tloonya
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Post by tloonya on May 12, 2014 15:10:17 GMT -5
FALSE again! She came back to me with story that ER procedures are coming in 1-5 numbers. Whatever was assigned - thatever you owe. I asked why? Who said biller was correct? She said I know but it is how it is. I said aren't we having rights to know what we are paying for? She said I understand... Then she said go to a hospital and talk to cashier. I said WHAT? Cashier as c.a.s.h.i.e.r who runs cash register and takes money? She said yes.
So we will go.
However do you really think that billing people are always right? And WHY can't I see charges like needle with xxx = $100 BP check 3x$50 = $150 and such and such and such... WHY doo we must pay for unknown hospital doings? And you all happy with it. How come?
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Angel!
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Post by Angel! on May 12, 2014 15:12:07 GMT -5
The charge is for walking into the door with the level of emergency you had. There is no further breakdown that what you received. You already have a breakdown.
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Angel!
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Post by Angel! on May 12, 2014 15:13:38 GMT -5
You aren't going to get anywhere questioning the breakdown. Accept that & ask for a discount & payment plan - that is where you have a little room to negotiate down the price.
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HoneyBBQ
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Post by HoneyBBQ on May 12, 2014 15:53:46 GMT -5
Anyone can use anyone's credit card in most cases. My SIL uses my credit card when he fills my car with gas for me. Sooo...that is not a lie, but calling about one's child to find out about charges mother has to pay is a crime. I hope you all had read that mother is here next to me and giving me all the info!!!!!!! Are you friggin kidding me Are you Mom does not speak any English!!! Every hospital employs interpreters. You are putting people out of a job by not letting them do theirs.
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HoneyBBQ
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Post by HoneyBBQ on May 12, 2014 15:54:25 GMT -5
Tloonya, do you even know what HIPAA is? You don't call and LIE to the hospital about billing for treatment received by a child not your own. Come to think of it, remember several of your posts - lying seems to be a way of life for you. What happens when some of these lies get found out? For one thing, they won't ask and just take your word for it that you're authoritzed to speak for another person. If they do, they can lose their jobs. Does that mean anything to you? She is clueless and doesn't give a shit if she gets someone fired because she lies to get information. Isn't breaking the rules the way she always does things, and then gets pissed that nothing falls into place for her. In all fairness, as long as they ask appropriate questions on the phone (DOB/SSN, etc) and get the correct answer, they cannot be faulted for TLooney lying as long as she has the right answers.
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NomoreDramaQ1015
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Post by NomoreDramaQ1015 on May 12, 2014 15:54:45 GMT -5
We've gone over that. Interpreters are useless because they do not care like Loony does.
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Deleted
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Post by Deleted on May 12, 2014 15:55:36 GMT -5
FALSE again! She came back to me with story that ER procedures are coming in 1-5 numbers. Whatever was assigned - thatever you owe. I asked why? Who said biller was correct? She said I know but it is how it is. I said aren't we having rights to know what we are paying for? She said I understand... Then she said go to a hospital and talk to cashier. I said WHAT? Cashier as c.a.s.h.i.e.r who runs cash register and takes money? She said yes. So we will go. However do you really think that billing people are always right? And WHY can't I see charges like needle with xxx = $100 BP check 3x$50 = $150 and such and such and such... WHY doo we must pay for unknown hospital doings? And you all happy with it. How come? My dear LOONY, I am here to help! Attached is a guideline from the government explaining how to code for Evaluation and Management services:
www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/eval_mgmt_serv_guide-icn006764.pdf
Now, the people who code bills for a living have to pass a Certification Test, but I know that you will be able to figure out if that bill is correct all on your own!
And, FYI, most places I know use the 1997 Guidelines, so start reading on page 40. Have fun!
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HoneyBBQ
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Post by HoneyBBQ on May 12, 2014 15:57:00 GMT -5
You aren't going to get anywhere questioning the breakdown. Accept that & ask for a discount & payment plan - that is where you have a little room to negotiate down the price. Exactly. They are not going to itemize the changing of the linen, the amount of lights used in the room, the cost of the air conditioning, the janitors that empty the trash, etc. It's a base ER charge by how long "you" were there. That's how it works. If you don't like it, move to Canada. Seriously. This is obnoxious. There is a right to understand your bill and what it is composed of, it is not your job to investigate the hospital's billing practices.
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HoneyBBQ
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Post by HoneyBBQ on May 12, 2014 15:58:27 GMT -5
We've gone over that. Interpreters are useless because they do not care like Loony does. Sorry, I'm just catching up. I thought maybe the idea that she's putting out one of her own people (most likely) might get through to her. And FWIW, nobody in the entire hospital is going to 'care.' Everyone will do their job professionally as they are supposed to, but nobody there actually "cares" about your friend or if they pay the bill or not.
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NomoreDramaQ1015
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Post by NomoreDramaQ1015 on May 12, 2014 15:59:31 GMT -5
I hate to open this can of worms but the mother could file an appeal.
