What will happen if I refuse to pay a medical bill?

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docbrown
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What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 9:43 pm

I have never not paid a bill in my life. I have never been late. In fact I often pay bills early. But I have a bill I'm pretty sure I'm not going to pay, ever.

I needed to see a doctor. His office assured me that they accept my insurance. I asked them again before I saw the doctor. I also called their billing person. They all said that they accept my insurance plan.

Then I got a bill for $345 for two visits because the insurance company says he's out of network. By the way, the doctor was helpful and I have nothing against him. I believe it is reasonable to rely on what they told me. I should not have to pay. Had they informed me that he was not in my network, I would have seen a different doctor.

I thought that I should negotiate the bill down to what they would have actually received from an insurance plan, rather than the inflated bill, but I'm not going to do that. I shouldn't have to. They told me the wrong thing several times and it's on them. I'm sick of this convoluted, buck passing, mickey mouse health care system.

Plot twist: When I saw that my insurance company rejected payment, but weeks before I received a bill, I figured out what was up and went Nixon on them. I now have several recordings of his staff telling me that they do in fact accept my specific insurance plan. I live in a one-party state so it's legal.

If I write a letter and tell them that I'm not going to pay and why, should I mention up front that I have evidence, or should I save that particular fact?

And if they eventually turn this over to a collection agency, what will actually happen? I have zero debt, own my house free and clear, and I have no need to borrow money. Would my car and house insurance rates go up?

I don't even really care what happens. I'm putting my foot down. This is wrong.
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midareff
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Re: What will happen if I refuse to pay a medical bill?

Post by midareff » Fri Sep 29, 2017 9:48 pm

Have you considered that they do accept your insurance, but at the out of network rate.

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Re: What will happen if I refuse to pay a medical bill?

Post by Dottie57 » Fri Sep 29, 2017 9:50 pm

Next time, don't ask the Dr office, contact insurance to make sure Dr is in-network. Each insurance company may have different provider networks for different plans/policies.

Pay the bill.

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docbrown
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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 9:56 pm

midareff wrote:
Fri Sep 29, 2017 9:48 pm
Have you considered that they do accept your insurance, but at the out of network rate.
The words you are saying do not make sense. The out of network rate is their normal non-insured rate, so I might as well not even have insurance. How could that possibly constitute "accepting" my insurance? If an ordinary person asks whether a doctor accepts an insurance plan, that means, to an ordinary, reasonable person, that the doctor has a deal with the insurer such that they will pay him for his services, minus my copay and deductible. Nobody is calling doctors and trying to find out if they can be not really covered and at a much higher cost than normal. Nobody is asking for that ever. "Do you accept my insurance?" means "Can I expect the insurance company to pay for this?"
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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 9:59 pm

Dottie57 wrote:
Fri Sep 29, 2017 9:50 pm
Next time, don't ask the Dr office, contact insurance to make sure Dr is in-network. Each insurance company may have different provider networks for different plans/policies.

Pay the bill.
This doctor was listed in their provider directory. It's amazing how they can claim that it's not within their power to keep the directory up to date, but if a doctor not in their network submits a bill, they know instantly that he's not in their network.

I'd say that allowing a doctor to remain listed in your electronic directory who is no longer actually in your network is misrepresentation at the least.

Not paying the bill, on principle, ever. So how much higher will my car insurance rate be?
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ResearchMed
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Re: What will happen if I refuse to pay a medical bill?

Post by ResearchMed » Fri Sep 29, 2017 10:00 pm

Dottie57 wrote:
Fri Sep 29, 2017 9:50 pm
Next time, don't ask the Dr office, contact insurance to make sure Dr is in-network. Each insurance company may have different provider networks for different plans/policies.

Pay the bill.
This.

The doctor's office can't be totally familiar with all the details of all variations of every insurer's policies.
Policies can vary considerably.

But the insurance office will know the specifics of *your* policy (all of their policies).
That's who should be asked, to be sure.

RM
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Re: What will happen if I refuse to pay a medical bill?

Post by midareff » Fri Sep 29, 2017 10:05 pm

docbrown wrote:
Fri Sep 29, 2017 9:56 pm
midareff wrote:
Fri Sep 29, 2017 9:48 pm
Have you considered that they do accept your insurance, but at the out of network rate.
The words you are saying do not make sense. The out of network rate is their normal non-insured rate, so I might as well not even have insurance. How could that possibly constitute "accepting" my insurance? If an ordinary person asks whether a doctor accepts an insurance plan, that means, to an ordinary, reasonable person, that the doctor has a deal with the insurer such that they will pay him for his services, minus my copay and deductible. Nobody is calling doctors and trying to find out if they can be not really covered and at a much higher cost than normal. Nobody is asking for that ever. "Do you accept my insurance?" means "Can I expect the insurance company to pay for this?"
Perhaps they do not make sense to you because you do not want them too. In all medical insurances I have ever had or been exposed to there is a contracted provider rate and there is a lesser rate for a physician who is not in their network. For those physicians you will have a much larger co-pay or deductible. That does not mean you have no insurance with them as you will receive some form of reimbursement from the insurance carrier for the "out of netwrk" provider.
Last edited by midareff on Fri Sep 29, 2017 10:11 pm, edited 1 time in total.

