“Stand on the shoulders of giants.” - Virgie Bright Ellington
Virgie Bright Ellington, MD, is an internal medicine physician and medical billing expert. A dedicated patient advocate, she earned her degree at the University of Michigan Medical School and trained at the Cambridge Hospital of Harvard Medical School. After practicing more than 20 years in primary care and psychiatric settings and as a health insurance executive, Dr. Virgie helps patients maximize billing accuracy and avoid financial devastation. Learn more at www.crushmedicaldebt.com.
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[00:00:00] Jeffrey Feldberg: Welcome to the Deep Wealth Podcast where you
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I'm your host Jeffrey Feldberg.
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When it comes to your business
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Of the quote unquote
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100% of the deal value in the buyer's pocket and don't even know it.
I should know. I said
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Are you thinking about an exit
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same ones to sell it.
After all, how can you master
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At the end of this episode,
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Dr. Virgie Bright Ellington is
an internal medicine physician and a medical billing expert. A dedicated
patient advocate she earned her degree at the University of Michigan Medical
School and trained at the Cambridge Hospital of Harvard Medical School.
After practicing more
than 20 years in primary care and psychiatric settings. And as a health
insurance executive. Dr. Virgie helps patients maximize billing accuracy and
avoid financial devastation.
Welcome to the Deep Wealth
podcast, and the doctor is in the house. Yes, we have a doctor in the house.
You heard the official intro, but we not only have a doctor, we have the host
of a radio show, an author, a thought leader, and someone who's just really
making a difference out there. And you may be wondering, Jeffrey, what the heck
is going on with a Deep Wealth podcast?
Why are you having a doctor on
the show? And as we like to say, that whole podcast is based around extracting
your personal and business Deep Wealth and what we're gonna be talking about
today. You know, my personal thesis is your outer world is a reflection of your
inner world. And on this topic, we're gonna do a deep dive on.
If you're worried, if you're
stressed you know what? You're not showing up for your best game in the
business. So, let's talk about that so it's gonna be smooth sailing. Virgie,
welcome to the Deep Wealth Podcast. It really is an honor to have you with us.
And you know what? There's always a story behind the story. Virgie, what's your
story? What got you to where you are today?
[00:02:59] Dr. Virgie Bright Ellington: Well First, Jeffrey, thank you so, much for
having me. The work that you're doing is absolutely, you know, is
paradigm-changing, and thank you. And thank you for having me. But I got here
through really, I would say a long history of just doing what I do. So, I was a
board-certified practicing internal medicine physician for years, and then I
was a healthcare insurance executive, US private healthcare company executive.
And I thought that I knew
everything about the US healthcare system from like all perspectives, I thought
I had a 360-degree view. But it wasn't until I became a patient that I really
figured out, oh my gosh, the US for-profit healthcare system is really gouging,
frankly, the American public, and it's because the US is the only
industrialized country where you have to have medical, financial literacy.
The US is the only
industrialized country where this is an issue. So, I was a patient, and my
hospital roommate had to get hospitalized. And my hospital roommate was sharing
a story about how she, This was her second actually admission in the past year,
and she was really sharing with me that she was really worried because the last
time she was here, the year prior, on the day of discharge, one of the hospital
administrators came into her room and said, Before you can leave, you have to
sign this form saying that you will agree to pay whatever your insurance
doesn't pay for this visit for this hospital stay. Jeffrey I will be completely
honest that certain dropped I saw red, I was enraged because I knew, number
one, she had been strict and intimidated and frankly bullied into signing
something that's going to put her and her family in debt for the rest of their
lives. wasn't working outside the home. Her husband worked for a 24-hour diner,
so, I knew very modest income, and I was just so, outraged. And I thought you
know what, Virgie, don't get angry. Don't get mad. Get to getting do something.
And that's how Crush Medical Debt was born.
[00:05:27] Jeffrey Feldberg: Wow. So, the doctor becomes a patient. And as a
quick aside, not just any doctor, I know you studied at the University of
Michigan at the medical school, and then you trained at some school. I don't
know if other people would've heard of it, something called Harvard Medical
School. I don't know if that rings a bell with other people, but really you're
out there with the best of the best doing your thing, then you become a patient
and you saw firsthand.
It sounds like that was a game
changer for you in terms of what you saw and what you experience.
[00:05:53] Virgie Bright Ellington: Yeah, so I knew that. Look, okay. It's kind of
theoretical. America's number one cause of debt and stress and bankruptcy is
medical bills. But I thought that's because it's a for-profit system and not
everyone has insurance. But that's not the whole story, Jeffrey. I found out
it's because even with insurance, half of the people that, again, the number
one cause of debt and bankruptcy, the United States have insurance and they
think it's quote-unquote good insurance so in the United States, the for-profit
system does not protect you from losing your life savings and your life's work
to just one accident or a serious illness. And I like to say, most Americans
are just one injury per accident or a serious illness away from a lifetime of
debt or worse.
[00:06:53] Jeffrey Feldberg: Which is nuts. And you know, as you're talking
Virgie, I'm reminiscing about a time we were in our Florida home, and my
daughter, she cut her toe. It was just a bizarre accident. It was a
three-four-hour visit at the hospital. It was essentially a few stitches, but
when it came time for the bill, and thankfully we had insurance, it was
thousands of dollars, and so you can imagine if it's just something as simple
as a few stitches and the hospital ran all kinds of tests, we won't get into
that. But it can just be debilitating. Why don't we start at the beginning of,
unfortunately, this sad story that so many of us face when it comes to health?
