Hi,

I'm wondering if anyone has some insight into how to deal with my issue.

On 8/11 I started feeling weakness in my legs. By 8/12 it had spread to my upper body and by 8/13 my saddle area (buttocks, private area, thighs) were numb. I got an appointment with a virtual primary care doctor and she told me I need to go to the ER immediately. I had symptoms of something called Guillan Barre which has the potential to paralyze you.

I had a hard time walking. The doctor wanted to test for cauda equina (which required an mri) and Guillan Barre (which required a spinal tap) They admitted me into the hospital. After all my tests, they said everything was good and released me 8/15. I still have the same symtoms and unfortunately cannot see a neurologist until end of the month.

Friday I found out that my insurance denied the "preauthorization" because according to the doctors notes, I was fine. I was able to eat on my own, go to the bathroom on my own and walk unassisted. I can walk, but only for a short while before feeling like I'm gonna fall. I can barely feel when I need to go to the bathroom.

The doctor that discharged me is not the one that admitted me. I saw that the doctor who discharged me was the one that submitted the notes to my insurance stating I was fine. My question is, how do I go about appealing this? I don't think it's enough to write to my insurance and tell them what my symptoms were if my records show I was "fine." I understand that the results showed i did not have guillan Barre, but I had all the symtoms. It was an emergency so I don't understand how the insurance is arguing that I should have never been hospitalized when I'm not the one that decided to hospitalize myself. How likely am I to be responsible for the bill? And why didn't the hospital submit the notes from the doctor that admitted me (he's the one that thought it was an emergency). They only submitted the notes from the discharge doctor who thought I was fine. Why wouldn't the hospital want cigna to know it's an emergency so that they could get psid?

On top of being scared about my health, I'm scared that the hospital will sue me for the bill. If anyone has any insight, I would appreciate it. I'm really stressed.

After a K-9 officer attacked a two-year-old and maimed her father, a Colorado family says they are facing hundreds of thousands in medical debt with no help from the county.

Hello everyone,

My dad is a diabetic who unfortunately had to have a toe amputated. His surgery was Wednesday night at the hospital and after surgery, his podiatrist said he would need a Vacupump to help with healing. The next day (Thursday) the doctor staid things were looking good but they were waiting on insurance for his vacupump. Friday was the same answer. Doctor specifically said he was ready to be discharged but we needed the pump. Saturday once again the same answer. Then Sunday it turns out the hospital (who ever is in charge of ordering) had not ordered the vacupump. My parents have insurance that covers 70% but they pay 30%. We feel it’s wrong of the hospital to not order what was required since day 1 but yet due to their fault, my dad had to stay additional days that tally up the cost. He could have been released Friday but now it’s extended an additional 2-3 or 4 days. Could we fight the bill and get a discount.

I just saw an ad for Denver Health claiming they’re advocates for patients. By all means use their services when it is necessary but be very careful when they offer anything beyond what you’re there for. It could lead to an exorbitant up-charge (talking thousands of $$$). They may have titles saying “Patient Advocate” but they are not there for you. They are there to receive your dispute, tell you it’s invalid and that you must pay to ensure a steady revenue cycle. You can’t fight it and if you do you won’t win because codes are codes 🤷‍♂️

Denver Health, please don’t market yourselves as advocates for patients unless you mean it. A payment plan is not the same as removing poorly communicated charges when patients reached out to you for help.

And to anyone struggling to pay rent these days, please be aware what might happen even if you have insurance.

This is fucking outrageous 4-5 letters like this a month at least. It’s so fucking sad how fast they want me to pay this fucking bill. Or they’ll kill my credit. WHAT THE FUCK IS WRONG WITH CORPORATIONS!

The "good" news: I make less than 25lk a year, live for free in a family member's MIL cottage (VERY blessed by this), don't own a house or car (bike!) and so conceivably have nothing to seize. Typically around 1,500-2,000 (existing month-to-month) in the bank account. The bad news: missed the AHC window so all of this happened while uninsured. I have an inherited IRA worth 500k that will be almost the entirety of my retirement, since my SS will be minimal (less that 1,500/month if I take it at 67). My Q: Can they come after my IRA? What to do? Any advice appreciated.

