Posted on 09/21/2021 7:49:53 AM PDT by DUMBGRUNT
Brittany Giroux Lane gave birth to her daughter, Alexandra, a few days before Christmas in 2018. The baby had dark eyes and longish legs. She had also arrived about 13 weeks early, and weighed just two pounds.
Alexandra initially thrived in the neonatal intensive care unit at Mount Sinai West. Ms. Lane, 35, recalls the nurses describing her daughter as a “rock star” because she grew so quickly. But her condition rapidly worsened after an infection, and Alexandra died early on the morning of Jan. 15 at 25 days old.
Last summer, Ms. Lane started receiving debt collection notices. The letters, sent by the health plan Cigna, said she owed the insurer over $257,000 for the bills it accidentally covered for Alexandra’s care after Ms. Lane switched health insurers.
Medical billing experts who reviewed the case described it as a dispute between a large hospital and a large insurer, with the patient stuck in the middle.
“The letters mean I’m constantly reliving the day, and that is such a hard space to be in,” Ms. Lane said. “I feel so frustrated that the hospital is making decisions about their own bottom line that influence our potential future, and the memory of our child.”
(Excerpt) Read more at dnyuz.com ...
Our daughter had a similar experience. Her health insurance plan paid the doctor for a surgical procedure then mysteriously asked for the payment back from the doctor sticking my daughter for the entire bill and then she was hounded by collection companies. We paid a lawyer several thousand dollars to straighten things out but years later she was still being hounded by collection agencies. After a divorce where her former husband refused to help with co-pays for further medical problems she went through bankruptcy. However recently she received a letter from a collection agency about that original bill. That was quickly resolved when she sent them a copy of her bankruptcy.
Maybe dealing with Verizon, but otherwise, I agree.
Very sorry for loss.
You really should look into a Medicare B plan. I pay about $130 a month. I have zero deductible for just about everything including medications. You’re old. You’re going to get sick.
You owe it your family and spouse to be a good steward of your money.
Just sayin.
Ya and that sigh of relief means they’ll hang a charge on your card you’ll pay for years.
10% off? Big deal. How about 50% off..
Thank you for taking the time to write this! I really appreciate it.
—” I have made some of those bereavement gowns for newborns.”
Thank you, some points of light and pretty color at a dark time.
The ones I have made, have been from donated wedding gowns, so mostly ivory with laces, and I have added bits of color. My daughter is a NICU nurse, so I could send them with her, for her hospital, but she has moved away, and I have not made any for awhile, but should go back to it. I need to ask whether her new hospital would also use them.
Other groups of ladies would knit or crochet little caps, booties, and blankets for the baby angels.
“So it’s the insurer’s fault.”
You are completely right but there has to be more to this situation than we are seeing. A payment by Cigna to Mount Sinai West that is accomplished within the coverage time frame is the responsibility of the insuring agency. However if they paid it outside of the insuring time frame, their responsibility to recoup it is with the hospital, not the parents of the child. There is no way they can make the client the target of the payment they made in that situation.
The only legitimate thing it could be is that insurers don’t always cover 100% of a bill. Most cover about 80% OF THE ALLOWABLE. But that bill wouldn’t come from Cigna, it would come from the hospital, Mount Sinai West. There has to be more than we are seeing. Cigna should have no business with the insured for the bill itself.
wy69
Medical billing is completely crazy, especially for preemies (been there, done that. Daughter is now a healthy adult). Preemie costs can reach in the high six figures (and, in some cases, over a million).
As much as we tried to stay current and figure out what we owed, we were always getting conflicting statements from the hospital and the insurance company.
Eventually, we thought everything was good. Then, about 6 months later, we received a notice that we overpaid, and then sent a check for the overage.
I held that money in my account for over a year before I touched it, in case they came back and said we owed. Fortunately, that day never came.
My father spent a lot of time in hospitals during his final years. Fortunately he had great insurance that covered almost everything. My brother nonetheless carefully checked the hospital billings that were received. On one he noticed a large charge for “special diet.” When he checked the date of the charge against Dad’s treatment he found that the charge correlated to a day that Dad was fasting for a medical test. The hospital was levying a charge for NOT providing meals!
