(no subject)

[noahgibbs]

Getting a lawyer to look at insurance settlement stuff. Talking to him tomorrow for the first time.

I had been hoping to avoid that, but looking at this, it would be stupid to. If I accept a settlement, I am by default left fighting against the other insurance company (my health insurance company), and having a lawyer is simply mandatory for that. I don't know my rights, and the insurance company's responsibilities, well enough to do that on my own.

The lawyer definitely feels I'm being lowballed on the insurance settlement. I'm mixed on that sentiment for a variety of reasons, but I *really* don't want to come out of this having spent a vast amount of money I can't get back on medical care.

Comments

[kraydon.livejournal.com]

stupid not to, you mean?

[angelbob.livejournal.com]

Stupid to avoid getting a lawyer is what I mean.

I stand to lose *way* more to my own ignorance of the law than to legal fees.

[kraydon.livejournal.com]

Ah. Ok. Awkward sentence. Makens sense now.

[onetarot.livejournal.com]

That is a well-chosen icon for your post.

[terpsichoros.livejournal.com]

There are two parties left to deal with after the other driver's insurance company: your health insurance company, and the hospital (plus other medical folks).

Hospitals are notorious for overbilling and billing errors, and in the normal course of events, the insurance companies don't pay much attention, as their discount and the occasional error in the patient's favor make things work out. In the aggregate, the hospitals would have to raise their rates to make up for the losses from accuracy. But in an - your - individual case, going over their billing with a fine-toothed comb may be worthwhile.

[angelbob.livejournal.com]

Yeah. I need to do more of that. Unfortunately, hospital billing is another thing I don't know a great deal about. Some of the items look pretty ridiculous to me, but in practice some of them are and some of them aren't.

Similarly, there are things where I'm not sure if I have a legal leg to stand on or not. While I repeatedly said "something other than morphine" for pain relief and they just kept giving me more morphine (which entirely failed to work), I'm not sure if that gives me grounds to challenge the amount (more than $1200) spent on morphine.

[terpsichoros.livejournal.com]

I would suspect that it does give you grounds to refuse to pay for the morphine, after you started saying "something other than morphine".

My experience is a much simpler case, but effectively, I ended up blowing off my co-payment, and having the hospital close my billing file, because I threatened them with a malpractice lawsuit for the way I was treated.

In your case, it'll be harder. Some things should be pretty easy to check - how many days were you there for? Were you billed twice for the ambulance ride? Other things you may not want to challenge without discussing with a lawyer, like the morphine thing.

[judith-s.livejournal.com]

Yes, you do have a reason to challenge it. And you should. I ended up getting a 30% discount on the amount owed, but the hospital never admitted that I didn't take the pain pills or the nausea pills (I refused both), and still billed me $300 for it. Yeah, hospitals suck. Good luck.

[ef2p.livejournal.com]

They probably ding your account when they get the drugs out of stock. So if they walk into your room with the pills, you are already dinged.

I been meaning to ask angelbob: Would you consider writing up a detailed accounting of your experience with hospital billing, insurance companies, etc. There is something seriously wrong with our current medical system. However finding concrete major examples is hard. If you do I would high recomend sending the story to you congresspeople.

[angelbob.livejournal.com]

I'd consider it, though I'm not sure how coherent my account of it will be. There's a lot that was handled for me (that is not a complaint, boot_slut and ravenslost *grin*), and more that I'm not entirely sure of due to confusion of one kind or another.

[terpsichoros.livejournal.com]

While mine isn't as dramatic, it's fucked up in ways which have public policy implications - I have successfully stiffed the hospital for my share, but Blue Shield has paid the remainder of the cost and is unaware that I've contested it.

http://g-blog.net/user/terpsichoros/entry/3516
http://g-blog.net/user/terpsichoros/entry/3521
http://g-blog.net/user/terpsichoros/entry/3537

I don't recall having posted about dealing with Alta Bates, but after many attempts to collect their $50 co-payment, including a number of phone calls from my end, I wrote back saying "If you bill me again, I will sue you for malpractice. Capiche?", and they gave in.