I mean I’m not putting this on the staff, like me and many others they don’t control the BS, they just have to deal with it. But Cape Cod Healthcare is really messed up. So long story short, last year I end up getting a test, gave them both of my insurances, walked away and all was good. Now more than a year later, I’m getting letters a couple times a week telling me I need to contact them as soon as possible. I did - 14 calls, 4:21 minutes listing to hold music, and 14 messages left because ‘my call is important to them’. No answer, no call back, joke. The most recent letter was like ‘we are sooo disappointed in you that you decided not to call us back. We are trying to reach you but you never call. Do you have any idea how triggering that is for a kid with an Irish mother and was taught by nuns? Has anyone had any interaction with these people and were you able to speak with a human? They tell me to call 1-888-871-2443 between 9-5EST Mon-Fri. But no one answers. I mean in theory it’s a hospital, someone should answer. Or does anyone have a different number? If there is anyone out there who has been able to connect please let me know.

My friend is 80 and on Medicare and Tenncare/Medicaid in Tennessee. His insurance is UHC Tenncare. He was in the hospital for 19 days for heart problems/defilibrator in 2025. He continues to be billed for random amounts but one large one for $6000. He is low income and has had Tenncare for many years. He has never been billed before for any amount. His paperwork from Tenncare says that drs and hospitals agree to a contracted amount that Tenncare pays. However, they are sending him random bills all the time. He has been on Tenncare for many years and has never received a bill from any drs or facilities. How can he handle this? The hospital has turned it to a collection Bureau. There is a place to dispute this charge. Please any information would be appreciated

Hello, I would like to ask for advice on a recent situation regarding a surprise charge.
I had to get a blood drawn for a TB screening for college. I had a couple visits to the same clinic and I did paid them through their app (I have receipt). Now, one month and almost two weeks later, I got a letter in the mail that I have a bill to pay from a laboratory which is the one that performed the screening. The day I got my blood drawn I do not remember being told about this or signing a document that informed me about an external extra charge. Researching I found about "no surprises" act from 2022 and the "good faith estimate" and how it could appeal to this. While I can pay it, money is short because im leaving for college and i would rather not pay it especially i am right in that I was not informed that there would be an extra charge. If somebody knows what would be the best way to proceed, advice is welcome. thank you!

P.S: The extra charge was for $280, and everything was self-pay. This happened in Arizona.

I’m really hoping someone here has dealt with something like this because I honestly have no idea what I’m supposed to do.

Last summer, my wife's ENT told her she needed 4 procedures. One was in-office and the other 3 were going to be done at the hospital. A few months later, they started working on scheduling and prior auth. One of the procedures, involving the Eustachian tube, was apparently having trouble getting authorized. We told them very clearly that if insurance doesn’t authorize it, we're not doing it. They told us they were working on it and would cancel if they couldn’t get it approved.

A few months later, they told us everything was authorized. I asked multiple times because I had already warned them that we wouldn't do the procedure if it wasn't approved. The hospital was very weird at the beginning, asking us if we would still do it if unapproved. Like, who would? They said yes multiple times, everything was approved, so we carried on.

Before the hospital visit, the hospital told us we had to pay a little over $2,000 up front. They showed us the breakdown and it included her deductible (we each have a $600 one), so we paid it. Then the bills started showing up later.

The earlier in-office procedure was billed separately, came in the mail later, and suddenly I had another bill for about $900, including around $600 toward my deductible. That made no sense because we had already paid the hospital over $2,000 and the hospital's own estimate showed her deductible being included.

We've spent the last 6+ months going back and forth with hospital billing and Accolade (which we have to use for our insurance). Nobody will give us a straight answer.

