Question - what would you do in this situation?

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Posted 10/3/2012 by Burning Feather in NSBR Board
 

Burning Feather
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Posted: 10/3/2012 11:51:26 AM
I'm having a bit of an ethical dilemma but it's in conflict with my "it's the principle" stand on this issue.

Just curious what someone else would do.

Last November we went to get flu shots. Our local hospital (that accepts our insurance) has a walk-in clinic at Wal-Mart. They advertised flu shots. There was nothing about it being a cash price (I had previously used them for a UTI and everything went through insurance). When we went in to get the shots, they took all of my DH's insurance information (and they already had mine.) We got the flu shots and nothing more was thought about it because our insurance covers flu shots at 100% no deductible. We used the walk in clinic instead of our doctor's office because DH was working a crazy schedule with a lot of overtime at that point and making/keeping an appointment was hard to schedule around his work schedule.

In late July of this year (so over 8 months later), we got a billing notice that we owed $25 each for these shots. I called to see why they didn't get payment from our insurance and why this was the first notice of it. The clerk on the phone indicated that they were aware of the problem; the invoices for everyone at that clinic had been in a "submit to insurance" folder on someone's desk. In addition, this was supposed to be a CASH ONLY price and was not to be submitted to insurance but the clinic had failed to advise people (we definitely weren't advised because we could have just gone to our doctor's office to get a vaccination if that was the case). I was told to ignore it.

I've gotten a couple more invoices and then just last week got a final notice that it was being turned over to collections.

At that point, I called and was pretty aggravated (especially since we are applying for a new mortgage and I don't need a collections account out there screwing things up). (a) we weren't informed it was cash only and they had taken insurance information (b ) I was told to ignore it by their clinic and (c) it was their mistake, not mine.

In the end, they are writing it off, but the supervisor (because it escalated to that point) was quite bitchy with me about it.

I contend that we don't owe them this money, but the other side of it is that they did perform a service for which they should be paid. But it's not a service that I would have accepted if I had been told it was cash only instead of covered under our 100% coverage.

What would YOU do in this situation. (I'm trying to ease my conscious but the truth of the matter remains that I'm still not going to pay it and they are writing it off)



Carla




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Posted: 10/3/2012 11:57:17 AM
I would have them write it off.


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JenAllyson
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Posted: 10/3/2012 11:57:24 AM
Same as you. Their mistake, and you submitted payment via insurance that they accepted at the time. Had they not accepted your form of payment at time of services you would have sought another clinic that would have. I wouldn't be paying them a dime.


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Posted: 10/3/2012 12:00:01 PM
Honestly, I don't think I'd pay it. I pay the insurance to take care of those bills, KWIM. We went to WM and our insurance covered it and I never heard anything else. I don't think you should be punished for someone else's mistake.

The clinic dropped the ball, not you, and clearly this happened to a bunch of others as well. I think it should be a learning experience for hte clinic to make sure they advertise things properly.

And I'm not getting why insurance couldn't cover it? Was it that they didn't want to waste the man power submitting the forms?

I wouldn't pay it based on the principle that you would have gotten it free from the same people if you went to the actual clinic to get the shot.


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Burning Feather
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Posted: 10/3/2012 12:05:26 PM
Okay, good. That makes me feel better. She acted like I was totally out of line and she really got pissy when I told her that I was aware that they knew there was a problem and that other people weren't informed also because I was told that the first time that I called about it.


And I'm not getting why insurance couldn't cover it? Was it that they didn't want to waste the man power submitting the forms?


I suspect that it was priced lower than normal so that they didn't have to deal with the cost of submitting, but honestly, I don't know what the normal price for a flu shot is so I had nothing to compare it to. They had a big poster up and I know there was nothing on there about it being a cash only price and they definitely took insurance info because I remember that DH was still providing it when I went in for my shot.

At this point, though, it's probably too late to submit. I think there's a time limit for an initial submission.



Carla




jennyap
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Posted: 10/3/2012 12:08:37 PM
The same as you. And as you had previously been told that you could ignore it, I'd be pretty unhappy with the supervisor getting bitchy about it. I would want to know why further invoices had ever been sent out.


