trouble with ins.

I don't know if they will print this or not, but has any one else had trouble with very large hospital bills from CTCA? After my husband passed away, it's been one year I ended up with a bill of over $116,000.00 When we went to CTCA we were told they talked with our ins.BC/BS and would accept what they would pay. We had already paid the out of pocket and they had been paying 100% at MD Anderson. Our treatment at CTCA was wonderful. We were in Tulsa for 2 months and we felt that was where God wanted us to be. But after one year I got a bill for that I can never begin to pay. It is a wonderful center but besure you check with your insurance co. yourself, you see they now tell me that the HOSPITAL is out of network. They didn't tell us that before we went or we wouldn't have gone because we couldn't afford it.

pappy

Pappy

Ouch!  Here's a resource that you may find helpful.  I've used it myself.  This is run by Loyola University Law students, but they are guided by PhDs.  You will need an appointment (i.e., telephone conference call) to describe your problem and such, but the students there are excellent at finding the answers (and they are guided by legal experts in this field). 

Here's the URL: http://www.lls.edu/academics/candp/clrc.html

This is weird, but this resource is 100% free. From the information and advice you gather from these guys, you'll be able to procure a legal expert in your home state.  Perhaps you could ask them to suggest a lawyer from your state that specializes in medical insurance issues.

Good luck!

Paula Jean

pappy,

So sorry for your trouble with CTCA.  Too bad no one advised you that CTCA is a for-profit hospital group, unlike most other hospitals which are non-profit institutions.

Good luck.

Thanks Paula, I am at my wits end over this because I felt that they were not truthful to us. I will look at the site you gave me. I do have a friend from Alaska who encountered the same problem with CTCA. Like I said before we were treated well by all Drs. and nurses.

Pappy

I don't have a problem with them making money but the man who started CTCA wanted people to have the best of care, I am sure he didn't intend for his people not to tell the truth about ins. when they went to CTCA. We trusted them.

 

pappy

 

 

 

 

 

 

 

 

 

 

Unfortunately, when someone enters a treatment facility, no matter what kind, they are asked to sign a form.  That form states that the person signing the form assumes ALL responsibility for ANY charges not covered by the insurance company.

Every doctor's office and medical facility does it.  Then when all is said and done, they slap you with a bill you never expected.  This has become even more prominent since the insurance companies negotiate "reasonable charges" for meds and procedures with the facilities and this way the facilities still make money by charging the patients a higher amount than the negotiated charge.  But they get around it because you've signed the form agreeing to pay it. 

I don't know any average family person that could ever afford to pay what they are requesting from you.  If it were me, I would pay them $5 a month and that would be that.  As long as you are making an effort to settle the account, there is not much they can do.  Just keep copies of every payment you make (preferably by check).  Then once they cash the check they have pretty much agreed to accept the payments.  And a lot of times they will end up writing off the balance in the long run. 

Call a lawyer in your area (usually there is no charge for a first time phone consultation) and see what they advise. 

Cancer patients, or any other kind of patient, do not need to face things like this on top of everything else. 

Good luck and God Bless

Pappy,

When I inquired into CTCA, I asked them if they took HMO or PPO insurances.  My husband has an HMO.  The "sales woman" at CTCA said no, but if could if he "qualified".  I then asked, what does "qualified" mean exactly the sales woman's response was not very clear.  But after much dialog, it became clearer to me that CTCA would treat my husband if he had enough assets/ income. 

Before you call the Legal Resource Center, spend time and try and remember what you were told by both CTCA "sales person" and what you were told by your insurance provider.  Reconstruct dates if you can.  You may have signed your life away, but contracts signed "under duress" (and a cancer diagnosis is stressful that may make you susceptible to duress) is a tricky, gray area of law.  In any case, a good lawyer may be able to help - and the students at Loyola's Cancer Legal Resource Centre are truly excellent. The students might take a few days to research your case and help point you in the right direction, but it does get done. 

If all else fails, pay off your medical bill at some insanely nominal sum, like say $5.00 a month as suggested by one respondent in an earlier post.  Indeed, I believe health care expenses in the USA are considered "unsecured" loans, which means that you likely can get away with paying them off very slowly without them repo-ing your home or car.  But again, talk to the students and try and retain a good lawyer that specializes in this particular area of law.

Good luck!

Paula Jean

I would urge you to contact the Patient Advocate Foundation. They will assign a caseworker to help you through the your issue with CTCA. Colorectal CareLine team number is 866-657-8634

http://www.patientadvocate.org

Also, you may be able to file an appeal with BCBS. Ask Patient Advocate to help you with this too.

Hope this helps. Karen

Thanks Karen  I will do that. I sent out letters but haven't heard back from CTCA. pappy1

I always call the insurance company to make sure our providers are covered in network prior to the service, since we also deal with an HMO.  Also, keep in mind that insurance companies have pre-negotiated 'reimbursement rates' which is much less than what the full rate is that they are billing you out.  Your hospital bills should be negotiable with the providers, perhaps by the Patient Advocate if you are unable to negotiate with them.  When looking up my husband's hospital bills online, I can see what the provider bills out, and what the carrier pays, often times their reimbursement is 50% of the billed amount.   Another thing to consider, when my SIL died of CRC, there were some outstanding medical bills and my brother basically told them to 'go pound sand'.  Seriously, what are they going to do?  I know its all frustrating seeing all the zero's on the bill.