Self Pay, Hosp not giving me itimized bill?!

NurseWiggins · May 17, 2007

:help: :help: So my insurance company denied me the first time....So I went ahead and paid cash for the surgery--12,500. So now, im going back to the hospital to get an itimized statement so I can appeal my insurance company and provide any and all info possible. I have the understanding that even if I was denied, they will many times cover things like the hospital room, etc. So thats what im trying to do now. BUT! The freaking hospital will not give me an ITIMIZED statement. Just a bill saying I paid 7500 to the hospital. Thats it, not the room, meds, pt, etc. When asked the girl with a crap attitude said, "the physcians center would get screwed" "WHAT?? how?? Did I NOT already pay you in full??" Then she proceeded to say that the insurance company this and that...Well, what it comes down to is this. Every other person who gets approved for the lap band at this hospital is paying 22,000 bucks. But they give a huge discount 7500 only (to the hospital) for the lap band. So, I assume that if I were to turn around and send in a statement for the lap band for 7500--and jane doe sends in one for 22,000 bucks, thats going to throw up a red flag for this hosp. But that isnt the point, frankly I dont care about that end of it. What are MY rights?! They were saying "its their policy" not to give a detailed bill with self pay patients. I feel Im getting the short end of the stick because I paid out of pocket!? Anyone know where I can turn to?! Thanks soooo much in advance!!!

Kristi :help: :help: :help:

Alexandra · May 17, 2007

Hmmm... that's an interesting quandary, Kristi. There may not actually be an itemized bill for self-pay patients, I guess. Those highly detailed bills are designed for insurance purposes and it might take a lot of labor to generate one.

Are you saying that you got a huge discount because you work at the hospital? If that's the case, the person telling you they can't give you an itemized bill may be right. They'd have to show that they undercharged you significantly as a "professional courtesy," and while that is indeed done all the time the people on the receiving end of that courtesy typically don't file insurance claims. In fact, that courtesy is usually provided with that understanding.