[ef2p.livejournal.com]

Wow, that really sucked. Thanks for sharing.

[mg4h.livejournal.com]

Godalmighty. That sounds way too familiar.

I've had actual fights with doctors over bad diagnosis calls, and "Oh, it's not that bad. Don't act like a baby."

Excuse me? My [bodypart] feels like a railroad spike has been driven through it, and now you're wiggling it around to see if it's REALLY that bad. HELLO?!

It always freaks them out when I start speaking medical tech back at them. I know *just* enough to get good attention, most of the time. And what I don't know, I can related to what I already do. It's helpful to know things like, oh, the name of the muscle/tendon/ligament that's injured from reading Gray's Anatomy ;)

I'm sorry you had such a bad experience. I got away from an HMO years ago, have never been happier. I just hope what I'm on doesn't turn into one, after a while.

[angelbob.livejournal.com]

I'm doing the HMO thing now (and, of course, was also doing that when injured). So far, the actual HMO part hasn't been all that awful and my amount of runaround was pretty minimal, but I basically did an end-run around all that due to incompetence (not mine, somebody else's) with paperwork, which caused me a whole *different* set of headaches.

[bayareajenn.livejournal.com]

Though I'm somewhat loathe to admit it, I used to work for an insurance company, for about six years. I was a Claims Rep for a year and a half, and I did Claims Entry before then. In the future, if you (or anyone) needs help with the paperwork or has simple questions about policy, diagnoses, coverage, the math, etc., you can always try asking me (for free). Since you have a lawyer now, though, s/he should be able to handle all of your problems, I hope.

My worst medical experience was when I went to a PP for a gyno in Madison years ago, and the doc was looking at my vagina, and suddenly she exclaims, "Oh, my God!" She never told me why she said it, either, though it panicked the hell out of me. Apparently there was nothing wrong, and mine was just shocking, I guess, on that particular day. lol

[angelbob.livejournal.com]

Thanks! As it turns out, this was merely paperwork I completed correctly and gave to the appropriate person, and it was lost somewhere between me and the insurance company. Filled out correctly as far as I know, but that didn't help - it was lost.

But I'll keep that in mind if I'm trying to figure anything more out. As you say, I've got a lawyer at this point. Oddly, I haven't been doing all that badly so far, but we're hitting the end of my competence (I'm amazed it took this long!).

[neverjaunty.livejournal.com]

I've had actual fights with doctors over bad diagnosis calls, and "Oh, it's not that bad. Don't act like a baby."

"Why don't I call my attorney and get a second opinion on that?"

I'm just sayin'. ;)

[coyotegrrrl.livejournal.com]

::hugs:: Good luck with everything. You ought to have karma on your side, at least.

::resist urge to make puns about legs, standing, etc.::

[zhaneel69.livejournal.com]

Blech. This sucks. Sorry to hear. Glad you are being educated.

Zhaneel

[darthsunshine.livejournal.com]

*nodnod*

Good luck with that.

[lady-phoenixice.livejournal.com]

*great big hug*
I hope you get whatever you're supposed to get, at the very least.
Too bad your accident happened before* we met and before* I went through school... I've learned *all* sorts of nifty stuff that I could have helped you out with... like... bathing and shaving and changing beds and feeding and peri-care... oh well *wink* I'm glad you're all healed, it could have been much worse. And best of luck with the blood sucking lawyer, remember to keep him on your side, but to stay away from the dangerous end...

[neverjaunty.livejournal.com]

terpsichoros is right. Insist that the hospital provide you with an ITEMIZED bill, with every charge specified. Not just "medication" but "200 mg acetaminophen," or whatever. Some health insurers, by the way, will let you keep half of any overcharges you report to them.

Both of our ends are dangerous, lady_phoenixice.

[mg4h.livejournal.com]

Probably a good idea. The lawyer should be on your side, and it's not a bad thing to feel better about either not being stiffed or getting enough to cover expenses. Good luck!