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suspicious Hilo Medical Center billing problems
#1
Got a bill in the mail the other day from Hilo Medical Center's billing company in Washington for our insurance co-pay. The service date was over a year ago, November 2015.

We called and inquired because we had a vague recollection of paying it. They said that wouldn't have been possible because the insurance JUST paid their portion so the bill was "new". Confused, we asked them to send supporting documentation.

Their supporting documentation didn't corroborate their story that this was a "new" bill. Our insurance paid their portion in December 2015. With some research on our bank web site I found the check # that showed we paid the co-pay in February 2016 and contacted the bank to get a copy of the cashed check. I also verified that the cashed check had all the correct account numbers it was paying, as well as patient name, on the "memo" line. It would have taken Herculean incompetence for the recipient to mess this up.

I called them today and explained we had a copy of the check they cashed from our bank (both sides of check, of course) and they gave me a fax number and I faxed the copy. Afterwards they "graciously" explained that they would "suspend" my account while they "investigate". When I asked what that meant, they aren't going to proceed into collections during the "investigation".

Are my experiences unique? Maybe I'm just being overly suspicious, but to send somebody a bill over a year after the service (when memories are fading) and give erroneous (or falsified?) information about it being a new bill, then I provide proof that 1) I *had* previously been billed for it and 2) I *paid* it 9 months ago. Something doesn't smell right.

I briefly entertained the idea that Hilo Medical Center's billing company was hacked, and this was a nefarious third party trying to profit, but all their info checks out.

Comments and thread hijacks are not only welcome, but encouraged.

ETA: added suspicion
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#2
My partner switched to Kaiser several years ago and quit being covered by HMSA, after about 18 months he had an emergency hospitalization and surgery that was pre approved by Kaiser. Not only did Hilo hospital bill both insurance companies, but HMSA and Kaiser both paid, Hilo then proceeded to harass and dun my partner for a copay for the part of his bill HMSA did not cover, right up to the edge of sending him to collections. Luckily my partner is a retired accountant, had records of everything, including a digital recording of Kaiser pre approving the course of treatment, so he was able to convince Hilo Hospital to not send him to collections. Now HMSA is threatening him with legal action because Hilo hospital will not return the money they were paid by the wrong insurance company. On the other hand the surgery went well and he he didn't die.

We did not realize there was a problem because Hilo didn't send him any bills for over a year, so that part seems to be standard practice.
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#3
Here is a site where people 'rate' Humana, one of the biggies in health insurance. Some of the stories are horrific. What you went through sounds like par for the course. Mild even compared to many. I never saw so many 1 star rating ever. For any product.

https://www.consumeraffairs.com/insuranc...ml?page=12
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#4
Curious how I'm supposed to proceed to put heat on this company to prevent others from being taken advantage of (whether it's intentional or not). I understand that people make mistakes, and am hoping that is what happened, but they should at least conduct a thorough internal investigation to determine what went wrong and develop corrective measures to prevent it from reoccurring in the future.

I can't imagine they will do this voluntarily. Though, I will ask. In the mean time, what regulatory agency in Washington / Hawaii would I contact to express my concerns?
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#5
File a complaint with the state insurance commission. I can almost guarantee that it will suddenly become resolved.
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#6
quote:
Originally posted by leilanidude

File a complaint with the state insurance commission. I can almost guarantee that it will suddenly become resolved.


Exactly. Do not waste time with anyone on island.
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#7
I've had similar problems with Kaiser, and to a greater extent, Hawaiian Telcom.
Kaiser eventually agreed with me; we had to go to the PUC to resolve the HT problem.

><(((*< ... ><(("< ... ><('< ... >o>
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#8
It looks like either these guys need to be regulated within an inch of their lives, or we need Medicare for All.
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#9
Most medical purchases are made under duress, with no competition, no negotiation, and no guarantees whatsoever. You have better consumer protections from your cellphone company than you do from your doctor. But be sure to shop around and get pre-approval when you are having a heart attack, or your insurance company won't cover you either.
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#10
HMSA is threatening him with legal action because Hilo hospital will not return the money they were paid by the wrong insurance company

It's almost as if the insurance is actually some kind of scam.

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