Understanding my Deductible/co Insurance/out of Pocket Max.

[ctg]

Does "usual and customary" come into play here? It sounds like an emergency situation.

 

[STIBROKER]

Maybe your experience has been different, but I have not seen providers willing to "write off" the balance bill,

everything is negotiable........

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Well regardless the person I spoke to said that we would owe 20% coinsurance, so it won't be over $8800. Of course, no way do I want to pay $8800!

who told you this.....after you meet your ded and co insurance then you get 100% paid.....which i am sure you ate up in hosp costs.....but then again you have a separate out of network deductible and co insurance.....so....you need to stay on top of in and out filings.......

 

[somarco]

Does "usual and customary" come into play here? It sounds like an emergency situation.

UCR has not been used in years.

There is a reason why some providers choose not to sign an MCO contract. They feel they are worth every penny and are willing to fight for it.

Sti, I know people that have walked away from serious accidents and they were not wearing a seat belt.

But I know more people who have been turned over to collections for failing to pay their medical bills.

That bill is from 1999 and is nowhere near $44k.

The lady can pay the bill, negotiate, or walk away. Never said there would not be consequences to paying less than billed.

The "lady" at the carrier can say anything. What matters is the policy language.

 

[STIBROKER]

But I know more people who have been turned over to collections for failing to pay their medical bills.

That bill is from 1999 and is nowhere near $44k.

The lady can pay the bill, negotiate, or walk away. Never said there would not be consequences to paying less than billed.

but there in lays the loop hole.....if you mail them $25 A MONTH then they have to take it....can not charge you interest or turn you over to collections.....

 

[somarco]

if you mail them $25 A MONTH then they have to take it....can not charge you interest or turn you over to collections.....

Show the statute that applies.

This crap has been floating around the internet for years. Same thing for sending a check for $50 and marking PAID IN FULL on the back.

I would expect this kind of crap from a rookie, but not from you. I really hate to see agents giving people false hope.

Carry on.

 

[AllenChicago]

https://www1.ghc.org/individual-family

looks legit.......the thing about your airlift bill is I thinking that it could be filed as out of network.....very few air ambulance's are in network.....now if it was a life or death situation can possibly be refiled as in network due to life or death emergency......

Mapper, if you go to https://www.ghc.org/ and type in the word "ambulance" in the search box, you'll see a list of Benefit booklets. Maybe one of them is for the plan you have and explains how Emergency Transportation costs are handled. Please come back when this is over and let us know how things went. Good luck!
-ac

 

[STIBROKER]

Show the statute that applies.

This crap has been floating around the internet for years. Same thing for sending a check for $50 and marking PAID IN FULL on the back.

I would expect this kind of crap from a rookie, but not from you. I really hate to see agents giving people false hope.

Carry on.

man thats what I did on the bill posted and am currently doing it on a $800 lab bill I got last year.....it is all negotiable as long as you have a insurance company paying a portion....

 

[Dweezil]

Show the statute that applies.

This crap has been floating around the internet for years. Same thing for sending a check for $50 and marking PAID IN FULL on the back.

I would expect this kind of crap from a rookie, but not from you. I really hate to see agents giving people false hope.

Carry on.

Actually if they accept a check properly marked "Paid in Full" can be used to settle a disputed amount if accepted by a creditor. It's meaningless if you tried that to pay your mortgage off if there was no dispute. If the requirements are met and the check is accepted then that is considered settled by law. It's covered in most business law 101 courses.

 

[somarco]

You might want to explain that maneuver to these lawyers. Seems they must have failed b law 101

Writing Paid in Full on Cashed Check

'Paid in Full' Check Memo

Is everything negotiable? Yes, as long as the creditor is willing to negotiate and the debtor is willing to pay according to agreed upon terms.

As for the balance billing question, 13 states prohibit balance billing by non-par providers in certain situations. WA is not one of those states.

 

[Mapper]

Mapper, if you go to and type in the word "ambulance" in the search box, you'll see a list of Benefit booklets. Maybe one of them is for the plan you have and explains how Emergency Transportation costs are handled. Please come back when this is over and let us know how things went. Good luck!
-ac

I know what it says for my plan. It says that we are responsible for 20% coinsurance of emergency transport so that said, 20% of $44,000 is $8800. BUT out of pocket per year for my plan is a max of $2,000. My confusion comes from that. I want to be sure that that is all we have to pay. Or is there some reason that we would have to pay the $8,800? Our hospital stay should only be $300 since we are only responsible for $100 a day up to 3 days. Yet my husband said he purchased airlift insurance for $79 as he does every year before racing and the company that airlifted him has a reciprocity agreement with the company he got it with so there should be no charge at all. Yet my fear comes because I am not sure if he really did purchase it or he just thinks he did and forgot because I can't find a receipt for his payment through his bank account or credit cards. Wouldn't that suck if the one year he forgot to renew it was the year he needed it??!!