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Payment for clinical trials

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

OK, here is one for those in trials, and for our beloved lawyers. Remember that I've made lots of jokes but none about lawyers.
Last year when I went to Yale, I was pleading to be treated with IL-2 as I thought that was my only chance for survival. As you all know, I was offered a placement in the MDX-1106 trial if I qualified. So, I signed the protocal committment which set requirements that I had to agree with. Scans, biopsies, blood work. In return I get infusions every 3 weeks for up to 4 years if necessary, depending on my progress or lack thereof. Not only was I told that the sponsor, Bristol Meyer Squibb would provide my treatment free of charge but there is a statement in the contract that says, quote,

"You will be responsible for regular copayments associated with your office visits through your insurance company. The study drug, study-related procedures, and study visits will be provided at no charge to you or your insurance company."

So, since spring, I have been billed thousands of dollars for my care. So I disputed the bills but I have paid them because the bills had been turned over to a collections agency and I don't want my credit rating ruined. Now, I keep fighting with Smilow cancer hospital of Yale that the bills should be going to Bristol Meyers Squibb and not me. I do want Yale to be paid and BMS should be more than happy to pay them. For one, that is the agreement. 2, I am proving that this drug is going to make them millions and millions of dollars.

How can I be wrong? They say that I misunderstand the agreement, that it is confusing and that I am wrong. So after no luck with their billing dept., I have gone above them to hospital administration with my perspective. I am waiting for a decision but expect that they will not support my claim. So I am preparing for a fight.

I would never have had a hesitation to pay for all my care if I knew MDX-1106 would save my life. It's not the money. I want that to be clear. I contend they are not billing properly. I expect that the Yale lawyers will bang their heads together for awhile and determine that "at no charge" really means that it costs money. They don't seem to understand their own billing process.

So, has anyone else been given a bait and switch? And what would be the contract law perspective? I don't want to risk my participation in the trial. I want the billing to be corrected and then be reimbursed. Why should that be an issue? I have the support from my caregivers at the cancer center just not the billing dept. I think they are being lazy.I am standing my ground until proven wrong.

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

Fox, of course I hope you prevail.

Who are the parties to the contract?

From what you say, it sounds as though neither BMS nor anyone's lawyers are to blame, but solely the billing department of the Hospital. Did you challenge the issue of bills to you at the outset and, if so, what reply did you get from the billing dept?

In the bit of documentation you've quoted, what do you take to be the referent(s) of "You will be responsible for regular copayments associated with your office visits"? Are the bills you've been sent for things outwith the "study drug, study-related procedures, and study visits"? (If so, perhaps they're justified.)

Assuming not, then it sounds as though you've hit the nail on the head in ascribing the mess to laziness on the part of the billing dept. Have you approached anyone at BMS on the matter? As you say, they have much to gain from your exemplary participation in their trial and they also have much to lose by bad publicity. I guess they'd be very happy to pick up the tab in these circumstances and I think you should, indeed, stand your ground.

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

I knew I could count on hearing from you Tex.
I signed the consent. Also signed by the trial nurse coordinator. She was the one who first informed me that BMS covered the MDX program. I had given her all my bills starting back in the spring when they first began to arrive. She said she would look into it as it was not correct. There were issues of my deductibles but I insisted there was no deductible if my insurance wasn't paying for it. That nurse has since left the hospital and follow up had been dropped so I started to directly contact the billing dept. which of course is off campus. Most phone calls have been left in voice mails. Others have resulted in being told that they are looking into it but they don't have all the information necessary. And that I am wrong and that the contract is ambiguous. I do pay for copayments for my visits but that is different. The contract is stamped and approved by the "Yale University Human Investigation Committee".
The bills started right off for my biopsies, scans, and even "chemo" as billing refers to my infusions. They obviously don't even have a proper billing code for infusions. I happily have paid for other services such as my skin biopsies and surgical procedures for removal of my skin cancers. None of which is related to the trial.
I have sent an email to BMS but they sent me a message saying, "thank you for your time to contact us. We do read all emails but due to an overwhelming amount of them we do not answer each one..Gee thanks.

Now the thing is that if I don't follow the protocol, then I can be dropped from the study. Therefore ALL requirements that I must meet are part of the protocol. That includes the biopsies, scans and keeping all my appointments and not skipping infusions. that means "The study drug(infusions),study-related procedures(biopsies, blood work and scans) and study visits will be provided to you at NO CHARGE to you or your insurance company. ?no?