Something unexpected happens.
We're in the hospital, even though we may have insurance, we find it doesn't
cover certain things. How does this start for most people? That ultimately gets
'em into such horrific, financial issues.
[00:07:40] Virgie Bright Ellington: So, just basic numbers that many of us have
heard, but they just like gloss over our head. Unless it's happening to us. We
don't really have a real picture of what's really happening. We've heard the
statistics that it used to be $500. Now it's $400, that the average American
does not have four or $500 to be able to come up with the cash to pay for an
emergency. Now, let's say that you are in a car accident. Let's say that your
appendix needs to come out. You need to have an emergency hernia surgery. Even
if you have awesome insurance, and I'm using we're doing audio so you can't see
me, but I have my fingers in quotations.
Great insurance, quote-unquote.
If your deductible is, which is average, a thousand dollars, $1,500, and that's
in the low end, and or you have co-insurance, then that's a thing where you're
responsible for a portion of the total bill.
If the deductible, let's say
you don't have co-insurance, if the deductible alone is $1,500, you're already
You're done for the average
American, and the clock starts every year, January one, every year you've gotta
meet that deductible. Basically, we're uninsured. Most Americans with insurance
are essentially uninsured. Some, unfortunately, there are stories of
deductibles that are unheard of $7,500, and some, I've heard of some now that
are $10,000 so effectively, insured Americans are uninsured so that's how we
[00:09:14] Jeffrey Feldberg: And you know what's amazing with your book,
firstly, and we'll have this in the show notes, Crush Medical Debt. I mean,
talk about a compelling title. You take what's otherwise a complex area and not
to confuse simple with simplicity. You really help to break it down and to make
it easy to understand. And when I was going through the book, what was
surprising to me because I never would've thought just a layperson looking in.
There's all kinds of, In part,
when you talk about this, there's all kinds of mistakes on the medical bills to
begin with. One thing that we have these high deductibles that can put
financial strain on us, but then maybe we're paying for some things that we
shouldn't be. so can you talk to us about, okay, how could it possibly be that
the hospital is making mistakes? And then since they are making mistakes, what
are we looking for? What would be a telltale sign?
[00:10:02] Virgie Bright Ellington: That's a great question, Jeffrey. And you said,
how can the hospital make these mistakes? It's not the providers usually that's
making the mistakes. It is the administrators, the billing department, the
finance department. The providers, the docs, the caretakers that provide the
care, they're totally, weer I'm gonna say, I'm a physician.
I was totally disconnected, had
no idea what was going on in the patient accounts department, in the billing
department, in the financial end of things, had zero idea. It's disconnected.
The mistakes, and this is what I'm teaching people longer. I do this work.
They're actually not mistakes, 80 to 90% of every medical bill generated in the
United States have mistakes.
And Jeffrey, if you can guess,
it's not gonna be in the interest of the patient. It's gonna be the interest of
the provider and or the insurance company if you have insurance. I used to say
they're mistakes, but I don't say it a lot anymore because it's by the process.
It is the US healthcare system process.
Debt is not a side effect. It
is part of the system that's how we get here.
[00:11:12] Jeffrey Feldberg: That's scary. As business owners, imagine if we
send every invoice to a client that out of 10 invoices, nine of them are not
accurate. I mean, we'd be put out of business. So, how is it that the hospitals
are getting away with this? The billing, the administration? How do they do
[00:11:30] Virgie Bright Ellington: Because the average American, I wouldn't even say
the average American. Again, I was part of the system, I worked in the system.
I didn't know 99.9% of the American public population does not know that this
is happening, 99.9% of us are not medically financially literate and in the
United States without medical financial literacy, you have no financial
stability. That's how it happens.
There are many examples
and the example I give often is my example, so this visit where I was really
angry about what I realized was being done to people. From that same visit, six
months later, that hospital stay unexpected, hospital stay.
About six months later, I get a
bill from them and the same institution that tricked my hospital roommate and
that's how crush medical debt was born. The bill, I'm not gonna call it a bill
because it was a statement. Is not a real bill, and I talk about that a lot. A
real bill is something that has what's called C P T codes, which is what
barcodes are to products in a store. Every product has one. In the United
States, every medical service has a barcode, and that's called a C P T code, so
what I call them now, these statements that you get in the mail, unless it has
a C P T code on it, and that's the type of bill you get, unfortunately, only in
my experience, about once every out of 10 times, eight to nine times, you don't
get a real bill, meaning it doesn't have C P T codes on it.
This particular state, I call
them statements. Or I call them like wishlist from the hospital, from the
facility because they're wishing and hoping and praying that you'll fall for
it. That number in the upper, usually right-hand corner saying patient
responsibility or patient owes. So I got a bill, or again, a statement, and an
upper right-hand corner it said basically $90,000, you owe 89, something like
[00:13:27] Jeffrey Feldberg: That's crazy.
[00:13:28] Virgie Bright Ellington: And so, I looked at it and of course, I went down
the statement, didn't see anything on the top that said C PT codes. It just
said brief description, three lines. Jeffrey, I think one line said, OR
services, I had to have emergency surgery, so, OR services, $361,000
[00:13:48] Jeffrey Feldberg: Wow.
[00:13:48] Virgie Bright Ellington: I can't even get it out. I often say I laugh,
so,, I don't cry. It's just crazy. The next line said, medical pathology so,
any tissue they took during their surgery. They sent it to the pathologist to
make sure it's not, there's no cancer hiding there or something. And they said
that line item said $44.
