Follow up from my recent medical bill post: 9 AM - I called to talk to billing, asking for an itemized bill. They returned my call several hours later. They will not provide me with an itemized bill, because they only bulk bill. I asked how they could justify that cost. She assured me it was not going to cost me $15552, as I had BC/BS insurance, and the contract with them negotiated the cost down to $6900. Then my insurance plan will kick in and cover the amount it is supposed to. Since I also have that self funded component from my employer, my responsibility would be far less. (It is... My responsibility for the facility charge is only going to be $1000 after all insurance pays.) I explained that my question is NOT what my final out-of-pocket is, it is how they can justify the full charge. She said that she simply applies the charge based on the CPT code. They bulk bill only because that was the decision made when they licensed with Medicare/Medicaid. I asked if CMS is who set the $15000 fee for this procedure and reimbursed at that rate? She said no. She doesnt know how the cost was associated with the code. She would have her supervisor call me. I asked again if there was no way an itemization of the costs associated with the charge. She said there was not. I asked if I could receive a letter from them, stating that they could not provide me with an itemized statement. She said nobody had ever requested that, so she wasnt sure what to tell me. I asked if she was refusing to to provide me with a letter stating they would not provide me with an itemization. She referred me to her supervisor again... I did not receive a call from the supervisor today.
Posted on: Tue, 04 Mar 2014 03:25:36 +0000
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