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The fault was yours imo but it doesn't stop you from trying to negotiate with the medical provider. I helped my Mom negotiate a big ER visit and hospital stay. Just by asking I was able to get her a 20% discount on a really big bill and get her on a 4 year payment plan at 0% interest. She has the money to pay off at a lump sum, but why when her money is making 4.35% at Ally.
Don't try to shift the blame. Your an adult, so own up that you didn't follow up to get that invoice faster.
The last 2 months I've been dealing with a surgery center to get $2k refunded. They kept giving me the runaround. It's a lot of money to me so I'm not going to let that go without a fight. Finally last week they sent a receipt showing the refund was on the way.
Most healthcare takes your insurance info before you get seen, then they file their bill with insurance. If it gets denied they come to you for payment or partial payment after your insurance pays their part.
Your healthcare dropped the ball unless you agreed up front to pay the charges.
However the fact that they did not provide a bill when you asked them to and then followed up is on them and they have some responsibility.
Negotiate, negotiate, negotiate. Write down your facts with dates then decide what you are willing to pay and what you want them to drop from your bill. Start with you at 25% them at 75% and see where that goes.
If you signed with them that you were responsible they will try and hold you to that but when they took too long to bill you they have some responsibility too.
Ask the PT office for the self pay (no insurance) discount. Then pay it, even if they don't give you a discount at this late date.
When I had physical therapy and no insurance, my self pay rate was about 1/3 of their regular charges. But of course, I established that with the office before I started and paid at every visit.
The treatment was directly between the patient and the practioner or it's facility.
The patient is primary pay . That has been the system .
Had a workman's comp plan been approved, they would have knowingly referred you to the place of care and required all treatment plans and payments be reviewed . You would have been given a letter for what is approved or why it may have been denied .
Our employer has our workman guidelines for claims. Please reach out to your current or former employer if needing a paper trail of what is and isn't covered based on how it was processed.
Back up a bit. You wrote that you want to dispute this BILL, right? Why? You aren't denying that the PT provided you with care, are you? What you are actually trying to dispute is how much of that bill you're responsible for. If you'd kept on it and filed for worker's comp in a timely manner you wouldn't be facing a payment demand for the total now.
Pay the bill and see if there is some way you can get reimbursed. Didn't your medical insurance cover any of these expenses?
If this is a work related condition, insurance companies are not required to pay those medical claims. Some employer sponsored plans may pay so long as a Worker's Comp claim is filed as they will seek repayment from the Worker's Comp fund.
Quote:
Originally Posted by Parnassia
Back up a bit. You wrote that you want to dispute this BILL, right? Why? You aren't denying that the PT provided you with care, are you? What you are actually trying to dispute is how much of that bill you're responsible for. If you'd kept on it and filed for worker's comp in a timely manner you wouldn't be facing a payment demand for the total now.
Yep. The issue is it appears the OP didn't file a Workers Comp claim within the required time period so they are stuck with paying the denied invoice. I get the impression the OP is trying to steer blame to the provider based on not having the invoice in time. Based on my experience, a provider not hounding a patient for payment when they know it's a Worker's Comp claim is because they are awaiting the Workers Comp letter to file the necessary paperwork. as the initial examiner. Although they may not be the treating approved attending PT, they will be paid for their initial services. By the OP's own admission, they forgot all about it themselves until contacted by the provider still waiting to find out what's going on.
However, I will give the OP the benefit of doubt simply because we don't know if they did file an initial Worker's Comp claim. I'm willing to do that since the OP said they needed the invoice which would only apply to seek payment on an active open claim since we all know, you don't need any invoice or even be seen by a health care professional to open the initial claim with Worker's Comp. Invoices for payment to non Workers Comp referred health care professionals occurs after an active claim is open.
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