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Fox - John and I have been going through his trial paperwork and found two sheets that we had forgotten we had. Perhaps it's something you already have, but I'm unsure from your writeup. These two pages entitled, "Insurance and Research Participant Responsibility Information Sheet" spells out what the insurance/participant covers versus the trial sponsor (BMS). If you think it would be helpful to review, I've scanned it into my documents and will be happy to forward. However, you'll have to pm me your private email as I don't think we can attach to CSN messages. Just let me know.

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

I recieved nothing like that. Also still haven't heard back from Yale since I contacted the program director.(whatever her title) I'll leave you an email. I understand the email doesn't notify us of new messages so just check your messages. Thanks again. You are wonderful. I appreciate it.

todd121
Posts: 580
Joined: Dec 2012

Fox,

I don't know if this would help, but every university that has research trials has a review board that makes sure they are following all ethical guidelines in treating their patients. I believe these review boards have quite a bit of pull with all different aspects of the trials and a lot of power within the university. My daughter-in-law worked on one at a local university.

Perhaps getting in touch with the IRB (I think that's what they are generally called), and getting them involved would help straighten it out? I would claim that the university is behaving unethically in billing you for study-related expenses instead of billing them to the study.

Might get some headway with that approach?

Todd

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

I've been in contact with the trials review "person". Was told that I would hear back in a few days. That was several weeks ago.  I will be a bit more patient. I must have put a big effin bee in their bonnet. I don't need to stir it up.  By the way, I had to pay another bill today to the collections company that follows up. The woman has been very understanding and gives me a 20% discount. My wife thinks it should be more. I just figure that they will have to reimburse me anyway.

pjune127's picture
pjune127
Posts: 127
Joined: Dec 2011

Here's what my document states.

There is no cost to you for the study doctors' fees for study clinic evaluations, procedures, and tests required to be done solely for study purposes. All bills for routine care (things you would have done even if you were not taking part in this study) will be billed to you or your insurance company. You or a third party will be responsible for the costs of all study doctor's visits, physical exams, lab testing, medications, x-rays, scanning procedures and other procedures used in this study, that are not incurred solely for research purposes. You will be responsible for any deductibles or co-payments required by your insurance company or third party payer. Some insurance companies and third party payers may not pay for treatment or lab tests conducted as part of a research study, including hospitalization costs. If your insurance company does not pay for these costs, you will be responsible for them. However, you should be aware that certain health benefit plans are required to cover care provided in the course of certain research studies. You should consult with your health benefit plan to determine whether the costs of care incurred because of taking part int his study are covered.

For more information on insurance coverage for clinical research studies, you can visit the Nation Cancer Institute's website at http://cancer.gov/clinical trials/understanding/insurance-coverage

Like you, I never considered NOT being in the trial if I was accepted. I am just "letting God take care of it" right now and have not yet had any snafus.

I have never received a bill from Sarah Cannon. I have Blue Cross Blue Shield insurance.

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

I do understand the concept of "routine care" that me and my insurance co. are responsible for. I think that is a major part of their argument. I understand. But they send bills to my insurance. They collect a partial payment or a denial, then bill me for the remainder. Including my "Chemo" which insurance wouldn't pay as it is a non approved FDA drug.
My contract only has that one quote I mentioned re:my responsibility for copayments and all else is it no charge. I guess they left alot out.

Additional costs are my responsibility. I know. For example, it seems that when I was recieving radiation, they didn't properly get my ins. auth. so it was denied and I have recieved a $30,000 bill for that too!....Radiation was not done at Yale. So that is not their responsibility.

Here is another pisser. My insurance company changed some time this spring. This has meant that I had a deductible from my last insurance for 2012. Then another deductible to meet with my new insurance. That was a quick $5G down the drain. Oh well. At least my Harley is paid for. And I know how to camp with it. So by summer you can reach me at Pine Hollow campground after I sell my house.

And I like your new picture. I will work on getting a new one up also. Gotta figure it out. Don't even know how I put mine up the first time.

Limelife50's picture
Limelife50
Posts: 411
Joined: Nov 2011

Cant wait for universal health care to kick in so everyone can recieve the same healthcare without having to worry about how to pay.

garym's picture
garym
Posts: 1651
Joined: Nov 2009

if you meant to be funny, but I am LMAO!!

