so rather then one long bill which can easily have the wrong codes applied for billings they do a bunch of short ones.

Everything about our for profit medical system screams the need for single payer,it has to happen.

The uncollectibles must be huge, but they are also probably over-billing by a wide margin. The system is unbelievable.

I just had a colonoscopy last week. The doc was great. The hospital staff were great, for people who were spending the day shoving things up my backside. No complaints about the quality of services.

(Which reminds me of a joke. Man is visiting his proctologist for a regular checkup. The doc has him drop his drawers. "This my feel a little uncomfortable, says the doc. The patient replies, "Yeah, Doc. Your wedding ring is really irritating me." The Doc says, "Oh I'm not married. That's my wristwatch. " But I digress.)

No complaints about the care. But the records make me feel like I'm in a third world country. A couple of days before the procedure I had to take a bunch of blood tests. But these are EXACTLY the same tests my GP had done just a few weeks before. These guys ought to be able to share records. Those tests were totally unnecessary. And likewise, I ended up dictating my complete medical history to three different people in the process. Again, in a world that can have a Facebook and a Google, it shouldn't be a huge challenge to have a database of medical records.

Why don't we have that? Because people are terrified about privacy.

And why are people terrified about privacy? Because of the goddamned private insurance system. It is as simple as that. If we had a universal health care system, most of us would not be all that obsessed about privacy of records.

Next up, receiving all the bills for this. Theoretically a screening colonoscopy must be covered by the insurance. But they have claimed a huge loophole. If the screening reveals ANYTHING that needs more than just a look through the scope, the insurance companies claim it is no longer a "screening" exam and therefore they don't have to cover it. That is, I have to pay the first $10,000 because that is my deductible. Almost every scope job is going to have SOME follow-up. I have a couple of tissue samples biopsied. Thankfully they were negative, but that is probably enough to push the full cost over on me. We shall see. I know I ate a $25 muffin.

I'd swear eliminating duplicate tests by going to electronic record keeping was a mantra of Obamacare - but I can't find a quote!

I'm not sure when that kicks in, but I recall a few docs (people who claimed to be docs, I should say) calling into radio programs complaining this would put them out of business.

I understand that if you have to spend $25,000 - $100,000 to upgrade your records system, that is a big investment. But the doctor;s practice should be more efficient, giving a fairly short payback. And the total cost of health care should go way down if doctors can easily see each others' test results.

The only doctors who should be complaining about this are the ones who pad their income by ordering all sorts of redundant tests.

I've got a stack of mystery bills myself, though I can't afford to pay anything yet. Even after I have some money again, it'll take awhile to figure out which ones to pay and which to ignore. I've gotten b.s. bills before where two people have sent me bills for the same thing, follow up bills have overlapped for some reason because the first bill didn't arrive until after the due date, and I've had bills where one thing was just completely re-written as something else so they could bill me twice. Had a $400 visit with a doctor to check on my knee re-written as a surgery that never happened. Our medical system is just a complete mess from top to bottom.

Did your mother have any assets when she passed? If not you can shred the bills. You are not responsible for her debts.

She consumed services and incurred the debts. Insurance and Medicare will pay their share and I only think it's fair for me to pay off the remainder or balance that wasn't covered.

However, in order to do that I need to know the dollar amount and would like to be able to get that information from one source - seeing that all her care was provided in the same hospital and in the same system - their MD's, labs, x-ray depts, home care, etc.

I will not shred bills or not - not pay them off - as if I did - I would be contributing to problem and the rising cost of insurance that would cause insurance companies to pass on the bill in the form of increased premiums to others.

If I did that - I would be part of the problem.

I went through this when my father passed and all sorts of bills arrived that were basically fake. Unless they could prove they provided the service I did not pay.

I do not intend to pay for 'unjust bills'.

it seems from your OP that you're not going to find out what were just and what were unjust

Grifters will go through the obituaries, make fake bills and send them to the deceased, hoping a family member will pay it. There's a lot of sick people out there.

You will have bills coming in for several months. Then, insurance or Medicare might deny payment for some services, resulting in more bills supposedly payable by your mom's estate.

Good luck, and don't get too personally involved and make too many promises at this point.

