Hi all, appreciate any advice you can give about my situation below. Thanks in advance!
I recently moved far away from my original MPN specialist and scheduled an appointment with a new MPN specialist at Johns Hopkins. I have my first appointment at the end of October. However, I already have a bill for $400!
According to Hopkins billing, Hopkins pathology did a second opinion consult on my bone marrow biopsy specimens. I was never informed about this. I talked to my original MPN specialist - who I haven't seen in over 1.5 years - and they did not ask for this consult.
When I looked at the Hopkins pathology test result, it says the new MPN specialist ordered this. I would not have agreed to this testing if I had been informed about it.
According to my original MPN specialist, they should not have done any sort of testing without me actually meeting with the doctor and giving my permission.
Wondering if you all can help with some questions:
- Has anyone else had something like this happen at Hopkins or another facility? What did you do?
-Is this common practice for when you change care to another facility? As in the new MPN specialist will test/reevaluate your specimens before you have an appointment with them?
- Any tips on how to get this bill removed from my account? I'm currently battling billing about this charge, and it's not easy.
As a side note, the entire process to become a new patient at Johns Hopkins has been disorganized and an overall headache. I'm going to be finding someone else at another organization to serve as my doctor.
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Lucy2022
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I've been to two different MPN specialists at Hopkins and neither charged for anything before I saw them, and I had a previous BMB in my chart. I suggest you keep complaining to billing that it was an unauthorized charge and take it up with the doctor when you get there.
Also, I suggest you make sure you know where to park and how to get to your doctor when you get there--that place is a maze!
Talk to the hospital's patient advocate. If that doesn't work, contact the medical director's office. Billing probably doesn't have the authority to remove the charge.
I was scratched by a wild kitten once and needed rabies shots. The ER doc said my GP could do them. Since I didn't have a GP at the time, the ER doc said they could do them in an area next to the ER. Much to my surprise I received a big bill for the shots. I didn't have insurance. I complained that I was never told about the extra cost beforehand. My complaint made it to the hospital's medical director's office who reduced the bill significantly.
In my experience it’s fairly standard for a new MPN specialist to do that. They want to check to see if they agree with your diagnoses and otherwise understand your situation.
Having said that, Johns Hopkins is definitely not the place it used to be just 5 years ago. Used to be a MPN specialist named Jerry Spivack who was very caring and willing to answer as many questions as you might have. New people aren’t quite accessible as he was but still provide good care in my experience. It’s fine if you have no issues and your tests are stable and you feel good.
The billing operation there is a total mess. You have to stay on them and be aware of every detail including what your insurance says about the charges.
One warning about patient services. If you complain to them about billing that’s probably ok - medically. If you complain about a doctor there’s a chance your docs and others in that office will not be very kind to you and you’ll have to find a whole new practice.
Sorry to hear about the negative experience at Johns Hopkins. I see several specialists there. My care experience has been excellent. The only glitch I encountered is when my last MPN Specialist left and I was reassigned without being consulted about the new provider. I objected and arranged to be assigned to a provider of my choice.
The hospital has reorganized the hematology department. There is no longer a MPN Clinic as such. Their structure is now a "Hematological Malignancies" division. The hematologists in this branch of the hospital may or may not be a MPN Specialist. You would need to check the qualifications of the specific provider to determine whether they have the expertise you need. If you came to Johns Hopkins from outside the system, you likely went through a "concierge" who processed your case. These administrative staff would assign you into an open slot with someone in the correct department but I would not expect them to find a MPN Specialist. You would need to specify the name of the provider you wished to see. Suggest you check the background of the provider you are assigned to see to determine whether they have the needed expertise.
Regarding the unexpected bill, this is unacceptable at several levels. While it is understandable that a new provider would want their own pathologist to review the BMB if possible, this should not be done without your consent. In fact, the original provider who had the sample could not release a sample without your consent. That would be a violation of HIPAA and other confidentiality regulations. Suggest you read the fine print of the releases you signed. You may find some details in the documents that you were not aware of.
It sounds like you are being billed the full amount for the pathology second opinion. A $400 bill does not sound like an insurance copay for this service. Suggest you check the bill to see whether insurance was billed. I sometimes get a bill for a full amount for a service when it is hung up in insurance processing. Note that one insurance code number incorrect means the bill will not be paid. This happens on a regular basis. It is worth checking on that before taking further action.
Your billing complaint needs to be documented. You can Contact Billing Customer Service in writing at pfscs@jhmi.edu .
If you have a patient complaint or question about Johns Hopkins Hospital, you can also contact the Johns Hopkins Health System legal department at 410-955-2273. They can give the contact information to file your complaint in writing.
I would use all three avenues to move your complaint forward in the system. It is worth doing. Even the best facilities make mistakes. Problems in healthcare systems will get ignored if no one complains when there are issues.
Thanks so much for your response and for sharing the resources. This is incredibly helpful and has helped me figure out a path forward.
I'm glad you've had a different experience with Johns Hopkins. As a new patient, it's been one issue after another. And yes, I had to really stand up for myself to make an appointment with a specific MPN specialist (Dr. Jain) I sought out as opposed to who hematology wanted to assign me. It's unfortunate that potentially good doctors are in these messy systems!
Dr Jain is who I see. She is a great hematologist, with Ruben Mesa as a mentor. She is very patient-centered in her perspective. I hope you het the issues with Johns Hopkins worked out so you can see her.
Hi, when I was referred to Cleveland Clinic for a second opinion my slides were also sent ahead of my visit to the MPN Specialist and he also had them read for a second opinion on the pathology report by a staff oncologist.
I guess I was lucky in that my Medicare and Medicare supplement completely covered the charges, I think they were also about 400.00.
There may be a law that says the hospital has to inform you if they use outside providers for tests or other consults that may not accept your insurance, I am not sure but have heard something along that line. You might ask the billing department at your local hospital how they handle such situations.
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