I delievered my baby at Inova Fairfax Hospital on March 24 this year, stayed there until March 26.
Few months later, I received a bill from the hospital asking me to pay $2K+. In the bill, it doesn't explain what that $2k+ is for which service or item. It listed out 8 different services ("nursery" and "room and board - semi private" are the first two) and the charge associated to each service.
Then total charges = $9,786.90
Insurance payment = -6968.00
Total insurance adjustments = - 565.32
Total insurance payments & adjustments = -7533.32
Patient Balance = $2253.58
I couldn't understand why I have to pay that much money since I delivered my first baby last year at the same hospital and it was even more complicated than this one, but I didn't have to pay a dime. I logged in to my insurance account, looked for the Explaina of Benefit (EOB). It appears that the amount that hospital billed me is considered as "personal item". After serveral calls with insurance customer services, I found out that hospital billed the nursery room charge to my new born's insurance account and that was waived as it is already included in the global fee and under my baby's EOB it clearly said that the patient doesn't have to respond for that amount. Hospital also charged my insurance account the nursery room charge (even i didn't stay in the nursery room at all, my baby did and they already billed her insurance account that service). They sent the insurance the code for that service as "personal item", of course if they say it is the nursery room charge, the insurance would reject and also indicate that patience doesn't have to pay that amount again.
Hospital billing department called me on July 31, 2014 and asked me to pay the balance. I got the insurance customer service representative on the conference call and she request hospital to send the itemized bill. I got that itemized bill instantly and it appeared on MyChart (Inova Hosptial patient account). On the itemized bill, they call nursery room charge as "new born services", nothing on there can be considered as "personal item". The hospital billing lady couldn't even point out what line on that itemized bill is considered as personal item. So, insurance customer service lady requested her to reevaluate and resend the bill to insurance for reprocess.
It looks like nothing happened or they just blindly resent the same bill to insurance for process. I got the letter from AMCB collection asking me to pay that amount. Hosptial billing department transferred me to there as they already transffered my account to collection. They couldn't explain what "personal item" that I used added up to $2253.58 (more than $2K), so then let collection threating me.
After talking to AMCB Collecton, they gave me the fax number to send my dispute letters with attachment to them. I did and got confirmation that the fax went thru fine. After that, I even called and left the voice mail couple times, the collection representative never replied my call. Until today she said she never reveiced my dispute letter (what an excuse).
With my company's insurance account representative help, I finally got the mystery resolved. The hospital double charged me the same service (nursery room). It's reasonable that they charged the nursery room to my new born's insurance account, but not my account as I didn't stay in the nursery room at all. Finally, I got a hold of the Collection Representative and she just received the EOB from my insurance which was got reprocessed Oct 15, 2014. The 2nd week of November 2014, I still received 2nd notice from Collection, threating that they will take further action if i don't pay that amount. The reprocessed EOB doesn't have that "personal item" charge anymore (everything else remains the same as the March EOB).
One thing that appears to be very funny to me is that a person from the hospital SBO Customer Support Team said she reveiwed my account and that $2K charge is for the semi-private room charge and most insurance doesn't pay that. However, on the insurance EOB from March, that service is indicated as 100% paid by the insurance. It looks like whatever name they want to call that "mystery" charge just to give you an "explanation" and the bottom line, they want to get your money by whatever method that they can use.
First, they charged one account, couldn't get the money. Second, they used different name to charge that same service to different account. On the itemized bill which was never released to the patient until the insurance requested, they called the same service with another different name. Spoke to another person in the SBO Customer Support Team, she gave that service a different name, but unluckily that name she used is appeared as paid by insurance.
Bottom line and lesson learn from all these, read your bill carefully and espeically the medical bills. They try to lur you and make you confuse on purpose just to get your money and also the insurance money as possible. Scamming you is easier to scam the insurance company, we all know that.