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Posted: 10/3/2012 12:11:11 PM
You were probably the 14th one that day to complain, which is why she was pissy. But I agree, they weren't clear on how things were going, so it's their fault. AND, their fault that it sat on someone's desk for a whole 8 months!!
I find hospital billing to be the most maddening bills of all.


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Posted: 10/3/2012 12:13:58 PM
I agree with the others but have to ask if you signed anything stating you would pay if the health insurance didn't? I agree it is now a stale claim that they can't submit. But that is due to their incompetence, not yours. And it is my understanding that the health insurance company would tell you that it is not something you are required to pay. But you might check with them so you have something in writing from their side that they would have paid it had it been submitted in a timely fashion.

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Posted: 10/3/2012 12:15:26 PM
I would have them write it off. Its ridiculous that they didn't tell you upfront that it was to be a cash only/no insurance shot. Why would you do that when you have insurance that will cover the shot for you at no additional expense to you? They are the ones that screwed up, not you. They should pay for their mistake.



Burning Feather
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Posted: 10/3/2012 12:15:28 PM

You were probably the 14th one that day to complain, which is why she was pissy


Yeah, I wasn't buying her "I've never heard anything about this problem. What do you mean you weren't told that it was cash only" BS. She acted like she didn't have a clue in the world what was going on and yet one of her clerks immediately knew about the situation when I talked to them 2 months ago.

I swear sometimes that dealing with insurance can be a full time job and it boggles my mind to see just how many mistakes are made. I'm sure that a lot of people just pay it without taking the effort to dig deeper and it almost makes a person wonder if they just want to see how much will slip by unnoticed.


Carla




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Posted: 10/3/2012 12:16:07 PM
I would only pay the bill if I thought it would affect my credit score. It's not your fault that they failed to disclose it was a cash up-front injection, plus they failed to turn any billing into the insurance.


Burning Feather
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Posted: 10/3/2012 12:19:00 PM

but have to ask if you signed anything stating you would pay if the health insurance didn't?


Hmmm, good point. I can't say for sure, but I know that it's common to sign that kind of form and I certainly have in the past. However, it's not a matter of my insurance company not paying but rather them not submitting. Just because I sign a form that states that I will be responsible doesn't mean that it absolves them of the responsibility to submit it - or at least allow ME to submit it. I've submitted things to the insurance company that weren't submitted by the provider but were covered under my plan and I have no problem doing that in a timely manner (that doesn't happen a lot but because I've had a transplant, my insurance covers mileage, meals, and lodging for the surgery and follow ups so I have to submit those on my own)


Carla




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Posted: 10/3/2012 12:20:05 PM

I would let them write it off but ask them for a letter that says they will not make any future claims to you.

This is what I would do making sure that it says you do not owe them. I'd only be concerned about your upcoming mortgage, I definitely would have an "all clear" letter from WM or the collections place (if it got to them, you said it didn't though).




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Posted: 10/3/2012 12:25:01 PM
Honestly, I would pay it. The $50 would not be worth ruining my credit for, especially if I was in the middle of buying a house.



Denda
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Posted: 10/3/2012 12:49:56 PM
I would pay it and forget about it. Not worth the hassle.


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Posted: 10/3/2012 2:12:03 PM
OMG- I know your pain. Years ago we had a receptionist at our dentist's office screw up billing -for I don't know how many people- but it was for more than a year. She put everything in a file and then... I don't know. Threw it away, filed it, whatever- but she never billed insurance.

They must have realized something was up when the money stopped coming in as it should have been- and then the office sent out masses of bills to patients that covered a year+ of work- sometimes x multiple family members. By that point, the insurance company would no longer honor the claim. The dentist just dumped it on the patients- for the full, un-discounted amount. Our bill was over $700.

I sent a letter advising them to try to work with insurance. Let's face it- I was paying for that insurance for a reason. Every single time we were there I asked about a balance and I gave my insurance card. I was told there was no balance and they copied the card again.

