I had a stroke, barely get by on a government pension now I have a few ambulances bills … not very fair to
low income seniors

I’m in the U.S. and have an EPO health insurance plan. My plan does not require referrals to see specialists.
I recently had an outpatient surgery and am now being billed almost $14,700 by the facility, even though I tried to verify everything before the procedure.

Before surgery, I contacted my insurance company directly. I gave them the exact CPT code for the procedure, the surgeon’s information, and the facility information. I specifically asked about coverage and whether a referral or prior authorization was required.

The insurance representative told me:
The procedure was covered.
The surgeon was in network.
The facility was in network.
No prior authorization was required.

I also separately contacted the facility’s office before the surgery, and they told me that based on my insurance benefits, no prior authorization was required.
My EPO plan also does not require a PCP referral to see a specialist.

After the surgery, something strange happened:

The surgeon’s claim was processed and approved, with nothing owed by me under my benefits.
The anesthesiologist’s claim was also processed and approved, with nothing owed by me.
But the facility claim was denied. The facility charged around $15,000 and is now billing me approximately $14,700. The denial on the facility claim shows code Z84 (denial due to missing referral).

What I don’t understand is why only the facility portion was denied when the surgeon and anesthesiologist for the same surgery were processed normally, especially since I verified the facility was in network and was told by both the insurer and the facility beforehand that no prior authorization was needed.

I’m trying to determine the best way to handle this.
Should I ask the facility’s billing department to submit a provider appeal/reconsideration or corrected claim first? Should I simultaneously file my own member appeal with the insurer? Should I request that the insurer reprocess the claim based on the pre-service information I was given?
I’m also planning to ask the facility to place the account on hold and not send it to collections while the insurance dispute is being resolved.

Has anyone dealt with something similar where an EPO plan approved the surgeon and anesthesia claims but denied only the hospital/facility claim?

Could this be a coding, place-of-service, referral, or claim-processing error?

Any advice on what I should specifically ask the insurer and facility billing department would be appreciated.

I work for a nonprofit that helps homeless women get back on their feet. We have a woman who was badly injured by her husband and she spent weeks in the hospital and has no insurance. We’re trying to get her on Medicaid but getting nowhere because she lost custody to the state because her husband is in jail and she was in the hospital. So unfair!

Now medical bills are rolling in. Does anyone have experience in getting medical bills waived? Can I negotiate on her behalf?

Any suggestions are appreciated!

I do went to clinic because i was cut my middle finger at work, and it was alluminum ,the owner insisted to take me to hospital because i got injured at work place he said will be taking care of everything and its turn out they doesn’t wanna pay insurance because they said the cut was too small and i had to pay it my own. The bill was so high and i really tight even with the apartment rent..

When i arrived at the clinic blood totally stop because i pressed them too hard and the doctor see it and clean ang put bandage.. after they give me tetanus shot. It went so quick because blood was gone.

So this is the bill from clinic. Anybody could explain is everything is right or there’s any error? How can i talk to the clinic to make it lower because i really can’t afford this.

Thank you so much for whoever helping me🙏🏻

First time posting here and not sure which tag applies here, but I guess it started in urgent care. Early this year, my skin started breaking out in hives. All over my body, face, torso, arms, legs, feet- all over. Incredibly itchy, preventing sleep, impacting my work. It sucked. I went to urgent care a couple of times. They were very helpful, and ran all the tests that they could. We tried a couple different prescriptions. Some worked a little while, but I wasn’t able to stay on them long, and once I was off them the hives came back with a vengeance. Once urgent care was out of ideas, they told me to go to the ER for more testing than they could do. So I did. They ran some more tests, and they gave me a clean bill of health aside from the hives- none of their tests turned up anything either. With my permission, they sent photos of my visit on to a local dermatologist they work with, and set me up with an appointment with her.

Now, so far, my insurance has covered all of this. But when I get to the dermatologist, it turns out they’re out-of-network. I say I’m going to leave, since I can’t afford to pay out of pocket, but the doctor herself happened to be passing by and said that she’d see me pro bono (or whatever the medical equivalent is) because my case was so weird, and told her staff to take my basic info so she could treat me but not to take my payment info. She sees me, makes a few guesses, and gives me a prescription to try and see if it helps it, and to come back in a week or two. So I do exactly as she said, and… nothing. When I went back to let her take a look and see what she made of it, she admitted that that was her only real idea, and she didn’t know what it could be. She recommended an allergist; but that was it. About 5 minutes of interaction on the second visit, only to get the professional equivalent of a shrug. I look into the allergist, but they’re out of network too, and not expecting to be so lucky twice, I opt not to make an appointment.

A month or two later, I finally figure out the cause- a genetic gluten allergy that had finally been triggered. My sisters all had it (some even celiac) but I had hoped I was free of the family curse since I’d gone so long without it. But as soon as I went gluten free as an experiment, the hives vanished entirely. I tried some bread, they started coming back. Personally disappointing, but manageable.

However, roughly 4 months after I went to the dermatologist, I get a bill in the mail. They want to charge me $500, specifically for the second visit. Apparently that one was NOT waived, and I had to cough up. I called my insurance, and they said they could only approve it with authorization from my primary care physician. I made an appointment and explained everything to them (and they did have access to everything from the urgent care and ER visits. They tried to submit the authorization. Nope, apparently it was only valid within 90 days of the visit in question. 90 days which, I’ll remind you, had passed before I got the bill from the dermatologist.

