someone or some company that would provide that service!

Try to get organized. Talk to the billing department. Make your notes from the phone calls right there on the statement (but not on the portion you may be sending in with a payment). I also always wrote down who I spoke with and tried to speak to that person if I had to call again.

pamstegma Jun 2016
You are the one who knows what was given and what was done. A third party would have no way of knowing whether the bill is correct.
When you see an error, call immediately for a correction or clarification.

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