My Support Forums - View Single Post - Got a hospital bill although we have Tricare

(JD) · Feb 02, 2011 at 01:34 PM

May I respond to this? I personally believe this is a ploy by the medical and insurance industies to try and keep their profits high.

I've heard more and more instances of this through the internet and even in the local paper...where medical companies are billing and even harassing patients to pay bills they don't owe. Many people are not in any situation to assume they don't owe or fight the companies, and may, in their depressed state, just add it to bills unpaid pile.

I'm experienced this on my own, this past year, and I'm still not sure it's bee cleared up. The same story: hospital billing me for a bill that was already settled by the insurance company. Fortunately, my hospitalization insurance is with a company that sends ME a notice of what was billed, what they paid on my behalf and what, if anything I owe. I doubt I could figure all that out on my own without must stress! If I continue to receive calls or letters from the hospital, I'm turning them in to the FTC (Federal Trade Commission) who is cracking down on such illegal activity.

What the hospital (and doctor or whomever is billing you) needs is a declaration from the hospitalization/health insurance company that you don't owe it.

What occurs when you have insurance is this: the hospital or doctor has an agreement with the individual hospitalization/health insurance companies. They agree that if they charge xx amount, that if the insurance company pays/covers that element of billing, that the doctor accepts that as "full payment" and will not bill the patient. OR, they have an agreement that the patient will pay a percentage (deductible?) only and the rest the doctor has to write off.

Many doctors have increased their fees to try and cover their losses. The insurance companies won't pay any more than what was agreed, and the covered patient doesn't have to either...but the poor person (literally and figuratively) who has no coverage is stuck with the larger fee and thus is carrying the lack of full insurance coverage of all, on their backs.

It's a failed system, imo.