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docbrown
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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 10:09 pm

ResearchMed wrote:
Fri Sep 29, 2017 10:00 pm
The doctor's office can't be totally familiar with all the details of all variations of every insurer's policies.
Policies can vary considerably.
But surely the billing department can produce a list: we accept this, and not that.

Speaking of billing -- intrigued by the promise of a 30% cash discount, I once asked what an eye exam would cost if I didn't use my insurance. I was led to a billing office where a lady searched through three huge binders and after 15 long minutes gave me a noncommittal answer. I literally flipped a coin to decide whether to pay cash or bill the insurance plan.

Medical billing is like a game show for accountants.
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docbrown
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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 10:10 pm

midareff wrote:
Fri Sep 29, 2017 10:05 pm
How many flavors of .. as an example, Blue Cross do you think are out there? Do they all offer the same coverage?
I am familiar with the complexities of plan offerings, but billing should be able to make it clear: here's what we accept so you can tell people the right thing. Because that's a thing people tend to ask.
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Re: What will happen if I refuse to pay a medical bill?

Post by midareff » Fri Sep 29, 2017 10:13 pm

docbrown wrote:
Fri Sep 29, 2017 10:10 pm
midareff wrote:
Fri Sep 29, 2017 10:05 pm
How many flavors of .. as an example, Blue Cross do you think are out there? Do they all offer the same coverage?
I am familiar with the complexities of plan offerings, but billing should be able to make it clear: here's what we accept so you can tell people the right thing. Because that's a thing people tend to ask.
Yes, they should. However, that is a different statement that they must, or they will.

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Re: What will happen if I refuse to pay a medical bill?

Post by ResearchMed » Fri Sep 29, 2017 10:13 pm

docbrown wrote:
Fri Sep 29, 2017 10:10 pm
midareff wrote:
Fri Sep 29, 2017 10:05 pm
How many flavors of .. as an example, Blue Cross do you think are out there? Do they all offer the same coverage?
I am familiar with the complexities of plan offerings, but billing should be able to make it clear: here's what we accept so you can tell people the right thing. Because that's a thing people tend to ask.
To repeat, one needs to ask the insurance company.
They are the ones you are expecting will pay your bill, per the terms of the contract.

This applies to "which physician" and also which procedures, or what the coverage limits are, etc.

RM
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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 10:17 pm

midareff wrote:
Fri Sep 29, 2017 10:05 pm
Perhaps they do not make sense to you because you do not want them too. In all medical insurances I have ever had or been exposed to there is a contracted provider rate and there is a lesser rate for a physician who is not in their network. For those physicians you will have a much larger co-pay or deductible. That does not mean you have no insurance with them as you will receive some form of reimbursement from the insurance carrier for the "out of netwrk" provider.
But I'm getting zero reimbursement from my insurance company. Not a special out of network rate, or a discount, or a reimbursement. Zero. It's not that this guy is merely out of my network. They don't actually accept my insurance plan at all, in any form, but they said they did.
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Re: What will happen if I refuse to pay a medical bill?

Post by midareff » Fri Sep 29, 2017 10:20 pm

docbrown wrote:
Fri Sep 29, 2017 10:17 pm
midareff wrote:
Fri Sep 29, 2017 10:05 pm
Perhaps they do not make sense to you because you do not want them too. In all medical insurances I have ever had or been exposed to there is a contracted provider rate and there is a lesser rate for a physician who is not in their network. For those physicians you will have a much larger co-pay or deductible. That does not mean you have no insurance with them as you will receive some form of reimbursement from the insurance carrier for the "out of netwrk" provider.
But I'm getting zero reimbursement from my insurance company. Not a special out of network rate, or a discount, or a reimbursement. Zero. It's not that this guy is merely out of my network. They don't actually accept my insurance plan at all, in any form, but they said they did.
When you send the doctor's bill you paid to your insurance company, under the provisions of out of network service won't you be reimbursed to some extent by your insurance carrier?

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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 10:26 pm

I understand what you're all saying. Only the insurance company knows for sure. You have to jump through the correct hoops. But look at the bigger picture here. What kind of a world is this where nobody knows what things actually cost, and the people who do the work and want to get paid can't even tell you whether the insurers they contract with will actually pay them. I should be able to ask a simple question of a doctor's billing staff (which I did) and get an answer that is accurate and I can use in reality.

Anyway, what should have been done or the way it should work is irrelevant. I still believe they acted improperly. They could have said "we don't know; call your insurance company". I should be able to rely on what the provider of my services says about the cost and billing of those services.

