Defeated....::vent::

probe1957

mrstjohnson

Plus, I think some insurance companies will pay for it, so they just assume they can charge you that much and "someone" else will pay for it.

My son had some lab work done the other week.  The lab billed $600.  Blue Cross paid $7.  We are not responsible for the rest.  I guess that is their agreement with BCBS.

whaaaat?! I have BCBS now (used to have Harvard Pilgrim) ow that scares me...

I think when it comes to medical emergancies doctors can't expect people to just have tons of money sitting in the bank and a payment plan is absolutely far (no hospitals have objected me from it, since they bill you / tell you the price after the procedure). Some people don't have credit cards, good credit, or anything to pay in full. I've never heard of a hospital not compensating for this reason. A hospital may not be a bank, but for medical emergancies you can't expect people to be able to pay... but...

When it comes to things like a pregnancy... personally I will not have a baby unless a crap load of money is sitting in the bank. But I still find it odd that a doctor dropped someone after being that far into pregnancy. I agree that there must have been some type of miscommunication. A payment plan or a discussion should have been set up the second you realized you didn't have $1300.

Still wishing you luck with it, hope we hear from you soon.

probe1957

dogslife

And a problem with ethics.

An ethical problem?  I guess I don't see it.  If you don't pay your gas bill, the gas company shuts off your gas.  If you don't pay your electric bill, the electric company shuts off your electricity.  Is there an ethical problem there too or are only doctors to take the abuse of not being paid?

I agree with you Billy when it comes to life CHOICES (i.e. pregnancy, plastic surgery, etc) [all though she is clearly in a tough situation and I mean no harm to her emotions] but sometimes I don't feel bad for people who don't think things through. You need to have money in the bank to start a family.

When it comes to life EMERGENCIES (i.e. heart attack, stroke, etc) and if there is still a balance left over I think it is absolutely fair to set up a payment plan. People don't live their lives day by day thinking 'oh I might be at death's door today, so I should save some extra cash'. Do some people? Yes plenty of people have money in the bank for emergancies; but most people seem to be in debt verses savings.

AB, that sucks. I hope you can find an option that works for you :/. I know how it feels to need medical care and to not be able to afford it.

sl2crmeg

And SOMETIMES, Pom, things happen, and we don't all choose to end a pregnancy.

Hense the word CHOICE? If you are keeping the baby by CHOICE and you can't PAY for that... yeah I agree with Billy 100%. I also believe everyone is entitled to their own opinion around here.

Moderator speaking...general reminder,

ALL folks posting need to remember that this thread is not about them, or their choices. Forum rules are in effect.

 I feel bad for you AB, I think you should move to Canada....LOL. 

Once again, glad to be Canadian. 

It is true that doctors have contracts with the insurance companies.  They can only charge what is agreed upon with the insurance company and they can't just haphazardly change the charge.  There may have been some miscommunication.  I would definitely call your insurance company and discuss the situation with them.  There may have been a mistake.  Sometimes doctors don't file to the insurance company--might have happened with the sonogram.  I know I was in a bad accident and doctors were billing me.  I called the insurance company and found out the doctors had not filed with them.  It will not hurt to call the insurance company to check what is going on and also to see what help you can get from them.  Also, if the insurance is with you job, call the department that handles insurance and explain your situation.  Between the two, they may have suggestions to help you.  I would not think that either would want you to have your baby without the proper prenatal care and without a physician present.  In the long run, it would benefit them to help you out. 

I wish the best for you.  Please let us know how things are going.  And CONGRATULATIONS on the new baby!

probe1957

mrstjohnson

Plus, I think some insurance companies will pay for it, so they just assume they can charge you that much and "someone" else will pay for it.

My son had some lab work done the other week.  The lab billed $600.  Blue Cross paid $7.  We are not responsible for the rest.  I guess that is their agreement with BCBS.

That's good insurance for you .  I unfortunately don't have good insurance and have a $5000 deductible, the way it works is the doctor/hospital bills the insurance company, the insurance company pays what they will pay and the patient is responsible for the rest up to their deductible, after that the insurance pays 100%.  The rates are lower per the insurance, but not by too much.  I don't have BCBS, I have United Healthcare High Deductible (no choice at work). 

