December 28,2016
Boyd A. Loving
Ridgewood NJ, If you receive a bill for services provided by The Valley Hospital, DO NOT PAY THE BILL without thoroughly checking its validity.
I received a $5,900 bill for services rendered at The Luckow Pavilion only to find out that an employee of The Valley’s accounting department failed to provide the correct authorization code to my health care insurance provider. It took three (3) in-person visits to The Valley’s offices in Paramus over a four (4) month period before I was able to straighten the matter out.
My attempts to quickly resolve the issue were stymied when a representative from the accounting department told me that I was “personally responsible” for contacting a supervisor at The Luckow Pavilion to gather information. Seems as though the accounting department will not initiate communication with other hospital departments by phone or e-mail. And, when a supervisor from Luckow did write to accounting, the e-mail was not opened for 30 days – it was opened only after the accounting department’s director was called by phone.
In retrospect, I’m now left wondering if all of this was a disguised attempt on the part of someone at The Valley to extract $5,900 from me instead of accepting the $4,800 agreed upon payment from my insurance company. I’m also wondering how many people just wind up paying these “bogus” bills instead of putting up with the hassle involved in challenging them.
What a way (not) to run a business.
I have private health insurance. Medical billing is as opaque as it gets.
Having a procedure at Valley was supposed to be easy – insurance company says valley and doctor are in network so anesthesiologist covered.
Then the billing started. Everyone is part of “Valley Physicisn services” or some similar named organization. Doctor, hospital and anesthesiologist start billing beyond my deductible. The Valley anesthesiologist was the worst, billing beyond whay the insurance company deemed acceptable.
The hospital uses confusion as a billing practice. They never clearly explain expenses but are certain that you owe more than in-network insurance permits.
Never ever pay any medical bill without questioning it . Was in valley hospital for four days in October and they tried to bill us the difference of what our private insurance company deemed acceptable . My husband was just going to pay it . I told him no way I’ll take care of it. I called our insurance company and they said that Valley is not allowed to do that (we are all in network) . They called Valley and straightened it out . I would bet that the hospitals do this to see what they can get from people!
Insurance would not cover the bill since the patient name was not the same as the insured, it was off by 3 letters.
So we had a similar run around when the billing department transferred me all over the hospital to get our last name spelled correctly on their bill. This lasted for 4 months and was sent out for collections as we refused to pay for their error, insurance would have paid 100% if they had just fixed the last name and resubmitted.
It came to a head when billing told me I had to speak to the ambulance driver to correct the mispelling of our last name.
I was beyond irritated and finally called Audrey Meyers office, told her assistant my problem and it was quickly resolved.
BUT, by that time insurance wouldn’t pay because it had surpassed the their timeline for submission, Valley had to eat the bill.
And we wonder why health care is so expensive…………
I have had procedures done at St. Joseph’s in Wayne, Clara Maas and Valley Hospital. Valley Hospital was by far the worst when it came to billing issues. By the way – this issue of “balance billing” has been addressed by changes to the law is other states, including New York. Some of our legislators are trying to get similar legislation passed in NJ. If you want to see this change call our State Senator, Kevin O’Toole at 973-237-1360, Assemblyman, Kevin Rooney at (973) 237-1362 , and Assemblyman David Russo at (201) 444-9719 and tell then that you want an end to surprise out of network bills and balance billing in NJ.
Articles on this in The Record and NY Times suggest that this practice goes far beyond Valley.
In the bill shown (thank you for including it), a clear indication of a mixup is that the insurance company paid NOTHING.
We went through similar issues after my twins were born. They were in the NICU for several weeks so you can imagine the charges. It took until they were about 18 months old to get it sorted out between their billing department and our insurance company. Absolutely insane.
I had major surgery, scheduled, not emergency. Valley is in my health plan. My surgeon and his whole practice are in my health plan. Good to go. Then a few weeks later I get a bill from a doctor who I had never heard of. Huh? I make several calls and determine that Valley had a policy that there has to be another surgeon present during all surgeries. Not going to argue the potential safety considerations with this policy; it is probably a sound rule for the sake of the patient’s well-being.
But they put someone in who is not in my health plan. Not a second surgeon from my surgeon’s practice. Not a second surgeon from another participating practice. Nope, a surgeon from a non-participating practice.
My health care provider refused to pay one dime of this surgeon’s bill. Now how is this possible? I never knew about this, no one told me. And I was of course unconscious when Dr. Unknown stepped into the room for this extra fee. I argued until I was blue in the face. All while recovering from major surgery. Eventually the doctor agreed to waive the fee. I’m not sure that was the right outcome, but I took it.
@3:44 that’s horrendous!
3:44 pm: A few years back, the NY Times had a front page story about the “second surgeon required” issue. They interviewed a former patient at a NYC hospital who received a bill for over $100K from a physician who acted as the “second surgeon” during the patient’s operation. Like you, the patient was livid. He argued until he too was blue in the face, but his insurance company paid the bill. He asked them not to, but they didn’t want to chance getting involved in litigation. So they just wrote the check out.
3:44 pm: The Valley does this all of the time. I recently had a colonoscopy and they assigned a cardiologist to read my EKG that wasn’t in my insurance plan. Fortunately, my out of pocket was a mere $9.00, but why they are unable, or unwilling, to schedule physicians based on the patient’s insurance coverage is beyond m.
3:44, sorry, being unconscious is no excuse…or so they apparently told you. These cautionary tales are good reminders of things to ask about that nobody would ever think of in advance.
I had the same problem with Hackensack Hospital billing department. They submitted bill incorrectly and I advise them so . They than sent it correctly and sent me another bill, another phone call and I was told I was responsible for the bill till the insurance paid. I let them know that wasn’t going to happen, I worked medical billing for 26 years and they were not handling this correctly. I then had another procedure and they again used wrong insurance company after we had been thru this and they said it was corrected in their system, only to find out they had corrected it and were trying the same thing for me to pay the bill. Never ever pay hospital or doctor bill till you have your EOB from your insurance or have called them to verify.