Bottom line is, I'm not going to pay. So what will actually happen? What will it be like to have a negative item on my credit report?
Roth was a Senator, not an acronym. Please, stop writing it in all caps.

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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 10:28 pm

midareff wrote:
Fri Sep 29, 2017 10:20 pm
When you send the doctor's bill you paid to your insurance company, under the provisions of out of network service won't you be reimbursed to some extent by your insurance carrier?
Nope! I already checked.

By the way, I am not a big user of insurance, so this is pretty new to me. Also the plans available to me have gotten worse and worse over the years.

You've got to admit, this is all way more complicated than it has to be. Should I have called the insurer rather than actually expect the doctor's own billing staff to give me accurate information? Maybe, but I guess I'm living in a fantasy world where people paid to do a job actually know what they're talking about.
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Re: What will happen if I refuse to pay a medical bill?

Post by ResearchMed » Fri Sep 29, 2017 10:32 pm

docbrown wrote:
Fri Sep 29, 2017 10:28 pm
midareff wrote:
Fri Sep 29, 2017 10:20 pm
When you send the doctor's bill you paid to your insurance company, under the provisions of out of network service won't you be reimbursed to some extent by your insurance carrier?
Nope! I already checked.

By the way, I am not a big user of insurance, so this is pretty new to me. Also the plans available to me have gotten worse and worse over the years.

You've got to admit, this is all way more complicated than it has to be. Should I have called the insurer rather than actually expect the doctor's own billing staff to be give me accurate information? Maybe, but I guess I'm living in a fantasy world where people paid to do a job actually know what they're talking about.
We are trying to help you.
Yes, you should call *your* insurer.

The doctor may "contract" with various insurance companies, but they can't know if *your* specific policy/policy type is one that includes them, the procedure, where it is done, or such.

Your insurer will be able to answer those questions, and also - and importantly - whether you have already met any necessary deductible. (If not, then you may need to pay anyway.)
Etc...

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Re: What will happen if I refuse to pay a medical bill?

Post by Incendiary » Fri Sep 29, 2017 10:42 pm

I'm sorry to hear this happened to you. Honestly, I blame the insurance companies more than I blame your doctor's office. They are like the school bully, picking on physicians and patients alike and indiscriminately. They pay what they want to pay, when they want to pay, or not. Or they pay and then change their mind. Crazy system. The system needs to be blown up.

Regardless, I'd ask the manager if xe can cut you a break and give you a discount given what they told you. Good luck.

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Re: What will happen if I refuse to pay a medical bill?

Post by Copper John » Fri Sep 29, 2017 10:44 pm

The posters stating you should have contacted your insurance company may have a valid point and no doubt you will be doing that in the future, but I am with you on this docbrown. Lets say a physician is dealing with say 10-15 insurance companies and lets say on average they all have 3-5 varieties. The billing office should at minimum as you point out have a sheet of paper for all 45-50 of these options showing their practice is either in network, out of network or does not accept payment at all from these entities.

They may not know the nuances of your coverage for all these options and that is on you, but to to give you incorrect information as to the plans they accept I agree is unacceptable. I disagree that a specific group billing practice would not know whether they are included in network or not for a given px or office visit.

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Re: What will happen if I refuse to pay a medical bill?

Post by knightrider » Fri Sep 29, 2017 10:53 pm

Your situation is a perfect example of how we now need insurance to protect against misunderstood insurance! Insurance has become so complicated that not even the insurers understand what they are insuring!

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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 10:54 pm

Copper John wrote:
Fri Sep 29, 2017 10:44 pm
The posters stating you should have contacted your insurance company may have a valid point and no doubt you will be doing that in the future, but I am with you on this docbrown.
Hooray!

So back to my first question -- when this unpaid bill shows up on my credit report, will I be treated like a leper? Will American Express take my card away? Will I have to use prepaid debit cards for banking? Seriously, what will actually happen if I just refuse to pay?
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Re: What will happen if I refuse to pay a medical bill?

Post by munemaker » Fri Sep 29, 2017 11:00 pm

docbrown wrote:
Fri Sep 29, 2017 10:54 pm
Copper John wrote:
Fri Sep 29, 2017 10:44 pm
The posters stating you should have contacted your insurance company may have a valid point and no doubt you will be doing that in the future, but I am with you on this docbrown.
Hooray!

So back to my first question -- when this unpaid bill shows up on my credit report, will I be treated like a leper? Will American Express take my card away? Will I have to use prepaid debit cards for banking? Seriously, what will actually happen if I just refuse to pay?
Your credit score will take a big hit. I don't know how much. Also, you will probably be hounded by some collection agency.

If you have not already done so, I would discuss it with the doctor's office.

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Re: What will happen if I refuse to pay a medical bill?

