Medical billing and debt collection in the US

[Jon Miller]

I don't know why Kuci and KH try so hard to defend the US system.

I take it as an example of how some regulation/etc can create a very inefficient market.

The facts are that sometimes markets are very inefficient and are worse than state controlled.

JM

[Flubber]

I wouldn't be quite so cocksure about that one either. Presumably the original provider had a cost of collection clause in their boilerplate, and even if they didn't, Canada follows the English Rule, does it not? Welfare for Lawyers 101: if they retained a voracious animal like me, I'd relentlessly fee it up until $711 becomes an obscene $5000, because I know you make enough to pay eventually, whether through a direct suit by local counsel or through a U.S. suit ultimately domesticated via treaty or basic comity principles. There's virtually nothing to lose if you're already known to have unencumbered assets, which is presumably the case because A) you are so liquid as to "n[o]t need credit" (which they now know) and B) you're an experienced attorney on Big Oil's teat (which they don't know yet but could easily find out).

Come to think of it, what's your full name and the creditor's name? Just curious.

LOLOL

John Smith
ACME Hospitals Inc

[loinburger]

I don't know why Kuci and KH try so hard to defend the US system.

US system is definitely better when you're well off. When I had the surgery I mentioned (I had a hardened lipoma that needed to be removed and biopsied) it took about three days to schedule the surgery. It probably would have taken weeks or months in Canada since the surgery was far from urgent. (Though I would have preferred to save two grand and have the surgery in six months)

[MikeH]

In the UK you could still have chosen to pay to have elective surgery done faster privately. (at which point you'd only have paid 1 bill)

[Elok]

We had a 63 hour labour, were in hospital for about 40 hours, saw 5 sets of midwives, 3 doctors, eventually hormone drip and ended up with forceps... hate to think what that would have cost.

Asked my wife, she replied, "you mean before or after you sue the insurance company to get them to pay for it?"

So...a crap-ton.

[MikeH]

Insurance companies are ****s, this is universal.

[Flubber]

I wouldn't be quite so cocksure about that one either. Presumably the original provider had a cost of collection clause in their boilerplate, and even if they didn't, Canada follows the English Rule, does it not? Welfare for Lawyers 101: if they retained a voracious animal like me, I'd relentlessly fee it up until $711 becomes an obscene $5000, because I know you make enough to pay eventually, whether through a direct suit by local counsel or through a U.S. suit ultimately domesticated via treaty or basic comity principles. There's virtually nothing to lose if you're already known to have unencumbered assets, which is presumably the case because A) you are so liquid as to "n[o]t need credit" (which they now know) and B) you're an experienced attorney on Big Oil's teat (which they don't know yet but could easily find out).

:

On the substance, I have also told them twice now that they have never tendered an invoice on me which both their agents implicitly acknowledged in describing their clients system issues in generating bills and sending them to addresses outside the US. If they ever do send me a bill, I will forward it to my insurers just as i would have done if they had tendered it promptly. So far all I have is some collection outfit I never heard of sending me paper with a 'Re" line that mentions a hospital and a balance due that names a figure. Not one piece of paper which identifies the services, the legal entity to which the debt is supposedly owed or the calculation of the amount owing. Also nothing that shows me their agency relationship or anything else which could assure me that a payment to these folks actually would satisfy the alleged debt which has never been seen.

So I currently don't see how I could be found liable for a penny. Or do US courts just say you are responsible for whatever some bill collection says with no requirement that the undelying alleged debtor be provided ANYTHING.


Oh and darsnan -- on either method, they have to come to my backyard if they ever want to enforce. We do have reciprocal enforcemement of judgements legislation but the court will not grant registration regarding an action if I have never appeared in the foreign action. They would have to start an actual action here. My first actions here would be a $1 settlement offer and a request for security for my costs (since plaintiffs pay defense costs if they lose and the rules of court can require such security from a plaintiff that has no assets in the jurisdiction)-- Oh and your fees would be subject to review- so it would be relentlessly hacked down--)

But all that is just funning. If they ever send me any REAL paperwork I will forward it to my insurance companies. If they take any real steps I will look to my insurers. For what actually occurred I was 100% insured twice over. I have a travel policy at work anyway but since there were some limits and exclusions we didn't love, we purchased a specific travel policy for this trip-- As it turned out, the appendix issue was covered by both. If for some reason my insurers won't pay, IF the doctors EVER GIVE ME SOMETHING TO GIVE MY INSURERS, I would involve the insurers one way or another.