In the end I was told since it was too late to bill insurance, it was all on us. I took issue with that. I told them that I they should itemize the bill as it should have been for insurance (discounted), and I would then pay the percentage I would have paid, had it been filed properly. The difference- sorry- that should have been absorbed by them since it was their error. They refused...they wanted the whole amount. I just couldn't see how I should be penalized for their bad employee.

In the end, we found a new dentist and the old one sent us to collections. I contested collections in writing and sent a letter to local dental-something-association, detailing my complaint against the dentist. That was that. We had a 20+ year relationship with that dentist and he wouldn't work with us at all over his error. I still can't believe it.

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Posted: 10/3/2012 2:17:03 PM

Honestly, I would pay it. The $50 would not be worth ruining my credit for, especially if I was in the middle of buying a house.

That.



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Posted: 10/3/2012 2:23:01 PM
So is the argument, that you got your service on a day that it was cash only? But you didn't know because there was no signage?

What bugs is that they waited 8 months to send you a bill. What bugs even MORE is that they still had the option to run it through your insurance instead of hassling you for the money. People just don't think anymore.

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Posted: 10/3/2012 2:27:40 PM
Walgreens, Dillons and Walmart here are cash only for flu shots. So I would pay it if it were me.


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Posted: 10/3/2012 2:29:44 PM
No, I wouldn't pay it. And she's pissy because she's likely getting her butt chewed over this pretty big mistake. That's her problem.


Joy


Burning Feather
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Posted: 10/3/2012 3:02:13 PM

Walgreens, Dillons and Walmart here are cash only


But this isn't Walgreens, Dillons, or Walmart. It's a clinic, run by the hospital - by the same name as the hospital - with employees and doctors from the hospital. And they accept insurance for everything. It's just a quick care clinic in a rented space within Wal-Mart, just like the nail salon, the bank, Subway, etc.

I think that sometimes doctor's offices and hospitals let these billing issues slide because people are too intimidated, busy, or lazy to make them do it right.





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Posted: 10/3/2012 3:26:01 PM
You don't owe them anything. Even if it were a cash payment thing, it was done through a place that takes tour insurance, therefore completely covered
They screwed up. Not you


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Posted: 10/3/2012 3:33:15 PM
If they had notified you in a timely manner, you probably could have paid them and submitted the claim yourself to insurance to get reimbursed. I have done this before when I went to a doctor that didn't take my insurance but some of the tests were still covered. I paid for the service and then filed it on my own and was reimbursed for the tests but not the office visit. Since they waited so long, it was probably too late for you to get reimbursed by your insurance company.

What I would do is call my insurance company and ask if it had been too long or if you were able to submit the claim for reimbursement. If you can still get reimbursed, I would file the claim myself and then pay the bill. If it is too late, then I would let them write it off. I would definitely NOT let it get to my credit report even if that meant paying the $50. It is not worth it, especially since you are looking for a new mortgage soon. By the way, we need to plan a lunch/dinner when you get here.





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littlelambchop
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Posted: 10/3/2012 3:38:59 PM
Their mistake, their problem.

I would contact your state consumer protection office. It should have been made very clear that it was cash only - if it wasn't clearly stated, that constitutes deception on their part.


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Posted: 10/3/2012 3:55:46 PM
If it were cash only, why did they need your insurance information?

angievp
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Posted: 10/3/2012 4:39:03 PM

Would you feel differently if they had only waited 3 months?


I would pay. Not worth the hassle and/or appearing on your credit report.

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Posted: 10/3/2012 4:46:25 PM
Does your state have a policy they have to bill within 90 days?



Burning Feather
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Posted: 10/3/2012 5:00:22 PM

Would you feel differently if they had only waited 3 months?


I would pay. Not worth the hassle and/or appearing on your credit report.


No. I "might" feel differently if they contacted me within a week or two and said "hey, we screwed up and this was supposed to be a cash only price; here are the documents you need to file it yourself." But the time factor doesn't have anything to do with whether or not I believed that they were submitting it to my insurance for 100% coverage since they collected insurance information. We didn't even walk away with any paperwork from that visit - it was merely go in, provide insurance information, get flu shot, and walk out.