Post by Diogenes » Fri Sep 29, 2017 11:03 pm

Sounds like you have a not-so-great insurance plan, and that you didn't properly check with them to determine if he was actually a covered provider. Why take it out on the Doctor? You received the service, correct?
Ask the office for their cash price and explain it to them nicely. Then pay it and move on. It's a learning experience. $345 is a pretty cheap way to learn that you don't have such a great insurance policy.
As to what will happen if you don't pay? It will be sent to collections. Pay your bills.

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Re: What will happen if I refuse to pay a medical bill?

Post by Nate79 » Fri Sep 29, 2017 11:05 pm

I suggest you research what never paying will do to your credit score.

https://www.credit.com/credit-scores/ho ... dit-score/

It will be sent to collections.

Your credit score and having a claim in collections can have a very big effect on any future need for credit or can also affect things like future employment, insurance, rental applications, etc.

How much of an effect? I don't know.

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Re: What will happen if I refuse to pay a medical bill?

Post by youdiditr2 » Fri Sep 29, 2017 11:11 pm

docbrown wrote:
Fri Sep 29, 2017 10:54 pm
Copper John wrote:
Fri Sep 29, 2017 10:44 pm
The posters stating you should have contacted your insurance company may have a valid point and no doubt you will be doing that in the future, but I am with you on this docbrown.
Hooray!

So back to my first question -- when this unpaid bill shows up on my credit report, will I be treated like a leper? Will American Express take my card away? Will I have to use prepaid debit cards for banking? Seriously, what will actually happen if I just refuse to pay?
Nothing is going to happen.

I had a medical bill that they kept sending to the wrong address. Then it went to collection because I never got the bill. I never paid it. Showed up on my credit report. Credit score is still 790.

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Re: What will happen if I refuse to pay a medical bill?

Post by csc-az » Fri Sep 29, 2017 11:13 pm

As someone who recently got "balanced billed" by an unexpected out-of-network doctor at an in-network facility, I have zero patience for the shenanigans going on between doctors and insurance companies right now. Doctors point their fingers at the insurance companies. Insurance companies point their fingers at the doctors. Meanwhile somehow it's the patients that seem to always end up screwed.

If the doctor's office mistakenly told you multiple times they accept your insurance, you shouldn't be the one expected to pay for that mistake. The doctor's office should.

I wouldn't recommend you just ignore the bill. Talk to the doctor's office and if you don't get a satisfactory resolution (that doesn't involve you paying the price for their mistake), perhaps you should contact a local news agency and give them the story, especially since you have it on tape. This is the kind of thing that really upsets people, and for good reason.

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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 11:18 pm

Diogenes wrote:
Fri Sep 29, 2017 11:03 pm
Ask the office for their cash price and explain it to them nicely. Then pay it and move on. It's a learning experience. $345 is a pretty cheap way to learn that you don't have such a great insurance policy.
As to what will happen if you don't pay? It will be sent to collections. Pay your bills.
But that's what guys like me always do. I'm always being super responsible. I've said myself, many times in the past, $X is just cheap tuition in the long run.

You know what? It's people like us who are supporting a crooked system. If we pay for the mistakes of others, if we voluntarily pay into a flawed system because we're afraid of a silly number dropping, then we are supporting the continuation of the system as it is.

It's the craziest system. You can't get a straight answer from anyone. Nobody knows what anything costs, not even the billing staff (see above, a totally different case). I program computers for a living and I don't understand it.

I will no longer be the guy who feels responsible to cover for the flaws and mistakes of a terrible system. Let them do what they will. I set up my phone to ring only for numbers in the address book, so I'll never even be bothered about it. I will never borrow money again. I pay cash for my cars. I can afford to take a stand.
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Re: What will happen if I refuse to pay a medical bill?

Post by BolderBoy » Fri Sep 29, 2017 11:30 pm

docbrown wrote:
Fri Sep 29, 2017 10:54 pm
Seriously, what will actually happen if I just refuse to pay?
The bill will ultimately go to collections if that is what the doc's usual and customary practice is with unpaid bills (his agreement with the collection agency may be that he sells the bill outright or that he shares in whatever is collected). The collection agency will harangue you about it at length. If the sum is high enough, they'll probably eventually sue you to collect and tack on court costs and attorney fees.

A report may or may not be filed with a credit bureau.
"Never underestimate one's capacity to overestimate one's abilities" - The Dunning-Kruger Effect

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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Fri Sep 29, 2017 11:34 pm

Diogenes wrote:
Fri Sep 29, 2017 11:03 pm
Why take it out on the Doctor? You received the service, correct?
His staff told me three times that they accept my insurance. They do not accept my insurance. I received services, but I received them under false pretenses. Well, mistaken pretenses. I'm sure they are decent people.

If I told you that I would fix your computer for no more than $15, and then I sent you a bill for $345, how would you feel? If it was just you and me, you would feel ripped off. But why is it okay for a corporation to say, that's just the way the system works, you didn't understand the system, too bad, now pay what you owe.
Roth was a Senator, not an acronym. Please, stop writing it in all caps.