And what it was interesting,
that line item next to it had a C P T code, so it looked official, looked like
it could be a real service. And then the third line said patient insurance,
slash adjustments. Something like $261,000 and then the last line was, okay,
almost basically $89,000. I just rounded off to 90,000 to keep the math simple
and it said, There you go.
You owe it. And here's a number
to call. If you have any questions, so I was cracking up. I have to tell you, I
was laughing so, hard, and I looked at this and I remember it was a weekday, it
was the middle of the day, and I didn't have anybody. I knew my husband was
I shouldn't bother him. But I
can bother my best friend at work if she if I can con into picking up the phone
in the middle of a work day. I'm good. So, she picks up the phone and I said,
Look, I just had to get this off my chest. And I told her the story that I've
gotten this bill that is clearly a balanced bill because my insurance is in
network with the hospital with this provider. Now in-network means that they
have contracted with they the provider in this case, the hospital.
The hospital system has agreed
to accept whatever the insurance company that they contract with to accept
whatever they pay for their services as payment in full, not including of
course if your plan includes deductible and co-insurance, that kind of thing,
or co-pay, but anything other than that is payment in full.
Just to keep the math simple, I
say, okay, let's say the facility charges or the provider charges a hundred
dollars for the particular medical service, but the insurance that they've
contracted with and agreed to accept is payment in full only pays $10 for that
service. Balance billing is coming after the patient for the balance, in this
case, $90. That's a breach of contract. Most Americans don't know this. Every
facility knows that most 99, again, I'm not exaggerating, 99.9% of us, even
those of us that were in the business thinking we have a 360-degree view, we
don't know this so I tell her this and I explain to her that this provider's in
network and what balance billing is they're trying to balance bill me for
$90,000 and I'm cracking up.
And she says you know what,
Virgie, you're the only person I know who's laughing when everybody else would
be curled up in a fetal position crying.
And that's my story. That's the
biggest story I give as an example of how the system tricks you into believing
that you owe money, that you totally don't.
And if you don't know any
better, that's your kids' college fund. That's your home down payment. If you
want a home for your family, that could be your life savings because you
believe that you owe it. That could be the starter fund for your business. Your
dreams to being able to leave behind the nine-to-five and start your
entrepreneurial passion and your gift to the world that's all gone because
you're tricked into paying something you totally don't owe.
[00:17:21] Jeffrey Feldberg: Virgie. Not to oversimplify this from what I'm
hearing, let's use that hundred dollars example that you're giving. And the
in-network insurance said, Okay, we're gonna pay $10 of that. Is that where it
really should have stopped? And the hospital is saying this is all the
insurance companies going to pay and that's it.
We're not going to get anymore.
Should that be the end of the story?
[00:17:40] Virgie Bright Ellington: You got it. That's it, Jeffrey. That's it.
[00:17:42] Jeffrey Feldberg: Instead, they're saying, Okay, we can add
whatever numbers we want to this, make it look official in a fake invoice, not
even an invoice.
[00:17:49] Virgie Bright Ellington: It's not a real bill. They say this is your bill.
They'll tell you it's your bill. They'll have bill all over it. This is your
bill. Call us if you have problems paying your bill. So just outta curiosity,
again, just for my entertainment more, I just wanted to see, because at this
point I was writing the book and I was like, they really don't know that
they're talking to the author of what your doctor wants you to know to crush
So I called them to see
what they have to say for themselves and I said, look, I have this statement. I
called it a bill. I got this bill and it says that my insurance paid this, but
I have a balance of $90,000. I said, can you explain to me like what is this?
And the response was, and this is how they're trained, so you have to be nice
them because they don't know any better.
This is the way they're
trained. The folks on the front lines the front desk representatives, customer
service, they said well, you're going to have to talk to your insurance company
about that, we can't answer any questions about insurance. We can't talk to you
about what your insurance paid and how much they paid and why, but you know,
$90,000, that's a lot of money.
You can't be expected to pay
that all at once. Can I transfer you to my team member who can help you make a
[00:19:07] Jeffrey Feldberg: Wow. Wow. Talk about assuming the sale. I've been
in marketing and sales my entire life. What a wonderful close that is. So
firstly, they scare you because as soon as you hear you have to talk to your
insurance company I know what's going through my mind. Oh gosh. There goes
weeks and hours of getting nowhere and bureaucracy and all the insurance gonna
say, Hey, this is what your plan paid out.
What do you want us to do? This
is all that we're on the hook to pay and the rest is up to you. And so what a
depressing story when you walk outta that conversation to, Okay you're in the
wrong so let us figure out a payment plan to have you begin to work this off.
Wow, I can only imagine I'm trying not to be cynical here.
I'm usually glass is half full
kind of guy here, but the hospitals, they, must have some really powerful
contacts and advocates on the Hill who are allowing this fraudulent kind of
activity to happen. And it's quote-unquote legal. This is just insane.
[00:20:01] Virgie Bright Ellington: Yes. The hospitals know, The providers know the
medical facilities and chains know that it's immoral, it's unethical, but it's
not illegal. So, yes. And I do wanna point out something, in their defense, the
insurance company is a for-profit, US healthcare insurance companies, And I say
in their defense because God knows they need one, but in their defense,
[00:20:26] Jeffrey Feldberg: Yeah.
[00:20:27] Virgie Bright Ellington: You'd be surprised if you have insurance, Call
Actually, they don't want their
members to be balance billed, but why don't they go after providers for balance
billing? It's not their problem and it doesn't affect their bottom line. That's
why they're not worried about it. But if you call them and say, look, I got
this bill and they said you guys paid this.
