[Question - Insurance] Partner and I went to ER for same issue and received different bills. Spoke with the billing department for a while to no avail. Where do I go from here?

Hi all!

I am trying to see if I can post our medical bills here for you to see. Long story short:

My partner and I thought something was a carrot. Turns out it was hemlock. Yup, we are idiots sometimes. We went to the ER at the same time and were seen by different doctors. We both were given activated charcoal and put on EKGs for six hours. We saw the doctors for about five minutes and each had nurses come and check on us maybe twice -once to put the EKGs on us and another time to tell us we were fine and could go home.

Although I expected large bills I was VERY surprised by how large. He and I have different insurance, btw.

My bill said I was a level 4 (out of 5) in the ER. It also said I was given activated charcoal. After insurance this came out to $979.36.

My partner's bill said he was a level 5 (out of 5) in the ER. It said he was given two doses of activated charcoal and has an EKG and blood tests. Obviously his doctor was far more thorough. After insurance his total came out to $1,418.12.

Now we could pay this and wipe out a good chunk of our savings. However... I would like to not wipe out our savings and also... The principal of it all.

These are the steps I've gone through so far:

1. Called billing and got detailed bills. That's how I found out what level we were classified as.
2. Compared the average cost of this hospital (my state has a website for transparent hospital billing) to our bill. Almost every item was SUPER inflated compared to that average cost.
3. Asked the billing department to have the coding department check that we were classified correctly. They did this twice for me. Each time the coding department told them we were classified correctly. I asked them for the information on how they reached that determination. The billing person told me it's very complicated and it's a series of points based on many factors. I used to be an auditor and told the person I can totally understand complicated paperwork/systems. I was then told that their process is not something they advertise.
4. I called my own insurance and asked about upcoding violations and how I could deal with that. Not much progress on that front.
5. I was told by another billing person to get in touch with a patient advocate who could better describe their coding process to me. I told them that my understanding of the process was not the issue rather it was my feeling that we were coded incorrectly. They said they could not help me with that since their coding department said it was coded correctly.

And now I am here. Any insight would be much, much appreciated. Am I really not allowed to see how they arrived at their coding? Is it really this much work to fight this unjust system?

Edit: I forgot to mention I was sent the documents to ask for financial assistance from the hospital. I have yet to fill them out because I would like to resolve this first.

https://ift.tt/eA8V8J Submitted August 06, 2021 at 08:50AM by ritytightyleftyloos https://ift.tt/3Aevqbt