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Re: What will happen if I refuse to pay a medical bill?

Post by wesos19 » Fri Sep 29, 2017 11:35 pm

I'll reference a CarTalk episode...When they mail you a notice, reply with a letter saying you'll pay them one cent every year for the next 34,500 years.

I place the blame on your insurance company! What's the reason for having private insurance companies...So that we can have more competition resulting in lower prices and better quality service? :annoyed

At least they have a similar approach as us:
Image

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Re: What will happen if I refuse to pay a medical bill?

Post by OldLearner » Fri Sep 29, 2017 11:40 pm

Had a problem a lot like this three years ago. $800 for blood tests I was told was completely covered. Called the office and asked to talk to someone in authority. Calmly but very (VERY) firmly stated my case. About an hour after the conversation, received a call back from the lady. She said the claim was submitted incorrectly, apologized profusely, and that she would "fix" it.

Talk to the office, but make sure it's someone in authority (almost never the doctor, by the way). Should you have to do stuff like this? No, but it's part of living in a complex society. Life's too short to spend too much negative energy on it.

Copper John
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Re: What will happen if I refuse to pay a medical bill?

Post by Copper John » Fri Sep 29, 2017 11:42 pm

Have you ever heard the story from each party as to why one thinks it is in the network and the other does not?

I would think it would not be in the physician group's interest to blatantly lie to you on purpose to obtain a few hundred dollars in charges. Were they ever in this network? Was the physician billing office just sloppy and made a mistake? Could this be a case where for example a credentialing deadline was not met by the provider and they were removed from the network or vis a versa the physician group submitted the required paperwork as they always have only to be told they did not meet a deadline.

I know from a patient's perspective to be in the middle of something like the situation I describe above is a pain as you often get the run around and waste a lot of your time, but the answers would help me guide what I am going to do with this bill.

livebelowmeans
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Re: What will happen if I refuse to pay a medical bill?

Post by livebelowmeans » Sat Sep 30, 2017 12:11 am

There are often different plans that are under the same insurer umbrella with different benefits. Your physician may participate with several plans that are under the general insurer, e.g. Kaiser, but may not take your specific one. That is why some plans are very narrow network, lousy reimbursement rates and no physicians wants to participate.

The insurance company is the bad guy. They pull this BS all the time. Oh we can't guarantee that the provider network information we provide is accurate. What a load. Been told the same thing. This is the evil empire and we can thank ourselves for letting a middle man run our healthcare.

It sounds like you looked into out of network benefits and you have none, just make sure. If you have them they will often pay 50% instead of 80% or whatever their part is to pay, just have to submit the bill you paid.

You can ask about a cash discount, but they may not be able to offer one. You can thank the insurance companies for this again, the often have a clause that does not allow the office to ever charge less than what they charge the insurance company for a given service.

I'd just pay, isn't worth $350 to me to stiff someone when I received the services, but that is my opinion. I'd save it for something egregious. You wouldn't be totally wrong in my book to refuse, but not totally wrong isn't totally right either. Probably won't have a big impact on your life if you just ignore it, but depends upon if you ever need anything with credit, active collection account is no bueno.

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Re: What will happen if I refuse to pay a medical bill?

Post by flamesabers » Sat Sep 30, 2017 12:41 am

OP,

A few years ago my claims with a particular provider were being denied even though the hospital itself was in-network with my insurance. It turned out the problem was the provider didn't update her credentials with my insurance company and that was why my claims were being denied. It took a few months to get the problem resolved, but I stayed in contact with the billing department so that they knew why I wasn't paying the bill for the rejected claims. Fortunately, it all worked out favourably for me in the end.

Maybe your situation is like mine? Or perhaps something got coded wrong in your claim and that was why your insurance company denied it?

I don't think that as the patient I should have had to call both my insurance and the hospital's billing department numerous times to get the issue fixed. However, I didn't want to get a reputation of being someone who doesn't pay his medical bills.

I think Copper John's post has a lot of good suggestions for you. I think something else to keep in mind is assumptions can be a two-way street in this sort of situation. You may assume the doctor's office/insurance company is either lazy or trying to cheat you on a $300+ claim and decide the best thing to do is stop trying to get the issue resolved and risk the bill going to collections. However, later on when you go to see other doctors you may find yourself being turned away as they assume you're a deadbeat who doesn't pay his medical bills. I'm not trying to be pro-insurance or pro-bad billing department, but rather I think it's important to consider that as easy as it might be for you to walk away from this medical bill, that's how easy it might be for doctors to refuse to provide services for you in the future.
Last edited by flamesabers on Sat Sep 30, 2017 1:03 am, edited 2 times in total.

GUtiger
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Re: What will happen if I refuse to pay a medical bill?