Can you tell me how much you
actually paid and what you covered and why, and that kind of thing? They'll go
over it with you. So, don't be intimidated in thinking, oh my gosh, they're
trying to scare me away to talk to my insurance company. You know what? Talk to
your insurance company because they'll say wait a minute, we got that.
This is, I wasn't gonna bore
you with the details, but I actually called my insurance company just again to
get a full picture of the story because I was so, entertained. I thought this
is too good to be true. This is like the type cover story for my book, for the
book to help people. And so, I told them the whole story. The hospital. The
hospital financial department. I wanna separate the providers, the actual
physicians from writing the care from the finance department. The finance
department sent the insurance company the same exact amount that it was trying
to collect from me.
[00:21:34] Jeffrey Feldberg: Oh my goodness. Wow. So, the insurance company's
[00:21:37] Virgie Bright Ellington: They know that it's easier. They providers know
that it's easier to get money from the patients. The American patient who has
zero medical financial literacy they're dealing with the Goliath.
The US healthcare system is run
by the US for-profit, publicly traded health insurance companies, period. They
run the show. How does it go? He has the gold, makes the rules. Well, the
insurance companies, they make the goals. So, they know, the providers know they're
not gonna get it from the insurance companies.
They just, It's easier to get
it from the patient to go after the innocent patient who knows nothing.
[00:22:14] Jeffrey Feldberg: Fair enough. I'm a layperson. I don't understand
the whole medical building system. Wanna go back to that incident where my
daughter needed one or two stitches that's all it was on her big toe. And we're
at the hospital and we're waiting and we're waiting and they keep on coming up
saying we wanna run some blood test and we wanna make sure that her kidneys and
livers are okay, not so much from a billing standpoint. I just got frustrated
and said, Excuse me, this is just a toe.
Let's just stitch it up. I
don't think we need to find out if the blood is tainted or anything else like
that. Let's just get on with this so we can get outta here. Is this a typical
protocol that the doctors are being told by the hospital, Here's a checklist
that you must do, because hearing what you're saying now, in the back of my
mind, I'm saying, Hey, every test that they run, whether it's needed or not,
they run the test now.
And that just begins to, it all
adds up and you get these huge, hundreds of thousands of dollars that they're
coming after you for perhaps for tests that aren't even needed. When you talk
about finding the mistakes in the medical bills, is this a way to even prevent
some of those things from showing up in the first place?
Am I on base with that? Off
base with that? What's your take as both a doctor and now an expert on you
know, crushing medical debt? What's going on here?
[00:23:22] Virgie Bright Ellington: Good looking out, Jeffrey. Great. This is the
issue if it's an emergency room and not urgent care, anything less other than
an emergency room. In an emergency room situation, an emergency room physician
is just going to wanna make sure that there is nothing emergent going on,
something that can hurt you or be a complication of what's going on at that
That can take you out when you
leave the facility in the next day or two, so, that's why they'll recommend
tests. Now, if it's not an emergency, the provider who recommends tests, maybe
you may not need them. And a good question to ask is, what happens if I don't
do this test and or if I don't do this test now, or I don't do the test this
Are the issues what could
happen? I have to say again, providers, were physicians. Physicians are so,
divorced from, we've lost control of the US healthcare system decades and
decades ago. We just wanna make sure you're okay. We wanna fix you, help you
make sure that you're well, fix things, make sure nothing's coming down the
pike that could hurt you.
We don't know about the money.
We're clueless about the money so we are thinking we're ordering a panel of
tests just to make sure nothing is wrong. So if you're in a situation and it's,
and you're not in the emergency room, say, Hey, what would happen if I didn't
have this test and that test?
What will this test show me and
how will this change? You decide to do or what we should do? Will it change our
treatment? Will it change my treatment?
[00:24:57] Jeffrey Feldberg: Terrific question, and I suppose Virgie with that
question, we also have to use some common sense because you're saying, and I
really believe that, and I get it. Doctors don't know what these things cost so
of course, a doctor wants your wellbeing. They just wanna make sure
[00:25:14] Dr. Virgie Bright Ellington: If you don't see C P T code, those letters at the
top, I won't pour you what it stands for. I know people in the who've been in
insurance industry for decades, and they don't remember what C PT stands for.
It's a long, convoluted word three words. And I was talking to a radio host
that says, You know what, Virgie, we should call this.
He said, Dr. Virgie, C P T
should stand for, can't pay this. That's what CPT so, anyway. It's not a real
bill. Great job, Jeffrey. It's not a real bill. If it does not have CPT
somewhere at the top with a list of five digits underneath. Someone was tricked
with thinking, Oh, it said code at the top. It said, Service code, not C P T
code, and it was like seven digits.
I'm like, that's not a real
bill. That's not a C P T code. So, apologies. I had to get that in. Jeffrey so
can you ask the question again?
[00:26:04] Jeffrey Feldberg: I mean, what's wonderful is, and everyone you
know, please get the book because the best time to know about something is when
you don't need it. By the time you need to know this, you're under pressure.
You're probably not in the best state of mind, and then you get this crazy
paperwork that's gonna throw you, for a little bit of a loop there.
But so what I is going on with
is what you've illuminated us with is you wanna see specifically CPT can't pay
this. That's a nickname, that's how we're gonna remember it, to see if it's on
the paperwork in the first place. And then we can speak to our insurance
company just to see, hey, what's really going on here?