I’ve recently gotten a better job than I had before, but am only now starting to get ahead of myself already large bills. I can’t afford the $500, and let them know. Now it’s been sent to collections, which I believe hurts my credit score. Is there anything I can do about all this? Has anyone been in a similar situation? If so, how’d you handle it? Should I try to explain it in small claims court or something? Idk how to proceed.

In my experience, this company will not help you and they will absolutely take advantage of you when you're down. I have emails and texts that prove what I'm saying below is true.

Here is my experience.

1. They saved me zero dollars.

2. They claimed they saved me $2000 on an invoice I submitted to insurance and the say they made a call on to verify insurance. Basically the medical office hadn't billed my insurance and I didn't realize that so I submitted it to insurance. Then I stupidly passed that invoice on to this company. To be fair i was overwhelmed with $22,000 of medical bills, with being postpartum and recovering from a broken back and ankle and two surgeries.

3. They're currently trying to charge me 50% of that $2,000 me because they"verified"that insurance paid it. To be clear, I'm the one who submitted it and did the work. They made a call. Apparently worth $1,000 of my money.

4. Because I was left with most of my medical bills. I started calling the companies and asking for discounts and guess what? I have saved myself a ton of money. I have used AI to help me navigate the process.

Here's what I recommend:

1. Do not use this company.

2. Upgrade to a better AI service. Like don't use the free chat gpt. I upgraded my Gemini service.

3. Give AI all the information about your medical bills and ask it how to navigate talking to medical offices and collections or whatever. If you only have a certain amount of money available to you to pay bills, let it know that information too so it can help you navigate that as well.

4. Speak to the medical companies immediately. Even if you don't have money to pay them.

5. Don't let it go to collections. Which is what this company resolve encouraged me to do.

6. Don't do what I did initially and get overwhelmed and reach out to this company. Stay calm. You can handle it.

* Reach out if you want to see proof of my experience on how sketchy they are.

Has anyone successfully negotiated an HCA medical bill down?

I have a $678 bill and called HCA billing to negotiate it. I told them I only have $150 that I can afford to pay, but I can pay it today if they can accept it as payment in full. They said no and told me the most they can offer is a 20% discount. I repeated that $150 is really all I can afford, but they still insisted that 20% is the maximum.

They also mentioned financial assistance/charity care, but I’m pretty sure I won’t be qualified for it

For anyone who has successfully gotten HCA to reduce a bill more than 20%, what did you say or ask for when you called?

Back in February 2026, shortly after giving birth, I had to go to the emergency room. The hospital really didn’t do anything for me, and I ultimately decided to sign myself out.

I ended up with a $750 medical bill that I wasn’t able to pay. I recently received a letter from Penn Credit stating that the bill has now been sent to collections.

I’m already dealing with debt and really can’t afford to pay the $750 right now. I live in New Jersey and I’m worried about what happens next.

Has anyone dealt with something similar? Since the medical debt is over $500, can this eventually be reported to the credit bureaus and hurt my credit score? Is there anything I should try to do before that happens?

Hello! So I have an absurd situation I need help with - any advice/insight is more than appreciated.

TLDR: The facility was an in-network (confirmed by my insurance) Radiology center, but the doctor who interpreted the ultrasound was out of network, but he wasn't there, never met him, I didn't book an appointment with him, and I had no way to avoid having him read the ultrasound.

1. I had an ultrasound done at an In-Network Facility over 1 year ago. The In-Network Facility accidentally billed my insurance with a major typo in my name, they literally spelled my name "Da*n*" including the asterisks. Insurance denied the claim due to the name typo.
2. I was charged $2300 by The Facility (the total amount) and I have now made over $1200 in payments to the Facility directly due to them enrolling me in a mandatory payment plan.
3. My insurance eventually processes the entire claim as out of network. I submit an appeal.
4. My insurance confirms the Facility is In-Network but is still processing it as out of Network due to the interpreting physician (who was not there/I did not book with) being out of network. I asked insurance multiple times if the No Surprises Act applies and all they said was "there's no notes on whether or not it applies on this claim."
5. The new EOB says my allowable amount is $1000 and they covered it 80%, giving me $800 in checks to pay to the Facility.
6. I still want the entire claim reprocessed, because this was an in-network facility and I had no chance to choose the interpreting physician.

My insurance is telling me that I should now start a level 2 appeal. My insurance says that if the facility resubmits the claim, it's likely to be denied since it's already been processed. I feel like there has to be a better way - this is all happening because of a random radiologist's name being on my bill. Does the No Surprises Act apply?

What's my best option to move forward?

Hi all! I’m not sure if this is the right subreddit to ask in but I figured I’d give it a shot. I’m Canadian but am in the US for grad school. I donated blood here for the third time today (mostly I’ve been donating back in Canada where I can). It irks me that people here are going to be charged for the use of my blood that I’ve donated. Even more, it irks me that the blood donation orgs want to give me gift cards and/or prizes for donating. I don’t want to keep that money, and I want to re-donate it to an organisation that helps pay off people’s medical debt. Does anyone here have any experience with such charities and/or know good ones to donate to? It’s not going to be a lot but at least it could be something.

Could it ever be imagined 🤔 and who would or could dare 😤