Post by GUtiger » Sat Sep 30, 2017 12:46 am

The important recurring thread in this post is that YOU, the consumer, need to speak to YOUR insurance company prior to accepting any services. After all, the insurance contract you are party to is between you and your insurance company, not between you and the physician's office. The physician's office may or may not have their own contract with the sample insurance company, but that contract often does not affect how much YOU pay, but rather how much the insurance pays the physician.

Just to mention, as well, I don't think I've seen many health insurance products that have ZERO out-of-network benefits. Perhaps you haven't met your deductible. If so you probably would have owed that same amount anyway.

You are upset because you don't understand the product you own. This is understandable because it is intentionally difficult to understand, for just this reason! You saved the insurance company money!

Maybe stiff the insurance company their next premium instead of trying to screw over the physician that actually helped you with your health.

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Re: What will happen if I refuse to pay a medical bill?

Post by MrJones » Sat Sep 30, 2017 12:47 am

That really sucks. Been there.

For $345, nothing significant will happen to you at all if you don't pay.

The medical office will send you a bunch of bills and eventually sell your debt to a collector for pennies on the dollar. The collector will send you a bunch of nasty letters but not much more because your debt is worth about $50 to them, and at that level they have to resort to using primarily automated methods to collect. They may also call you through an auto dialer a gazillion times, which is not that hard to block using modern phones.

Eventually, they will add a note to your credit history. Many collectors don't contract with all three bureaus, so your note will typically appear in one or two. If you had a stellar credit history to begin with, such an unpaid account should virtually not have an effect at all on your car or home insurance or credit card applications, because insurance companies typically have ranges and this ding should not push you to a lower range. YMMV here, obviously.

Eventually after several years, this entry will fall off your credit history, and that will effectively end this story. You may find possibly find some ways and methods to speed this process up, but a certain amount of luck is needed.

I would not try this if you were going to buy a house or car in the next couple years, but it sounds like that's not the case.

Source: I ran into pretty much exactly the same problem many years ago to the tune of about $600. I too refused to pay for the principle of it. If every single person who ran into this situation refused to pay, the medical billing industry would learn their lesson pretty quickly.

Good luck.

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Re: What will happen if I refuse to pay a medical bill?

Post by GUtiger » Sat Sep 30, 2017 12:50 am

MrJones wrote:
Sat Sep 30, 2017 12:47 am
I ran into pretty much exactly the same problem many years ago to the tune of about $600. I too refused to pay for the principle of it. If every single person who ran into this situation refused to pay, the medical billing industry would learn their lesson pretty quickly.
Just a note here, you aren't screwing over the "medical billing industry," you're screwing over the physician.

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Re: What will happen if I refuse to pay a medical bill?

Post by MrJones » Sat Sep 30, 2017 12:55 am

GUtiger wrote:
Sat Sep 30, 2017 12:46 am
Just to mention, as well, I don't think I've seen many health insurance products that have ZERO out-of-network benefits. Perhaps you haven't met your deductible. If so you probably would have owed that same amount anyway.
Just wanted to point out this is not likely correct because in-network rates are typically very different from out-of-network rates. This means OP would have likely paid a much lower rate even if they had a very high-deductible that wouldn't have covered this at all. Plus, the paid amount would count towards the deductible.
GUtiger wrote:
Sat Sep 30, 2017 12:46 am
Maybe stiff the insurance company their next premium instead of trying to screw over the physician that actually helped you with your health.
The sentiment is nice but in practice, stiffing your insurance company may result in them not paying a much bigger claim should one arise. So it's kind of shooting oneself in the foot. Just something to consider.

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Re: What will happen if I refuse to pay a medical bill?

Post by MrJones » Sat Sep 30, 2017 1:01 am

GUtiger wrote:
Sat Sep 30, 2017 12:50 am
MrJones wrote:
Sat Sep 30, 2017 12:47 am
I ran into pretty much exactly the same problem many years ago to the tune of about $600. I too refused to pay for the principle of it. If every single person who ran into this situation refused to pay, the medical billing industry would learn their lesson pretty quickly.
Just a note here, you aren't screwing over the "medical billing industry," you're screwing over the physician.
I disagree for many reasons. First, this is a common practice across the industry, and should stop being so. When the physician hires an employee that does their medical billing, that employee will follow this common practice unless it changes across the industry.

Second, it is the physician who screwed you over by not being upfront about the specifics of billing and insurance. It is also the physician who bills people in-network far lower than people who are out-of-network or have to pay cash, for the exact same service. Here, it's the cash paying patient that is getting screwed.

I could go on but will leave it at this.

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Re: What will happen if I refuse to pay a medical bill?

