3/06/2005
Advice from Nashville's leading Financial Aid Advisor Dave Ramsey
Dave Says
By Dave Ramsey
Author of:
Financial Peace and
The Total Money Makeover
"Nursing home billing grandma instead of insurance?"
Dear Dave,
My grandmother was in a nursing home for around eight months. For a portion of
her time there, the nursing home is refusing to bill her insurance providers –
she has two plus Medicare. Instead, they are billing her. I also suspect they
are padding the bills. They charged her for a private room, which she never had,
and this is the portion they are not turning in to the insurance companies.
After several conversations with them, I believe they are going to try to get
the money from her and then submit the charges to insurance after that and get
paid again.
On top of all of this, they have taken her dentures and her glasses on several
occasions – for instance, when she mistakenly left her glasses on her food tray
– and not returned them. I don’t know if they got thrown away or what. However,
she’s had to pay her co-pay to replace these things and the nursing home refuses
to help out with that cost, even though they took this stuff. They say it’s not
their responsibility to take care of everyone’s dentures that get lost in the
nursing home.
Jeff in Flint, MI
Dear Jeff,
I wonder why the nursing home is refusing to bill the insurance companies? With
regard to the two insurance providers, you can just file the bills with those
two companies to have them paid. Medicare, however, does have to be billed
directly and the nursing home will have to do that.
I would recommend you send those bills to your grandmother’s insurance companies
and that she not pay the nursing home any money at all. Work with the insurance
companies. If you don’t get fair treatment on this from the nursing home, I
think you ought to consider hiring an attorney. You’ve come to the conclusion
that these people don’t have any integrity and it’s very difficult to work out a
problem with people who are lying to you.
With regard to the lost items, the nursing home is correct that they can’t be
held responsible for everything lost there. They are caring for a lot of people,
many who lose things like that due to their mental state. If you can prove the
nursing home was being negligent, that’s another matter.
In the end, your grandmother may end up having to get legal representation to
protect her against these people. No matter what you do, though, don’t let her
pay them any money directly.
-Dave
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