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Medical bills



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amother
Teal


 

Post Mon, Feb 13 2017, 12:42 pm
My son was born premature and was in the NICU for 2 months. Baruch Hashem he is home and healthy.
I just got a bill for $8500 (for what insurance didn't cover as well as deductibles and out of pocket)
Insurance told me that there's still over $100,000 in claims that were not yet processed!
Some of these bill were for me for the birth.
I applied for financial aid but was denied because we make too much money ($95,000 between DH and me).
The hospital offered to give us a 12 month interest free payment plan.
Help!! I was out of work for 1 month on bed rest, and then 2 months while baby was in the hospital. I returned to work the day after he came home. So I was not paid in 3 months!

Does anyone have any practical advice to get this bill lowered?
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amother
Crimson


 

Post Mon, Feb 13 2017, 12:46 pm
Does your insurance have a "max out of pocket" expenses?
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amother
Teal


 

Post Mon, Feb 13 2017, 12:50 pm
amother wrote:
Does your insurance have a "max out of pocket" expenses?


Yes, I believe it's $9,000 per person per year.
However the baby was born in December and was in the hospital December and January so we need our deductible/max out of pocket for both 2016 and 2017 met.
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amother
Crimson


 

Post Mon, Feb 13 2017, 1:18 pm
I hear. That is tough. Maybe can you verify that the out of pocket max is per person & not for the whole policy? Also, for Dec, would the baby be covered under you, so that even if the out of pocket max is per person, then only 1 person (your) out of pocket expense must be met (I think my plan had it that baby was covered under me for first 31 days)?
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gibberish




 
 
    
 

Post Mon, Feb 13 2017, 1:56 pm
Try to see if you get the first 30 days of your baby's medical claims reprocessed under yourself. That way your baby won't have any of its own claims for 2016.When calling the insurance, keep calling until you get a rep that will do it for you. That should save you a hefty amount. I found it to be gray area regarding how to process the claims for a baby in the nicu. Good luck!
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amother
Teal


 

Post Mon, Feb 13 2017, 2:51 pm
gibberish wrote:
Try to see if you get the first 30 days of your baby's medical claims reprocessed under yourself. That way your baby won't have any of its own claims for 2016.When calling the insurance, keep calling until you get a rep that will do it for you. That should save you a hefty amount. I found it to be gray area regarding how to process the claims for a baby in the nicu. Good luck!


Wow interesting. Definitely worth a try!
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newmommy22




 
 
    
 

Post Mon, Feb 13 2017, 3:26 pm
gibberish wrote:
Try to see if you get the first 30 days of your baby's medical claims reprocessed under yourself. That way your baby won't have any of its own claims for 2016.When calling the insurance, keep calling until you get a rep that will do it for you. That should save you a hefty amount. I found it to be gray area regarding how to process the claims for a baby in the nicu. Good luck!

My insurance would not process any claims for the baby under my name. They all were denied.

See if you can figure out what will stop the bill from going to collections. I have found that for certain hospitals if you make a minimum payment every month the claim won't go to collections. So even if they won't set up a payment plan for you you might be able to just pay a small amount every month. Try to find a hospital rep who will help you. Is the entire bill from the hospital? When my baby was in the NICU we got bills from the hospital, the NICU doctors, and lots of random specialists. Maybe some of them will work with you. Also double check every bill. I was able to get rid of a bill for over 1k that I wasn't supposed to be billed for.
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amother
Sapphire


 

Post Tue, Feb 14 2017, 11:48 am
Go through the bills carefully. I was billed (regular birth, not preemie) for a specialist who showed up who didn't do anything and was told to leave as the main doc said they weren't needed.

Also with financial aid was it for 3 people or two since they should count the number of kids you have. Did you total all your other bills? Did you explain that you weren't paid for 3 months? I got a little off my bill with financial aid as I explained things (we have student loans, had another major medical bill we just paid up for a different family member etc). Can you speak to anyone?

I am so glad your little one is ok!
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amother
Teal


 

Post Tue, Feb 14 2017, 1:17 pm
amother wrote:
I hear. That is tough. Maybe can you verify that the out of pocket max is per person & not for the whole policy? Also, for Dec, would the baby be covered under you, so that even if the out of pocket max is per person, then only 1 person (your) out of pocket expense must be met (I think my plan had it that baby was covered under me for first 31 days)?


The max out of pocket is $4000 per year so total I would have to pay for baby is $8000 and me $4000.

My insurance denied this stating that this 31 day thing is only if the child is born well.
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amother
Crimson


 

Post Tue, Feb 14 2017, 2:46 pm
amother wrote:
The max out of pocket is $4000 per year so total I would have to pay for baby is $8000 and me $4000.

My insurance denied this stating that this 31 day thing is only if the child is born well.


Oh, sorry I didn't realize there was a difference if child is well or not. But I guess it's still good to know that most need to pay out of pocket is $8,000 for 2016 & $4,000 for 2017 (a lot, but still much better than the 100,000 of original bills!) - maybe can ask insurance company how exactly that works practically, so that they know how much you already paid & then they need to pay the rest. Hatzlacha - I know first hand how hard insurance companies are to deal with.
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gibberish




 
 
    
 

Post Tue, Feb 14 2017, 2:47 pm
newmommy22 wrote:
My insurance would not process any claims for the baby under my name. They all were denied.
.
it took many many calls (and hours of time) to my insurance until I got a rep that reversed the claims for me. But it saved me $4,000! Similar situation as op.
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