My reader knows that I lament the state of American healthcare on this blog often. I recently had an episode that neatly encapsulates so many of the problems. Don't mind if I share . . .
Let me preface this by saying that I have a 3-year-old daughter, and I am still trying to clear my debt owed for her birth in January 2015.
Anyway, a few months ago, my wife received a phone call from a collections agency insisting that we owed $120 for a doctor's visit. My wife insisted otherwise and explained the basis for her opinion, to no avail. Collectors continued calling, and we eventually sent the check for $120, only to have it promptly sent back to us because we didn't owe it.
Just think about this for a moment: my family was threatened with financial detriment, repeatedly, over a bill that we didn't owe. How many "man hours" went into making this determination? How much labor was spent by the doctor and health insurance company to figure this out? Is it any wonder that American healthcare is monumentally inefficient?
How much of my wife's time was spent (without compensation) trying to explain to these people how their own books were supposed to work? Is it any wonder that people have lost faith in American healthcare? Not because of the actual healthcare workers, mind you, but because of the business practices of the organizations that employ them.
It is episodes such as this that frustrate me to no end. Generally, when I purchase a good or service, I know what I'm purchasing and how much it will cost. Contrarily, with healthcare, I just get a bill and am expected to pay it, no questions asked.
To anyone who defends this current system, I say to you: "You owe me $120; pay up or else!"
I keep getting a bill from my podiatrist for $10. They say it's part of my copay that didn't get paid. I always pay the whole $40 Every time I see a doctor. They wouldn't listen to me so now I just chuckle when I get a bill from his office. I'm sure they have spent more than $10 on postage sending them out.
ReplyDeleteI whole heartedly agree with you Tabletop Joe ! I could give you several stories similar to the one you’ve mentioned ! The first that comes to mind is the recent one . Husband goes in for an annual physical with annual labs . These are both supposed to be free annually as stated in our benefits brochure ,if one visits a Tier One physician , of which his doctor is . Bill comes in the mail , unpaid by health insurance , we owe $189 . OK . I call insurance company , they say , doctor did not code labs or visit as annual physical . Health insurance representative tells me to call them and have them code it correctly , OK . I call doctors office , was told by person in office they “ can’t change codes , it’s against the law “. OK . I say put me through to the office manager . I get her voice mail , leave a message including that my health insurance says to have them code it correctly and re bill it . Left my phone number , no one calls for a week . OK . I call again , leave similar message . No one calls for another two weeks . I contemplate a letter . I call once again and office manger picks up . I explain . She says “ well I don’t know , maybe your insurance doesn’t cover physicals any anymore” ( eye roll ) I say , I have may benefits here , and I called to verify that an annual physical and the labs are covered 100% . And further more the insurance company said that your office coded it as a sick visit . So she then says “ I guess I’m going to have to call the billing office . I said , you need to speak to the doctor because he is selling himself as a Teir One provider of this insurance and he needs to know how to correctly bill , or he will loose customers, my husband for one ! As a matter of fact I went through this exact same problem with this billing last year when he had his physical . She then calls me back and says “ well I think maybe either your husband mentioned a medical problem he has and the doctor talked to him about it and that’s why the doctor billed it as a sick visit or our lab maybe is not your teir one lab anymore . So I say ok I’ll verify the lab with the insurance . The insurance says the lab IS teir one ! My husband says he mentioned he wasn’t sleeping well . OK , I call back talk to the billing . I say tell her the same things I’ve been saying ( eyeroll ) and also say “ aside from your ,in my opinion ,possible unethical billing practices of switching an annual physical to a sick visit if a patient mentions an ache or pain , thereby taking our benefit of an annual physical for free away, being wrong and underhanded .... those labs are preventative labs taken at an annual physical and they should be paid for in full per our insurance agreement with your doctor !” So , she says she’ll have to contact the doctor before she can change the codes . OK .
ReplyDeleteShe calls back in two days , says the doctor says she can change the codes and re bill for annual physical and preventative labs ! Holy shit , how stupid are people , and lazy. They will do anything to keep from doing their jobs !
Oh , I know you’re a lawyer and one of the things that was said to me by one of the girls before I got to the last one with half a brain in her head was : “ why are the insurance people telling you that we coded it wrong ? That’s against the law “.... wait what ? An insurance company can not pay a claim and then when I call them they can refuse to tell me why ? Hmmmmm
How dumb are people ?
I’m pretty persistent , sometime I’ll twll your aboit the billing beef with the eye doctor I had . Went on for months , ended in the doctor calling me up and APOLOGIZING for their stupidity. Lol .
I wonder how many people unnecessarily pay these erroneous bills ?!?!