11 of 30: Bills, Bills, Bills

Now that NaBloPoMo is a third of the way over, are you just pushing the PGDN button on your keyboard while in your reader? Go ahead, you can admit it to me. I do it and I’m participating for heaven’s sake.

Working a decade in the healthcare industry has given me such an insight to the internal bullshit, especially the patient billing. EOBs (Explanation of Benefits) are not scary and confusing bits of paper to me. Now that I’m self-pay/private-pay/uninsured/underinsured I can easily understand why so many billed people get annoyed and angry and frustrated.

One of the clinics I use locally gives self-pay patients a 25% discount.  The hospital I had my surgery at in The Metro gave us a 20% discount. However, the hospital, my former employer, had a policy of giving a whopping 5% discount for self-pay patients IF paid within 30 days of the first statement. It would seem that in the past couple of years they’ve been under a bit of a financial strain, what with deciding to build a multi-million dollar expansion during the financial downturn and losing their asses SO when I received a statement from them, I found out that the “generous” cash discount offer had been rescinded.

Of course I’ll be calling to negotiate: 10% discount or I’ll pay $10 a month for the next couple of years. Of course I’ll be nice. I can be nice. Stop looking at me like that. I can too.

I also called another clinic about a balance from Doodicus’s visit to find out what kind of discount they offer. The person who took my call countered me with the most ridiculous response: “We are a self-funded, self-employed clinic.”

“And I’m an unemployed, uninsured guarantor on my son’s account, so what?”

“We don’t offer a cash discount. We don’t get kick-backs from the state.”

“Neither do I.”

Really?? As long as that doctor sees any patient who has insurance, he (“he” as in “his business office manager”) is     negotiating discounts. This rep went on to tell me that they can set up a payment plan but that they have a minimum monthly requirement. I should have replied with, “Well, I have a maximum monthly availability and that trumps your requirement,” but I didn’t. I could tell I was stressing her out, so I told her once I get a statement we can figure out how to proceed. Never mind Doodicus’s visit was nearly two months ago already.

The other notable experience I had as an uninsured patient was just yesterday at yet another follow-up appointment with the surgeon (don’t have to go back for another six weeks!). Just as the nurse calls me back, I get halted by the receptionist who informs me that their business office manager wants to speak to me first. O f course I know what this is about. I get redirected to a tiny, windowless, torture room where the manager hems and haws uncomfortably while she pulls up my account on the computer, which she informs me has been “flagged.”

“Have you talked to anyone in our office about financial counseling?”

“No and I don’t need to.”

She stared back at me, a little stunned.

“Oh. Well, we normally try to work out something with our private-pay patients before their balance gets too out of hand and your account, which is over a certain amount was flagged because we didn’t have any arrangements in place.”

I wanted to tell her that it’s not my fault that no one from HER staff contacted me about the financial arrangements. The surgery was scheduled. It wasn’t emergent. Not my responsibility. I don’t work for the surgeon, she does. I also thought about telling her that there’s really nothing she can do at this point as she can’t deny me my follow-up visits which are all included in the surgery itself, but I didn’t. I just told her that when I finally get a bill, I’ll take care of it. She told me it was sent out on the 5th….it’s the 11th and I STILL don’t have it. Gotta love that outsourcing, don’t you?

Now don’t you wish you had clicked the PGDN button?