Hospital Bill Received 14 Months Late

Aaron at Subject to Change has received a tardy bill.

We just received a bill for Cole’s birth. In case you haven’t heard, he’s fourteen months old. The bill was dated 5/7/08, which makes the billing cycle 425 days (14 months to the day, plus leap year, minus the two days before our actual release date), not 30 days, not 60 or 90, not even 120. It’s 425 flipping days! My kid has been to the doctor or urgent care a dozen times since then and each of those bills came in a timely fashion. We’ve even paid the bill for Kelly’s emergency visit to the same hospital six weeks after the birth! Why not wait eighteen years to send the bill? That’d be a great graduation gift for my child.

Riddle me this: what reasonable person expects to see the first bill for services rendered a year ago, unless they’ve established some sort of big-box style deferred payment plan? And, what ethical business expects that they can simply demand payment in full for services rendered a year ago when there hasn’t been any follow up in between?

My personal feeling is that if a business doesn’t send me a bill within a reasonable time (90 days?), than they can save the stamp and shove the bill in the same orifice where their head is.  Legally, I don’t know where Aaron stands.  But I sure as heck hope he gives ‘em hell. 

Hospital bills are incredibly annoying.  I understand why one gets a smattering of bills over several weeks after going to the hospital.  They kind of operate in a bizarre sub-contractor model except instead of the sub-contractors billing the hospital and the hospital sending one an aggregate bill, all of the sub-contractors send the customer their own bill.  So the customer will get separate bills from the hospital, anesthesiologist, pharmacy, lab, etc. instead of a single bill.  It is further complicated by the insurance companies.  Before the bill is sent to the patient, each of these sub-contractors will usually send the bill to the insurance company first to see what they will cover.  Then they will send a bill for whatever is left to the patient.  If the provider and the insurance company decide to bicker for a while over the amount that the insurance company will pay, it makes it even more confusing. 

Frankly, I don’t see any reason why Aaron and anyone else can’t get an itemized total bill at the time they leave the hospital.  Yes, that bill will have to be sent through the insurance company before an invoice is sent to the patient, but there is no reason why a patient can’t see the total bill at the time they walk out the door - just like a hotel or any other business.  A cynical person might think that they want it to be complicated… 

1. Wow, centralized billing?  But that’s… that’s… simple.  Therefore, hospitals cannot figure out how to do it.

   Posted by Recess Supervisor on May 18, 2008 at 1906 hrs




2. “If you think the country’s bad off now, just wait ‘til centralized health care gets through with it”—Rufus T. Firefly

   Posted by (JavaScript must be enabled to view this email address) on May 18, 2008 at 2015 hrs




3. I’m not surprised at this year-after billing.  Of course, my opinion of medical billing is pretty low, even though my personal aggravation is due to a much less extreme situation.

   My insurance is through an HMO.  Thus far, I’m not cranky about the fact it’s an HMO, even though they have a lousy reputation.  It has, over the past 12+ years, worked well for my family.  There is a billing issue, however, that is not limited to me.  Many of my coworkers mention the same annoyance.

   When I go to the doctor, I pay my $25 copayment at the check-in desk, before I’m ever called from the waiting room into the examining room.  Even though I’ve paid up front, I can generally expect to receive a bill two or three months after I’ve seen the doctor.  The bill will say I owe $25 for the appointment.  At the bottom, it will also mention that I have an unallocated $25 credit.

   I had the same difficulty earlier this year when I went to a local hospital’s physical therapy department.  In late March, I began receiving collection calls over three visits to the physical therapist; the visits in question were in January.  Again, I had paid my co-payments up front, but the payments weren’t credited properly to my account.  It took me half a dozen phone calls to find out that, while I supposedly owed $75 to the hospital, I also had a $75 unallocated credit on my account.

   Makes perfect sense, right?

   Posted by (JavaScript must be enabled to view this email address) on May 18, 2008 at 2019 hrs




4. Thanks for bringing this to the attention of your readers, Owen. I think this deserves a heavy amount of ridicule.

   Just to be sure that I’m not the total idiot I usually turn out to be I’ve taken another look at the bill. I expected to maybe see “ninth notice” or something stamped on it, but it’s not there. Instead, the comments at the top tell me that the bill was submitted to insurance more than 60 days ago and the bill was not paid in full. They submitted an appeal and waited at least 30 days, apparently.

   That would be 90 days. 425 - 90 = 335. I can’t wait to hear the explanation for that!

   Oh, and the due date is blank. So, I guess I can pick my own. I’m thinking 73,000 days is fair.

   Posted by Aaron on May 18, 2008 at 2048 hrs