How do I fight this Health Care Bill that should never have been a bill?
Asked by
radcliff (
253
)
February 6th, 2011
I have completely been misled by a health clinc and I believed I was not to be billed for their services because they said If I was a on medical assistance I was eligible. I was never told about any fees what-so-ever. When I got my first bill the worker said “We don’t bill out to Medical Assistance Clients”. She was wrong. I have a huge bill and am not happy!
This is what their phamphlet says about fees.
FEES
Services are reimbursable by Medical Assistance administered through the State Department of Human Services. This includes most Prepaid Medical Assistance Plans (PMAP).
I have been fighting this bill for months and no one will help me at clinic. Now it is in collections and I am waiting for my medical records release form and have been for a while. I have contacted every person who is a boss of a boss and no one will resolve this issue. I completely know I am right….what do you think?
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74 Answers
It sounds like they want you to pay the bill, then you get reimbursed. You would be taking a risk that they won’t.
@radcliff is the state where you received the health clinic care?
Have you tried talking to the department you get your medical insurance through (I know it varies a bit from state to state), but maybe they can help you with it. If the clinic had a deal not to bill medical assistance patients, then it should be something you tell the state since they are going back on that deal now.
@radcliff my question is “what” is the state where you received the health clinic care? Just reading your question, I take it that when the clinic said, “We don’t bill out to Medical Assistance Clients,” they meant they wouldn’t do a third party billing for you. That means, they don’t file the paperwork for you to your provider.
@bkcunningham @Seaofclouds @filmfann
Minnesota
No the worker said they do not bill (charge) Medical Assistance Clients.
The worker was wrong and said if she knew I had a “Spendown” she would have told me before she came to my home.
I am more concerned that I was misled and given false information. The clinic wont work with me and have banned my calls to ask questions. I sent an email to the director and all he said was that he would look into it. He nevfer returned the email nor did he return 2–3 calls. He NEVER got back to me. I have records of other emails that I sent as well. It is a “Christian” Clinic and they do not even care.
I have recently sent in a Medical Release Form only to find out they have no record of it and have lost it. (How convenient) I am ready to file a report with the Dept. of Health and Attorney Generals Office.
If I knew Iwas paying a social worker $!00 dollars an hour for helping me fill out paperwork and to chit chat, I would never have agreed to this so called “Care”.
You can always let it just sit on your credit report, and put a note in there explaining why it’s there.
@ Dutchess
So, after the whole staff, including the C.E.O. of the company snubs me and one person “promised me” that she would help me after I told her the rather long story. (I shortened it here) I would like to report their lack of any help. This is a mental health clinic and I have severe memory damage and I am FURIOUS about the lack of any intentions to resolve this bill informally…
I want any advice on a complaint and is it going to go anywhere. Thanks!
(Don’t put a space between the @ and the name…)
Well, take that other complaint to the BBB
@Dutchess_III @bkcunningham @Seaofclouds @filmfann
The reason I had this social worker come to my home is to help me sort out the confusion of medical assistance and to get on charity care programs for helping pay for my hospital and medication bills due to a FREAK accident that I can not prove…that has created awful memory issues and physical damage to me so I can not drive.
@Dutchess_III
What about state agencies? Can others read a BBB complaint?
You got it @radcliff !!
Yes, others can read a BBB complaint, but they have to go looking for it. IDK….maybe you could take it to your local newspaper? Here we have a news station that explore complaints like yours in a very public manner. They tend to get things fixed!
@Dutchess_III
:)
BBB complaints and how do you read them or look for them? The clinic has 7 in the last 3 years.
@Dutchess_III
Due to the FREAK accident that I have not been able to prove, I have not wanted to go public with the nature of the accident and want to remain anonymous for now…
@radcliff so you are dealing with either a potential workers’ comp claim or potential litigation regarding the “freak accident?”
@bkcunningham
I can not medically prove and/or prove causal relationship to what caused me to become more and more physically ill. Plus no lawyer will touch this one so far. I have tried.
