Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
I am a deadbeat
Old 03-06-2008, 03:40 PM   #1
Recycles dryer sheets
winger's Avatar
 
Join Date: Jan 2007
Posts: 251
I am a deadbeat

Can I rant?

As retirees, we were forced into Aetna EPN in 2008. Better than no insurance, and we are dealing with it

I had a major stroke in September, 2007. Doctors unable to find a clear cause. All is fine, I have no effects from the stroke. This was on previous HMO.

After many test, the best diagnosis is to watch my cholesterol, and my homocysteines were out of range. I'm now taking medications for both.

In January, my neurologist ordered another round of blood tests to check my progress. Tests were good, but Aetna refused to pay for the homocysteine part of the test. Said the test is experimental. Aetna was billed $195 from Quest for the test.

From Aetna's website, they actually pay Quest $102 for the test, if they would have paid. I hate this phone stuff, so I called Quest and offered to pay them the $102 that Aetna wouldn't pay, and I'd be done with it.

No, thanks. They will only accept the $195 from me. I asked them to explain. Basically, they have a contract with Aetna and allow them to pay less, and count it as a payment in full. They have no contract with me, so I'm expected to pay the full amount. I explained" But, Aetna works for me. I pay them a monthly premium. Aetna exists in this because of me"

Nope. Any thing less than $195 is only a partial payment. The remaining amount may be turned over to collection at some time.

I asked her to type a note on my account. "Customer will pay $102. He will never, NEVER pay $195."

I am now a deadbeat.
__________________

__________________
winger is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 03-06-2008, 03:45 PM   #2
Moderator Emeritus
CuppaJoe's Avatar
 
Join Date: Jun 2007
Location: At The Cafe
Posts: 6,866
Quote:
Originally Posted by winger View Post

...No, thanks. They will only accept the $195 from me. I asked them to explain. Basically, they have a contract with Aetna and allow them to pay less, and count it as a payment in full. They have no contract with me, so I'm expected to pay the full amount. I explained" But, Aetna works for me. I pay them a monthly premium. Aetna exists in this because of me"
...
Perhaps logic has no place in the corporate world?
__________________

__________________
CuppaJoe is offline   Reply With Quote
Old 03-06-2008, 03:45 PM   #3
Moderator
Sarah in SC's Avatar
 
Join Date: Sep 2005
Location: Charleston, SC
Posts: 13,456
Winger, I once told a hospital billing clerk to write on my file that I would pay the bill (that they submitted too late to the insurance company to receive payment) when hell froze over. I heard her typing as I was speaking, and I never got another bill, nor did it show on my credit report.
Fight the good fight!
__________________
“One day your life will flash before your eyes. Make sure it's worth watching.”
Gerard Arthur Way

Sarah in SC is offline   Reply With Quote
Old 03-06-2008, 04:40 PM   #4
Recycles dryer sheets
 
Join Date: Jan 2007
Posts: 284
You do realize that by refusing to pay bills like these, you can be sent to collections?

Now, if you are one of those living free in your post-foreclosure McMansion, this will not be distressing.

It's always better to call, be nice, and ask if they have a discount for cash.
__________________
A854321 is offline   Reply With Quote
Old 03-06-2008, 04:48 PM   #5
Full time employment: Posting here.
MikeD's Avatar
 
Join Date: Apr 2003
Location: Leesburg, VA
Posts: 805
I had a giant fight with Discover card that lasted over two years and ended up in court over $335.00. I told Discover not to pay a charge within my 60 days. They paid it anyway and told me it was now between the fraud biller and me. I had been a Discover card customer for over 20 years with never a late payment. I carefully explained that it was now between me and Discover and I wasn't paying. They called trying to collect from me about 1,000 times (Really!), sometimes 10 times in one day. I sent them a letter explaining it when it all started but they just ignored it. At first they said that they got the letter but later they said they never received it.

Finally they took me to court. The judge said Discover's contract lawyer and I should confer in the hallway and come to a decision. I carefully and cheerfully told the guy that I wasn't paying and why. He said "Sounds good to me." We went back in and he told the judge they were dropping their claim, which with magical and mysterious fees had gone over $10K.

They never put a mark on my credit report and the whole thing went away.

The worst part of it is that I don't have a Discover card anymore.