Post by flamesabers » Sat Sep 30, 2017 1:21 am

MrJones wrote:
Sat Sep 30, 2017 12:47 am
If every single person who ran into this situation refused to pay, the medical billing industry would learn their lesson pretty quickly.
That's true, but the medical billing industry might respond in a way you don't like. For instance, instead of the current system, patients might be required to pay the cash price (or other amount) upfront as a deposit and you won't get any of your money back until your claim is finalized. If your claim gets denied, the hospital gets to keep all of your money. This way the burden of ensuring the claim gets processed correctly falls on the patient instead of the doctor.

A second option is doctors circulate a blacklist of deadbeat patients. If you get on the list, good luck with getting service for non-emergency treatment.

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celia
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Re: What will happen if I refuse to pay a medical bill?

Post by celia » Sat Sep 30, 2017 2:00 am

DocBrown, Did you read the entire Explanation Of Benefits (EOB) explaining the insurance company's payment/rejection? Does it actually have a symbol for your visit(s) referring to "doctor out of network" or is that one of the possible codes, but not the code that was assigned to your visits?

I am wondering if this is the first office visit you've had this year and insurance would have paid it, but first you have to pay your deductible for the year. For example, if your deductible is $1,000, you need to pay for the first $1,000 of covered expenses before insurance picks up the remaining expenses for the year. If you chose the lowest cost premium insurance plan at work, it probably has the highest deductible. In this case, the doctor's staff is correct that your insurance company will pay (after you've met your deductible for the year) and the insurance company would be correct in that they won't pay until your covered expenses for the year are more than the deductible. You are also correct that the billing systems are too complicated and you don't understand them. I've had to call my insurance several times to clarify why things were/weren't paid and it usually increased my understanding of my coverages.

I would start resolving this by talking to the insurance company and have them explain the coverage you have. and why they didn't pay. It could also be a billing error on someone's part. But it is best if you don't just ignore it.

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Re: What will happen if I refuse to pay a medical bill?

Post by Dude2 » Sat Sep 30, 2017 4:52 am

First off, these statements that the doctor's office will turn this over to collections if you do not pay are far from certain. This is especially true if you work with them and explain the situation. They have the ability to drop it and consider it a "one off". Then you have the ability to not go down that road again. Similarly, even if you do decide to pay this, you should not allow yourself to get burned by this again.

Indeed, this situation is very common and typically occurs when you are using a new flavor of insurance for the first time with a doctor or lab. A nice trick would be to go in for a cheaper (routine) office visit to test the system before trying a more expensive procedure. One technique I found to work was to marry my insurance with a particular office park group. In other words, there may be something in a town such as the Blue Cross Center -- a place where every doctor in the place is affiliated with Blue Cross, and they have a lab and X-rays that are part of Blue Cross. How can we possible get burned if we go there with our Blue Cross insurance?

Furthermore, nothing is as simple as has been presented in some of these comments. I have had it be the case that the issue was in how it was coded, and nothing I could do would cause the doctor's office to change the coding. Another time, the doctors office used the wrong id number for the doctor, and nothing I could do would cause the office to resubmit with the correct number. It isn't always the fault of the insurance company. In some cases, it is the doctor's staff. It is also the complexity of the contract the doctor signed with the insurance company as opposed to this notion that the focus is on our business relationship with our insurance. Trust me, this issue cuts both ways.

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Re: What will happen if I refuse to pay a medical bill?

Post by Billionaire » Sat Sep 30, 2017 5:04 am

What a mess. I suspect you'll have to pay the bill or end up having a judgement against you. I've been dealing with CIGNA and different Dr's for the last year or so on a variety of bills. In a couple of cases, I did not understand the procedure to follow and in a couple of cases the information I received from CIGNA was not quite accurate. I ended up paying, although for one situation I wrote the CEO of CIGNA a letter and ended up receiving the money I thought I was due.

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Re: What will happen if I refuse to pay a medical bill?

Post by Dottie57 » Sat Sep 30, 2017 5:35 am

docbrown wrote:
Fri Sep 29, 2017 9:59 pm
Dottie57 wrote:
Fri Sep 29, 2017 9:50 pm
Next time, don't ask the Dr office, contact insurance to make sure Dr is in-network. Each insurance company may have different provider networks for different plans/policies.

Pay the bill.
This doctor was listed in their provider directory. It's amazing how they can claim that it's not within their power to keep the directory up to date, but if a doctor not in their network submits a bill, they know instantly that he's not in their network.

I'd say that allowing a doctor to remain listed in your electronic directory who is no longer actually in your network is misrepresentation at the least.

Not paying the bill, on principle, ever. So how much higher will my car insurance rate be?

Knowing more, I think you have a complaint with insurance company and not the doctor.

P.S. Not related to a Dr. But am employed by healthcare ins industry.

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Re: What will happen if I refuse to pay a medical bill?