What did you do? What didn't
you do? And so, we're doing that. And in each of the steps that you list in
part one when it comes to this paperwork that you're getting, you're telling us
what we can do, what we should be doing, of how to get in best position
possible. But you say something interesting as well because really the billing
departments, again, data 0.01, just me but it sounds like they're really
playing off of social programming.
You owe money and if you don't
pay what you're owed, you're not a good person. You're scandalous, and that is
a heavy weight and so when it comes to this paperwork. You're saying, Hey
Jeffrey, it's not final. You can actually speak to the hospital, speak to the
billing department, and you even in the book talk about negotiating.
Which most people are afraid to
do. Oh my goodness, how embarrassing. I can't ask for anything. So, what are
some strategies when we get this paperwork and it has all these crazy numbers
on it, and we've looked for the C P T, we've spoken to the insurance company,
so we've done all that, and now it's time that we're armed with this knowledge
to go back to the billing department and we're gonna look to really alleviate
this painful, fake problem that they put on us.
How do we do this?
[00:27:44] Dr. Virgie Bright Ellington: That's an important point. At the very top of
this conversation, I want everyone to remember all medical bills are
negotiable, and that is because referring back to what I discussed, we
discussed at the beginning is that the providers make up numbers of what their
services technically costs, allegedly cost to get more.
Because I have to discount it
to try to get business from the A contract with these big insurance companies
to get more patients. How well can they discount it? Look, we're giving you a
90% discount. It was only worth $3. complete blood count was literally worth
$3, I think 3 36 or something.
But they charge $300 for it. A
hundred, $300 for it. These are all made-up numbers, which is why every medical
bill is negotiable, but in the United States culture, we are not comfortable
negotiating in our culture and I tell people, you know what? You're not
negotiating. This is what you're doing and this is why I call it the three
steps to crush medical debt.
Three steps to crush medical
debt. Step one you talked about Jeffrey, is when you, again, I laugh, so I
don't cry. When you get this wishlist from the provider, for the services that
you received. When you get an alleged bill and it's a wish list again, they're
wishing and hoping and praying, you'll fall for it. If it does not have C P T
codes on it, it's not a real bill. It's not an accurate itemized bill. It's not
a real bill so, step one, you're going to call the provider that number that
they want you to call to make a payment plan for the full amount that made up
Wish list fantasy amount. No, you're gonna call that number and ask for a real
Just say, I need something with
[00:29:24] Jeffrey Feldberg: Oh, you're playing the game. I Love that.
[00:29:26] Dr. Virgie Bright Ellington: And their gonna give you pushback. They're gonna
give you pushback. We don't have that information here. We're have that kind of
bill here. Or if they know you have insurance, you're gonna have to call your
insurance company or go your insurance website and find out what your EOB is
Blah. There are all these terms
at you. No, you're gonna say this. If you get pushback, I need something with C
P T codes. Quote as per HIPAA federal law unquote.
[00:29:52] Jeffrey Feldberg: The magic words. You're giving us the magic words
to uncloak this nonsense to put them in their place. I'm not ignorant here. I
know what's going on and you have a legal obligation as per HIPAA. So give me
the CPT codes. So, cough it up.
[00:30:08] Dr. Virgie Bright Ellington: Yeah, send it to me, and if I've had someone told
repeatedly well, no. HIPAA, the patient was saying that they used the term
HIPAA I need something with CPT codes as per HIPAA law. They said the person
still didn't budge. And I would say, what I do is I say I really need something
with C P T codes as per HIPAA federal law.
If I can't get that, I'm gonna
have to file HIPAA violation federal complaints against you, the department,
and hospital. Can you tell me who I should speak to? Who I can speak to?
Actually, that's not what I say. I say never ask a close ended question because
they'll just say, No, just so, get you off the phone.
Who can I speak with who can
help me? An open ended question, right? Who, what, when, how, why? Who can I
speak with? Who can help me with this? Who can help me find, get a bill with C
P T codes as per HIPAA law? And if after that, if they still say we can't help
you, then yeah, you're gonna file a HIPAA violation complaint.
But that's another story. Get
the C P T code. Say, Look, I know you have it, what you might wanna do. If you
have insurance, the insurance company has it. Why would a provider send a C P T
code, a real bill to insurance companies? They don't accept anything. They're
not gonna pay anything that doesn't have a C P T code on it. Why would they
send it to the patient? Why nine out of 10 hospital systems send it to a
patient, something demanding payment that doesn't have a C P T code on it? If
they don't send it, they wouldn't dare send it to the insurance companies.
[00:31:44] Jeffrey Feldberg: And Virgie, would the insurance company if I
called my insurance company, would they give me the c PT codes that they
receive from the hospital?
[00:31:51] Dr. Virgie Bright Ellington: Excellent question, Jeffrey, for clarifying.
Thank you for asking, Cuz that clarifies what they'll give you. It's called an
EOB or an explanation of benefits. And often you'll see that it comes from your
insurance company. People often confuse it with a bill, but insurance companies
don't send you bills and to remind you, they'll say on it, it'll stay someplace
on it like this is not a bill. The EOBs explanation of benefits will have if
you turn it on the back, the pages will have the CPT codes for each service and
what they pay for, or not a percentage of it. Great point. And that's your
first step is to get the C P T codes. If you have insurance.
You had to go to your insurance
company to get the EOB think about filing a and I include this information in
the book and other places, and I'll, if you remind me, I'll include it. This
show, I'll write a note to include it. I've had to file a HIPAA violation
complaint with a Federal Office of Civil Rights.