For her to do that though Loony needs to butt out and let a translator take over. The translator will know the proper procedure for filing a claim and trying to appeal charges. Loony screaming at people over the phone won't achieve anything.
I strongly doubt the mother will be approved. The costs sound about right from what we've experienced for the same situation. But she could try.
Her better bet would be to tell Loony to butt out and set up a payment plan with the hospital via a translator. Then she can pay what she can afford over time.
Loony screaming at people over the phone isn't going to solve anything and will make them much less likely to work with anyone.
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Deleted
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Post by Deleted on May 12, 2014 15:59:44 GMT -5
And an FYI for everyone else, a billing agency can talk to someone about a medical bill. They cannot say what was done or when it was done or why it was done, but if someone wants to know about a balance we can verify that there is a balance due. I used to tell someone that if they don't agree with the way a bill was processed they should call the Insurance Company.
As for questioning if it was coded correctly? At my company we will have someone else audit the report and see if they come up with the same code. The regulations can be subjective, but that is why we get trained and certified before we start doing the job.
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Blonde Granny
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Post by Blonde Granny on May 12, 2014 16:24:36 GMT -5
This is Loony you're all talking about. Nothing will be right until SHE says it's right.
Loony vs Doxie? who wins?
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Rocky Mtn Saver
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Post by Rocky Mtn Saver on May 12, 2014 16:38:41 GMT -5
We've gone over that. Interpreters are useless because they do not care like Loony does. Sorry, I'm just catching up. I thought maybe the idea that she's putting out one of her own people (most likely) might get through to her. And FWIW, nobody in the entire hospital is going to 'care.' Everyone will do their job professionally as they are supposed to, but nobody there actually "cares" about your friend or if they pay the bill or not. Loony needs to start moonlighting.
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Deleted
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Post by Deleted on May 12, 2014 17:02:18 GMT -5
And once you've figured out the code, then you can make sure it paid correctly! There are people at CMS who's sole job is to figure out the "Relative Value" of procedures, but I just know you will let them know that they're wrong according to your calculations.
Now, for this one you're going to have to do some digging. Here is the chart for the conversion factors of hospital based codes.
www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY-2014-IPPS-Final-Rule-Home-Page-Items/FY-2014-IPPS-Final-Rule-CMS-1599-F-Tables.html?DLPage=1&DLSort=0&DLSortDir=ascending
Cliok on the link named "Hospital VBP Table 16A". Column A is the list of CPT codes and Column B is the "value" assigned to the code (VBP).
Next, you will have to find out what the "relative value" MY BAD! It is called "The Geographic Practice Cost Index (*GPCI) in your area of the country (I can't do everything for you, now can I?).
Then you multiply the VBP (in column B) and the *GPCI (which is a dollar amount that you found out on the web) to see what the "price" for each code is. And finally you will know if the charge is correct! HOW EXICITNG FOR YOU!!!
*Edited to correct the terminology
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Blonde Granny
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Post by Blonde Granny on May 12, 2014 17:07:37 GMT -5
And once you've figured out the code, then you can make sure it paid correctly! There are people at CMS who's sole job is to figure out the "Relative Value" of procedures, but I just know you will let them know that they're wrong according to your calculations. Now, for this one you're going to have to do some digging. Here is the chart for the conversion factors of hospital based codes. www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY-2014-IPPS-Final-Rule-Home-Page-Items/FY-2014-IPPS-Final-Rule-CMS-1599-F-Tables.html?DLPage=1&DLSort=0&DLSortDir=ascendingCliok on the link named "Hospital VBP Table 16A". Column A is the list of CPT codes and Column B is the "value" assigned to the code (VBP). Next, you will have to find out what the "relative value" is in your area of the country (I can't do everything for you, now can I?). Then you multiply the VBP (in column B) and the RV (which is a dollar amount that you found out on the web) to see what the "price" for each code is. And finally you will know if the charge is correct! HOW EXICITNG FOR YOU!!!
No wonder I just toss & shred copies of my Medicare statements. It is what it is, Medicare and my supplement have paid the bill. What the devil do I know whether my $80K knee replacement bills were correct?
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Shooby
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Post by Shooby on May 13, 2014 6:35:49 GMT -5
Does anyone really understand hospital billing? Even the billers don't understand it, lol
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Deleted
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Post by Deleted on May 13, 2014 7:24:18 GMT -5
The less you people know, the more job security I have! BWAHAHAHAHAHAHAHAAAAAAAAAAAAAAAAA!!!!
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NoNamePerson
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Post by NoNamePerson on May 13, 2014 7:48:02 GMT -5
I'm almost afraid to ask but is this their bill AFTER insurance kicks in. I am dumb as a red brick when it comes to hospital bills and insurance. Fortunately, the one time I had emergency surgery I had a good friend in medical profession who could read/interpret bills. Now I know I can ask @beerwench if I ever need info
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Nazgul Girl
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Post by Nazgul Girl on May 13, 2014 7:53:45 GMT -5
I understand hospital billing. Trying to explain it to even a reasonable person is sometimes a challenge. Trying to explain it to somebody who just wants to argue is impossible.