Limelife50's picture
Limelife50
Posts: 411
Joined: Nov 2011

A little sarcastist and yes funny

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

I'd assumed Mike's remark to be in all seriousness. Is there widespread cynicism in The States about a goal of universal healthcare, or at least, greater eequality of access?

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

American politics prevent common sense from dictating policy. Universal health care would be socialism and therefore not likely to be achieved in the U.S.

garym's picture
garym
Posts: 1651
Joined: Nov 2009

Speaking only from personal experience as an employer, and not wishing to start any arguments, I'll state the following. My cynicism comes from the fact that from inception in 2011 to full implementation in 2014 the so called "Affordable" Healthcare Act (aka Obama Care) will have doubled the premiums I pay to provide this already expensive benefit to my employees, and this is true for every employer I have talked to. This makes us less and less competitive in the world market place and only worsens the situation as the number of employed declines and the number of those in need increases. I have no axe to grind with the need for reform, but simply sticking it to those that are left paying taxes is not going to work IMHO.

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

I have neighbors who were given a golden handshake when a local division of General Motors moved. They put in 20 years of employment and have not had to work since the early 80's. Full benefits. Both have 3 vehicles, including corvette, $50k pickup, and 2 cadillacs. They have cost of living adjustments that keep them ahead of us in income. AND full medical for them and families.
In our case my wife is paying a $1,000/month for our health insurance on top of our current medical bills. That's insane. And we work in health care. But those on welfare not only get housing, food, cellphones, cable tv, and all health care services for free,they get free taxi service to appts. How does anything in health care make sense?
My brother in law retired from the state after 20 years service at 47 years old. Full benefits and health care at no cost. He is now 75 years old. They paid for my sisters dialysis for years. So every working person is already being unfairly taxed so that others can get a free ride. Somehow there needs to be a balance.

And how does one justify CEO's making 100x the hourly wage of front line workers? Especially Insurance CEO's bringing down millions a year yet deneying basic coverage for it's members?

garym's picture
garym
Posts: 1651
Joined: Nov 2009

I totally agree and I think you start with putting all politicians and government employees back in the boat with the rest of us. You want reform, take away their, self instituted, tax payer paid for, perks and entitlements, take away the bloated reelection accounts and contributions, limit income to a reasonable sum and give them access only to the same healthcare and retirement systems as those they represent, and let them pay for it out of their pockets like the rest of us. There seems to be a large misconception that the government has its own money, or a lack of understanding that whatever the government spends, no matter on what, it comes directly, dollar for dollar, out of the taxpayer's pocket. So when one person gets something for "FREE" from the government it is actually being paid for by taxpayers with additional fees added on for some bureaucrat to manage the transaction. My father used to call it "The inmates running the asylum."

Joe_fh
Posts: 47
Joined: Aug 2012

... as a different way of looking at it ...

Have you considered that in the boxing ring of politics, AHCA was never supposed to work? IMHO it is a stepping stone toward a single payer system. It's my belief that as the full weight of AHCA bears down, it is by design a means to loosen resistance to creating a single payer system.

Historically speaking, the United States is fully vested in the "Employer supplied HC System". There was no way in the political arena to make the leap from A to C without first dabbling at a mid-point.

Who knows where we go from here, I only know (or think I know) that this is not the destination.

... just saying

I am alive
Posts: 221
Joined: Jul 2012

You are probably right, Joe, in that the AHCA as it stands today is not its ultimate destination. It is what it's proponents could get passed into legislation at the time. It most certainly will evolve. But here's what I have been wondering vis a vis this discussion. Why has no one mentioned the pre existing condition clause when we are all in that boat? In this economy it is not inconceivable for any of us - or our spouses - to lose a job, or a business. Sure there's Cobra, but that only goes so long. And you need to be able to afford it. One slip in coverage and any of us are royally screwed. None of us can be cocky about this. If having cancer has taught us one thing, it is that anything can happen, at any time, with no warning. So I, for one, am grateful for this particular clause, among others, in the AHCA.

Limelife50's picture
Limelife50
Posts: 411
Joined: Nov 2011

I spelled sarcastic incorrectly but oh well it was late.I had started a thread a few months back on this same subject of health care and how i feel people with health insurance are more welcome than people without.Here i believe most health facilities here are high profit buisnesses that overcharge and yes sure there are free clinics and even a free county hospital in my county but you to travel long distances and then wait long hours to get any medical attention.Something really does need to be done in this country so everyone has access to the same qaulity healthcare if not thousands upon thousands of people either suffer or lose their lives due to the lack of qaulity health care for people without health insurance.