@Dutchess_III
I need a case number to see other complaints…..? How do I see the other complaints?
I don’t know. Contact them.
@radcliff so you are dealing with a Medicaid Spend Down and you haven’t qualified for total disability yet. Right? This means you are in the process of seeing if your income exceeds the income limit so you may qualify for Medicaid. In other words, to determine if you have medical bills that equal or are greater than your “excess” income. The process of subtracting those medical bills from your income over a six month period is called a Medicaid “spend-down.”
Every state has different guidelines for this, but basically, the amount of your spend-down is the extra income that is over the limit to receive Medicaid automatically. DSS figures out this amount for each person, taking into account the person’s income and living arrangements.
@bkcunningham
The whole spend-down thing really shoulndt play any part in this. I was misled. I am on S.S. Disability and am poor regardless.
I would NEVER have paid or even considered paying a social worker any money out of pocket for helping me do something that took me a rather long time to accomplish. I took advantage of the “knowing” that it was a free service.
I have got to be frugal since I became a non-working wage earner after over 30 years of working hard and having a freak accident that I cant even sue the source of the cause.
I was given false info all along…about the billing part.
@radcliff I was just trying to understand the situation. You have to spend so much out of pocket, the spend down, for Medicaid to kick in play. Just trying to grasp what the situation is you are talking about.
I’m getting really curious about the ‘freak accident….’
@bkcunningham
I was told because I was on Medical Assistance I could have this service. That I waseligible. Nothing was said about cost and that infuriates me!!! Almost $100.00/hour.
I was trying to get out of bills I couldnt pay, not accrue anymore. I was misled and to top it off the clinic wont even help me. The woman who promised she would help me has not returned my calls and one coworker said she no longer worked ther. I found out that was not true.
@Dutchess_III
:( You wouldnt believe it and I want it to be proven before I tell all. It is horrifying and un-natural.
@radcliff I’m sure you are feeling frustrated. I’m sure you are feeling frustrated with questions here when you are trying to get help and advise. So bear with me please. You have paid cash for something you thought was going to be free to you, or at least billed to Medicaid for you. Do I have that right so far? Sorry for being so confused. It is me and not you. I really want to help.
@No, I appreciate the “free” service here and thank you all. I will explain further.
@bkcunningham
Aside from the fact that the I have suffered the worst nightmare freak accident….
My sister and I who found this program were totally convinced it would help me sort out the newly aquired Medical Assistance Insurance. I have become more and more disabled and it takes me forever to understand and remember simple tasks. I thought since this service was free to me due to being on Medical Assistance, it could help me to apply for charity care that I was eligable for. Also, M.A. was taking forever to return calls etc.
I had a social worker come in and help me. She did very little to help me and we chatted for the first part of her stay and when it was time to do some work she had to go to another clients home. I was also billed travel time and costs. She was here an hour at most. If I ever knew I was going to be charged anything at all for hervisits, I would not have had her come. She also breached my privacy rights and I should have said see ya to her right then.
Are you following me. Look at my original question on what their phamphlrt/brochures says on FEES.
@radcliff so the “social worker” who came to your home is the one billing you? This “social worker’s” fees are what you are concerned with, right?
@bkcunningham
No, the clinic that she works for.
She told me after I gotthefirst bill that she was sure it was wrong and she said clients on M.A. do not get a bill. (as in it is a covered visit)
Then later she emailed me and said if she knew that I had aspend-down she would have told me before she came. She didnt know much and was new. She doesnt work there anymore.
@radcliff that was my point with the explanation of the Spend Down. There is a period, it varies from state to state, that you must pay out of pocket, sort of like a deductible with some regular health insurance plans. At the end of the six months or whatever it is in your state, the amount that Medicaid will pay is determined and the remaindor is reimbursed to you if you over paid.
