Hospital charge

ichabod

My wife recently spent 3 weeks as a public in-patient in Connolly hospital. During her stay, she underwent two day procedures in the Mater as the equipment was not available in Connolly. She was transported by taxi to the Mater and returned to Connolly by ambulance.
Now here's the rub. On discharge, she received the expected invoice for €800 from Connolly. Then she received 2 more invoices from the Mater for €80 each for day patient charges.
I am not looking for advice as such e.g contact the accounts dept. Rather, I would like to know if this type of charge is permissible. Because to me, it is either down to an inept clown in the Mater's accounts dept., or an attempt at gouging patients even further, on a par with trying to get patients admitted through the public system to sign health insurance forms without offering any of the benefits of private health insurance.

coylemj

In relation to the Mater invoices, just don't pay them. Hundreds of thousands of those invoices for public hospitals remain uncollected every year and for €160, no debt collection agency is going to bother chasing you. Even if they do, it can only affect your credit rating if they take you to court and get a judgement and they're not gong to do that for €160.

But you are correct, the Mater should not have billed you as the procedures in the Mater were part of the treatment that you should have received in Connolly.

kathleen37

Looks like €800 in a year is the maximum, so I would contact the Mater as I wouldn't want my credit rating affected.

http://www.citizensinformation.ie/en/health/health_services/gp_and_hospital_services/hospital_charges.html

Xterminator

coylemj wrote: »

In relation to the Mater invoices, just don't pay them. Hundreds of thousands of those invoices for public hospitals remain uncollected every year and for €160, no debt collection agency is going to bother chasing you. Even if they do, it can only affect your credit rating if they take you to court and get a judgement and they're not gong to do that for €160.

Terrible terrible advice. Sticking your head in the sand and ignoring them is the single worst thing you could do. There is no scenario i can think of where that's the best advice.

OP if you think you have been billed incorrectly you call the number on the invoice and tell them you believe they made a mistake.

If you believe you will billed correctly but that the system is flawed, pay the bill and call your TD about changing the system.

if you believe you were billed correctly but dont have the funds, call them and schedule a payment plan.

ichabod

Thanks for the responses. One point, I stated the Mater. That is incorrect, it was Beaumount ( not that it makes any difference ). The only problem is that my question as to, shall we call it, the legality of the day patient charges is still unanswered. My wife spent 20 nights as an in-patient in Connolly. The discharge cert states this clearly. She was transported to Beaumount twice on the authority of her attending doctor for procedures which cannot be done in Connolly. These procedures were part of her treatment as a patient in Connolly. She was not discharged and re-admitted to Connolly on either day. Therefore her stay was for a continuous 20 days under the care of Connolly. So how can procedures which are a essential part of her treatment in Connolly be treated and charged on a day patient basis by Beaumount.
This may be a simple error but somehow I doubt this. If this transpires to be incorrect billing, the question arises as to how many other patients have been billed similarly and have paid up. This may be just the tip of the iceberg of another charging rip-off by out illustrious Health Service. Let us not forget that, despite the adverse publicity on the private health insurance scam, hospitals are still doing this.
Anyway, the wife will be making a call to Beaumount's accounts dept., and we will see what the response is ? I will let you know what happens, for those interested.

.......

I dont believe the charges for Beaumount are correct.

The maximum a public patient can pay for inpatient charges in one 365 day rolling period is 800 euro (10 nights at 80 euro per night).

You cant be a (billable) inpatient of one public hospital and a (billable) day case of another public hospital on the same day. The day procedures should have been charged through Connolly Hospital - regardless of where they took place.

Beaumount need to bill Connolly and if necessary then Connolly pass on the bill to the patient - in this case your wife has already hit the maximum - so she cant be charged beyond that. If she had only had a 2 day stay then maybe the charges would be appropriate. But because she has exceeded 10 days they are not.

IMO.

Former Former

Ring Beaumont. Explain situation. Get it resolved.

I hate it when people's starting position is that they've been ripped off. It could be a clerical error, maybe the accounts system simply isn't set up to handle out-patient procedures for in-patients from a different hospital. Coming on here talking about "inept clowns" and "gouging" is not fair when they're dealing with thousands of patients all with varying levels of complexity.

You couldn't even get the name of the hospital right, is it fair to accuse them of ripping you off without considering it might have been a similar error?

NUTLEY BOY

It is always wisest to bring these matters to a formal conclusion rather than to ignore.

I went to local ED a few years ago with a GP's note. Faster than an ambulance on blue lights I got a bill for the ED charge. I simply wrote back telling them to consult the chart where they would find the referral letter thus negating the charge. I told them that I would take all as being in order if I heard nothing further. Sorted.

The reason I bothered is that if I ever had to go again I don't want some twit telling me erroneously that I owe €100 "according to the system" :rolleyes:

In this case I would write to Beaumont informing them of the pertinent facts in relation to Connolly and that the maximum annual statutory charge of €800 has been discharged in full to the original hospital and that nothing would appear to be due to them. Ask them to confirm that they accept the position.

I get the impression that some public hospitals whiz out invoices willy nilly.

.......

NUTLEY BOY wrote: »

I get the impression that some public hospitals whiz out invoices willy nilly.

A lot of them just dont have sophisticated accounting software and the old system just bangs out an invoice because it cannot handle the exception that you were being treated from another hospital.

ichabod

Former Former wrote: »

Ring Beaumont. Explain situation. Get it resolved.