Post by TIAX » Sat Sep 30, 2017 5:48 am

docbrown wrote:
Fri Sep 29, 2017 9:43 pm
And if they eventually turn this over to a collection agency, what will actually happen?
You'll get a letter and a call, then you'll send a letter back requesting that the collection agency no longer contact you (no need to get into details). After that, they can't contact you. The debt may be reported to a credit reporting agency and you can dispute it with the agency if you don't believe it's a valid debt. It's possible that you may be sued in small claims court but pretty unlikely over $400. If you signed a contract with the doctor that included an attorneys' fees provision, you would want to avoid court. Good luck!

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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Sat Sep 30, 2017 7:40 am

Dude2 wrote:
Sat Sep 30, 2017 4:52 am
A nice trick would be to go in for a cheaper (routine) office visit to test the system before trying a more expensive procedure.
Funny thing is, this was a routine office visit! Just talking! $345 for two of 'em!
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Re: What will happen if I refuse to pay a medical bill?

Post by docbrown » Sat Sep 30, 2017 7:50 am

I'm probably beating a dead horse, but here's how ludicrous this is:

ON THE PHONE BEFORE THE VISIT
Them: You must pay us in one of our approved forms or we'll raise the price by a factor of 23.
You: Do you accept checks from Bank XYZ? That's all I have.
Them: Yes, we accept checks from Bank XYZ.

AFTER THE VISIT
Me: Here's my check from Bank XYZ.
Them: Why are you giving me this? This is no good here. We'll have to charge you 23 times more.
Me: But you said you accept these checks.
Them: We do accept them, but our bank, Bank ABC, does not.
Me: But you gave me reason to believe I could pay with an XYZ check.
Them: You didn't ask the question in the exact right way!
Me: Doesn't the verb "accept" have a customary and ordinary meaning in this case?
Them: Makes no difference. It's actually your responsibility to check with our bank before, during, and after the visit. You can't rely on what I tell you about our billing practices. I just work here.
Me: What do you do?
Them: I manage the billing department.
Roth was a Senator, not an acronym. Please, stop writing it in all caps.

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bottlecap
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Re: What will happen if I refuse to pay a medical bill?

Post by bottlecap » Sat Sep 30, 2017 7:59 am

We have this Mickey Mouse system precisely because people don't like to pay for medical bills. But nothing is free. This is the price we pay.

Just call and say you told me several times this was in-network and you were wrong. I'll pay the in-network rate of $250 or you can send it to collections.

Let them decide.

JT

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Re: What will happen if I refuse to pay a medical bill?

Post by Jack FFR1846 » Sat Sep 30, 2017 8:36 am

Our medical insurance system is so screwed up, I can't even imagine how you'd have figured out ahead of time whether the bill would be paid. I have a wife who is a case manager and knows the system inside out and even finding the answer whether a new lab is in plan or not was hours of work. Lab says yes, insurance network website doesn't have the lab listed, calling the insurance company....they're so incompetent that they can't even find me in their system....wife finds the one person in the insurance company who covers my employer.

Ok.....what can the doctor do if you don't pay:

They can drop you. Since they look at you as a deadbeat, they make $0 when you come to see them so you're no longer welcome.

They can send you to collections. Big deal, right? Well, the collections agency can go to court and get an order to garnish your wages. Of course this would have added fines and fees added.

That's some of what can happen. I would add that you don't ask a provider if they accept an insurance and leave it at that. You need to find someone in the insurance company who says that this specific provider (not just a facility, a specific provider) is in network. By the way, they could drop them as a provider 10 minutes after talking to you on the phone (this has happened to me).
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Re: What will happen if I refuse to pay a medical bill?

Post by oldcomputerguy » Sat Sep 30, 2017 8:55 am

docbrown wrote:
Fri Sep 29, 2017 9:56 pm
midareff wrote:
Fri Sep 29, 2017 9:48 pm
Have you considered that they do accept your insurance, but at the out of network rate.
The words you are saying do not make sense. The out of network rate is their normal non-insured rate, so I might as well not even have insurance.
What did the statement from the insurance company show? Did they pay anything at all to the doctor? If so, then yes, the doctor accepted your insurance but got paid at the out-of-network rate.

This happens sometimes. DW had surgery this past February, when we got the invoices we found that they used a non-network lab for a tissue test. We never were given the choice of selecting an in-network lab. I paid the bill. Life is too short.
"I’ve come around to this: If you’re dumb, surround yourself with smart people; and if you’re smart, surround yourself with smart people who disagree with you." (Aaron Sorkin)

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dm200
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Re: What will happen if I refuse to pay a medical bill?

Post by dm200 » Sat Sep 30, 2017 9:55 am

What a mess!

For this amount, even if you are correct - just pay the bill.

One common reason for this kind of confusion is that there may be several different plans from the same insurer. Perhaps the doctor, for example, accepts/participates in Anthem's PPO, but not Anthem's HMO.

You have Anthem's HMO - call the doctor office and ask if they accept Anthem and are told yes.

Another source of confusiton is when a doctor accepts insurance now, but is terminating next month and that is when you see him/her.

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