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their asses SO when I received a statement from them, I found out that the “generous” cash discount offer had been rescinded.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?

8 thoughts on “11 of 30: Bills, Bills, Bills”

  1. This is just crazy. How are people suppose to deal with this shit when they are debilitatingly ill? (not belittling your op but you know what I mean)

  2. I had the same problem, even being insured! I was insured when I gave birth almost 2 years ago, and the hospital took FOREVER to send me the bill for what I still owed. As in, it got sent to collections before I was able to actually talk to someone about payment plans. It was so ridiculous.

  3. It’s ridiculous. Ridiculous.
    People who don’t want single payor, obviously have never gone though this.
    I find it outrageous that hospitals and physicians (of which I am one) have a “charge” which is really just funny money. That “charge” is where they/we negotiate the “discount” to the insurance companies.
    In Minnesota, or at least at the hospital conglomerate that I work at, we offer the same “discount” that is given to our largest insurance company that we get payments from, to our patients. Not sure what that equals, but the Attorney General insisted on that.

    Tell the people that don’t want to give you a discount that you’re going to take them to the AG and see if that helps. Tell them you’ve heard what happened in MN and it could happen in Nebraska too.

    Sorry you are going through this.

  4. I remember my mom doing this with all of my dad’s medical bills – and he had insurance, and probably medicare. But, he also probably exceeded his maximum lifetime limit. It sucks.

  5. This is one of the most brilliant posts ever written.

    The thing that really gets me though is the fact that there are a gazillion people out there that either sell their souls to the devil to pay their bills, or they won’t pay their bills at all and drive the cost of everything up.

    If an office is going to take a write-off from an insurance company, (billing $125/accepting $47.75) why do they not automatically do that for the self pays? They are still making the same amount. It drives me crazy. It’s like the guy sitting next to you on the plane that got his ticket for $12 and you paid $200. It just blows.

  6. Ha ha ha! (Laughing WITH you, not AT you of course)

    We vets like to joke around that if we ever got a decent pet health-care insurance program going, it would be a godsend to us – always having to nickle & dime & take it on the chin a lot of the time w/all of our self-paying clients… But now I have my doubts.

    Our way ain’t so bad – after all, how much extra staff would I have to hire to manage the paperwork?

  7. Oh I don’t wish I had pushed PGDN, that’s for sure. I have worked in the health care industry for over 7 years now and definitely come up against the same things you have encountered. What bothers me when I have to deal with doctor’s offices is when they try to get the condescending attitude of “well, I’m sure you don’t understand your EOB but this is why we’re doing what we’re doing” and I’m all “I’ve done medical billing, I understand completely and what you’re doing is WRONG – FIX IT”. I usually get that hemming and hawing thing and just want to hang up on the moron I’m talking to.

    Like I said, I used to be in medical billing and dealt with setting up payments for people. We always did our best to work out a payment plan – and I mean ANYTHING, even if it was $10.00 a month, as long as something was coming in. I have had doctor’s offices that wanted to give me that minimum crap and they got what I had, even if it was $10.00 every two weeks, and nothing more. Also, I have dealt with making an arrangement to receive a lump sum payment and write off the rest. After having my son I was hoping to do something like that with my OB’s office. I owed approximately $1,200.00 and had $800.00 I could pay if they would write off the rest. Of course they said they couldn’t do something like that so instead they got $50.00 a month until they offered me a lump sum payment six months later and only got $300.00. So they ended up only getting $600.00. Makes a lot of sense, huh?

    Okay, didn’t mean to hijack your post, it’s just an issue that hits very close to home and I feel your pain. I just set up payments for an ER visit from July because I couldn’t get them to work with me before now. I think I’ll have it paid off before next July though. Maybe.

  8. I just read someone’s blog post about the health care industry and her frustrations. She talked about it being a teacher-student attitude instead of treating her like a peer. Like an adult. With intelligence of even a small measure.

    What is wrong with these people? That they have this attitude?

You can say it here.

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