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Post by Deleted on May 13, 2014 7:54:08 GMT -5
I'll do my best to help!
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tloonya
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Post by tloonya on May 13, 2014 8:22:30 GMT -5
You aren't going to get anywhere questioning the breakdown. Accept that & ask for a discount & payment plan - that is where you have a little room to negotiate down the price. Thanks, Angel. that is basically ALL I was asking about. Nothing else. However we like to argue anything we can, don't we? I had always had insurance and never had these questions. So now I was just stunned. Thought it was unfair. But what do I know?
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Deleted
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Post by Deleted on May 13, 2014 8:25:22 GMT -5
My English to LOOONY-ese app is glitchy then, because I could have sworn you wanted to know if the bill was coded and charged correctly. My bad!!
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Rocky Mtn Saver
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Post by Rocky Mtn Saver on May 13, 2014 8:25:21 GMT -5
You aren't going to get anywhere questioning the breakdown. Accept that & ask for a discount & payment plan - that is where you have a little room to negotiate down the price. Thanks, Angel. t hat is basically ALL I was asking about. Nothing else. However we like to argue anything we can, don't we? I hate to argue logic, but that's not at ALL what you were asking about.
OP: What am I supposed to do to dispute these seems too high charges? And double on ER visit? Is there place I can go and plug in procedure code and see whats what?
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Rocky Mtn Saver
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Post by Rocky Mtn Saver on May 13, 2014 8:25:46 GMT -5
My English to LOOONY-ese app is glitchy then, because I could have sworn you wanted to know if the bill was coded and charged correctly. My bad!! So much this! It's hard to play the game when someone keeps moving the goalposts.
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NancysSummerSip
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Post by NancysSummerSip on May 13, 2014 8:25:56 GMT -5
I'm almost afraid to ask but is this their bill AFTER insurance kicks in. I am dumb as a red brick when it comes to hospital bills and insurance. Fortunately, the one time I had emergency surgery I had a good friend in medical profession who could read/interpret bills. Now I know I can ask @beerwench if I ever need info Good point. On the bill it will usually say that insurance is pending on some or all of the charges. I always wondered why, if the hospital has billed the insurance company, they don't just wait until payment has been made. I've been told that the bills are issued in a cycle that isn't in sync with insurance payments. The hospital has no idea when the insurance will pay, though I'm told most reputable insurance companies get the payments out within 60 days. I've been on the receiving end of a medical bill, only to call the billing department and been told that they received payment already.
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Deleted
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Post by Deleted on May 13, 2014 8:29:07 GMT -5
Ours runs every 30 days from when it was input into our system. If the person handling the account is any good they will look at the accounts before releasing the bills. Sadly, not everyone cares enough about their job to do it properly. Besides, going though the stuff before billing someone cuts down on bothersome phone calls! I've been here since 1999 and I still don't know why my coworkers haven't figured that out yet.
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tloonya
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Post by tloonya on May 13, 2014 8:32:36 GMT -5
I hate to open this can of worms but the mother could file an appeal. For her to do that though Loony needs to butt out and let a translator take over. The translator will know the proper procedure for filing a claim and trying to appeal charges. Loony screaming at people over the phone won't achieve anything. I strongly doubt the mother will be approved. The costs sound about right from what we've experienced for the same situation. But she could try. Her better bet would be to tell Loony to butt out and set up a payment plan with the hospital via a translator. Then she can pay what she can afford over time. Loony screaming at people over the phone isn't going to solve anything and will make them much less likely to work with anyone. False....some of it. I had actually set up monthly payments for them 2 weeks ago when all of it started. Then second bill came in and we started to question if that was a double charge due to the clerical mistake. I had nicely explained both billers that we are about to straighten this all out and will pay as agreed. They all agreed to wait a few weeks. Keep carrying on. I am glad you are getting your emotional fix here and after my thread you are all stress free (because you left it here) and you can go give people useful advices.
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tloonya
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Post by tloonya on May 13, 2014 8:35:15 GMT -5
This is Loony you're all talking about. Nothing will be right until SHE says it's right.
Loony vs Doxie? who wins? FINALLY! You got it. So now you know not to tell me what to do, right? RIGHT P.S. For people who listen to themselves only: count how many times in this thread I told posters 'this is all I asked for, thanks, that is what I needed'...go ahead, you have plenty of time on your hand, don't ya?
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Deleted
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Post by Deleted on May 13, 2014 8:36:18 GMT -5
Stop asking us "useful people" for "useless advice" then....
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tloonya
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Post by tloonya on May 13, 2014 8:37:52 GMT -5
My English to LOOONY-ese app is glitchy then, because I could have sworn you wanted to know if the bill was coded and charged correctly. My bad!! Yes! Not ever I said 'I will advice them not to pay the bill'. So let's drop it!
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