Inova Fairfax Hospital Reviews
I delievered my baby at Inova Fairfax Hospital on March 24 this year, stayed there until March 26.
Few months later, I received a bill from the hospital asking me to pay $2K+. In the bill, it doesn't explain what that $2k+ is for which service or item. It listed out 8 different services ("nursery" and "room and board - semi private" are the first two) and the charge associated to each service.
Then total charges = $9,786.90
Insurance payment = -6968.00
Total insurance adjustments = - 565.32
Total insurance payments & adjustments = -7533.32
Patient Balance = $2253.58
I couldn't understand why I have to pay that much money since I delivered my first baby last year at the same hospital and it was even more complicated than this one, but I didn't have to pay a dime. I logged in to my insurance account, looked for the Explaina of Benefit (EOB). It appears that the amount that hospital billed me is considered as "personal item". After serveral calls with insurance customer services, I found out that hospital billed the nursery room charge to my new born's insurance account and that was waived as it is already included in the global fee and under my baby's EOB it clearly said that the patient doesn't have to respond for that amount. Hospital also charged my insurance account the nursery room charge (even i didn't stay in the nursery room at all, my baby did and they already billed her insurance account that service). They sent the insurance the code for that service as "personal item", of course if they say it is the nursery room charge, the insurance would reject and also indicate that patience doesn't have to pay that amount again.
Hospital billing department called me on July 31, 2014 and asked me to pay the balance. I got the insurance customer service representative on the conference call and she request hospital to send the itemized bill. I got that itemized bill instantly and it appeared on MyChart (Inova Hosptial patient account). On the itemized bill, they call nursery room charge as "new born services", nothing on there can be considered as "personal item". The hospital billing lady couldn't even point out what line on that itemized bill is considered as personal item. So, insurance customer service lady requested her to reevaluate and resend the bill to insurance for reprocess.
It looks like nothing happened or they just blindly resent the same bill to insurance for process. I got the letter from AMCB collection asking me to pay that amount. Hosptial billing department transferred me to there as they already transffered my account to collection. They couldn't explain what "personal item" that I used added up to $2253.58 (more than $2K), so then let collection threating me.
After talking to AMCB Collecton, they gave me the fax number to send my dispute letters with attachment to them. I did and got confirmation that the fax went thru fine. After that, I even called and left the voice mail couple times, the collection representative never replied my call. Until today she said she never reveiced my dispute letter (what an excuse).
With my company's insurance account representative help, I finally got the mystery resolved. The hospital double charged me the same service (nursery room). It's reasonable that they charged the nursery room to my new born's insurance account, but not my account as I didn't stay in the nursery room at all. Finally, I got a hold of the Collection Representative and she just received the EOB from my insurance which was got reprocessed Oct 15, 2014. The 2nd week of November 2014, I still received 2nd notice from Collection, threating that they will take further action if i don't pay that amount. The reprocessed EOB doesn't have that "personal item" charge anymore (everything else remains the same as the March EOB).
One thing that appears to be very funny to me is that a person from the hospital SBO Customer Support Team said she reveiwed my account and that $2K charge is for the semi-private room charge and most insurance doesn't pay that. However, on the insurance EOB from March, that service is indicated as 100% paid by the insurance. It looks like whatever name they want to call that "mystery" charge just to give you an "explanation" and the bottom line, they want to get your money by whatever method that they can use.
First, they charged one account, couldn't get the money. Second, they used different name to charge that same service to different account. On the itemized bill which was never released to the patient until the insurance requested, they called the same service with another different name. Spoke to another person in the SBO Customer Support Team, she gave that service a different name, but unluckily that name she used is appeared as paid by insurance.
Bottom line and lesson learn from all these, read your bill carefully and espeically the medical bills. They try to lur you and make you confuse on purpose just to get your money and also the insurance money as possible. Scamming you is easier to scam the insurance company, we all know that.
STAY AWAY FROM INOVA HOSPITAL as possible.