A Visit to a Canadian Hospital (finis)

The Hospital Bill and Resolution

About two months later, a bill arrived from the Ottawa hospital with a past due amount of $2,000. Richard gave the hospital a telephone call and spoke with the accounts receivable department. A nice lady there explained that the health maintenance organization (HMO) had refused to pay the bill the hospital had submitted to them. At Richard's request, she faxed a copy of the rejection letter from the HMO to him. Richard then telephoned his HMO to find out why the bill had been refused, the letter being unclear.

After a bit of digging into the billing history, an HMO representative told Richard that the bill had been refused because it wasn't itemized. The HMO required an itemized bill to determine if any of the charges would not be covered. Richard telephoned the Ottawa hospital accounts receivable department to request an itemized bill be sent to the HMO representative who would then expedite payment. The lady explained that the hospital did not itemize its bills. The charge was a flat $2,000 since Richard was not a Canadian citizen. Whether Richard had had brain surgery or a couple bags of saline, the charge was $2,000.

Richard then telephoned the HMO representative and explained why the bill wasn't itemized. At that point the HMO representative realized that not only was the hospital and attending physician out of network, they were out of country as well. The HMO representative said she would take care of the bill.

Three weeks later, Richard telephoned the Ottawa hospital accounts receivable just to check on the bill. The lady there said, yes the bill was paid and everything was fine with the exception of one final issue currently being addressed. The US HMO had paid the $2,000 but with US dollars rather than Canadian dollars. With the exchange rate at around 75 United States cents for a Canadian dollar, the HMO had overpaid significantly and the hospital was processing a chargeback for the difference.