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Dealing with my dad's bills after a recent hospitalization and I feel completely lost. The EOB makes no sense, there's a charge I'm pretty sure shouldn't be there, and I don't even know where to start.
do i call the hospital billing department? The insurance company? A patient advocate? Has anyone here gone through this and actually gotten a bill reduced or a denial overturned? What actually worked for you?

For each bill call the Accounts Receivable department.

My boyfriend had $70,000 US bill with his Obamacare Blue Cross 11 day hospitalization for liver problems.

He owed the $70,000. Blue Cross paid the rest.

I called each billing provider:

hospital
doctors
lab companies

I had to call on each individual invoice. I was able to negotiate the $70,000 down to around $11,000. I told them I wanted the lowest cost to close out the invoice if we paid it off now.

He paid off the $11,000 and now owes nothing.

Some providers made him sign a form before I could talk to the Accounts Receivable clerk. Usually the A/R clerk would have to talk to their boss and came back to me with a lower fee to close the invoice.

The only company that would not negotiate with me was the lab company.

Everything is negotiable in US medicine.
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Reply to brandee
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Is the person on Medicare? If so, you need to look at the statement sent to Dad. The provider will have the amount billed. Medicare will show what they consider reasonable and then pay 80% of that. The supplimental should pay the 20%. (For my Mom and I, our insurance is employee/company based so we always had a balance after suppliment paid their share) Its now the beginning of the year so there are deductables that have to be met.

If the charge is the hospitals, yes you call their billing department first to find out why that particular charge was made. But doctors and labs charge separately. So those providers you talk to. Insurance cannot help you concerning a charge made by a provider. The insurance company pays for what the provider has billed. I would call them, though, if after talking to the billing department gets you nowhere. They can then research the charge. If on Medicare, they would be the insurance to call. Supplimentals only pay what Medicare allows.

Now if Dad has Medicare Advantage, those are the people you call if you get nowhere with the hospital billing. I had something come up years ago when I had Blue Cross and they ended up taking care of the problem after I tried every avenue to get the problem resolved. I have been there with a doctors office. I had proof and even wrote a letter to the doctor himself. Nothing came of it till I called BC and they threated the billing clerk. Yes, it got resolved.
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Reply to JoAnn29
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Call billing department and ask for a representative to help understand the denial. If you still believe that it is an error then inform them you will start an appeal of the denial. Then call your insurance to initiate the appeal process. You may meed to contact your states department of Insurance You need to do this within 180 days of the denial. It is a major process and you will need to follow all procedures and regulationsin a timely manner or it will be dismissed.
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Reply to AMZebbC
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Speak with Billing or find the Hospital social worker to speak to Billing with you.
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Reply to KNance72
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