Tag Archives: Health care

Do You Smell That Smell?

Maybe it’s because I deal with the subject nearly every day, but I find it fascinating what others have for costs associated with healthcare, whether they are out of state of out of the country. I’m such a cynic though, that I know "free" healthcare isn’t actually free. We pay a hefty premium to have "free" vaccinations. Some countries pay incredibly high taxes for "free" health related services (see previous post and comments).

In the U.S., our healthcare’s system is amok. Personally, I blame Medicare. Not necessarily the program, but the system which controls it (the government through the Centers for Medicare & Medicaid Services), because if they determine a doctor’s visit is payable at $ .25 on the dollar, who do you think gets to make up for the other $ .75?? Providers jack up the price to make up for the growing Medicare population; CMS lowers what they pay again; providers raise their prices again. Something has got to give.

** SEGWAY **

This weekend I went clothes shopping with my son. I survived. Amen and The. End (oh, but there’s so much more!). I rewarded him for his patience by taking him to Toys R Us and as I strolled along the aisles, a woman with PERFECT hair (which my husband and I have dubbed Politician Wife Hair or more accurately, Helmet Hair), I felt envy. She didn’t have to wear her matchstick, cropped pants and little kitten heels. She didn’t have to press her immaculate blouse or airbrush on her make-up, but she did and then walked into what is certainly a Hell on Earth by not only looking good, but she smelled nice, too.

She breezed by me as she followed an staff employee, which made her the only adult there not being dragged from aisle to aisle by a cooing, sticky, whiny, commandeering kid, and her expensive perfume wafted past. I couldn’t entirely hate her because it was a nice scent that didn’t make my throat seize up and gag. Unlike my MIL’s Channel No. 5 that she must not be able to even smell because flies drop in her presence. Or maybe she thinks that since she hasn’t bathed in a couple of days, she’d better double-down on its use. Seriously, the woman uses so much, that if she joins us for dinner, I cannot taste my food. I taste No. 5, and for the record, it does not taste good.

Anyway, back to the Politician’s Wife. I took some care with my appearance, but I began to think that maybe the extra step of putting on a dab of perfume was the proverbial cherry. I normally top off with a healthy dollop of whip cream (my ass is thanking me). This morning I applied a light spritz, bearing in mind that my office is small and patients tend to be more sensitive to odors post-procedure, and headed out the door. I now feel conspicuous; like I’m trying too hard. On the other hand, I feel a touch more "worldly", too.

The Cost of Vaccinations. Literally.

Did you know that medical providers are one of the last bastion against transparent pricing? Somewhere along the line, they decided their patients shouldn’t "shop" for care, and I guess there’s a logic to that as the idea of their doctor being the least expensive might read "poor quality and service". Even when we were uninsured, I didn’t make phone calls to different clinics to see who had the least expensive office visits. Our pediatrician was Dr. Kidd before I lost my insurance; it was Dr. Kidd after.

Our insurance through the Evil Hospital did not cover vaccinations. We took Doodicus to the clinic his pediatrican referred us to that was funded by the state. We paid a palsy "copay" ($20 maybe?) and for almost nine years, all shots were administered by them. Our current insurance now covers vaccinations 100% and with that coverage, the clinic prefers we take the kids back to Dr. Kidd, which is totally understandable.

In July, I took Aitch in for her well-baby check which included five vaccinations. I paid the office visit co-pay of $30 and never gave it another thought until I received my Explanation of Benefits from the insurance company. I wish I could play the game, "Guess How Much It Cost?!" through my blog, but obviously I can’t, unless you’re willing to spread this post out for the next couple of weeks and no one has time for that level of shenanigans, right?

Aitch’s exam, five vaccinations, and the administration of the vaccines came to a grand total of $1,000*. The specific breakdown (I’ve included the codes for you medically-inclined) follows:

99392 – $152. This was for Dr. Kidd to tell me that Aitch is perfect.
90461 – $100. This was for the nurse to poke my kid in the thighs with a pointy object and make her cry.
90670 – $205. Prevnar 13 vaccine (pneumococcal)
90716 – $125. Varicella vaccine (chix pox and boosters)
90707 – $78. Measles, mumps and rubella vaccine
90713 – $48. Polio vaccine
90700 – $52. DTaP vaccine (diptheria, tetanus, and pertussis)

Now let’s play a game. What does it cost in your area for vaccinations?

* This is for a provider in a rural-based community in the middle of the Prairies.

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?