question from the clueless

[Khan]

Back in December '08, I used my medical insurance for the first time since retirement and switching to a high deductible.

I received a note from the insurance folks telling me it wasn't covered (which I expected).

Should I go to the clinic and pay or should I wait until they send me a bill?

 

[REWahoo]

I'd wait for the bill.

 

[73ss454]

Trust me, they'll bill you.

 

[Amethyst]

I'm in the opposite situation...my doctor's office charged me too much (I have PPO insurance, where the doctors are supposed to charge me fees according to a contract with the insurance company); I had to pay up front to get treatment, and now I'm waiting for the doctor's office and insurance company to synch up so I can get my refund. It's only been 2 months...

 

[Rich_by_the_Bay]

Wait, Khan.

 

[Darryl]

Definitely much cleaner to have them bill you get your eob and your bill from provider and then pay the remaining balance.
As Amethyst's experience supports if you pay more than your obligation it has all the potential to become a total clusterf#%k. First you have the 2 or 3 or 4 months to get reimbursed and then the feeble attempts to follow the rules to get money back in to your HSA UGHHHH!
I have paid a very small amount a few times over the past couple years on the front end, taking great pain to stay on the low side so I would still owe but it has been my experience if you tell the provider you have money in your HSA you just want it to clear insurance first and then pay the remainder they are very accommodating.

 

[Alan]

Definitely wait for the bill.

One Saturday morning I had to pay $1,200 to DW released from Hospital even though I was sure we had met the annual max out of pocket, but being a Saturday there was no-one on the insurance company phone line. (this was 1990). The EOB a few weeks later showed the insurance company had paid in full. Took another 2 months to get my refund from the hospital

 

[SecondCor521]

Easiest way, as most have said, is to wait for the insurance to pay the provider, then wait for the bill from the provider, then pay that.

However, if it is very clear cut what your share of the bill is, you sometimes can get a discount for paying quickly in "cash" (which usually can include checks and sometimes can include using a credit card). I think you are more likely to have success the sooner you offer to pay and the larger the bill amount is in dollar terms.

Back in 2001, my daughter's birth via emergency C-section resulted in a small 4-digit hospital bill balance after insurance paid. I called the hospital billing office and put the amount on a credit card and got a few hundred dollars off.

2Cor521

 

[SC]

Our deductible is $10,000 and sometimes a medical office will behave as if we have no insurance at all. So far, in all but one case, I've convinced them that the proper procedure is for them to submit the claim to the insurance company, wait for the insurance company to process the claim, then bill us for "whatever they don't cover," same as for people with low deductible plans.

Even though the insurance company never pays a dime in direct payments (knock on wood, we haven't needed $10,000 in care yet), this makes sure that the medical office reduces the bill to the negotiated "in-network" rate before they send us the bill. There have been several instances where this discount was greater than the monthly cost of our premium.

I told DW that, aside from the catastrophic coverage, what we really purchased was a discount card.

 

[RonBoyd]

Rules for a profitable [-]enterprise[/-] life.

Buy low,
Sell high.
Collect early,
Pay late.

I have found nothing to add to that.

(BTW, the "Pay late" does not (necessarily) mean paying AFTER the due date only to pay at the last possible second.)

 

[waltwill8]

I've offered to pay cash on the spot, for a discount. The doctors just look at you funny!

 

[Billy]

Definitely much cleaner to have them bill you get your eob and your bill from provider and then pay the remaining balance.

As Amethyst's experience supports if you pay more than your obligation it has all the potential to become a total clusterf#%k. First you have the 2 or 3 or 4 months to get reimbursed and then the feeble attempts to follow the rules to get money back in to your HSA UGHHHH!

It has been my experience that persistence pays off when dealing with the hospital’s billing office. Call regularly and often and follow up on promised action. Take notes like names, dates, and what transpired.

When you get your EOB compare it to what your insurance covers. Find out what CPT code (Current Procedural Terminology) they used to bill your insurance company. Also find out what codes your insurance pays for. See what, if any, similarities there are and if you are able, campaign for the code that your insurance company pays for. These codes are all agreements that the hospitals and insurance companies decide each time the contract comes up for renewal.

Sometimes the hospital billing office bills for a newer, pricier code - sometimes the hospital billing office simply makes a mistake. Be cordial and respectful yet focused.

I did this and yes, it was a bit of a tenacious enterprise, but I succeeded, and it saved me hundreds of dollars.

Good luck. BTW, these codes used to be freely available online, but the AMA now has them copyrighted. You may have to go to the library or call your insurance company to get a copy.

Akaisha
Author, The Adventurer’s Guide to Early Retirement