I know this inconveniences you because of your income. It is ashame you didn’t understand before you agreed to the “social worker” coming to “help” you. It is a disgrace to the entire system, but really one way to look at this is that it only re-enforces the fact that you have a disability. Since you have memory problems, I’m sure you’ve been in touch with agencies for this. They will stress to document, document, document. Write everything down to have a record and to assist in your memory lapses.
If your situation is so dire that you need basic necessities like food or heat, contact your county social services or get your sister to contact them for you. If your income allows you can get food stamps or as it is called now Supplemental Nutrition Assistance Program or SNAP and fuel assistance.
Also, what do you care what your credit report says or doesn’t say? If you are in the process of getting on total disability, it seems to make little difference in that respect.
@bkcunningham
What about being misled, given false information, and no one helping me to resolve this billing issue. They didnt even tell me that Medicare would not cover a thing. I wanted the social worker to help me with exactly situations like that. She was not helpful at all. She confused me more…
@radcliff here is the way I look at this. Please, don’t be insulted. I’m just saying how I see it after a few minutes on the Internet reading your side of this. In life, there are really three sides to everything. Your side. (Their side.) The side of the clinic. And the truth.
The truth is what your costs are going to be regardless of what you say or what the clinic says. If you don’t have the funds to pay it or you want to take a stand and not pay, what difference does it make? None.
So my way of thinking in trying to help you, is to use the truth to your advantage. The truth of the costs because you were misled due to your disability or you misunderstood because of your disability. Document what has happened. It may have been that you were midled. If you were, you were more easily misled because of your illness.
You may have completely misunderstood. If you did misunderstand it was because of your illness.
Either way, misled, lied to, given false information, misunderstood; document everyone you speak to with dates and times. Regardless. You may need this information in the future. In the mean time, because these are medical expenses; they can be deducted on your income taxes. Just saying use whatever life hands you to your advantage.
Exactly what I am trying to say. My illness is a key factor.
My sister refered this program to me. She also was misled about it being a free service. The Social Worker was misled as well.
I have no taxable income to even deduct anything.
What agency can I coplain about the quality of service and lack of it and make sure it doesnt happen again to someone else. Also, this clinic needs to be more willing to communicate with the client about how their sevices are billed.
@bkcunningham
Also, Isnt a social worker from the state a free service to residents?
@radcliff bear with me please. When you say “social worker from the state,” what exactly do you mean? What agency?
@bkcunningham
My social worker was not from a state. She was a social worker from a facility that the program was only offered to Medical Assistant recipients.
2–3 times I was called and told she couldnt come that day because billing checks to see if the client has M.A. that day. Each time it was a mistake. Once it was a computer mistake. The other times it was just not correct and I cant remember why.
I would have gone with Human Resources from the state to get a for sure free social worker to help me out.
I did not know better.
@marialisa Okay… Where the heck did you come from in this discussion? LOL I mean that is fine that you answered, but it is Super Bowl Sunday whatever that means.
Thank God. It isn’t me. Which it could be. But it doesn’t seem to be. Right, @Jeruba and @Dutchess_III ?
Since you were nice enough to call me Art Linkletter….???? I will say it is not you!!
OK.. @radcliff or @marialisa..
If you are in MN there is one last venue you might be able to consider: Startribune Whistleblower
If you can put together an email with as clear a time line as possible with what you were promised and what you ended up being charged they could look into this on your behalf.
They may determine that due to the spendown and the confusion on the part of the new employee you were misinformed and at worst you might get a clarification/apology, and at best, perhaps they’d refund the billing amount.
However, if I’ve understood @bkcunningham‘s excellent explanation..you may still be responsible for the amount of the bill, unfortunately. But, at least Whistleblower can call attention to this unfortunate gap for others who might experience the same misinformation in the future..
LMBO
I went to fix something for dinner and my GENIUS friend was on her account…I was wondering why there was so much CONFUSION!!! Like I need more of THAT!!!
She didnt log out!
I am back!
Yes, it was a different thread @bk!
LOL @radcliff!
@Dutchess_III I am new to Fluther but that was funny.