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

Thanks for the responses guys. It seems clear that the ideals of equal access are being thwarted by disastrous implementation of welfare policy and the "something needs to be done" rings out from all but the freeloaders.

I don't have the temerity to offer opinion on American politics - I just hope matters move in the right direction. I guess the lament about public sector employees being feather-bedded is common to many different societies.

garym's picture
garym
Posts: 1651
Joined: Nov 2009

Ben Stein:

"Fathom the hypocrisy of a government that requires every citizen to prove they are insured... but not everyone must prove they are a citizen."

Now add this, "Many of those who refuse, or are unable to prove they are citizens will receive free insurance paid for by those who are forced to buy insurance because they are citizens."

garym's picture
garym
Posts: 1651
Joined: Nov 2009

"Anyone who thinks he can be happy and prosperous by letting the Government
take care of them; better take a closer look at the American Indian."

Henry Ford I

Wolflvr's picture
Wolflvr
Posts: 14
Joined: Dec 2012

I agree that people who don't have health care are treated differently/poorly compared to people with. I also believe that much of the time people with Medicaid are treated VERY badly. It seems that if you get medical assistance you are looked at as someone who is getting a "free ride". While I do completely understand that this is very often true (and am just as frustrated by it as the next person) it makes me crazy when I or my family are treated that way. Here's why....

My husband works like 3 whipped dogs and always has. The man never sits down and has busted his behind for the same company for the last 12 years. They do not offer insurance. Up until 2007 (when I was diagnosed with epilepsy) I worked at least 2 and sometimes 3 jobs. I provided our health insurance through my main job as I was the main breadwinner at the time. He works construction, I have management experience and also veterinary technician training and dog training so was able to get higher paying jobs that offered insurance. When I got sick that went down the drain. I lost my jobs, my insurance, everything. We had to sign up for medicaid and for a short time welfare. We were desperate and drowning. BEFORE I got my disability we had reined in our bills and learned to manage on his income so we dropped the food stamps and other benefits and kept only the insurance - despite the social workers constantly telling us we qualified for more. He looked for other jobs, but the market is hard and at least he has a job. I got disability and Medicare, but my kids still needed insurance and so did he (though he constantly tells me he doesn't - that's what duct tape and super glue are for!).

We are still well below poverty level, quite frankly, despite owning a home I adore and having food on the table. We still qualify for all of those extra services but we don't take them because we take only what we really need. I AM looked at differently quite often right after I hand them the second insurance card. The one that pics up what medicare misses. The one that labels me as lazy. The one that says that person is paying for not only my healthcare, but also my food, my clothes, my rent, my electric, my cellphone. No they're not. We pay taxes. He works damned hard and so did I. I'd bet I worked harder between the ages of 13 and 27 than a lot of people did during their whole careers.

Anyway, yes, there needs to be reform, there needs to be change, there needs to be many many things. But a little less judgement sometimes would be a good start IMO.

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

Just lately we've had several new members here who have been through a lot but keep their chins up, have the ideal attitude and have penned messages so inspiring that some of us old folks can retire (of course, not including Methuselah, who dates back to the ice age!).

Wolflvr, someone on another thread (Alice, maybe) opined that you will make a lot of friends here and that seems to me to be a very safe call. I, for one, am hoping to hear a lot more from you and to see you getting the breaks you and your Family so richly deserve.

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

Don’t believe anyone disagrees with the necessity of health care reform. And I think this thread—while spouting many different opinions—reflects that need with a common denominator of frustration, growing frustration. It’s evident in people receiving and needing care, the hospitals and doctors providing care, and the taxpayers paying for care. We are all frustrated and lack confidence in our egotisical, greedy politicians who bicker like children while our country falters.

I hope the frustration will unite us--not divide us--and promote positive change. I'm sure no one intended to offend you.

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

Thought I would mention that I was told that they would get back to me in a couple days. Haven't heard anything yet. Alice, thanks for the info you had given me. Sort of my Ace in the hole.

