Posted on Jul 27, 2023
They billed Medicare late for his anesthesia. He went to collections for a $3,000 tab
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https://www.npr.org/sections/health-shots/2023/07/27/ [login to see] /anesthesia-bill-sent-medicare-late-he-got-sent-to-collections-for-3000-dollars
Thomas Greene had been experiencing pain in his right leg, a complication from diabetes, when doctors recommended a procedure to increase blood flow to the limb.
Retired from a career as an electrician and HVAC technician, he had an outpatient procedure in April 2021 to alleviate his pain by dilating the clogged artery using a balloon snaked into his blood vessel.
Greene, who lives in Oxford, Pennsylvania, came through the procedure without any problems, and it reduced his discomfort, said his wife, Bluizer Greene. She spoke with KFF Health News on behalf of Greene, who is recovering from other health problems.
Greene is covered by Medicare and a supplemental policy through Humana and did not expect to pay anything for the care, Bluizer said.
Then the bills came.
Thomas Greene had been experiencing pain in his right leg, a complication from diabetes, when doctors recommended a procedure to increase blood flow to the limb.
Retired from a career as an electrician and HVAC technician, he had an outpatient procedure in April 2021 to alleviate his pain by dilating the clogged artery using a balloon snaked into his blood vessel.
Greene, who lives in Oxford, Pennsylvania, came through the procedure without any problems, and it reduced his discomfort, said his wife, Bluizer Greene. She spoke with KFF Health News on behalf of Greene, who is recovering from other health problems.
Greene is covered by Medicare and a supplemental policy through Humana and did not expect to pay anything for the care, Bluizer said.
Then the bills came.
They billed Medicare late for his anesthesia. He went to collections for a $3,000 tab
Posted from npr.org
Medical
Health
Posted >1 y ago
Responses: 4
This has happened a couple of times to my wife and her folks (there must be something in their genes) where something related to their medical care wasn't submitted in a timely manner to the insurance company (which would have covered it) and was denied because it was late. They then turned around and tried to bill the full amount to us.
It was more a PITA in getting it straightened out, but it never went to collections. However, it shouldn't be the responsibility of the patient to ensure that all the various healthcare entities involved submit their claims to insurance.
When that happened and I was researching what steps to take next if it wasn't resolved, I found that there has been a lot of success in leveraging the federal Balance Billing (surprise medical bills) law (the "No Surprises Act"*) that went into effect on 1 JAN 22 if you had procedures after that date and this situation occurs.
Additionally, you might have state laws already about surprise billing that would predate 1 JAN 22 or have increased protections from the federal law (I looked and it doesn't seem like Pennsylvania does in regards to this article).
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* https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills
It was more a PITA in getting it straightened out, but it never went to collections. However, it shouldn't be the responsibility of the patient to ensure that all the various healthcare entities involved submit their claims to insurance.
When that happened and I was researching what steps to take next if it wasn't resolved, I found that there has been a lot of success in leveraging the federal Balance Billing (surprise medical bills) law (the "No Surprises Act"*) that went into effect on 1 JAN 22 if you had procedures after that date and this situation occurs.
Additionally, you might have state laws already about surprise billing that would predate 1 JAN 22 or have increased protections from the federal law (I looked and it doesn't seem like Pennsylvania does in regards to this article).
--------------------------------
* https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills
No Surprises: Understand your rights against surprise medical bills | CMS
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.
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If the provideror the hospital billed late then it is on them...not collections. TImely bills get timely payments. Do what a friend of mine did when they had a huge hospital bill...they sent them $10 a month until the insurance kicked in and got squared up...legally nothing the hosp could do as they were receiving a payment
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