I do not pay things simply because it's too much of a hassle to make it right. Would YOU feel differently if your landlord billed you an extra $50 each month - would you pay it just because it's too much of a hassle to make him correct it?





Carla




Burning Feather
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Posted: 10/3/2012 5:01:21 PM

we need to plan a lunch/dinner when you get here.


You have peamail. We just got back from there on Monday and we will be permanent residents within a month.


Carla




angievp
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Posted: 10/3/2012 5:24:05 PM

I do not pay things simply because it's too much of a hassle to make it right. Would YOU feel differently if your landlord billed you an extra $50 each month - would you pay it just because it's too much of a hassle to make him correct it?


Well, that would be a different situation, no? Because my rent comes once a month, every month. It's not an episodic, once a year event like your flu shot.

Furthermore, if, like you mentioned, I had no recollection of whether I signed paperwork that would indicate that I would be responsible for any payment (I'm not saying you did or didn't, I'm simply stating that since it was 8 MONTHS AGO, as you emphasized in your post), then I would pay. Yes, they were wrong in not putting up a sign indicating it was cash payment only, yes, they were assholes for waiting 8 whole months to inform you that you owed money. But, quite frankly, my time is worth more than the 2 seconds it would take to write a check and the 50 dollars it would cost me.

I simply have a different opinion than you.


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Posted: 10/3/2012 5:32:56 PM
I don't understand the logic of "just pay it, it is not worth the hassle" either. 50 bucks is 50 bucks. Lots of other things I could spend that 50 bucks on. The only people who say "pay it, it is not worth the hassle" are people with money to burn. Sorry to offend, but just how I feel. That is how other people, insurance companies, stores, and big corporations get over on you. They are HOPING you will just shut up and pay it. More money for them that way, and less for you.

Once I bought something at McDonalds, and the kid working there was supposed to give me $3 change, but gave me $2. I pointed it out, he said there were no more singles left in the drawer, or some such drivel. So he says, "Do you want that dollar?" You betcha I do! Just think how much money SOMEONE would be making (him or the store, I dunno which) if they did that to every customer?


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Posted: 10/3/2012 5:42:13 PM
Can you pay it and submit it to your insurance company yourself? They are totally in the wrong here, but I am thinking of you being in the process of buying a house and you really can't take their word that it will not go on your credit. They could still submit it to the credit bureau as a write off, I think. That would bring your score down a lot. It just is not worth the risk when you have time constraints and it could take months to get it off of your record once it is on there. I would definitely send a letter to corporate and complain after you close on your house.




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Posted: 10/3/2012 5:49:36 PM
Nope I would fight it... that is the way I see it. I wouldn't pay something just to get rid of the problem unless it was only a few bucks.

I still haven't paid a daycare bill that they screwed up and then closed the doors. They haven't billed me and I also heard all the teachers up and quit because they were getting screwed by the school as well. I am not paying until they correct their mistakes.. It wasn't my fault they cannot figure out their billing.



eebud
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Posted: 10/3/2012 5:55:02 PM

Would you feel differently if they had only waited 3 months?

The time factor WOULD make a difference to me. It was their mistake. If they can't correct their mistake within whatever time frame my insurance company will allow me to submit the claim myself, then I think they need to eat the cost. I would not push it so far that it would affect my credit but I would fight it.

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Really Red
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Posted: 10/3/2012 6:30:15 PM
You are right.

If they had told you then and there it'd be different and only that.

I had someone bill me one year after the service. They told me that was their right, but my insurance didn't cover it one year later. Also, I could have eventually deducted it with money in my cafeteria plan, but I needed to have it in by the end of March - that didn't happen.

So when an employee makes a mistake it is their fault. Not yours.



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lusundraeverett
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Posted: 10/4/2012 12:56:32 AM
Ordinarily I wouldn't pay them a darn thing! HOWEVER, your applying for a mortgage gives this a different flavor. The more important issue is the mortgage and making sure it doesn't end up on your credit report. I would pay them only to save my credit report and then fight to get my money refunded. If there is no credit issue... let them write it off. Good luck and keep marching forward!


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