Hospital Bill /Insurance Co-Pay Stress

Mental and Emotional Wellness
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I’ve had two surgeries this year - carpal tunnel in both hands. My first was in February. I pre-paid the hospital $1700-ish. I also got a bill from them for $150-ish for bloodwork and an EKG. When I got my EOBs, my insurance said I only owed $127 for the labwork and around $1450 for the surgery. This means the hospital owes me money, I guess. I called the hospital and my account is “in review” and if a credit is owed, they’ll refund it onto my credit card.

The time for my second surgery rolls around and the “in review” bit hasn’t been sorted out yet (I’d actually only looked at the EOBs from the first surgery about 3 weeks prior, so no surprise there). Due to having met my deductible my second surgery is much, much less expensive and I’m told my portion is only $622 for the hospital fee. (Surgeon and anesthesiologist separate), so I pay that.

So far, 11 days later, nothing has been sent through my insurance for my second surgery, including the pre-op labwork and EKG that were done several days prior to the surgery. In addition to this, I know I’m going to have another fee to the anesthesiologist, and I’ve also got a therapist who has 3 visits for which claims haven’t been processed. In short - between the outstanding claims, I will have more than met my max out of pocket.

The problem is that I’m also going to physical therapy, and each visit I’m having to pay a co-pay that I wouldn’t pay if these claims had been filed. I’m also approved for a CGM, which will be 100% covered under durable medical and be free, once the claims go through.

Does anyone have any tips on how to get the hospital to hurry up to A) refund the money they owe me and B) file the darn claim so I can stop being in limbo? I called this morning and explained that I am close to my max out of pocket, and that every delay means more money they have to pay me back, so hopefully that will help, but they didn’t seem too encouraging. The suggestion they had was to use the credit card that I’d paid them with to pay my other medical fees, as they’d be crediting any money owed me back to that card. Is that just really the best way to go, or would it be better to wait until they get it sorted? I have no idea how long they’ll take.

Edited to add: By comparison, last time, the bill was submitted to and paid by my insurance 4 days after surgery. I called again and she clarified that it’s pending in THEIR system. They haven’t even finished adding all the charges up. ARG.

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Hospitals can be notorious for inefficient and error ridden billing systems. If you truly dispute the amount paid and you paid by credit card you could threaten them with a chargeback. That will get their attention.

2 Likes
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D’oh. I did forget to mention that when I went to pay the $150 b bill for the bloodwork and EKG, they said it’d already been paid, even though I showed no record of paying it. Not out of my main debit card account, not my husband’s account, and not on my credit card. I can only guess that they took some of the difference between the $1700-ish and $1450-ish and paid the $150 out of it. In all, the amount they owe me is probably around $100-$150. I have little doubt that they’ll get that all sorted out, eventually, and put it back on my credit card.

Mostly I’m just irked that last time they had the claim filed (and paid to them!) in 4 days, and here it’s been 11 days and they haven’t even filed it. Meanwhile I’ve got another doctor who’s sitting on $90 in co-pays that aren’t showing up in my claims yet, either. Between the hospital and the other doctor, I should be at (or very nearly at) my max-out-of-pocket, but I’m having to pay $18 to my physical therapy 2x a week… when if the claims were filed, I wouldn’t. It’s irksome, especially since the last time I saw the doctor with the 3 outstanding claims was 4/4 - 22 days ago, for goodness sake.