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

I hope in your case - no news is good news, as long as the silence isn't accompanied with more bills. I continue to keep my eyes open for some type of uniform guidelines in regard to trials, but no luck thus far. Keep us posted on appeal. "Fox versus Yale" sounds kinda cool. ELF

Wolflvr's picture
Wolflvr
Posts: 14
Joined: Dec 2012

I agree with everything you said, Alice. So sorry if I seemed offended, I'm not at all. Was simply adding my experiences and feelings about the subject to the others posted. It will take much more than a conversation about healthcare and politics to offend me, lol.

TX- Thank you.

Fox- I hope things work out for you. You've been through so much and I would have interpreted the trial terms the same way you did. It seems crazy to me, but then many things do.

garym's picture
garym
Posts: 1651
Joined: Nov 2009
1. In my many years I have come to a conclusion that one useless man is a shame, two is a law firm, and three or more is a congress.
-- John Adams
2. If you don't read the newspaper you are uninformed, if you do read the newspaper you are misinformed.
-- Mark Twain
3. Suppose you were an idiot. And suppose you were a member of Congress. But then I repeat myself.
-- Mark Twain
4. I contend that for a nation to try to tax itself into prosperity is like a man standing in a bucket and trying to lift himself up by the handle.
-- Winston Churchill
5. A government which robs Peter to pay Paul can always depend on the support of Paul.
-- George Bernard Shaw
6. A liberal is someone who feels a great debt to his fellow man, which debt he proposes to pay off with your money.
-- G. Gordon Liddy
7. Democracy must be something more than two wolves and a sheep voting on what to have for dinner.
-- James Bovard, Civil Libertarian (1994)
8. Foreign aid might be defined as a transfer of money from poor people in rich countries to rich people in poor countries.
-- Douglas Casey, Classmate of Bill Clinton at Georgetown University
9. Giving money and power to government is like giving bombing instructions to muslims.
-- P.J. O'Rourke, Civil Libertarian
10. Government is the great fiction, through which everybody endeavors to live at the expense of everybody else.
-- Frederic Bastiat, French economist (1801-1850)
11. Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it.
-- Ronald Reagan (1986)
12. I don't make jokes. I just watch the government and report the facts.
-- Will Rogers
13. If you think health care is expensive now, wait until you see what it costs when it's free!
-- P.J. O'Rourke
14. In general, the art of government consists of taking as much money as possible from one
party of the citizens to give to the other.
-- Voltaire (1764)
15. Just because you do not take an interest in politics doesn't mean politics won't take an interest in you!
-- Pericles (430 B.C.)
16. No man's life, liberty, or property is safe while the legislature is in session.
-- Mark Twain (1866)
17. Talk is cheap...except when Congress does it.
-- Anonymous
18. The government is like a baby's alimentary canal, with a happy appetite at one
end and no responsibility at the other.
-- Ronald Reagan
19. The inherent vice of capitalism is the unequal sharing of the blessings. The inherent
blessing of socialism is the equal sharing of misery.
-- Winston Churchill
20. The only difference between a tax man and a taxidermist is that the taxidermist leaves the skin.
-- Mark Twain
21. The ultimate result of shielding men from the effects of folly is to fill the world with fools.
-- Herbert Spencer, English Philosopher (1820-1903)
22. There is no distinctly Native American criminal class...save Congress.
-- Mark Twain
23. What this country needs are more unemployed politicians.
-- Edward Langley, Artist (1928-1995)
24. A government big enough to give you everything you want, is strong enough to take
everything you have.
-- Thomas Jefferson
25. We hang the petty thieves and appoint the great ones to public office.
-- Aesop
 
FIVE BEST SENTENCES EVER
1. You cannot legislate the poor into prosperity, by legislating the wealth out of prosperity.
2. What one person receives without working for...another person must work for without receiving.
3. The government cannot give to anybody anything that the government does not first take
from somebody else.
4. You cannot multiply wealth by dividing it.
5. When half of the people get the idea that they do not have to work, because the other half is
going to take care of them, and when the other half gets the idea that it does no good to work,
because somebody else is going to get what they work for, that is the beginning of the end of any nation!
Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

A lot of great lines there - unsurprisingly from Mark Twain and Winston Churchill but some real good ones attributed to Reagan as well.

There's many a true word spoken in jest but sometimes such apophthegms are more clever than true - for instance "You cannot multiply wealth by dividing it." is appealingly witty but goes against what I for one, believe inThere are many would-be entrepreneurs who could multiply wealth for all if they had the funding to pursue their ideas into production and many wealthy despots who preside over starving populations where a fairer division would be better for all, except the lice in control.  That said, I like 19 in your list, Gary.  