Mike D.
__________________
MikeD is offline   Reply With Quote
Old 03-06-2008, 04:58 PM   #6
Recycles dryer sheets
 
Join Date: Sep 2005
Posts: 101
I offered Quest Labs $300 on a $500 bill and they would not do it. I had Health Insurance but Quest was not in network and my insurance would not pay them.
__________________
burch64 is offline   Reply With Quote
Old 03-06-2008, 05:20 PM   #7
Recycles dryer sheets
 
Join Date: Feb 2005
Posts: 188
I hate insurance companies. My experiences are nowhere near as bad as those above, but I always feel as if I'm dealing with "sleazy" folks when it comes to insurance people. I know that's not necessarily true, but ...
__________________
playaman is offline   Reply With Quote
Old 03-06-2008, 05:27 PM   #8
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Midpack's Avatar
 
Join Date: Jan 2008
Location: Chicagoland
Posts: 11,970
Quote:
Originally Posted by winger View Post
I called Quest and offered to pay them the $102 that Aetna wouldn't pay, and I'd be done with it.

Nope. Any thing less than $195 is only a partial payment. The remaining amount may be turned over to collection at some time.

I asked her to type a note on my account. "Customer will pay $102. He will never, NEVER pay $195."

I am now a deadbeat.
I'd guess you might be subjecting yourself to more than $93 worth of grief in the end, but it's your credit record and your quality of life.
__________________
No one agrees with other people's opinions; they merely agree with their own opinions -- expressed by somebody else. Sydney Tremayne
Retired Jun 2011 at age 57

Target AA: 60% equity funds / 35% bond funds / 5% cash
Target WR: Approx 2.5% Approx 20% SI (secure income, SS only)
Midpack is offline   Reply With Quote
Old 03-06-2008, 06:15 PM   #9
Thinks s/he gets paid by the post
ladelfina's Avatar
 
Join Date: Oct 2005
Posts: 2,713
Midpack, sounds like you are advocating giving in to extortion just to make your "quality of life" easier. I can direct you to some small-business associations in Palermo and they can tell you how that's been working out for them.

Sometimes it's the principal of the thing. I'm curious how a regular patient/insured could find out the Aetna cost of the test on a public web site.. at the same time Aetna maintains the test is "experimental". They obviously pay the $102 in some cases, yeh?

What I might do is: make a copy of the web page, then send that to Quest with the $102 and a copy of your Aetna insurance docs. At least that way you are only a $93 deadbeat and not a $195 deadbeat, and you show good intentions. It may not change your standing with either of them.. but at least you are meeting them 1/2 way. Make sure to keep copies of what you send, along with a copy of the cancelled check if they cash it. It may be unlikely that you hear any more about it after that. Just my .02.
__________________
ladelfina is offline   Reply With Quote
Old 03-06-2008, 06:34 PM   #10
Moderator Emeritus
CuppaJoe's Avatar
 
Join Date: Jun 2007
Location: At The Cafe
Posts: 6,866
Quote:
Originally Posted by ladelfina View Post
....
What I might do is: make a copy of the web page, then send that to Quest with the $102 and a copy of your Aetna insurance docs. At least that way you are only a $93 deadbeat and not a $195 deadbeat, and you show good intentions. It may not change your standing with either of them.. but at least you are meeting them 1/2 way. Make sure to keep copies of what you send, along with a copy of the cancelled check if they cash it. It may be unlikely that you hear any more about it after that. Just my .02.
I agree with this, there is nothing better than a good long paper trail.
__________________
CuppaJoe is offline   Reply With Quote
Old 03-06-2008, 07:14 PM   #11
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Midpack's Avatar
 
Join Date: Jan 2008
Location: Chicagoland
Posts: 11,970
Quote:
Originally Posted by ladelfina View Post
Midpack, sounds like you are advocating giving in to extortion just to make your "quality of life" easier. I can direct you to some small-business associations in Palermo and they can tell you how that's been working out for them.
You're entitled to your opinion, but extortion is a little dramatic given we're talking $93. The test is not covered, like it or not that's not unusual for an insurance company, happens all the time. And larger institutions benefit from reduced rates, and in turn everyone they cover benefits too. It's curious to me how he got a reduced amount they would pay for a test they don't cover, but anything is possible. And finally, if he pays less, someone else pays more - ultimately no way around it. Do you want to pay his $93 (or the full $195) along with the rest of us?
__________________
No one agrees with other people's opinions; they merely agree with their own opinions -- expressed by somebody else. Sydney Tremayne
Retired Jun 2011 at age 57

