Hospital Bill #2
This is the second post on a 3-Part Series, dealing with one particular medical bill.
Called 9/8– I now had the information the last person asked for. It was on their website. I mean, if I can access it via their website, shouldn’t they be able to find it? There were 3 fairly large charges that were getting passed on to me.
I was told my doctor was a participating provider, but out-of-network. Basically that means I have a $100 copay each time a doc sees me in the hospital. However there is a $1,000 cap that I pay out of pocket for these types visits. So why am I paying for this? I’m already paying a $3,000 bill to the hospital. So when was my deductible met?
After 42 minutes, the representative was able to explain to me why I have to pay this bill. The services rendered were out-of-network with a participating provider. When I go out-of-network, I have a $1,000 deductible. There’s ALSO a different category that is a $3,000 out-of-pocket, which is another $3,000. Surely I had paid and met these requirements.
The rep took the time to count up all of my out-of-pocket expenses to see when I had reached my combined amount of $4,000. Turns out that as of today, I had paid $3,900.50. I’m $99.50 away. Figures!! Bad News: I do have to pay this bill. Good News: Once I pay another $99.50, I will have no co-pays, no co-insurance or deductibles for the rest of the year.
That got me thinking. I’ve been doing in-patient treatments once a year. With this insurance I know understand that it will cost me $4,000 a year. So do I try to get into the hospital now for another treatment before the end of the year? I haven’t been doing very well and could probably benefit from a ketamine stay. I’m frustrated that money and insurance are starting to dictate how and when I get treated, but I gotta be smart about this. I see the doctor in October and will discuss.
I also realized that I didn’t ask to put this on a payment plan and now I’ll have to call back tomorrow to set that up. Blah!!
Click here to read the first post in this series:
This picture is being sold as part of a fundraising effort between the US PainFoundation and 540WMain, a non-profit run by my dear friend Calvin Eaton in Rochester, NY. Learn more about this project and how to purchase artwork by those who have chronic pain conditions.
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