It's every patient's right who
receives care in the US healthcare system. All right, That's step one. Get the
C P T codes. And then step two, you're gonna take those C P T codes and you're
going to Google them. So what happens? Basically, you're doing like a price
scanner with Google so a barcode and a product.
On a product. When you go to
store, you take it on a price scanner, and up pops like a brief description of
what the product is and the size. It's a 16-ounce size bottle of this
particular brand of water as opposed to eight ounces and the price that
particular provider charges. Same thing with the C PT codes.
In step two, you're going to
find out what plugin. Let's say you got a CPT code 9 9 2 1 3. Type in C P T
code 99213 and up-flow pop a brief description it was a type of outpatient
office visit. Then it takes a little bit more digging. You're gonna find this
is really important. Plug in what Medicare pays for that C P T code for that
Why the federal government,
what they pay for medical services? That is a fair baseline retail rate.
Anything else, the insurance companies pay more than Medicare, which is why the
providers want to work with and get into contracts with insurance companies
because they pay more than medicare often 200, 300% more.
But usually, if you're not
paying Medicare rate, what Medicare pays for that service, each medical
service, you're paying on average 300 to 500% more than what Medicare pays for
it. And it's really not unusual, unfortunately, a thousand to 2000% more.
[00:34:32] Jeffrey Feldberg: Wow. Talk about a business.
[00:34:33] Dr. Virgie Bright Ellington: I went into the wrong business.
[00:34:35] Jeffrey Feldberg: Exactly.
[00:34:36] Dr. Virgie Bright Ellington: We should start our own, you know, private health
insurance companies. When you're gambling, you can't beat the house except for
blackjack, so yeah. The insurance company. They're always gonna win. So you're
gonna take that number.
Let's say that in step
one. I got this wish list that's, that I owed $90,000 for an emergency surgery.
And step two, I've realized, okay, the CPT codes add up to $10,000. Let's just
make the Math simple..
That's what Medicare pays for
each of those so I total up, I have $10,000 now that I owe as per step two.
When I Googled and did a price
scan on those C P T codes for the services, medical services I received, step
three, you're gonna call back the provider, that billing department, that
number that you call to get the C P T codes from, and you're going to say, Hey.
Yeah, I got a bill and in my research, the bill I got was $90,000, but in my
research, what I'm willing and able to pay is $10,000.
Who can I speak with again?
Don't ask. Can I speak with somebody? No. No close-ended questions where they
can say yes or no and lie to you just to get you off the phone and bully you or
whatever intimidate you or block you. Who can I speak with who can help me get
an interest-free payment plan?
Because many of us, when we're
starting out in our business and our lives and trying to start our passion
projects and basically our lives work, we don't have just $10,000 lying around,
or maybe that was our seed fund to start our business so you're going to ask
for an interest free payment plan that you can't afford that fits your budget and
let's say, again, I'm just starting out. I can only squeeze out this is an
emergency. I, am on a really, really tight budget. I can't squeeze more than a
hundred dollars out of my budget to pay for this. And you're gonna say, who can
I speak with who will help me come up with a payment plan for $10,000?
For which I can pay a hundred
dollars a month. Again, they're trained. You're gonna get pushback and you're
gonna be thinking this too. They're going to say if we just accept a hundred
dollars a month, it'll take us forever to get paid. It'll take us years. And
you're thinking the same thing.
They're like, Oh my gosh,
they're never gonna accept this so, Jeffrey. Why would they accept a hundred
dollars a month payment plan on something like $10,000? It'll take 'em 5,7, 10
years easily to pay off. Because they know it's cheaper. You're reaching out to
them. You're not avoiding them. You're not hiding from the bill.
You're being proactive. You're
coming to them so that saves them money from having to chase you down. Where
theoretically, if you don't pay anything at all, they would have to sell it,
eat at all, or sell it for pennies on the dollar to a debt collections company.
This is why they're going to accept it.
So, stand to your ground, step
three, and say, this is what I can afford. This is a payment plan I can make.
Who can I speak with? Who can help me?
[00:37:38] Jeffrey Feldberg: And you know what Virgie, as you talk about this
in Deep, Wealth or Nine Step Roadmap, we always talk about tuning into the
world's favorite radio station for your buyer, for your advisors.
[00:37:48] Virgie Bright Ellington: W I I F M. What's in it for me? The number one.
The only radio station everybody listens to in the world. right?
[00:37:56] Jeffrey Feldberg: And so really what you're saying is, you know,
sometimes our self-talk and talk is outta everything all.
A hundred dollars a month.
We're not gonna take that. But when we tune into their world for starters,
we're not filing a federal complaint, which is a violation. That's. Pretty,
pretty big deal on the legal side, or they're gonna be selling it, as you say,
for pennies on the dollar so, sure, it'll take them eight-plus years to
collect, but you know what?
$10,000, even eight-plus years
interest-free is $10,000 is better off than selling to a collections agency,
maybe it's only hundreds of dollars that they would get, or having to write it
off, which is a loss now for them. Or having all these expensive high price
lawyers, That's another story to defend them with the government, doing all
Really from their perspective,
as negative as it sounds, you're absolutely right. This is the best deal around
and this is the way to go. You know, Virgie, we can keep on going because
there's all these different steps and different parts in the book, but here's a
question for you because we're starting to bump up again sometimes.
You know what, our listeners,
they're smart, they're successful. Can they do this on their own? They
absolutely can. They can get your book. Master it, go through it step by step.
Having said that, there's a cost to everything. We're running the business, we
don't necessarily have the time to, Yes, it's important.
