Careful where your dollars go

Discussion in 'Fibromyalgia Main Forum' started by tedebear, Mar 24, 2003.

  1. tedebear

    tedebear New Member

    Shock and disbelief. I recently went through 3 months, 28 physical therapy treatments for my pressure points in the back. I was told no problem Insurance will take care of things. The therapy group just sent me a bill Sat. for $1453.00 and asked me to pay it in 6 months at $250 per payment. The total bill was $6731 and insurance covered $5277. Why didn't therapy tell me that all would not be paid by insurance. After I pay doctors co-pays monthly visits and 16 med pills per day, there isn't any monies left to do much else expect for extra food monies. I would have rather suffered than had the therapy. The therapy was not long term relief anyway. I am physically back to square one. Unbelievable. Hope no one else has gone through this. This Fibro has been very costly.
    Soft teddy hugs to everyone today and always.
  2. pam_d

    pam_d New Member

    I can relate! Somewhere I read that the average person with fibro has spent several years and several thousand dollars out-of-pocket before even getting diagnosed (and I can vouch for that)-----then there's treatment costs, supplements, drugs once you are dx'd.....you are right, insurance doesn't cover it all. I guess we are better off with it than without it, though....a good reminder that we need to weigh the out-of-pocket cost for us, against what benefit we can get from the treatment.

    Hugs (at no charge),
    Pam
  3. IndigoSC

    IndigoSC New Member

    I can most definitely relate as well. I don't have any medical insurance and haven't had for several years now, so every doctor visit or medication or testing is all paid out of my pocket. I've had to turn down physical therapy and other care several times for that reason. It's a pain....literally!
  4. Mikie

    Mikie Moderator

    You need to be very clear on what is covered in your plan. Usually, in an HMO, PT is covered at little or no co-pays. If there are no co-pays, they cannot bill you for the balance.

    In a PPO or Point of Service plan, there may be deductibles, co-pays, and/or co-insurance (like 80/20 percent). If this is the case, then you may be liable for the difference, but check it out.

    Call customer service at your healthcare plan, figure to be on hold forever, and possibly get someone who knows what he or she is talking about. If not, ask for a supervisor. The C/S number should be on your card. If you have a policy, you can look at it. If this is an employer plan, ask the plan administrator. It's easier than dealing with C/S.

    I hope this helps. You might also call the P/T office and ask what these charges are; i.e., deductible, co-pays, co-insurance, etc. Unless you are in a managed-care plan, you may be responsible for balance-billing.

    Love, Mikie
  5. baby-bear

    baby-bear New Member

    I'm so sorry this happened to you. I do work in a Medical Insurance referral dept. at the university and I always tell my patients that they need to CALL their Insurance co....look for the 1-800 number on the back of your insurance card. Call and tell them what you are having done. Ask them what your co-pay, your deductible is.... if you have one, and any other monies you will have to pay. DO THIS each time your going to have lab tests, x-rays,any thing that requires a specialist or any special technician. MRI's, Ultrasound and Cat Scans..also ask about charges on your part. The rule for insurance is anything a regular practioner doctor wants you to do extra..call the insurance co. and find out your part you will have to pay. Also the physical therapy place should be able to work out a better way for you to pay. I know that as long as your paying something they can't touch you or your credit. At least thats the way it is in Texas. They usually have to work with you and can't make you pay X amount of money each month. Hope this helps...Pammy
  6. klutzo

    klutzo New Member

    I spend about $150 per month for supplements, and I need all of them to function. I don't know what I'd do if I was not married, as I am on disability. I feel so guilty about the money, but I cannot even take care of the house, feed my husband, and care for our animals without the supps. I really do feel for you. Insurance hardly ever pays the whole bill, and it seems they pay less and less every year.
    Klutzo
  7. Shirl

    Shirl New Member

    this has happened to you, how awful. Isn't there anything you can do about this? I sure would try if I were you.

    I am like Klutzo, I spend about $150.00 to $200.00 a month on supplements, but without them I don't know where I would be, my poor animals would be in bad shape without me too!

    I have insurance, but don't go to doctors except for the Xanax. I am tired of doctors as I did not get very much help anyway. When I was first diagnosed I was paying out of pocket too. After a few years of that with no serious help, I simply quit going.

    I sure hope you get this straight and not have to be paying all that money for something that did not have any lasting effects for you.

    Let us know if you can get out of paying that.

    Shalom, Shirl
  8. tedebear

    tedebear New Member

    I appreciate the replies.
    Apparently I signed a paper at the beginning of therapy that stated that any costs insurance didn't cover were my responsibility. They got me there huh.
    Well thanks guys and have soft teddy hugs from me.
  9. Mikie

    Mikie Moderator

    Don't believe that by signing that paper that you are liable for these expenses. In theory, the patient is ultimately responsible; however, depending on your insurance plan, you may not be. This is why I'm urging you to find out just what these charges are for and whether you really are liable for them.

    Let me tell you that ambulance companies and physical therapy centers are the worst, absolute worst, at helping you with your insurance. They will bill people, and 90 percent of the time, people will pay it. This increases their revenues, sometimes illegally. Now, I'm not saying this particular case is one of illegal billing, but it could be. Check it out. It's your money.

    Never, never, ever pay a medical bill until you are convinced you owe the money. This does not mean stiffing legitimate charges, but it does mean being sure you are not being ripped off by anyone.

    Love, Mikie