Some co-pay advice

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Jennifer1961
Jennifer1961 Member Posts: 137
edited March 2014 in Breast Cancer #1
Well I've had quite a few procedures and will start chemo next Friday.

When I got my biopsy I was told by the medical office finance person that I needed to pay $330 up front. so of Course I did. Insurance came back and my co-pay should hve been about 220. Surgeon's finance person told me to pay $200, my actual co-pay is $80. The hospital told me to pay $920 up front for my lumpectomy. Actual copay $175 FRIGGING DOLLARS!.. They still have my money and I'm so pissed off about it.

I'm having my port put in on Wed. and I asked the insurance people how to avoid getting "hosed". They advised me to tell them I didn't have the money and to request a payment plan. Please be aware of this. They have my money that I could be paying my other medical bills (which are plenty) with. When these people tell you what to pay, make them get on the phone with the insurance company while you are there and get the actual copay. I had an echo cardiogram and they were insisting I needed to pay a $350 deductable. I DON'T HAVE A DEDUCTABLE FOR IN NETWORK DOCTORS! They argued and argued and finally I called the insurance co. on my cell phone and lo and behold they backed off. I just needed to pay $40. Once you hand over the money it can take months to get it back. It's tough to put up with this crap when you're sick but you have to do it.

Comments

  • sbmly53
    sbmly53 Member Posts: 1,522
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    I agree,
    I work in a medical office. Co-pays are a nightmare, when in doubt, I always advise the patient to wait to be billed. I don't care what finance says, it's easier to get it right through billing than to fix it after you overpay, and I will not do anything that will be a burden to my patients. Sheesh!

    Sue
  • ladyg
    ladyg Member Posts: 1,577
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    Guess I was lucky
    I guess I was lucky. When all of my treatment started no one had their hand out. The only thing I paid was at the Surgery Center. They insisted that I pay up front. When my insurance paid them more than they thought I got a refund check immediately.
  • cavediver
    cavediver Member Posts: 607
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    good advice!
    I agreee, dealing with the tests, treatments, surgery, chemo et al is more than enough. I was overwhelmed when one of my dr. office owed me $350 they collected as a co-pay deductible and insurance said I had already met my deductible and max out of pocket and the dr. should reimburse me. Well that took multiple phone calls to his finance office and unnecessary stress for me....and 6 weeks later I finally got the refund! The next several doctor visits (different drs.) they all wanted me to pay co-pay, and I explained I had med max out of pocket........each time when I refused to make a copay, and after they finally took time to contact BCBS, they accepted I did not have to pay anything. It is frustrating to have to fight the finances when so much else is going on for us to focus our strength on........
  • MichPro
    MichPro Member Posts: 19
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    Money
    Money is as scary as the cancer, especially when you support yourself all by yourself and have used up all your paid leave.
  • survivorbc09
    survivorbc09 Member Posts: 4,374 Member
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    ladyg said:

    Guess I was lucky
    I guess I was lucky. When all of my treatment started no one had their hand out. The only thing I paid was at the Surgery Center. They insisted that I pay up front. When my insurance paid them more than they thought I got a refund check immediately.

    I am lucky too. With my
    I am lucky too. With my husband's health insurance, I only have a copay of $20.

    Hoping you get your money back soon.
  • GregStahl
    GregStahl Member Posts: 188
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    Everyone
    should of pre-cert'ed the proceedures and knew exactly what the co-pays were. My wife works for a hospital in insurance billing and every single thing she has had done was pre-cert'ed and approved and we knew how much to bring.
    If they are holding your money, call your insurance company and see if they have someone that can work with you or on your behalf to get your money back
  • jamiegww
    jamiegww Member Posts: 384
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    I also had my money "held hostage".
    I had to pay almost $900 during a pre-op visit to get my port so I put it on my credit card thinking that I could get a credit if for some reason I didn't get the port. I did cancel the surgery because I changed doctors and hospitals but the hospital would not issue a credit on my mastercard claiming they had to apply it to my account. I argued that the charge was made in lieu of a procedure that did not take place so they didn't have any right to that money. I considered having my credit card company withhold payment but was afraid I would be turned over to a collection agency even though I had been paying their bills immediately upon receipt. I got my first dose of chemo at that hospital and had to pay 20% as opposed to a $25 co-pay at the cancer center I switched to afterwards. The hospital I switched to didn't ask for any kind of deposit before my port surgery. It is difficult enough to deal with a cancer diagnosis without having to worry about being taken advantage of. It's sad, but apparently some of us have to shop around and we have to find that out the hard way. I also think it's sad that to avoid "being hosed" you have to humiliate yourself and request a payment plan. I'm sorry this ended up being so long but I appreciate the chance to vent on this subject. Hang in there and I hope it gets easier for you.