I admire your desire to help pay (did that myself), but if your mom was in the hospital that long and saw a bunch of doctors and other providers, you don't know what will ultimately be due from your mom's estate.

while you wait for the hospital to get its act together, start paying whatever credible invoices/bills that you have received (i.e pay everybody else besides the medical bills). Then if there is anything left over make payments as best as you can. If there is not enough funds at that point to pay all the medical bills, well that is the hospitals tough luck. If all other bills are paid first, you have taken care of entities that have established good business practices and there is less money that can potentially be scammed by the hospital. You could take it Department by Department and force them to provide the details behind their billing. Make them prove to you what is owed by your mother's estate.

Big caution - Please make sure that you don't give the Hospital or anybody acting as their agent, any indication that you are personally liable for any of the debt or they will become your permanent worst nightmare. You might want to consider getting an expensive pre-paid phone like a Virgin Atlantic at Target, just add 200 minutes on it each month and give that phone number only to any entity acting on behalf of your mother's medical bills. This could keep any calls off of your personal home phone and cell phone. When the time comes you can dump the phone and hopefully they won't have any way to make harassing phone calls to you.

medicare statement should tell you exactly how much was left unpaid.

she probably won't owe much of anything. Let them filter thru the process. It will take a while.

Years ago, when my mother-in-law died, we went to the accounting office to make sure her bills were all paid. There were no bills, but they had sent a "This is not a bill" notice that she had received an injection costing $900. We asked what that injection was for and they refused to tell us, as it was private information. My husband was executor. They still wouldn't tell us, but she suggested we call her dr., which I did. He said the only thing he could think of that would cost that much was for snake bite, and he certainly didn't give her one of those.

On further research, that was when we discovered the hospital was charging her insurance to cover indigent bills. That was back in 1978. The more things change, the more they stay the same.

Eventually they will all get their ducks in a row, and if there us anything they really want to be paid for, they WILL seek you out and mail things addressed to YOU.

In the meantime, use her assets to attend to her burial costs, your own lost wages (if you work outside the home), and perhaps set the rest aside for any taxes she may owe..

given to me by the attorney who helped settle dad's estate. Dad was legally insolvent when he died.

You do yourself more harm than good opening his bills.

First off I doubt you're responsible for her bills. Second if they can't tell you what you owe then why ask? If they haven't contacted you then don't worry about it. If they send you a nasty letter send them back a copy of her death certificate.

If there's any money in your Mom's estate spend it or put it in an account not in her name.

That's exactly what I did two years ago when my mother died. She owned nothing but personal items and a burial account to cover her final expenses.

They should be paid by her estate but you personally are not liable.

then tried to say I owed them since the insurance didn't pay it.
And each time it seemed as the ER computer did not communicate with the billing computer.
The first time when I got the bill it said it was rejected by insurance company A because I wasn't covered-we had switched to a different company in the 4 years since the previous ER visit.
I called them up and told them they had billed the wrong insurance company and they ER had taken my new insurance card and gotten all the info they needed. I told them to resubmit it to the proper insurance and it would be paid. I was told that they didn't do that, I had to do it for them.
My response was "So you expect me to do your legwork for YOUR screwup?"
I told them they had 3 options: 1. They could resubmit it to the right insurance and get paid
2. I could do their work for them and I would bill them for my time and effort-which would be equal to or greater than the amount they wanted from me
3. They just just write it off now.
I was told they wouldn't pay the bill if I submitted one and I told them then I would turn that bill over to a collection agency.
About 3 weeks later I get a statement saying it was paid by the insurance.

Happened again a few years later with the same results.

If your mom was not married, and you didn't sign anything taking on responsibility for the debt, then the liability passed away with her.

Her estate can be billed, but it's only your debt if you signed something saying it's your debt.

It's very common for collections agencies and billing departments to insist the survivors have to pay when they do not.

I think it's been true for a long time that no one source can provide a full accounting of costs for an episode of medical care.

The hospital only has a record for actual hospital staff and services.

It is fucked up ten ways to Sunday and people have no idea how badly. We knew it, so we talked to different sections. Oh and te ambulance was billed by the city.

I 100% agree that the situation you describe shouldn't exist, but won't the hospitals still have some sort of billing department (even with the bills going to the same place) so that there's some sort of account of what was done and how much it cost? I think if you wanted to resolve THIS issue, single-payer wouldn't necessarily fix the issue, you'd have to nationalize all the hospitals.

Consolidate all billing for services incurred throughout the hospital - that means all the services provided in house - like lab, radiology, etc - as well as the MD's that are on staff at the hospital and work in the outpatient offices adjacent to the hospital and any Homecare or Hospice services provided in the system.