Target AA: 60% equity funds / 35% bond funds / 5% cash
Target WR: Approx 2.5% Approx 20% SI (secure income, SS only)
Midpack is offline   Reply With Quote
Old 03-06-2008, 08:19 PM   #12
Recycles dryer sheets
 
Join Date: Sep 2005
Posts: 101
It has been my experience that when your health insurance company does not pay for a test\procedure and the patient is required to pay it, the patient pays the insurance company's negotiated\contracted price if the providor is in the Insurance company's network of providors.
__________________
burch64 is offline   Reply With Quote
Old 03-06-2008, 08:46 PM   #13
Thinks s/he gets paid by the post
growing_older's Avatar
 
Join Date: Jun 2007
Posts: 2,608
Interesting. My experience has been a little different. When I am seeing an "in network" doctor who recommends other tests/work if they tell me in advance that it isn't covered then I can decide if I want to do it or not. If they tell me it's covered and it turns out it isn't for whatever whimsical insurance reason, then they erase the charge. I guess I better keep these doctors, they sound much better than many of these stories.
__________________
growing_older is offline   Reply With Quote
Old 03-06-2008, 08:49 PM   #14
Recycles dryer sheets
winger's Avatar
 
Join Date: Jan 2007
Posts: 251
Quote:
Originally Posted by Midpack View Post
The test is not covered, like it or not that's not unusual for an insurance company, happens all the time. And larger institutions benefit from reduced rates, and in turn everyone they cover benefits too. It's curious to me how he got a reduced amount they would pay for a test they don't cover, but anything is possible. And finally, if he pays less, someone else pays more - ultimately no way around it. Do you want to pay his $93 (or the full $195) along with the rest of us?
From Aetna's website, I can see previous claims and past claims. More info than I have had with other insurers. I doubt if this disclosure was Aetna's idea.

Among other things, it shows date, charge submitted, charges at Aetna's agreed pricing, your plan paid, not paid, and remarks. The remark says "not paid, experimental". From the Quest website, I can see that it is CPT code 83090.

Midpack- never said I wasn't willing to pay. I am. I'm not willing to overpay.
__________________
winger is offline   Reply With Quote
Old 03-06-2008, 09:05 PM   #15
Thinks s/he gets paid by the post
ladelfina's Avatar
 
Join Date: Oct 2005
Posts: 2,713
Midpack.. why should private firm Quest be protected from the vagaries of the free market? If they don't lose money at $102.. give them $102. At $102 THEY MAKE MONEY, count on it.

I advocate a socialist-type UHC approach only to purge similar pricing inequities/iniquities out of the supposedly "free" market, seeing as, apparently, it will take nothing less to do so.

Is it not better that the OP pay Quest $102, as I suggest.. rather than $0, as he suggests?

Slice the extortion up into tiny "tranches", and you have.. the status quo?

Here in Italy we have men called "parcheggiatori" (parkers). They hang around in big city parking lots and demand a euro or two to "look after" your car. It's extorsion. Extorsion is not a matter of scale. We never pay, and have never had any damage to our cars so far.

Tocca ferro = touch iron = knock on wood.

Sometimes you have to act on principle and not "feed the beast".


Growingolder.. right, the offense is worse when they advise you about it after the fact!!! A free market, for those who promote that in Health Care.. requires transparency.
__________________
ladelfina is offline   Reply With Quote
Old 03-06-2008, 09:15 PM   #16
Full time employment: Posting here.
 
Join Date: Mar 2005
Posts: 927
Quote:
And larger institutions benefit from reduced rates, and in turn everyone they cover benefits too. . . . And finally, if he pays less, someone else pays more - ultimately no way around it. Do you want to pay his $93 (or the full $195) along with the rest of us?
I admit to being confused by this. Is the suggestion that it's ok to charge OP more so that people covered by larger institutions pay less? But that it's not ok for the large-institution people to pay more so that OP pays less?