I can see a judge just loving that--So an insured buys insurance and does everything in his power to comply with everything in the policy. There wasn't anything else I could have done. A caregiver waits 20 months before providing an invoice (I have never ever been given one to date ) and somehow the insurer would be off the hook and I have to pay?? I cannot envision any judge ever saying that, particularly a canadian judge who probably travels to the US frequently and could imagine being caught in such a situation themselves. I don't even have to look at the policies to know a judge would look for a way to make the insurer pay or deny the claim

[Flubber]

Insurance companies are ****s, this is universal.

I generally agree but here the travel insurer stepped up as primary and paid everything promptly. I think it helps that we did everything right in that we called them BEFORE we went to a hospital and I ended up speaking with them pretty much every day asking if there was anything else they required.

[Aeson]

We had a 63 hour labour, were in hospital for about 40 hours, saw 5 sets of midwives, 3 doctors, eventually hormone drip and ended up with forceps... hate to think what that would have cost.

You can always sell the baby to help mitigate the costs. The pricing data from the baby selling and maternity bill collection markets help give signals about whether it will be profitable to have a baby or not. Otherwise how could we know?

[Dr Strangelove]

US system is definitely better when you're well off. When I had the surgery I mentioned (I had a hardened lipoma that needed to be removed and biopsied) it took about three days to schedule the surgery. It probably would have taken weeks or months in Canada since the surgery was far from urgent. (Though I would have preferred to save two grand and have the surgery in six months)

Try that when you're on Medicaid or worse yet, have no insurance or job. A woman came to my office because she had a shoulder injury 5 months ago. The free ends of her snapped clavicle were literally sticking out of the back of her shoulder. She had been seen in the ER right after her injury but given pain m eds and sent on her way until she stumbled into my office 5 months later. I had a guy wheeled into my office by his family. He hadn't walked in over 4 months, and hadn't seen a doctor because no one would see him. It turns out he had stenosis of the neck spine compressing his spinal cord, he had been having neck pain for several months before he became paralyzed. I got him to a neurosurgeon, they releived the compression of his spine, but it's hard to say whether he will walk again.
If you go to a hospital with heart disease, respiratory failure, or cancer you won't be turned away. They're not stupid, they know what would happen if they started shutting the door on gravely ill people. If you're not gravely ill that's a different story.

[Krill]

I generally agree but here the travel insurer stepped up as primary and paid everything promptly. I think it helps that we did everything right in that we called them BEFORE we went to a hospital and I ended up speaking with them pretty much every day asking if there was anything else they required.

My baggage got lost on a US Airways flight returning from Seattle via Philly (yes Albie it's a junkyard) and I got reimbursed by the insurance after I sent them all of hte paperwork as they requested, giving copies of everything to the airline...and then the airline reimbursed me as well, for "hassle". The insurance company tried to get the money back but as each side gave me money for different things (insurance for lost items, airline simply because they lost them) the insurance company backed down and left me alone after 3 or 4 letters.

Insurance companies do occasionally screw up in your favour.

[Darius871]

Medical bills are the single largest cause of bankruptcy in the United States.

Not that I'd doubt it, but what's your source on this? In my experience the vast majority have been a garden-variety job loss combined with insane credit card usage. In the several dozen Chapter 7's I've filed I've seen maybe three or four with aged medical bills of significant size.

[Darius871]

dp

[Sava]

The solution is mass identity theft. Destroy the credit system. Empty accounts. Target people with money to lose.

When it becomes a bunch of financial nitwits versus the rest of us, we'll just shoot them all.

[MikeH]

http://finance.yahoo.com/news/pf_article_109143.html

62% Medical

One of the interesting caveats of this study shows that 78% of filers had some form of health insurance, thus bucking the myth that medical bills affect only the uninsured.