So yes - hospitals will still have to have some sort of billing department - but it would be one billing department - not 5 or more as I indicated in my original post. This billing department would then be responsible for dealing with the government - in any accounting functions that would need to be in place if we had a single payer service.

This would simplify the process - in my opinion - for all involved. There is too much over-duplification of such accounting departments now. This is another factor that is costing us more and boosting the dollars spent in healthcare.

Currently - this even is more complicated by the fact that hospitals and their billing departments - be they consolidated or spread out over many departments - have to deal with a multitude of different insurance companies now. Think of the cost associated with that.

One way to think about it is run it like the credit card companies run. There are many providers of services and products that I use and bill on my credit card. At the end of the month - I get one bill from the credit card company and am able to pay it off if I choose to.

So this isn't rocket science. It could be done. Much of what I've seen in dealing on the caregiver side of healthcare is that there is tremendous confusion, lack of communication and duplication of tasks - that if things were consolidated, made into an electronic file - both healthcare delivery and the financial situation would benefit.

that's the point

or how much it cost? Unless all the hospitals are nationalized, they are going to be required to keep detailed records of what was done, how much it cost, and send a "bill" to the government administration for reimbursement. No, patients won't see a bill anymore, but there will still be bills and therefore, a billing department (or many billing departments).

Hell, even if the hospitals are all nationalized, there will still be some department that handles this, although they might be able to consolidate it even further.

How are procedures and expenses tracked? How are co-payments billed?

The consumer has nothing to do with expenses. They are probably tracked with a computerized bookkeeping software.

http://online.wsj.com/article/SB124958049241511735.html

No hospital bills?
http://fracassifamily.blogspot.com/2011/02/trip-to-hospital.html

Here's a hospital in Paris's description of how it works, including having the consumer apply for reimbursement from the national system and possibly a private insurer.

http://www.american-hospital.org/en/your-stay/billing-insurance.html

"Because the American Hospital of Paris is a private institution, French Social Security will only reimburse a portion of your hospital bill. The remainder may be partially or completely covered by your private or supplemental insurer, depending on your policy.

The day of your discharge, you will be asked to settle the entirety of your Hospital and physician bills. You will then receive a complete administrative file that will enable you to be reimbursed by French Social Security and/or your private insurer(s)."

Someone at these hospitals generates a bill, and I'm sure it's not the doctors themselves. Call it a "billing department", or "patient services" or whatever else, but it's still people doing roughly the same thing. The big difference between the US and France is who pays the bills.

some from doctors and other medical professional you never saw, and who never saw you.

Most screwed-up system in the world

are often contracted out in privately owned hospitals. Radiologists, labs, even ER physicians are often not employed directly by the hospital, so they can charge their own rates and bill separately. Not only does this cause billing complications, but these physicians have loyalties to their own teams and not as much say in hospital policy like they used to when they were working for the hospital. That puts more power in the hands of the hospital administration, who often are more interested in business than healthcare. This is one more way business has wormed it's way into service professions (it started in the 80s), policies that naturally benefit those at the top at the expense of everyone else.

State and government run hospitals I worked at were different, physicians were employed by the state too, and although these places had their own power structure and challenges, I saw physicians who worked their tails off for much less salary than the private sector, and actually had say in how their departments were run.

The privatization of hospitals has resulted in our current healthcare crisis, and there have been too many cuts in state hospital programs. Plus often state run student programs are much more affordable too. This all got shoved aside under Reagan, I remember it well.

Just some background, I hope it helps. Good luck settling your mother's bills, you are definitely not alone.

My son was attacked in the street in his college town last March. Luckily, he escaped with just bruises and a broken nose. We paid the hospital bill in May and considered the matter closed.

Last month, we got a bill for $2200 from a medical billing group in Texas (we live in Illinois and the incident happened in Missouri). We drove over to the hospital, talked to the billing department extensively, and it was worked out that we actually owed them $217, which we promptly sent. A week later, we got another bill from the billing group, with a balance of $1983 and a threat of legal action against our son. Another trip over to the hospital, only to find out that our insurance (Blue Cross/Blue Shield) is not a preferred provider for the ER doctor's group, even though the hospital's insurance is BC/BS as well. The hospital is wrangling with them right now, and their advice to us was "call and yell at them and they will back down. We hope to have all this negotiated by this time next year". Um, what?
No one seems to know what is going on. Luckily for us, my husband is an attorney and his partner does extensive insurance work, but I wonder what clueless people (like me) do - I assume just pay the bill, which is why the insurance companies get away with it.