I've got a crazy idea. How about one, fair price for everyone?
__________________
Caroline is offline   Reply With Quote
Old 03-06-2008, 10:02 PM   #17
Thinks s/he gets paid by the post
ladelfina's Avatar
 
Join Date: Oct 2005
Posts: 2,713
Quote:
Is the suggestion that it's ok to charge OP more so that people covered by larger institutions pay less? But that it's not ok for the large-institution people to pay more so that OP pays less?
Caroline, you've nailed it. See the recent mortgage/bank debacles.. it's a given, and it's called "privatization of profits/socialization of losses". Socialism is grand when the beneficiaries are the ultra-rich. The hint of it working in the other direction is cause for institutional alarm, and the 'free market' is valid only to the extent that it is uni-directional. The game must be rigged or the big boys will want to take their ball and go home.

At $102, private concern Quest cannot be losing money. Pay them $102.
__________________
ladelfina is offline   Reply With Quote
Old 03-07-2008, 04:28 AM   #18
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Feb 2007
Posts: 5,072
Quote:
Originally Posted by winger View Post
Can I rant?

As retirees, we were forced into Aetna EPN in 2008. Better than no insurance, and we are dealing with it...
Call your companies benefits department and complain. Otherwise, they will not know that AETNA is playing hardball. If they get enough complaints, they will step in or dump them for another carrier.

When you call... insist on talking with the VP in benefits. Pitch a fit or that person will not really hear you. Threaten to write the board of directors a letter. Look... the board may not care about this issue. But the VP will not want the threat of a spotlight shown on it. He will be more likely to deal with it. Especially if there are others complaining.

I would also suggest if you have other retirees that you know to try to get them to complain if they have had issues with AETNA.

It may not do much good, but it is likely your only course of action. AETNA will just stonewall you.

I would go ahead an pay the $195 if I could not negotiate it down. That is a small amount of money. It is not worth the headache or personal angst.

But I would use that awareness to figure out how to mitigate the risk of other more costly charges that may come along.



BTW it sounds like you will be voting Dem this year
__________________
chinaco is offline   Reply With Quote
Old 03-07-2008, 06:51 AM   #19
Thinks s/he gets paid by the post
Texarkandy's Avatar
 
Join Date: Feb 2008
Posts: 1,281
As a federal employee I once had a co-worker who had a child with a serious congenital condition requiring $$$$ of healthcare. Whatever bills he got that his insurance plan didn't pay - he just threw in the trash - been doing it for years - when they called him on the phone, he told them his child's condition & that he just plain didn't have the money to pay the bills - his credit was shot, but he had never been taken to court and had a judgement against him.
__________________
Retired 2009!
Texarkandy is offline   Reply With Quote
Old 03-07-2008, 05:07 PM   #20
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Midpack's Avatar
 
Join Date: Jan 2008
Location: Chicagoland
Posts: 11,970
Quote:
Originally Posted by Caroline View Post
I admit to being confused by this. Is the suggestion that it's ok to charge OP more so that people covered by larger institutions pay less? But that it's not ok for the large-institution people to pay more so that OP pays less?

I've got a crazy idea. How about one, fair price for everyone?
One fair price sounds good, but that's not how the world works. Unless I'm understanding this wrong, the big guys get a volume discount and their customers get a better deal.

Is it any different than WalMart getting lower prices from their suppliers and in turn their customers getting lower prices? Millions of people benefit every day, I'd be willing to bet including some folks that are posting here right now and saying the $93 difference is unfair.

Avis and Hertz get lower prices when they buy from Ford, GM, etc. because they buy in volume and meet other terms that benefit Ford, GM. I'm sure you'd like the same deal as they get, but do you think you could go tell a dealer I will pay the Ford, GM fleet price, and expect to get it?

If a customer comes to me to buy one widget I will give him a price. If someone else comes to me wanting 1,000 widgets and he demands 10% off - I might be willing to make that deal.

Right or wrong, it's naive to think everyone is going to get the same price when players are of substantially different size. Health care is always more emotional because people think they are entitled to it - it's a service and we're no more entitled to the best health care than we are any other service.
__________________

__________________
No one agrees with other people's opinions; they merely agree with their own opinions -- expressed by somebody else. Sydney Tremayne
Retired Jun 2011 at age 57

Target AA: 60% equity funds / 35% bond funds / 5% cash
Target WR: Approx 2.5% Approx 20% SI (secure income, SS only)
Midpack is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
First deadbeat renter Buku FIRE and Money 35 01-31-2008 08:57 AM

 

 
All times are GMT -6. The time now is 12:50 PM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.