For example, Riley's immunizations last year cost $700 - that's after insurance rates.  If I haven't met my deductible yet, I pay $700.  If I take her to the health department they are free.  So, we go to the health department now.

Now, when we had DH's Michigan Insurance, all we paid was a $10 co pay for office visits and $25 for ER visits and $10 for perscriptions.  No deductible...man I miss those days!

Please, don't take one tiny fragment out of my post and spill run off with your own thought. Talking about the ethics.

The topic of insurance and the communication that a certain price had been agreed upon, and most likely would be found in said policy or it had been agreed upon by someone in that office is the mainstay of my post...

It is ethical to be plain about what your terms are for payment if you own a business of any kind.  There are all kinds of forms of communications, the most important are the ones you have to read, and sign.

And please, anyone not ever had a double billing or over billing ?  It never hurts to dig further, ask and get some specific questions answered.

"who told you that the remainder would be just $1300?  If it was your insurance co. and the doc is only supposed to charge the insurance agreed cost at that lower amount, then you should not have to argue this.  If it was the doc office, then that argument would have to be taken up there, and probably not a winning one.

Review your policy. Talk to your insurance co. and confirm facts.

Doesn't seem right that you are that far into a pregnancy and are then dropped due to confusion of coverage.

Sounds like a major lack of communication. And a problem with ethics."

I would go into the Dr.'s office and in a very nice way, ask for a detailed statement of everything that has been charged, what you have paid and what the insurance has paid, it is the only way you are going to get to the truth. If you ask for it by phone it will take longer, if they even send it. Do it in person, be nice and respectfull to the staff, use volumes of sugar, be sincere but do not leave until it is in your hand.

 THEN:

Also you should have been getting EOB's (Explination of benefits) from your own insurance company, telling you what has been billed and what has been paid, and what the price is that they paid. Play match up. If you do not understand something call your insurance company, explain the situation to them, once again be sweet as can be.

If your (former) provider was in network with your insurance company, then he has contracted rates, they can charge whatever they want, but the insurance company and you will only pay set amounts based on your benefit plan. If he was out of network then he will still be held to certain rates and whatever your plan benefits are for out of network providers.

Either way you need to call and have your benefits explained to you so that YOU understand them.

Send me a pm if you have any questions.

dogslife

Please, don't take one tiny fragment out of my post and spill run off with your own thought. Talking about the ethics.

Huh?

dogslife

It is ethical to be plain about what your terms are for payment if you own a business of any kind.

To me, her doctor was quite plain.  You no pay, I no see.  But again, what I don't understand is why people just expect their doctor to allow them to make payments?  Why do they assume that is okay, without discussing that with him beforehand?  I don't assume, when I go to the grocery store, that I will be able to make payments if I don't have enough money to pay for what I am buying at that time.  I had my pickup to the mechanic yesterday for brakes.  It cost $600.  I am sure he expected me to pay the bill before I took the vehicle, which I did.  Yet, neither the grocery store nor my mechanic communicated that expectation to me.  I just assumed that they wanted paid immediately.  But some of us criticize the doctor when he expects immediate payment?  Some of us question his ethics?  Please?

I appreciate everyone's opinion. And I thank the people that actually had some suggestions to help.

I called another doctor today...who also was concerned that they dropped me so late in my pregnancy. And will see me and it won't cost me $1156 up front... only $500.. because they do not charge you the deductible. Another issue with my previous doctor, they never explained anything to me. This place took the time to help me understand.

To clarify to some people:

1. I was told by the doctor's office my portion would be $1300. And I have made payments, as we had agreed, to $700. At my last appointment they told me I still owed $1156... not the $600 I had planned for and explected.  I don't expect a hand out and I expect to have to pay, but I can not afford that in one payment. That is why I was dropped, because I could NOT pay $1156 all at once.

2. Yes, in an ideal situation I would have money saved up for all of this. Unfortunately life is not always according to anyone's set plans. Trust me, I would not be pregnant right now if my plans had gone accordingly. However, even with birth control I managed to make a mistake. A mistake that I am working my ass of to take care of... the right way. I am choosing to take care of my responsibility. Again. I thought I was being careful. Obviously not careful enough. But I am old enough to realize that this is my responsibilty.