It's a great comfort to see that there's no prospect of your ever running out of highly entertaining material!

saintmont
Posts: 43
Joined: Feb 2013

I live in Australia, I was on the Sutent and Everolimus trial amd every thing such as mri, ct scan, bloods and doctors were payed by the drug company involved.

Now I am off the trial all ct scan,mri, bloods, drs are billed to the government. I will be going on to votrient in next couple of days and that is on our pbs scheme which means the it will cost me about $36.20 a month because the government subsides drugs. I dont have any health insurance we are very lucky in australia.

tacyarts
Posts: 73
Joined: Apr 2012

I am on the sutent/ mdx trial and my co pay for is now $3500 for a month. I'm not sure what I'm going to do.

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

I have been sending emails to billing and the director of trials. 8 weeks ago they said they would get back to me in a couple days. Still nothing. So, my latest said," Do you recommend that I again approach higher management levels to resolve this issue?" Yep, no answer. No email It must be going on a year. Then last week, after 5:30, I get a call from the nurse who supervises the treatment trials. She tells me that they are dilligently working on this as we speak. I told her that after all my efforts to deal with the proper responsible people, they had the audacity to have an RN call me! She said you will recieve a reply by next week. Guess what? the week is over again. I thanked the nurse for her involvement but the only business between us is how I am doing. I nicely said that billing is none of her business. What have I instigated? I just don't think that anyone is listening. I am not saying that I don't want to pay. And I am current with thousands of dollars of payment. I keep trying to tell them that according to the protocol they gave me and had me sign, it says, "At NO cost to you or your insurance for ALL protocol related procedures." The protocol specifically states I will have biopsies, scans, blood work, and treatments as THEY determine.  So, all I am telling them is to send the bills to Bristol Meyer Squibbs per contract that they made me sign and abide by. Has this never been questioned? Have they been so lazy that this problem is years deep in improper billing? Are they in deep crap with correcting everything? I haven't been more aggressive because I really like everyone involved in my care,  and Yale New Haven hospital. I don't want to jeopardize my care. Maybe it's time to invovle someone in contract law to look into this.

Tacyarts, I don't know what I would do in your situation either. I hope we all get through this. It just wouldn't be right to make our families go broke and then we die anyway.

DonMiller's picture
DonMiller
Posts: 96
Joined: Feb 2013

Hey.  I joined up the other day.  I had my surgery on October 5th. 11CM pT3a   grade 3 with sinus fat and vascular involvement as an added bonus.  Didn’t have a sick day in 30 years. No symptoms or anything. Sounds like most of you guys.

I am a lawyer in New Jersey but I am of no help unless you want to buy a business or get divorced.  I do think should consider being as proactive on the legal front as you are on getting treatment.  Not all lawyers are *******s.  As of basic rule of law, all contracts are construed against the people who drafted them.  I have been sometimes able to resolve problems for people just by writing a strong balanced demand letter.  The medical people are not involved in billing so it never affects their attitude towards you at all.

There are often contractual provisions which limit the time you have to formally contest these issues. You don’t want to miss a deadline.  Like you, I am really worried about spending every penny and then some and then dying anyway.    

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

Thanks for the advice. It is my point exactly. It's their contract. That's all. And yes the care givers aren't involved in the business end so they treat me great.

alice124's picture
alice124
Posts: 860
Joined: Mar 2012

It's hard to believe they still haven't attempted to rectify this. Perhaps its because they have no motivation to do so. I'm not the lawyer of the family, but it seems to me that if you write a letter to the administrators and BMS with a copy to your credit bureau saying that "since your inquiries continue to fall on deaf ears,  any future payments will be placed into escrow until the billing inconsistencies are resolved",  maybe it will get their attention.

This thought just came to me reading your post. John isn't home right now but I'll run it by him when he returns. I'm not sure a letter from an out-of-state lawyer would carry any weight, but I'm sure--if you think it would--John could help you out.

 

 

foxhd's picture
foxhd
Posts: 1914
Joined: Oct 2011

Escrow is a good idea. At this point I don't want to make this a legal issue because I think something will be straightened out. Sometimes I am still naive. I have several lawyer friends who I will be able to approach if needed. I can still afford to pay my bills and it shows good intent on my part. I think the inaccurate billing system has just been exposed and they are trying to cover their a**es before action. Thanks Alice. I've been missing you. Try to enjoy your retirement.

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