Hence, separate bills with separate mailings.

All docs associated with our hospital are acually owners/employers of their own practice elsewhere.
ALL of them.
Even the ER docs
and the ambulance service.
Even the docs who come to see you in the hospital bed.

I had to get mammograms/sonograms for a suspicious lump, in July.
My local GP had to call the next door hospital to arrange for the tests,
the x-ray/sonogram person is local, at the hospital,
the hospital had to schedule the reading of the tests with the radiology service who sends 2 docs to the hospital from a town 100 miles away.

So I got 3 bills.
One from my GP I had to see for the lump.
one from the Radiology practice in the other town for reading the test results ( 2 doctors read the tests)
one from the hospital for the techs and the machines.

Thankfully I had just gotten on Medicare B.
Only 140.00 of the charges were mine to pay.
BUT
they all sent me their bills and I had NO idea of which bills Medicare was going to pay and which they were going to charge me with to reach my 140.00 deductible
because Medicare sends patients the bills 90 days after the service is provided.
Fortunately, you can call Medicare and they will send you the information sooner if you ask.

Which is part of the reason why they find suspicious things that require all those tests, scans, etc.

Any good gastroenterologist doing a colonoscopy ought to be able to find a tiny polyp to snip off to send to his path lab. He can double his income from the job that way.

The medical profession is filled with "small business" doing their best at "job creation".

... her advice is (always) "Don't send them a penny.... no matter what they do or say or send you.... don't send them a penny."

Built into the health insurance business is the unwritten law... "Bill everybody for the maximum... or more... You'll only get some back, but it will be enough to make a big profit."

will be Tricare both government policies. I haven't had problems with Tricare.

when i try to pay multiple bills from them online- they don't organize by name or SS number- you need each individual invoice number.

Quest, Lab Corp. Fall After Fraud Whistle-Blower Interview

Quest Diagnostics Inc. (DGX) and Laboratory Corporation of America Holdings fell after a man who accused the companies of Medicare fraud in lawsuits explained his allegations to a trade publication.

The Dark Report, a newsletter published by R. Lewis Dark, includes an interview in the Feb. 20 issue with Andrew Baker, a former lab company executive who filed whistle-blower lawsuits against Quest in 2005 and LabCorp in 2007. Baker claims the companies used a sales tactic called “pull-through” that has drawn scrutiny from congressional investigators.
http://www.bloomberg.com/news/2012-03-23/quest-lab-corp-fall-after-fraud-whistle-blower-interview-1-.html

and reported here in DU:
$14 Billion Medicare Scam by Quest & LabCorp exposed
March 23, 2012 /PRNewswire-USNewswire/ -- Quest Diagnostics Incorporated (Quest) and Laboratory Corporation of America (LabCorp), the nation's two largest laboratories, are currently involved in a multi-billion dollar Medicare scam, according to a lengthy and critical expose published in one of the medical laboratory industry's leading trade publications.

The Dark Report revealed recently that the two labs have billed the federal government $14 billion in questionable Medicare fees over a 10-year period and that the practice continues today.
http://www.democraticunderground.com/1002505988

and Quest is(was?) another real beauty to deal with.
they refused to give me a copy of my own blood work results. fuck-sticks.

When the dr. office calls us after the lab work, I ask them to mail us a copy, since we paid for it.
We always get the copy from the dr. office, and I enter the numbers into a spreadsheet I have been building,
so that I can see what is going on over time.

Our doc used Lab. corp till this spring, then suddenly a tech was coming over to the office from the hospital, no more Lab. Corp.

but now i have them write me an order and i take it to the hospital.
they(the hospital) give me copies of everything. my previous hospital even gave me copies of x-rays at no extra cost.

It's all a fucking billing mess with multiple "suppliers" and no coordination. The best thing I have found to do (and have been advised to do by the insurance-medical providers involved-- is just wait six months or so for all the final bills to coalesce from all the providers. By then you are a late payer, but nobody can do anything about it, so nobody cares.

in recent years has signs all over the place that physicians and most other medical personnel are NOT employees of the hospital but rather independent contractors, and if you have an issue with a physician, anesthesiologist, etc. that you are to contact the state medical licensing board.