Anyway.
@geeky_mama I do not want to be on the news. I want to make sure that the facility does get in trouble with the Dept. of Health for not being accountable and shunning my attempts to resolve this.
@radcliff so, when you say “social worker from the state,” what exactly do you mean? What agency?
@bk
Just like I wrote on the wrong account.
My social worker was not from a state. She was a social worker from a facility that the program was only offered to Medical Assistant recipients.
2–3 times I was called and told she couldnt come that day because billing checks to see if the client has M.A. that day. Each time it was a mistake. Once it was a computer mistake. The other times it was just not correct and I cant remember why.
I would have gone with Human Resources from the state to get a free social worker to help me out.
I did not know better.
@bkcunningham
Right, it was not free. It was a medical assistance funded for low income people. Why would you even think they could charge $100.00/hour to someone with low income for services that were to help me minimize my health care bills and help me figure out all the bills I had in collections I could not pay and the ones from a hospital stay and for testing from an accident I had. That I also could not afford.
@radcliff most likely, they thought they could bill Medicaid for the expenses. Dirty rotten shame, but probably the truth. They thought I’d pay and not you.
@ If I could have afforded that, I should have went to a financial consulting, sliding fee scale, agency to help with my bill. She came once a week or once a month.
I never had other bills for anyone in this time period. They were old bills I was dealing with.
Plus by the time we started to work on anything she had to go to another client. We chit chatted for a while before we started. Each visit was 1 hour.
@bk By the time I realized anything It was in collections.
Are you Medicaid?
@radcliff are you trying to get in on a class action against Rohm and Haas, BP or some other chemical company?
@radcliff because of your illness. Are you trying to get in on a class action lawsuit against a company or corporation?
@bkcunningham
No,I had something happen to me that I can not prove. I have tried and am still doing research.
@radcliff : contacting Whistleblower does not land you on or in the newspaper. You can be called a pseudonym (like…“radcliff”)
I’m suggested Whistleblower (or something similar – like an Attorney General’s office contact) to be a sort of an ombudsman for you since you feel that the conduct of the clinic was wrong / you were misled.
@geeky_mama
The clinic doesnt even care that I was misled or that I was given false information of the services.
That is another reason I am furious about this issue.
@radcliff – I can surely understand your anger, and since the bill is in collections and you feel the deck is stacked against you (and especially if you’re having memory problems and other difficulties) – that’s when it might be worth reaching out to others who can help make the clinic care.
Look at it this way.. Right now, they see you as just one person complaining: “Unfair! I was misled.”
But, they’ll get their payment by any means necessary and move along – as that is in their best interest.
However, if they get contacted by someone in the AGs office or a writer for the Strib that says: “I’m looking into these charges and we’re going to publish an article…” ...NOW it becomes financially wise for them to avoid the potential bad press – and the embarrassment can certainly be connected to a real concern that their business would decrease if prospective customers (patients) read about how you were misled. Then perhaps the clinic may see incentive to settle the bill with you.
Moreover, if you’ve had this negative experience, is it possible that this sort of bait & switch is actually their modus operandi? If the AG or Strib Whistleblower can find a pattern of this sort of “misinformation” THEN you’ve really not only helped resolve your billing situation, but stopped them from taking advantage of others.
@geeky_mama
If possible, I am going to send the complaint to BBB, Department of Health, Attorney Generals Office and the newspaper.
I just need my mredical records and they say they lost the signed release form. I requested them 2 plus weeks ago. I need them for a timeline of events since I can not recall dates.
Sounds like you’ve got some good plans for next steps.. Good luck to you.. Personally, I’d park myself in the office and ask for the medical records release in person..because it seems like they aren’t being very helpful.
@geeky_mama
I can not drive, It is 20 miles away and it is hard for me to walk anyway. That is one reason I wanted someone to come to my house instead of driving somewhere.
If I do not have my records by the 16th, I will have a ride then.
@radcliff have a good night. I hope it all works out for the best.
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