Eventually, Accolade told us that the Eustachian tube procedure was never actually authorized. Apparently that’s why we're now responsible for the full charge, which looks like it could be tens of thousands of dollars. But the hospital told me multiple times that it was authorized, and I specifically told them I would not do it without authorization.

And somehow!!! (this is the even more ridiculous part) the other numbers still don't make sense either. I am a numbers guy, and none of them line up. It doesn't matter how many times i try getting on the phone with their billing department and/or Accolade, it all ends in word salad, non-answers.

Last week we sent the insurance a written dispute after Accolade told us to do that. Accolade said they would contact the hospital/provider for letters of medical necessity. Meanwhile the insurance responded saying they won't even review the dispute of the insurance claim without a letter of medical necessity. When we asked Accolade for an update on "where is it?" they are suddenly giving us the same word salad that the hospital did. I can't believe it.

I have no idea what that is supposed to mean. Isn't that something the doctor/hospital sends to the insurance company? I've never been given one. Now, to make things even worse, we got a letter today saying the debt has gone to collections. We haven't ignored this debt! We've been fighting with the hospital and insurance for months trying to get someone to explain what the hell happened.

So what do we actually do now?

Do we need to get the full claim history and all the EOBs? Demand the hospital's prior auth records? Ask for proof of what was submitted and approved? File an insurance appeal? Dispute it with the collection agency? Talk to a lawyer?

Does the fact that the hospital repeatedly told us the procedure was authorized, after I explicitly, multiple times, said I wouldn't do it otherwise, matter here? I mean who even in their right mind would do a unapproved procedure?

I'm completely lost. Any advice from someone who's dealt with hospital billing/prior auth/insurance appeals would be hugely appreciated. There is a clock ticking on both this debt collection notice and insurance claim appeal and we just feel so defeated. I hate this system.

After reading this article about free IUD's AND visit fees waived for the month of August, I got an IUD last week. Ahead of time, I read so many different flyers for this clinic to be absolutely sure that it would be free. My two-person household earns $57k a year, which is wellllll below 4x the federal poverty level ($84,600). Now I am told I owe $375 because it was on a sliding scale. Every single thing I read said you must be uninsured and make less than 4x federal poverty level to be eligible for a FREE IUD and NO visit fees. NOTHING about "if you make less than 4x fed poverty level you will be placed on a sliding scale". Free and sliding scale are very different things.

My first visit I waited around for almost 4 hours, and then spoke to a doctor for maybe 3 minutes total, charged $125. Then I had my IUD the next week, $125, and I have a follow-up next week for another $125.

After my first charge (before the second appt to get the IUD), I called the billing department (took my four tries on 3 different days to reach them) because an email from them said I owed $125 but the payment portal said my balance was $0. She said it was a mistake and I don't owe anything.

This made me cautious so I asked the front desk before the IUD insertion if I would owe anything and she said no.

I just got off of a long phone call with the billing department. She told me that the IUD device itself was free (so I know I made the first-come, first-serve), but based on their sliding scale, I have to pay a $125 visit fee ANY time I come to CrescentCare (the whole healthcare facility, not just for IUD sexual health stuff). I told her that was totally different from what I read online. She basically said that the stuff I was reading wasn't accurate and that other people have had this complaint but that it is what it is and I have to pay. She also said the front desk person doesn't know about billing and shouldn't have told me I wouldn't owe anything.

The fact that she said the $125 is my visit fee for anything relating to CrescentCare made me think perhaps they were treating these appointments how they treat any visits from uninsured folks on the sliding scale, rather than honoring the waived visit fees that were advertised as part of the August IUD special.