3. Health care systems in the country suck. They just do. Especially for some of us who are not dirt poor or filthy rich. I am somewhere in the middle...where the gov't won't help and I can't afford everything.

4. There are other alternatives. Hence the reason I started out by contacting JPS (a low cost medical place). No, its not convenient. That place sucks IMO. I don't like their care. But I was/am willing to go them if I need to. And how do you think I know I am not eligible for Medicaid...I looked there too. And I called other doctor's offices. I didn't just cry and give up expecting someone else to take care of all of it myself. I knew there was no way I could afford THAT bill.. so I called and researched and found something I COULD afford... even if it wasn't convenient for me to do so...as I still work full time. And I found a solution.

 Again. I don't expect a hand out. Hence the reason I have a job and pay $160 a month for health insurance. If I was looking for convenience I would do just what I said someone else I know has done.... which is not work, not have health insurance, and just expect all the taxpayers (of which I am one) pay for all my care. All I expect is to be told upfront what is expected of me so that I can plan accordingly.

I am glad you have some sort of plan.  I do think you should call the insurance company and talk to them until you have an explanation you can understand. 

Doctors should explain your medical care so that you can understand it.  So it is good that you have one that will and I am glad you found him.  I respect you for trying to do the best that you can.  Life does happen, I agree.  Atleast you didn't just stop work and expect a handout as many would have.  That is something to be proud of and something to be admired.  I wish you the best of luck and the best for both you and your baby.  Try not to get to stressed, because that is not good for either one of you.  Remember to enjoy this time of your life, it is one that goes by so quickly and will mean so much to you in the future.  Again, my best to you and you sweet little baby.

AB - best wishes to you, I'm sure you'll figure something out but I'm sure it must be stressful for you right now. I think some people have never been in a situation where life really throws you a curveball and so it can be hard for them to relate, but I do respect you for following your beliefs and taking responsibility to the best of your ability.

My BF's mother had 3 kids, the first and last of whom were completely unplanned. (Apparently a faulty diaphragm, lol. The things you don't want to hear from a BF's mother...) They were dirt poor and really struggling, and ended up moving in to a tiny, crowded little house with some of the husband's family members. After a ton of scrimping and saving and some lucky breaks on job offers, 25 years later they own a beautiful home with 4 acres of gorgeous gardens, all 3 kids went to excellent private universities, and they have a strong retirement plan.

Keep your chin up. This too shall pass. 

westiegirl3

It is true that doctors have contracts with the insurance companies.  They can only charge what is agreed upon with the insurance company and they can't just haphazardly change the charge.  There may have been some miscommunication.  I would definitely call your insurance company and discuss the situation with them.  There may have been a mistake.  Sometimes doctors don't file to the insurance company--might have happened with the sonogram.  I know I was in a bad accident and doctors were billing me.  I called the insurance company and found out the doctors had not filed with them.  It will not hurt to call the insurance company to check what is going on and also to see what help you can get from them.  Also, if the insurance is with you job, call the department that handles insurance and explain your situation.  Between the two, they may have suggestions to help you.  I would not think that either would want you to have your baby without the proper prenatal care and without a physician present.  In the long run, it would benefit them to help you out. 

I wish the best for you.  Please let us know how things are going.  And CONGRATULATIONS on the new baby!

This is sort of true, doctors do not have to accept what the insurance company reimburses depending on their contract or the insurance company.  There are LOTS of doctors that don't accept insurance.  By this I mean that they will take what your insurance pays, but you are responsible for the other portion.  For example, the vascular surgery group at my hospital is like this.  If they charge 10 thousand dollars for a lower extremity bypass and your insurance pays them 1000, you owe them 9000.  This is of course discussed before hand.  It acutally is not your doctor's responsibility to explain your insurance benefits to you.  You should figure that out on your own, it's our responsibility to take care of you.  Many/Most of us have no idea how the different insurance plans function.  Some companies have 100 different plans and it's impossible to figure them all out.  I'm glad you are working to figure things out and being responsible.  It's nice to see people take ownership over their own healthcare and make calls and figure things out instead of insisting someone hand them the answer ;)