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Lucille Packard Children's Hospital Horrible Billing Practices!

Complaint
Review by 122395 on 2013-01-16
Rating: StarStarEmpty StarEmpty StarEmpty Star
In September 2011 I had a level II ultrasound after my OB/GYN find a spot on my baby's heart. I had the ultrasound at a Packard Children's satellite office here in my hometown. I don't know when I received the bill for this service, but it was in the amount of $99.38, and it was paid via check on 11/30/11 and cleared my bank in December. That is the only bill I ever received.

In May or June 2012, I received a check for $55 from Packard Children's Hospital for "overpayment". And now on January 12, 2013, I received a $180 bill from Packard, for the September 2011 ultrasound!!! I called Packard and I am given a story that doesn't make sense to me. They have no record of my $99 payment, no record of the partial refund I received, they say they billed my insurance in October 2012 and then my account was closed out and then placed on hold in May 2012 and subsequently re-reviewed on December 25, 2012 when they resubmitted the claim to my insurance and I do in fact owe them $180.

Ok, if my account was not put on hold until May, why did I not receive a bill between Dec.11-April 2012? I called my insurance to find out if I do in fact owe this, because I don't believe that Packard is just now billing my insurance as they claim, seeing as how I never received an explanation of benefits from my insurance. According to my insurance, they received the claim in Oct.2012 and after adjustments and payments, it was "resolved" in April 2012. They said I was responsible for $44, which makes sense because I was billed $99 and received a refund of around around $55 and that the $44 was related to my deductible.

Then the lady I was speaking to went on to say yes I do owe $180 for the ultrasound. Well thats just dandy. If I owe, I will pay but here's my gripe. I'm rather annoyed that I am being billed for this 16 months later, in addition to the amount of time I had to spend trying to resolve this issue! I had to find old bank statements (because my CU does give you online access to statements from this far back) and make several phone calls thanks to Packard's lies. I really think that someone in Packard billing dropped the ball and failed to bill me back in 2011! Per my insurance, they have not submitted a claim or initiated any contact with them since the original claim was submitted in 2011.

Had Packard not tried to cover their mistake and said hey we forgot to bill you, then I would said ok here's your money! Packard, please get your billing practices straight. No one likes medical bills, especially when they appear 16 months later!
Comments:2 Replies - Latest reply on 2013-01-17
Posted by Anonymous on 2013-01-16:
Believe it or not, some providers wait to bill the insurance company. They will bill you though. Why they do this, I have no idea. Some insurance companies give providers a certain amount of time to bill claims. The last company I worked for had a timeframe of 1 year. But I would get calls from providers wondering why we won't pay their claim that they billed 3 years after the date of service. I wonder if you owe more because they billed too late. You might want to find out what the timely filing limit for claims is. If thats the case, then the provider needs to write that off. Another possibility is that you used an out of network facility and are being charged the difference of what was allowed and what was paid.
Posted by At Your Service on 2013-01-17:
Your absolutely correct in contacting your insurance for assistance. I went through a similar situation recently and the insurance cleared up the issue.

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