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Refusing to sign or altering hospital billing admission forms?

Bogleheads • View forum - Personal Consumer Issues -
This is a broad topic but I'm wondering what patients ("consumers") can legally and realistically do (these are two different things) if they enter a hospital or other provider, especially under an emergency circumstances, in order to not get financially destroyed by many of the gotchas in the system such as balanced billing and out of network exploits that are becoming ever more common.

I've researched this topic and haven't found any comprehensive answers; everything I've found is about fighting bills and "abuses" after the damage is done, when the provider has an open-ended contract you signed, to charge basically whatever they want, especially in an out of network situation.

If one has scheduled work it should be possible (I think?) to get all the billing information approved in advanced on paper, whether via an in-network rate or a cash upfront rate.

Two strategies that come to mind and again this would be typically in an emergency type of circumstance where one has to go out of network, such as when travelling:

- Refuse to sign any contract or admission form at this time, with the excuse that you must have your attorney first review it.

- Modify or cross out billing sections with a phrase such as: "I will only pay Medicare rate for any billed service." (Or instead of Medicare rate, 2x Medicare rate or you agree to pay no more than the in network rate for the largest commercial insurance carrier in your region.)

I'm looking for feedback from anyone who'd have insight on this issue - people who work in medical billing, lawyers, doctors, etc. What are the likely consequences of these strategies? Are there other better strategies to accomplish the main goal?

These videos are motivating me to make this post:

Lawmaker steps in after extreme hospital billing investigation

Family fights $474K hospital bill

Date: Jan 25, 2017   

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