    Hugs!
    Jamie
  • dottie68
    dottie68 Member Posts: 31
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    jamiegww said:

    I also had my money "held hostage".
    I had to pay almost $900 during a pre-op visit to get my port so I put it on my credit card thinking that I could get a credit if for some reason I didn't get the port. I did cancel the surgery because I changed doctors and hospitals but the hospital would not issue a credit on my mastercard claiming they had to apply it to my account. I argued that the charge was made in lieu of a procedure that did not take place so they didn't have any right to that money. I considered having my credit card company withhold payment but was afraid I would be turned over to a collection agency even though I had been paying their bills immediately upon receipt. I got my first dose of chemo at that hospital and had to pay 20% as opposed to a $25 co-pay at the cancer center I switched to afterwards. The hospital I switched to didn't ask for any kind of deposit before my port surgery. It is difficult enough to deal with a cancer diagnosis without having to worry about being taken advantage of. It's sad, but apparently some of us have to shop around and we have to find that out the hard way. I also think it's sad that to avoid "being hosed" you have to humiliate yourself and request a payment plan. I'm sorry this ended up being so long but I appreciate the chance to vent on this subject. Hang in there and I hope it gets easier for you.

    Hugs!
    Jamie

    i HAD A LUMPECTOMY WHEN I
    i HAD A LUMPECTOMY WHEN I WENT FOR THE SURGERY, HOSPITAL WANTED 550 DOLLARS, TOLD THEM I DIDN'T HAVE IT, THEN HAD TO HAVE A MASTECTOMY, THE HOSPITAL WANTED 550 BEFORE SURGERY, AGAIN I TOLD THEM I DIDN'T HAVE IT. WHEN INSURANCE PAID, IT PAID ALL. THIS REALLY UPSET ME, WHEN I SET UP THE DATES WITH THE HOSPITAL, THEY DIDN'T MENTION THIS. I WONDER HOW LONG IT WOULD HAVE TAKEN TO GET THAT MONEY BACK. I DO HAVE A LOT OF DIFFERENT DOCTOR BILLS. THEY SAY AS LONG AS YOU PAY A LITTLE EACH MONTH, THAT'S OK.
    dOTTIE
  • Ritzy
    Ritzy Member Posts: 4,381 Member
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    GregStahl said:

    Everyone
    should of pre-cert'ed the proceedures and knew exactly what the co-pays were. My wife works for a hospital in insurance billing and every single thing she has had done was pre-cert'ed and approved and we knew how much to bring.
    If they are holding your money, call your insurance company and see if they have someone that can work with you or on your behalf to get your money back

    You should always contact
    You should always contact your insurance company to make sure what is covered, what is not and how much deductible you have to pay. I was lucky, as my doctors offices did a lot of the calling for me.

    I hope you get your money back!

    Sue :)
  • mariam_11_09
    mariam_11_09 Member Posts: 691
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    This is just awful!! I am

    This is just awful!! I am sorry that you have beening gowing through this.

    I had my surgery on Jan 5th of this year. I was told by the hospital (Stanford) that I needed to pay the $500 deductible upfront. They would have taken the payment via credit card over the phone but I told them I would give them a check when I arrived. I knew I had the $500 deductible anyway so never questioned it. Then out of the blue, less than 2 months later I get a $500 check from the hospital!! I called the hospital and the Health Insurance (Blue Cross) and Blue Cross said they had no right to charge me the deductible!

    My max out of pocket does not include $30 copays however the clinic I go to does not charge me up front for the copay, they bill me about every month. This makes it a little easier so I don't have any upfront payments.

    I was also told my the clinic and another doctor who was involved in my surgery that I just need to pay a little something each month, as long as something is coming in they are alright with it.