puna clinics co-pay

[kalianna]

I received three copies of this notice today, one from Pahoa Urgent Care, two from Kea'au Ugent Care, stating in part:

"In the last several years our facility has implemented many changes to help meet the medical needs of our ever-growing rural community.  One of these exciting changes includes our clinics receiving the Rural Health Clinic (RHC) designation. RHC's have a different Medicare reimbursement structure, and coinsurance amounts are slightly higher.  In exchange, they allow for patients in rural area such as ours the convenience of being cared for in their community rather than having to travel."

The Pahoa clinic is in the same place it's always been.  The Kea'au clinic moved one mile from where it was.  It goes on to say that these changes were made between May and August of 2020.  I had paid my $50 copay at the time of each service, dating from 11/21 until 8/22, all for minor problems.  Now I have just received additional bills for $86, $121, and $186. This is not, "slightly higher".

IS THIS EVEN LEGAL???  Had I known that I would have to pay this much I would have walked away each time.  I have receipts that the accounts were paid in full.  Did anyone else get these notices?   I'll call them in the morning but suggestions on what recourse I might have would be greatly appreciated.

[TomK]

Call them. Just the other day I got a bill for a treatment I never received. Not from urgent care but from another health provider I've never used. HMSA has already paid them about $1000 for that so-called treatment and I've been billed the co-pay for pain management and oxygen treatment which I never received or needed.

Just curious, those bills aren't from Clinical Labs, are they?

[kalakoa]

Seems like there's a whole other thread about this same issue a couple of years ago.

Don't be surprised when the insurance company says "we assume the provider is telling the truth". Happened to me; provider's offices were CLOSED on the day I was allegedly seen.

[kalianna]

The bills are from East Hawaii Health Clinics. I just talked to them and they very quickly told me they had made a mistake and to disregard the notices. I wonder how many people will just pay them. That's a pretty big oopsie on their part.

[randomq]

It pays to make some mistakes...

[TomK]

Seems like there's a whole other thread about this same issue a couple of years ago.

Don't be surprised when the insurance company says "we assume the provider is telling the truth". Happened to me; provider's offices were CLOSED on the day I was allegedly seen.

In my case, it's for a date I actually saw my doctor for a scheduled check-up. His name appears on the invoice although it's not from his office, it's from Clinical Labs for treatment I never had.

[terracore]

I received a bill for a co-pay I had paid over a year prior. It was long enough ago I couldn't remember the details of the transaction but I knew I had paid it because I'm a bill payer. It took some research to get a copy of the check and send it in as proof of payment. A lot of people wouldn't have been able to do that and would have paid the bill a second time, or they would have paid it because doing the research etc wasn't worth their time. Frankly, I feel like they owe me compensation for making me correct their mistakes because it did require some investment of my time that was equal to or greater than the amount they were erroneously trying to re-collect.

I'd like to think it was an "accident" but I'm also suspicious if these "mistakes" are "overlooked" because it's income. It was from Hilo Medical Center's billing company.

In another instance, I was charged an "Urgent Care Fee" of $50 at Keaau Urgent Care. I protested the charge but the receptionist said it was now a "standard thing". This was in addition to the normal co-pay and fees negotiated with HMSA.

A few months later the clinic sent me a check for $50 with a cryptic short explanation about some sort of billing error. I'm only speculating they charged their fake fee to the wrong person and they contacted their Uncle at some regulatory agency or the insurance company.

[AaronM]

The healthcare industry is not a trillion dollar business by accident