We don't have the time to do
this. We have other things that are gonna be making us more money, moving the
dial on the business and just like in other areas, if I have a legal issue,
I'll go to a lawyer. I'm not gonna defend myself if I'm gonna be buying or
selling a house. You know, I'll get the appropriate advisors, a real estate
agent, a real estate lawyer, do all those kinds of things.
Could I turn to someone like
yourself where I can come to you and say, Hey, here's my issue. Let me know how
this is gonna work financially with you, but if it sounds right, can you just
take this off my plate and see what you can do? Is that something that we can
[00:39:41] Dr. Virgie Bright Ellington: Absolutely. Yes, exactly correct. You can do
that. The reason, however, and I'll talk about how to do that in a second, but
the reason why I want folks to become medically financially literate, just
basic three steps is because it can save you from having to pay the percentage
to the folks who can take care of it for you.
There is a case $80,000 bill,
It's a long story that the mom of twins of couple had twins that were born
premature and the NICU was coming after them for their share of an $80,000 bill
that they frankly knew they didn't owe. It was a mistake. The insurance said
it's not an emergency. So we're not paying for it.
And the provider said well, the
insurance company says it's not an emergency. How is a baby being born
prematurely two babies? It's not to just one being bored prematurely. How's it
not emergency so they were going back and forth and they retired successfully.
I think they were actually both. I think they ran two companies independently,
so they had the resources, the intellectual resources to understand, but they
didn't have the time. And this has been going on for a year, going back and
forth. And they just said, We're gonna pay a company. And there are companies
that will do this medical billing advocate, companies for profit that will do
this for you for a percentage of usually what they save you.
In this case, they saved them
$80,000 wiped off because they didn't owe it in the first place. so,, They paid
the company $8,000. You just have these basic three steps of medical financial
literacy, I may be able to save you a hundred percent. You may be able to save
yourself a hundred percent.
The other thing is we don't,
The reason why I did this and wrote this book and why I'm doing this work,
Jeffrey, is because we don't have time. I started my own company a couple of
times, self-directed IRAs. Instead of spending time, I don't have time to try
to look for VC money. That's a full-time job in itself.
I wrote this book for
people that don't have time either. You don't have the temporal resource, you
don't have the time resources, the intellectual resources, because you're sick,
you're in pain, you're not feeling well. You don't have the financial
resources. so I wrote the book for that reason.
Three Simple Steps To Crush
Medical Debt. Just learn them and you'll be able to figure out, Hey, I can do
this myself. It just will take at most two maybe three phone calls and I'm
done. There are, I do wanna say this, There is an organization that is
nonprofit that will do this. It's called the patientadvocate.org. It's the
Patient Advocacy foundation based in DC. They can't go to court with you. They
can't go that far, but they do a lot of amazing work, and the same people
literally with bills that are tens and hundreds of thousands of dollars.
You can do that. Pursue that
please for free patient advocate. I think it's patientadvocacy.org. And look it
up the patient advocacy foundation. Yes, someone can help you. But again,
Jeffrey, the point is the reason why I do this work that you don't have to, it
does not take time out of your day.
Last thing, think about your hourly
wage. In my case my case, $90,000? Now I'm an expert. I can make these phone
I can do it in three steps, it
took me 10 minutes. What's the hourly wage? What did I save myself? To make the
math simple. Let's say it was a hundred thousand dollars bill, and it takes you
two years to fight it, which is not unusual.
It sounds crazy, but
unfortunately, it's not unusual. Well, let's just say it took your year to,
again, make the math simple. It took your year to fight it. So, that's an
hourly wage. You save. A hundred thousand dollars. You figured out I don't owe
any of this money or only owe part of it.
You save yourself. Eh, that's a
good part-time job. That's the good, you know, side hustle money. That's great
seed money for your business, for your company.
[00:43:16] Jeffrey Feldberg: Absolutely. While you're paying yourself. You
know, over a year.
[00:43:18] Dr. Virgie Bright Ellington: That's your time. It's your hourly wage. I was
paying myself, I think $250 an hour so, I with saving $90,000.
I think that was a, came out to
be an hourly rate of, I think it was like a hundred thousand dollars an hour.
Something crazy like that. My point is, think about your time as you're running
businesses. You're really busy. Get the three steps, learn how to do it, so you
can do it yourself, and that's a great money saver, and you're paying yourself
thousands and potentially thousands and hundreds of thousands of dollars per
[00:43:51] Jeffrey Feldberg: And just to do some crazy math here, let's take
your a hundred thousand dollars example, and let's really bump up the hours. I
don't think this would take 20 hours based on what you're taking, but let's say
it's 20 hours because you read the book. And however long that took, and then
the rest was spent on calls back and forth.
And I know in your book you say
document everything, email, so,, You've done all that. Well, 20 hours into a
hundred thousand dollars, you're paying yourself $5,000 an hour. Is that worth
your while? And you know what? For our listeners, you can always say, Okay, my
last resort is to go to a third party.
We will put, by the way, the
Patient Advocacy Foundation and it's patientadvocate.org. We'll put that in the
show notes, But perhaps the plan is, let me educate myself, let me see what I can
do on my own to deal with this. And if things aren't going the right way. Then
I'll get a third party and off we go. And so, there's so, much power in there.
So, the takeaway for the
listeners. Get the book, read about it now. You never know when this is gonna
come in handy for yourself. A family, a friend, a colleague, someone at work, a
loved one. You can really be a game changer, a lifesaver, literally for them on
the financial side by doing this.
