FOWC with Fandango — Ingenuity

Today or maybe tomorrow if I have the energy, I have to try to explain to UMass that if Blue Cross says I don’t owe money, I don’t owe the money. That is the theory and supposedly, that’s the legal way it works. If I know this is the law, I’m pretty sure so does UMass.

They are not allowed to “charge the balance” to us. When you are on Medicare, all that “leftover money” is a write-off. I know it makes hospitals unhappy, but that is how it works.

This will be an amazing trick of ingenuity and I’m not sure I have the strength of character to do it today.

In fact, I’m sure I don’t.


I’m too tired now.

Categories: #FOWC, Daily Prompt, Fandango's One Word Challenge, Health, Money

Tags: , , , , ,

35 replies

  1. Two hundred dollars is probably not a lot to a doctor but it is to people on a tiny fixed income. They probably will back off but it should never have arisen in the first place.


  2. I have only once had a problem with billing from any hospital, and when I did, I contacted BlueCross. The woman there was amazingly good natured about the whole thing and explained that no matter what the hospital said, we did NOT owe four figures for anything. And to call her back if there was a problem.
    There was, and I did. She said, quite firmly, ‘I’ll take care of it.” and she did.

    My one suspicion about itemized billing is that much of it reads like padding. The last bill we recieved had an item called ‘topical insertion of intravenous needle” and it was several hundred dollars just to stick an IV into a vein.


    • This is that kind of thing. I understand that Medicare doesn’t pay what they want to get, but that’s the way it is. BC is REALLY good with service. They are the absolute best of the medical care companies, possibly because it’s the only thing they do. They aren’t part of some huge insurance company.


    • Hospitals have an overhead and they bill to meet it. The individual charges generally make little sense and come from nowhere. They just hope to be paid and that it will add up at the of the year and they will come out with enough to cover the overhead.


  3. So I have this to look forward to with Medicare? Wonderful. My husband was told by a doctor’s office that he would have to pay the co-pay at the visit. I told the woman we don’t have a co-pay. We have made our deductible. She tried to tell me, ‘Some people don’t understand deductible and out-of-pocket.’ I told her I understood that quite well and we had met everything and would not be paying them a dime. You really have to be vigilant with these medical providers.


    • Not necessarily. Not every hospital does this. I went through my entire heart surgery and was never charged a penny. Also, you don’t have to stay with basic Medicare we have Medicare Advantage Plan using Blue Cross Blue Shield. Yes, there is a co-pay and co-pays for some drugs (not for any blood pressure drugs, however — those are completely free, at least with BCBS). It’s a hell of a lot less than paying the full bill and significantly less than “straight” Medicare. Generally, surgery and hospitalization are free. Garry’s fees are probably for individual doctors. To be fair, the surgery cost more than a $90.000 surgery and our cost (if we pay it) would be $200. Let’s not go crazy here.


  4. I think and have heard that a lot of providers know you owe any money but send the bills out anyway knowing a lot of people will pay without objecting. That sounds like fraud to me. There should be penalties but most of the amounts are too smsll for people to take action. Maybe a good, large class action suit would get the attentions of the people that do this. But who has the time or energy for that. Class action suit lawyers make money from those suits and the public gets some benefit if the suit has effect on future behavior. Hood luck tomorrow.


    • I’m pretty sure that’s what’s happening here. It’s individual doctors like the anesthesiologist, for example. It’s a moot point. I don’t have the money right now. They know they are not allowed to do “balance billing,” but they assume you don’t know it and will pay anyway. I understand that the amount Medicare pays is much less than the bill, but that’s the deal.


    • It IS fraud but most people are like me. Too tired to try and take on the local hospital. And right now, we NEED that hospital, so I’m just not paying them. This is Massachusetts. They actually can’t do anything about it anyway and if they want to push it, they lose because we actually DON’T owe them the money. So I figure I don’t have to kill myself over this one.


  5. Know how tiring and frustrating MOST of this senior business can be… I’ve got to fill out mega paperwork this week for my RMD’s for Traditionals IRAs at Age 70 1/2 and have been putting it off for a month. Then there are all those health insurance forms to reconcile. Thinking of you…


  6. Stick to your guns, Marilyn.


  7. Oh, no — that shouldn’t even be a question!


  8. Forgot to add I hope Garry is doing well.


  9. I hope you get a knowledgable person on the other end. I had 3 different answers to the same question. Don’t take anything for granted. Good luck.


  10. That is the way I understand it as well. There is Medicare A and B and whatever supplement you may have, and they write off the rest after whatever out of pocket you may have for the year. They over charge to start so they can get close to what they want anyway.


  11. We Medicare beneficiaries must remain diligent. Most of us on fixed incomes can’t afford to pay for services that are not supposed to be balance-billed.

    Liked by 1 person

    • I know. I got all the bills from BCBS (our Medicare Advantage Plan) and it said zero zero zero for all the bills. So suddenly, I guess this bill. Probably individual doctors who feel they don’t have to follow the rules. Really, they do.

      Liked by 1 person

  12. I suspect a lot of Medicare patients don’t know that and just go ahead and pay those bills, or make arrangements to pay them. People are too used to regular insurance, where you do, in fact, have to pay the remaining charges after the insurance payout. Rest up – and then fight the good fight!

    Liked by 1 person

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