I hate it when people's starting position is that they've been ripped off. It could be a clerical error, maybe the accounts system simply isn't set up to handle out-patient procedures for in-patients from a different hospital. Coming on here talking about "inept clowns" and "gouging" is not fair when they're dealing with thousands of patients all with varying levels of complexity.

You couldn't even get the name of the hospital right, is it fair to accuse them of ripping you off without considering it might have been a similar error?

Gee, you have made me feel guilty now. So sorry I got the hospital name wrong initially. Not that the name of the hospital is really of any relevance. It could be any hospital.
It's funny though that you hit the nail on the head with your comment " maybe the accounts system simply isn't set up to handle out-patient procedures for in-patients from a different hospital ". It's not exactly something that you would expect in a modern health system, that the accounts dept., would not have the basic info that the patient was an in-patient in another hospital. They sure enough had all the personal details to send an invoice. You wouldn't be an " insider " would you ?
As for " gouging ", do you condone the hospitals' practice of trying to get patients' who come through the public system to sign off on private health insurance ? Just because the insured doesn't have to pay the private bed charge directly doesn't mean s/he won't pay indirectly eventually. If that practice is not gouging nothing is.

ichabod

....... wrote: »

A lot of them just dont have sophisticated accounting software and the old system just bangs out an invoice because it cannot handle the exception that you were being treated from another hospital.

It's not an exception though. Because of the way the health service is set up, certain procedures are performed only in certain hospitals which means transfers of in-patients are made regularly for various procedures. So, it should be no surprise or exception that a patient arrives from another hospital for an op or procedure and is returned to the base hospital and that information conveyed to the accounts dept.
You are probably right that accounting systems are outmoded. Likely that some of them are still using XP as an OS. But really, don't you just get sick of the whole thing. FUBAR after FUBAR after FUBAR. The issue here is fairly minor but symptomatic of a fairly ramshackle system.

Glass fused light

ichabod wrote: »

It's not an exception though. Because of the way the health service is set up, certain procedures are performed only in certain hospitals which means transfers of in-patients are made regularly for various procedures. So, it should be no surprise or exception that a patient arrives from another hospital for an op or procedure and is returned to the base hospital and that information conveyed to the accounts dept.
You are probably right that accounting systems are outmoded. Likely that some of them are still using XP as an OS. But really, don't you just get sick of the whole thing. FUBAR after FUBAR after FUBAR. The issue here is fairly minor but symptomatic of a fairly ramshackle system.

If its a choice I would rather the hospital spend on core services eg medical upgrades rather than non essential administration upgrades.

L1011

You can have a fully functional accounting system running on XP, there's a good chance that your bank is using actual IBM mainframes and Revenue are still using OpenVMS for everything important as far as I know.

Former Former

ichabod wrote: »

You wouldn't be an " insider " would you ?

Would you ever cop on FFS.

Purgative

....... wrote: »

I dont believe the charges for Beaumount are correct.

The maximum a public patient can pay for inpatient charges in one 365 day rolling period is 800 euro (10 nights at 80 euro per night).

You cant be a (billable) inpatient of one public hospital and a (billable) day case of another public hospital on the same day. The day procedures should have been charged through Connolly Hospital - regardless of where they took place.

Beaumount need to bill Connolly and if necessary then Connolly pass on the bill to the patient - in this case your wife has already hit the maximum - so she cant be charged beyond that. If she had only had a 2 day stay then maybe the charges would be appropriate. But because she has exceeded 10 days they are not.

IMO.

This would be the post I would have written if I'd logged in a bit more often.


I hope you and your wife are doing OK Ichabod.

GerardKeating

ichabod wrote: »

Anyway, the wife will be making a call to Beaumount's accounts dept., and we will see what the response is ? I will let you know what happens, for those interested.

I was incorrectly charged once by a hospital once, the sent me a bill for the €100 out patient charge, which i queried, since the patient was admitted, they appologies and cancelled the bill.

They could have been "trying something on", or more likely just a mistake in an over working health service.

the_syco

GerardKeating wrote: »

I was incorrectly charged once by a hospital once, the sent me a bill for the €100 out patient charge, which i queried, since the patient was admitted, they appologies and cancelled the bill.

I find most of their bills to be automated. I got billed once; I just told them I had insurance. All good. But part of the automated system is yes or no.

Grab All Association

kathleen37 wrote: »

Looks like €800 in a year is the maximum, so I would contact the Mater as I wouldn't want my credit rating affected.

http://www.citizensinformation.ie/en/health/health_services/gp_and_hospital_services/hospital_charges.html

HSE or private hospitals don’t have write access to ICB or Central Bank register. It would not affect his/her credit rating. HSE and private hospitals are open to negotiations though and do waive charges in cases of hardship.

ichabod

Update. Beaumount accounts contacted. To cut a long story short, reason for day patient bills being sent is that accounts does not receive referral information. The accounts person said she would have to check with Connolly to confirm that my wife was an in patient there before the day patient invoices could be canceled. Which begs the question as to why a simple notation indicating the referring agent can't be included on whatever document accounts receive.
Now, it may seem that I am making a mountain out of a molehill but am I really ? Consider just one factor. If this is the usual practice in Beaumount because the accounts dept., have no clue as to where the patient came from, how many patients in similar circumstances have received invalid day patient invoices and simply paid up without query?
Now, I don't know if this " double billing " is unique to Beaumount. I do know that, in 2011, I was an in patient in Connolly and was transferred to the Mater for a " day procedure " and was never billed for for the procedure by the Mater.