Virgie, we're at the
point now. We're gonna start wrapping up. Unfortunately, we're gonna start
wrapping up this episode. We could just talk on and on in the stories and the
wisdom and the Wealth that you have. But let's do this. Let's do a quick
thought experiment, and I have the privilege of asking every guest on the Deep
I'd like you to think about
that incredible movie Back to the Future. And in that movie, you have this
magical DeLorean car that can take you to any point in time. Virgie, now
imagine it's tomorrow morning and you look outside your window. Not only is the
DeLorean car there, but the door is open and it's waiting for you to hop on in
and you're now gonna go to any point in your life.
It's Virgie, as a young child,
a teenager, whatever the point in time would be. What are you telling your
younger self in terms of life wisdom or, Hey, Virgie, do this, but don't do
that. What does that sound like?
[00:45:44] Dr. Virgie Bright Ellington: I would go back to about the 25-year-old Virgie
who just graduated from medical school and had made my dad and mom and
grandmother, my family's humongously proud. My dad was the only one in his
family that went to college. It took him 13 years to do it, but he it and this
was just a big deal and I would go back and give them a hug each a hug and ask
more questions about the stories of the hardships that they overcame.
Jeffrey, I wrote the book. I
wrote, What Your Doctor Wants You to Know to Crush Medical Debt. Crush Medical
Debt was written at a fourth to ninth-grade reading level because I wanted everyone
to have access to it, and that's because I wrote it with my grandmother, my
father's mother in mind who never made it past sixth grade.
[00:46:43] Jeffrey Feldberg: Wow.
[00:46:44] Dr. Virgie Bright Ellington: So, that's what I would do. I would go back, hug
my grandmother, tell her stories, and tell her this is why I did it. I would go
back, hug my father, and thank him for everything. He was a self-taught
financial whiz investor and taught me everything I know and hug my mom because
she was just, she was pretty, pretty freaking awesome too overcame lot too so,
that's what I would do.
[00:47:08] Jeffrey Feldberg: Right. You know what, you're paying homage to
your family, and you're really, as I like to say, standing on the shoulders of
giants who paved the way
[00:47:17] Dr. Virgie Bright Ellington: Jeffrey, you took my motto. That's my number one
motto. I stand on the shoulders of giants. Yes, sir. Good stuff.
[00:47:25] Jeffrey Feldberg: There you have it. There you have it. And you
know we're gonna have everything in the show notes, including a link to get the
book and to your website, Virgie, if someone would like to reach you online,
where would be the best place?
[00:47:37] Virgie Bright Ellington: You can find us of course, at
crushmedicaldebt.com. You ever reach out to me? That's Dr. Virgie
[00:47:51] Jeffrey Feldberg: It doesn't get any easier and so, for our
listeners. There you have it. That can be a life-changing situation, whether
it's with the book or you're reaching out to Virgie or you're going to the
website. I really encourage you to do that. Be smart. And do the right thing
here. Listen, as we wrap up this episode, a heartfelt thank you for taking part
of your day and sharing your wisdom and your insights of truly what can change
lives and really make a difference.
And on that note, please, as
always, stay healthy and safe.
[00:48:21] Virgie Bright Ellington: Thank you, Jeffrey.
[00:48:22] Sharon S.: The Deep Wealth Experience was definitely a game-changer for me.
[00:48:25] Lyn M.:
This course is one of the best investments you will ever make because you will
get an ROI of a hundred times that. Anybody who doesn't go through it will lose
[00:48:35] Kam H.:
If you don't have time for this program, you'll never have time for a
[00:48:40] Sharon S.: It was the best value of any business course I've ever taken. The
money was very well spent.
[00:48:46] Lyn M.:
Compared to when we first began, today I feel better prepared, but in some
respects, may be less prepared, not because of the course, but because the
course brought to light so many things that I thought we were on top of that we
need to fix.
[00:49:02] Kam H.:
I 100% believe there's never a great time for a business owner to allocate
extra hours into his or her week or day. So it's an investment that will yield
results today. I thought I will reap the benefit of this program in three to
five years down the road. But as soon as I stepped forward into the program, my
mind changed immediately.
[00:49:24] Sharon S.: There was so much value in the experience that the time I invested
paid back so much for the energy that was expended.
[00:49:34] Lyn M.:
The Deep Wealth Experience compared to other programs is the top. What we
learned is very practical. Sometimes you learn stuff that it's great to learn,
but you never use it. The stuff we learned from Deep Wealth Experience, I
believe it's going to benefit us a boatload.
[00:49:48] Kam H.:
I've done an executive MBA. I've worked for billion-dollar companies before.
I've worked for smaller companies before I started my business. I've been
running my business successfully now for getting close to a decade. We're on a
growth trajectory. Reflecting back on the Deep Wealth, I knew less than 10%
what I know now, maybe close to 1% even.
[00:50:06] Sharon S.: Hands down the best program in which I've ever participated. And
we've done a lot of different things over the years. We've been in other
mastermind groups, gone to many seminars, workshops, conferences, retreats,
read books. This was so different. I haven't had an experience that's anything
close to this in all the years that we've been at this.
It's five-star, A-plus.
[00:50:33] Kam H.:
I would highly recommend it to any super busy business owner out there.
Deep Wealth is an accurate name
for it. This program leads to deeper wealth and happier wealth, not just deeper
wealth. I don't think there's a dollar value that could be associated with such
an experience and knowledge that could be applied today and forever.
[00:50:52] Jeffrey Feldberg: Are you leaving millions on the table?
www.deepwealth.com/success to learn more.
If you're not on my email
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please stay healthy and safe.
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Enjoy the interview!