This spring, my wife’s grandfather passed away after a short illness. During the course of it he was hospitalized for 5 days and had one ambulance visit where he was not transported. Soon after his estate started getting the bills for his medical care. My MIL initial though was to pay everything that came in at once. My wife and I was able to convince her to wait until the estate got final bills as well as to let us look over a itemized billing and the EOB from the insurance company.
Fast forward two months later. MIL is getting worried about these bills. She already paid the bill for the Ambiance as she though they would refuse to come if no one paid them. She also did not want to call any of the billing departments to get a itemized statement because they might yell at her. So she finally brings me the bills and the insurance EOB.
It becomes apparent with just the EOB that something is messed up. The EOB had the estates responsibility at under 2k while she had bills for around 5k. A few calls turned out that the hospital had received additional payments and that they had not sent a revised bill yet. The bill was in line with the coverage at that point (just hospital copay for 5 days)
Had I not taken a look, she would of sent them a check for over twice the amount she should of.
I then noticed on the EOB that the ambulance bill was denied for being out of network. That did not make sense as their is only one ambulance district that serves the area. Calling the insurance company determined that they were in fact out of network, but they should of covered 80% of the bill. It took getting the billing person for the ambulance as well as a insurance rep on the phone to get that straightened out. So since she already paid it, she now gets to wait 60+ days for the billing to process before the estate is refunded $500.
Lessons learned here are in the US, medical bills are complicated as fuck and mistakes on billing will happen. At the bare minimum, compare your EOB with the bill and question anything that was denied.
Submitted June 21, 2018 at 09:58AM by Master-Potato https://ift.tt/2lmomoE
