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HUGE bill from the hospital, now in collection, help !!!


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In March, I got into an accident in Wisconsin and ended up in Froedtert  Memorial. Just under 5 hours there and a few scans, they billed me $27,000 +.

I am on Medicaid in Illinois and Froedtert basically did everything not to submit the bill to Medicaid, claiming they are out of network.

They wouldn't send medical records as required and itemization of services / procedures performed.

Instead, they have been billing directly to me. I am financially broke with Covid and everything, hence the state insurance.

After 6 months, trying to convince the hospital to submit a proper paperwork to the Medicaid to get paid, they sent me to the Americollect

and I received the first bill / notice. Insurance did paid several doctors from the hospital. The Medicaid is trying to sort the things out with 

Froedtert.  09/23 is the day they will have to come to some conclusion. But meanwhile, I want to prepare with any steps I can take. I am 55 and really have 

no pot to piss in. Can they go after me when I am on Medicaid ?

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12 hours ago, woodpacker said:

In March, I got into an accident in Wisconsin and ended up in Froedtert  Memorial. Just under 5 hours there and a few scans, they billed me $27,000 +.

I am on Medicaid in Illinois and Froedtert basically did everything not to submit the bill to Medicaid, claiming they are out of network.

They wouldn't send medical records as required and itemization of services / procedures performed.

Instead, they have been billing directly to me. I am financially broke with Covid and everything, hence the state insurance.

After 6 months, trying to convince the hospital to submit a proper paperwork to the Medicaid to get paid, they sent me to the Americollect

and I received the first bill / notice. Insurance did paid several doctors from the hospital. The Medicaid is trying to sort the things out with 

Froedtert.  09/23 is the day they will have to come to some conclusion. But meanwhile, I want to prepare with any steps I can take. I am 55 and really have 

no pot to piss in. Can they go after me when I am on Medicaid ?

 

Your situation is of a nature that nationalized healthcare advocates cite in support of their position.  Critical healthcare after an accident is a necessity, not an optional service, and the present private system leaves much to be desired when it comes to affordable options.  (I'm not such an "advocate", but readily admit that you're being very poorly served by the current private system.)

 

Let me clarify the realities that you face:

 

Private hospitals, such as Froedtert, are within their rights in stipulating the insurance plans in which they wish to participate.  Froedtert only accepts in-state Medicaid coverage.

 

In seeking services at Froedtert, as an out of state patient, they likely informed you that your plan wasn't an accepted plan.   This means that you're responsible for any billing and that it's your responsibility to seek eligible reimbursement, after the fact, from Medicaid - IL.  The key problem here is that Medicaid plans have one of the lowest reimbursement rates for services in the US (a reason why some hospitals don't participate, or only participate for in-state patients).  You will likely be left with the lion's share of the billings uncovered.

 

I understand that your needs were likely critical and you weren't likely in a position at the time to "shop around".  That's the most unfair and unfortunately aspect of your situation.

 

Most hospitals, including Froedtert, have a financial assistance office that specializes in drafting payment terms for any billing that hasn't been paid by insurance.  This can include a reduction of some charges (since you haven't benefited from the negotiated discounts that they've arranged with their accepted insurance plans) and long-term installment contracts that can entail payments as low as $100, or even $50/mo, continuing for years.

 

Typically, their billing statements will make you aware of such assistance, but the onus is on you to reach out.  If you fail to do so, and timely payment isn't forthcoming from your insurer, and you don't enter into any other agreement to pay your outstanding bill, it's inevitable that your account will be placed with a collection firm. 

 

------------

 

Truthfully, I'm light on advice here.  If their financial assistance office hasn't previously been involved, you should initiate contact immediately and ask for advice for your circumstances.

 

Your state Medicaid office should also have a resource to advise.  You aren't the first patient having had out-of-state care that they've encountered and I imagine they have tips on how this can best be negotiated.

 

in my limited experience, medical providers aren't keen to refer accounts for outside collection, but when the patient isn't responsive to notices, have no other alternative.  That you have limited financial resources is largely substantiated by the fact that you have Medicaid coverage (as you also suggest in your post).  I suggest a frank discussion that involves the hospital financial assistance people and the billing people to seek away to retract the charges from the collection agency, noting that the collection agency and that you'll diligently work with them to work out any payment plan that your financial circumstances can accommodate. 

 

I wish I could offer more solid advice.  I welcome you to continue this discussion as you work through this.  I, and others here, will put our best foot forward in advising you further.

 

 

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Thanks so much for the advise, but I am afraid it is too late to talk to hospital financial office

In either case they weren't too eager to negotiate. Didn't offer much of an assistance either. 

Now that I am in collections, what the steps they can take to pursue it? I don't have relatives / friends

who can loan that type of cash. What am I to expect moving further  if I don't pay ??

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13 hours ago, woodpacker said:

What am I to expect moving further  if I don't pay ?

Hey woodpacker - Credit Boards has its own resident medical collections fairy named Why Chat.  Your post is less than a day old, and I'll bet Why Chat will be piping in soon.  He/she has helped hundreds, maybe thousands, of people out here with medical billing and collections issues.  You are in good hands!

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I am sorry for your problems.

 

I wish I had some easy quick answers for you but I don't.

Who was at fault in the accident?? Was it a vehicle accident?? Were there any responsible entities with insurance??

 

Meanwhile get your current credit reports and opt out so you won't be harassed later on by junk debt buyers.

https://whychat.me/GUIDEBOOK.html

 

Get your records from Medicaid and see what was charged, what was allowed, what was paid and what amount was left as your responsibility.

 

Being in "collections" is not the end of the World. If you have been affected by the pandemic look to your own County and State programs for what assistance may be available. Depending on the State you are in you may be exempt from the danger of being garnished if you are sued. 

 

I will try to help as much as I can once you have the information you need from Medicaid.

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Have you obtained your credit reports??

https://whychat.me/GUIDEBOOK.html

 

If the account is reporting you would have to start with the dispute letter to the CRAs

https://whychat.me/hipaadisp.html

BEFORE sending the medical DV

https://whychat.me/ltrcavalhipaa.html

 

If they have NOT reported yet then you can send them the medical DV and use this paragraph;

This letter is being sent to you in response to your attached letter. 

This is not a refusal to pay, but a notice that your claim is disputed.

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