Billing Issues

Recently, I’ve had a lot of interesting calls from clients who’ve had billing issues with Baylor Scott & White. Please, do go to Baylor Scott, while the doctors may be wonderful, this is not a knock against the doctors with the care that they give, I do have concerns about how they operate their billing and admin.

It seems that way, way too many things are done incorrectly. From billing the wrong insurance, billing the facility incorrectly, to the person’s insurance, by not covering a newborn.

A particular client of mine went to Baylor Scott White and had their baby. The plan paid for the mom but didn’t pay for the baby since it wasn’t covered yet. Babies are automatically covered for the first 30 days. Now we’re having to dispute and argue with them to get them to pay the bill. The client is receiving a bill for $5,000 for services that would have been covered by insurance.

I see this happen all the time. I hate this because I’m sure they have very good doctors working there. But you’re going to have a nightmare on the back end with billing, I always strongly encourage my clients, if you don’t have to go to Baylor Scott, then don’t go there.

St. David’s is very easy to work with from a billing admin standpoint, and Seton is not horrible either. They both offer generous cash discounts. If you’re a cash patient, they offer great financial assistance programs if you need help getting a bill paid, or if you’re unable to pay a bill.

Not so much as Baylor Scott& White, they just don’t have a very robust financial program, which is really strange, because they’re supposed to be a nonprofit. But they just don’t, and their fees are higher than the other two facilities; they offer the same services are higher at their place. So, I strongly encourage you, if you do seek care there, to look at your itemization when you receive those bills, and make sure your insurance paid correctly. And if not, then yes, you can fight it. You can dispute it, and I strongly encourage you to do so. But it can be very frustrating because they’re just very difficult to work with. Even once it goes to collections. They don’t want to offer any payment discount if you pay the bill, which I find so strange because they’re charging these really high fees. And they’re not trying to help patients who want to take care of the bill.

So why is this happening? Well, I really think it’s due to a lack of training. The employers are not spending enough resources on training and maybe hiring enough people. I get that everybody is short-staffed. But this is important stuff, and having come from the medical field, I understand that this is not rocket science. It can be a little complicated, but if you understand billing and coding, which you should, if you’re a billing department at a hospital, then you should be coding and billing correctly. They should be certified coders. Sometimes people can make mistakes, I get that. But the process to get it corrected shouldn’t be so hard to get resolved.

One way to avoid these kinds of problems is to have a plan.

I tell all my clients to have a plan, know ahead of time where their insurance is accepted, and put it on a little sticky and stick it on the fridge, which urgent care and ER they need to go to.

And again, if you’re fearful of dying, don’t worry about the insurance piece. Go! I don’t want anyone to die because they didn’t seek medical care or were worried they were going to get a big bill. Yes, they may get a big bill. But we’ll just have to deal with that on the back end. I don’t want anyone not to seek care because they’re so afraid of the bill that they’re going to get.

So, you know, “the buyer beware clause” is what I’m trying to warn people about.

  • Know where and what your insurance covers
  • Who’s in-network with your insurance
  • Where to go
  • Be prepared

If you have any questions please feel free to reach out to me.

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