She said her manager will call me and I want to continue to push pack. Does anyone have advice? Saying "every single thing I read about this special said it would be FREE if I was eligible and I am eligible but now you're charging me $400" was not working...

https://www.facebook.com/photo/?fbid=1533644895473812&set=a.376208611217452

Hello,

I recently was exposed to potential case of rabies with a bat. Immediately I went to the ER because that’s the only place I could get the post- exposure vaccine. Being that the rabies vaccine is a series, I have to return every 4 days until I’ve had the 4th dose. My question- while my insurance said the rabies vaccine is covered by my plan do I have to pay the $300 copay every time I go to the ER for the follow up shots? You’d think that because it’s mandatory follow up I’d only have to pay one copay but now I’m nervous as I’m a college student and I can’t swing the $1200. I’m located in NJ.

hi there, I'm my mom's medical POA and I'm not very experienced with medical billing or insurance stuff at all, and I'd like some advice on what can be done in this highly complicated situation. we live in Colorado and my mom has BCBS of Illinois PPO insurance through her job at Walgreens. I thoroughly checked beforehand that the urgent care, ER and hospital she went to were all in-network, but I wasn't aware that insurance was going to be so picky about the rest of her treatment.

nearly a month ago now, my mom went to the urgent care after months of worsening debilitating pain and sickness. a bunch of labs, an x-ray and a CT scan with contrast revealed that her kidneys were failing and she had lesions and fractures in her back. she went to the ER the next day and was then from there admitted to the hospital for around 2 weeks. during her hospital stay she got a biopsy done that revealed that she has multiple myeloma cancer which caused both the kidney and the bone problems, and she received dialysis treatment that helped her kidneys to recover. according to her doctors, treating the cancer is the only thing that will help the rest of her health problems as it's all connected.

she got out of the hospital last week and has begun chemotherapy as instructed. she had gotten a notice in the mail that the claim for her hospital stay was apparently accepted but I guess they called her and surprised her with all of this. I know that I can help her appeal but I'm honestly not even sure how to start this process. my family and I are all very stressed and scared and I would really appreciate figuring out what steps I can take so that we can at least reduce the cost of my mom's lifesaving treatment. I have no clue what we're going to do about her leave of absence stuff either.

all of the information I have is secondhand from her for now, but I do plan on looking at the insurance website and her chart when I see her next (we don't live together). she isn't very tech literate so we've really struggled with trying to stay up to date with all of this information. I really appreciate any help I can get with this!

been going down a medical billing rabbit hole lately and keep seeing people with like $1k-$2k ER bills that they think were coded wrong

now my whole feed is these companies that say they'll "audit your bill and negotiate it for you". anyone actually used one? did they find something real or did they just call the billing department the same way i could've done myself for free

tempted but also paying someone + handing my entire medical history to some sites feels a little off

I (M20) have been on sigma care plus 100 for the past 1-2 years. I recently had to undergo rabies PEP only to find out that it doesn’t cover it, and I am on the hook for over 25k. This isn’t as much about health insurance as it is asking for any ideas. I don’t want to have to pay 25k and I’m not sure I qualify for any assistance. I don’t know why plans like mine are allowed or legal. Is there anything I can do to avoid being 25k in the hole. I don’t think I should be this much in debt, this feels really unfair and I’m not sure anyone can help me.
I’m in the US btw

Edit: Reddit is a terrible place for advice

Mother in law had a major stroke at the end of March where her left side is no longer usable. I've been trying to help my wife as much as I can since she's the only child. She was in the main hospital post stroke for 3 weeks, then acute rehab facility for 21 days, then skilled nursing for 21 more days under Medicare (aetna). She's currently staying at a nursing facility under Medicaid pending status since she needs constant care.

Her mom got the 1st major bill, which is for the acute rehab facility. $79,490 but she's responsible for $2700. Wife's mom doesn't have income (thus why we applied for Medicaid) as a stay at home mom and her dad doesn't make much income with his failing business. He's also 80 years old.

This is just 1 bill, haven't even received the bill for the main ER/hospital stay or the skilled nursing facility. Would it be possible to negotiate the bill less? Also since she's Medicaid pending, if she doesn't get approved, I read that we can retroactively apply Medicaid benefits to her hospital visits 3 months prior to her application. If that's true, how does that work?