Today, I want to share a frustrating experience I had during a mediation that lasted over four hours. The main issue? Medical bills. It’s a mess, and I think it’s time we talk about how complicated this process can be for everyone involved.
Key Takeaways
- Medical billing can be a nightmare, especially with work comp claims.
- Always negotiate your medical bills; you might save a lot.
- Communication between providers and insurance companies is often broken.
The Mediation Experience
So, I had this mediation that dragged on for hours. Honestly, it shouldn’t have taken that long, but the payment of medical bills was a huge headache. My client had to be rushed to the emergency room, and guess what? He didn’t have the work comp information on hand. So, he ended up getting a bill later, which is pretty standard.
We usually send out what we call dispute letters. These letters say, "Hey, this is a work comp claim. Please send it to the right company, and here’s all the info you need to process it." We also send the bill to the adjuster, hoping they’ll pay it. We did all this back in the summer, so we’re talking about six or seven months ago. Did anyone pay it? Nope.
The Collections Nightmare
Then, one of the bills got sent to collections. I called them up, and they told me that initially, my client was given a discount. The original bill was $110,000, but they knocked off $88,000 because he didn’t have insurance. So, it was down to $10,000. Always negotiate your bills, folks!
But when it went to collections, they said, "Oh no, it’s back to $10,000 again." And here’s the kicker: they couldn’t send it back to the hospital because they bought the debt. So, I had to go back to the insurance company and say, "Hey, please process this again with the right forms and codes."
The Ongoing Struggle
We reached a tentative settlement, but the adjuster still hasn’t paid. The state still has jurisdiction over this issue, so I can file a hearing request to enforce the settlement, which includes payment of those bills. Meanwhile, I’m just hoping this doesn’t end up on my client’s credit report.
This whole process took four hours to sort out, and that was just for the emergency room charges. There were also CT scans and a separate physician’s bill from a different group of independent contractors. Each of these had their own billing service, which made things even more complicated.
Communication Breakdown
I had to call the physician’s billing service to get more information. When the representative found out I was a lawyer, she wouldn’t talk to me anymore. So, I had to have my client step in and talk to them. When I asked how to get the information to them, she said, "No, you can’t email it, fax it, or mail it. It has to go through this service called Chart Swap."
But the other billing department said, "No, you can’t use that either. It has to go through US mail." And we all know how reliable that is these days.
Conclusion
If you’re wondering why I have a headache, well, now you know. This is my job, and I deal with this mess regularly. But I can’t imagine how overwhelming it must be for people who aren’t in this field. The system is broken, and it’s time we start talking about how to fix it. Medical billing shouldn’t be this complicated, and it’s high time we demand better.