....from a single hospital source you intend to pay nothing. Send a copy of your letter to the state board responsible for certifying the hospital, and make sure the hospital knows you've done this. You may also want to send a copy of your letter to your local media and see if they'll do a story on this subject (I bet they will).

Additionally, you are NOT responsible for any charges for which you never co-signed. The hospital will get their money....it just won't be from you.

The people...and I use that term very loosely....who are sending you invoices you can't identify are the lowest forms of opportunistic scam artists, and so is the hospital for failing to set up a centralized billing function.

responsible legally to pay them.

We used to have good insurance through my husband's employer. Bills were minimal and easy to understand.

Now we have to pay for our own insurance, with an immense deductible. Preventive care is supposedly covered but I'm afraid that lab fees and assorted other things won't be, so I don't go. I wouldn't go for an acute illness and I probably wouldn't go if I were concerned about a chronic illness unless I genuinely thought it might be a matter of life or death. Horror stories like in the OP are 100% the reason why.

My kids get well-child exams and I've never had a problem with billing from our pediatrician's office, so I don't dread going there. But for me and my husband, there would have to be a lot of blood involved before we went to the doctor because of the labyrinth that is medical billing these days.

My sympathies for your mother's death.

My husband died over 12 years ago. He was covered under my insurance, so I had to sign everything as the responsible person. He was in the hospital for less than 12 hours. I kept getting new bills for months. And from people I never heard of. The kicker though, was a bill that was sent out for the first time about four months after he passed, and marked as overdue and about to be turned over to collections. I was livid, and I called on that one. They tried to tell me that because the payment had not been received, they were justified in threatening me with collections., even though they had to admit that they had never sent a single previous bill to me or to the insurance company!

I threatened them right back, since they were preparing to take action that would damage my credit rating even though the delay was totally their fault.

When everything went through the insurance, I began to feel that I understood the reason for this tactic. The bill they sent be was for well over a thousand dollars. When the explanation of benefits came in, the 'agreed amount' for the service was $25. Blue Cross paid the whole $25, and I owed nothing. So this was clearly an attempt to trick me into paying a lot more than was actually owed to them.

The last bill didn't actually arrive for almost a year. That was the ambulance.

Hang in there, though. This too shall pass.

We went through this with a $14,000 bill for my moms death in the hospital which took 18 hours. I even went to my congressman who was honest and said that hospitals routinely charge the max allowable from Medicare to cover indigent patients. I was repulsed with the sanctioned dishonesty. When all was said and done we paid $166 for justifiable procedures we asked for, pain meds. That's all we ended up paying for her death. They won't come after you, believe me.

but my mom had two knee replacements this year, and I took care of her through both.

Both times she was in the hospital for a few days after the surgery, and both times, when it was time to leave the unit she was in, the staff acted like they had never checked anyone out before.

The first time, they brought a commode and a continuous motion machine, plus she had all her clothes and stuff. I asked if I could get a cart to wheel the stuff to the front of the hospital, and they acted like this was a crazy request.

The second time, they didn't have an appropriate wheelchair, they didn't have the continuous motion machine, and they didn't have her meds ready. I sat there for three hours while they tried to track this stuff down, and finally I told them I would come back for the machine and the meds.

The joint and spine unit here has about 80 beds, and they must check people out of the unit 10+ times a day.

It's different in that it's not a billing issue, but it's the same in that it's a problem of organization and coordination. How many hours are spent trying to figure out things that should be routine?

to Obama, the Health Secretary, and your Senator and Congressman and the local media and MSNBC like Ed Or Rachel.

THis is a perfect example as to how American health care is fucked up


I Never had this problem when my son and husband were being treated for cancer....There were no bills They died and I was able to go on with my life without any bills or bill collectors calling.

With the exception of places like Mayo, Cleveland Clinic etc. US healthcare remains a cottage industry.

ambulance company tried that shit after my father died. My brother and I had called the ambulance company and knew that one was NOT the one that took him to the hospital. We paid the company that had picked him up but weren't about to pay crooks that were trying to shake us down.

I'm not nearly smart enough. So you're in good hands.

But I did want to say that I'm very sorry about your mother.

It's not just the billing practices. In 1994, NBC began airing the series ER set in the chaos of a typical hospital emergency department. Look at the original episodes, and tell me what has changed since then!

The only cost cutting measure these managers use is to cut the nursing and housekeeping staffs! Ironically, these people are the front line in the fight against hospital based infections!