No health insurance? Are you prepared for the $500,000 bill if you or Mrs. Cuban Leaf gets cancer or gets in a bad car accident?
Everybody manages their own risk according to their risk tolerance. We have always had employer health coverage and, now that we are retired, got both Medicare Part A and Part B. I can’t stand the thought of seeing a lot of our life savings and assets wiped out by unexpected medical bills.
I just turned 70 and my wife is 69 — the ages when those sudden medical catastrophes hit out of the blue.
Well put.
There is also the Part B penalty for delaying enrollment in Part B: your premium goes up 10% for every 12 month period you delay. Here's an example from the Medicare site:
For each 12-month period you delay enrollment in Medicare Part B, you will have to pay a 10% Part B premium penalty, unless you have insurance based on your or your spouse’s current work (job-based insurance) or are eligible for a Medicare Savings Program (MSP).In most cases, you will have to pay that penalty every month for as long as you have Medicare. If you are enrolled in Medicare because of a disability and currently pay premium penalties, once you turn 65 you will no longer have to pay the premium penalty.
How do you calculate your premium penalty?
Let’s say you turned 65 in 2013, and you delayed signing up for Part B until 2021 (and you did not have employer insurance, which allows you to delay enrollment). Your monthly premium would be 70% higher for as long as you have Medicare (7 years x 10%). Since the base Part B premium in 2021 is $148.50, your monthly premium with the penalty will be $252.45 ($148.50 x 0.7 + $148.50).
Note: Although your Part B premium amount is based on your income, your penalty is calculated based on the base Part B premium. The penalty is then added to your actual premium amount.
—”the hospital put in a wrong code “
My personal physician sent me for a normal, scheduled PSA test.
The hospital lab requested I sign for $400.00 that would NOT be covered??? This is a $70.00 test and I had top-of-the-line insurance (before 0care).
I spent time beating my gums and they brought out managers...
Thinking my Doc speced some odd test by mistake, I stopped by his office.
And was he unhappy!
He believes the hospital does this with intent and said it’s not an accidental slip-up.
He pulled up another patient’s record, covered the name, and showed the billing; ~$10 cost for the test, and said ~$7 at an outside lab.
I went to a different branch lab of the same hospital, presented the same paperwork; in and out, done?
I do not know?
Seems to be the hospital was quite happy double billing. Sounds like insurance fraud but the hospitals and insurers are so incestuous they will never admit the mistake. The hospital owes the money back to cigma.
—”Other groups of ladies would knit or crochet little caps, booties, and blankets for the baby angels.”
Yes, he had all of that.
Again thank you.
But as soon as a greedy segment decide to use that freedom to steal it all for themselves...it turns into a cluster____.
...of course you have those that are doing it deliberately...to change our country/way of life...while at the same time profiting immensely from their sabotage/corruption/greed.
My wife & I had a son that had extensive medical problems that claimed his life after 25 months. The entirety of his many months in the hospital was along with children of parents who were either on welfare or had no ability to pay. There were also many self pay people who would come from around the world to have their children treated at The Cleveland Clinic Children's Hospital.
Many of the children did not have insurance or Medicaid. Their treatment was no different.
The reality is that the United States has universal healthcare. It does however bill for it. We paid well over $100,000 in medical bills between him & his twin brother born at 32 weeks, spent 27 days in NICU & were 3.3# & 3.8# at birth. The insurance company was billed over $12 million & paid out over $4 million.
This family needs a good attorney that will threaten a multi-million dollar law suite against both the hospital & the insurance company as well as advocate to the state board of insurance to censure, fine or even cancel the state license of the insurance company.
Considering the child died of an infection puts the hospital directly in the cross hairs of an ambulance chaser. The insurance debacle puts it in the wheelhouse of a big law firm .
...There’s little I hate more in the world than dealing with insurance companies....
Amen, brother!
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