We see this day in and day out – outrageous medical bills full of errors and inflated charges. And we fight these outrageous bills every single day – to the tune of millions of dollars of savings so far.

We’ve given previous examples of crazy medical bills we’ve fought in our blog posts 5 Real Life Examples of Out of Control Medical Bills, 5 More Examples of Out of Control Medical Bills,  and Another 5 Outrageous Medical Bills – but felt that it was time to write another edition of “Outrageous Medical Bills”.

 

Coding Error Correction saves 90% off a $40k bill

One of our patients was taken to the ER by her husband and then had to undergo emergency surgery. She had great insurance so thought nothing of it, and was surprised when she received a bill for over $40,000 nine months later.

She was unable to fix the problem despite multiple appeals to the insurance company, so she turned to Resolve to get this fixed.

Our Advocates jumped to work. Recognizing that the denial was due to incorrect coding on the hospital, they overcame multiple objections at the hospital to have the bill recoded as an emergency situation, then worked with insurance to get it properly processed and covered. In the end, the patient was only responsible for her deductible, a little over $4k, or a 90% savings off her initially charged amount.

 

Resolve Negotiation Saves $250k

A Canadian retiree came down to the United States for Vacation and ended up in a Florida hospital for multiple weeks before being airlifted back home. While she had travel insurance, they refused to cover for a “pre-existing condition” (we’ve said this before but it’s worth repeating – travel insurance looks for every reason to deny coverage so be very careful when using it).

The hospital sent her to collections, and, smelling blood, refused to negotiate – instead threatening a lawsuit in an attempt to squeeze as much money from the retiree as possible.

Resolve Advocates conducted a fair price analysis and discovered that despite being charged over $320k, the hospital would only collect around $75k on average if the patient were insured. The hospital was attempting to charge the patient 4x as much simple because they weren’t insurance!

Despite a series of initial roadblocks, we were able to come to an agreement with the CFO of the hospital to settle for under $75k, or nearly $250k off the originally charged amount (and within the fair price range).

 

100% savings on a $150k hospital bill

A retired couple both went to the ER after a motorcycle accident while on vacation. They had insurance and assumed that the bill was taken care of. Two years later, they found a hit on their credit report for an outstanding bill.

Resolve went to work attempting to figure out what happened and how the hospital could justify not only charging the patient instead of insurance but also sending them to collections and hurting their credit without actually notifying the patient.

Resolve quickly discovered that insurance had paid and that the hospital had been balance billing the patient in an attempt to squeeze more money out of them. Our Advocates brought this to the executive leadership at the hospital, and were able to have the patient balance wiped entirely AND have the hospital take the lead in fixing the patient’s credit. That’s a savings of over $150k!

 

90% Savings off a $30k Emergency Room Bill

An emergency appendectomy and a Limited Benefit Insurance plan left one of our patients holding a $30,000 hospital bill. 

Resolve’s fair price analysis concluded that insurance would have paid $15k on average for the ER visit and appendectomy. Our negotiating team got to work, and were able to push the bill down even further – so that in the end the patient was able to settle the entire bill for $3k, a 90% savings!

 

85% Savings off ER Visit and 3-Day Stay

A patient went to the ER and landed in the hospital for 3 days with no insurance. The sticker price for such a visit at that particular hospital was $95k. Because he was uninsured, the hospital offered to discount the bill down to $40k. Unable to make that much of a lump sum payment, the patient turned to Resolve for help.

Our fair price analysis suggested that the hospital would have received about $20k from most insurance plans for that visit. In other words, the hospital was still attempting to charge the patient twice the insurance rate, despite a large discount.

Our negotiators got to work and were able to settle the bill for $11k, a savings of 85% off the original price and 70% off the “uninsured discount price).

 

Conclusion

Hospital price inflation, crazy and esoteric insurance rules, and bad actors are all pitfalls that patients have to avoid when dealing with their medical bills. The system is confusing and broken and it’s extremely important to pay as much attention as possible when dealing with your medical bills. 

If you’re still confused or worried about being overcharged, we’re happy to help. Give us a call at 877-245-4244 for a free consultation to find out what we can do to help you make sense of and lower your medical bills.