Caving In

This morning I walked a check for $15.00 down to the mailbox. It's the result of a coding error on a bill that I've been trying to get resolved since April. For a regular doctor's appointment in February, at which I paid my normal $15.00 co-pay, I was charged an additional "facilities charge" of $15.00. The $15.00 facilities charge isn't supposed to apply and, in most of these visits, isn't applied.

I've made phone calls to the billing agency. I've made phone calls to my insurance company. I've left messages for the coding clerk. I've called customer service. Everyone agrees that the $15.00 charge was wrongly assigned, but nobody seems to be able to take it off my bill. And now I've gotten a "FINAL NOTICE" threatening action by the state attorney general's office.

So, I'm paying the $15.00, like it or not. Chances are it will be refunded to me as soon as the check clears, because somebody will look at my account and have a eureka moment - "Gosh, she doesn't owe that. Let's send her a refund check."

The worst of it is, it's for a god-damned $15.00 charge. Who knows how much money has been spent by 3 or 4 different agencies trying to sort this out, send out billings, review statements, talk to me, ad infinitum? That's not even counting my time or my blood pressure. I had thought I could get this straightened out easily, which is why I hadn't paid the damned thing.

Things like this make me crazy. No wonder there's "business opportunity" out there for people who do nothing but straighten out medical billing messes!

Paperwork, arrrghhh ...

Don't you just love getting mail? Don't you just love getting mail from places with names like "Patient Financial Services" or "Patient Accounts"? I admit to some palpitations every time I pick up the letter opener, wondering "what have they screwed up now?"

Over the past 18 months I've gotten pretty good at keeping things straight. I have a 2" notebook with sections for each entity I deal with (Cleveland Clinic, OSU, and my local clinic), plus a section for the "explanation of benefits" (EOB) statements from my insurance company, and a manila envelope that I've 3-holed to corral all of my receipts. When something arrives from any one of my financial friends, I go over it quickly to see what's pending with insurance, what's been paid and what they say I'll have to pay. Sometimes I get quite a heart-stopping surprise, like the bill for over $17,000 representing numerous espohageal scopes that I had during my month of bleeding episodes last fall, or the $4,300 bill for emergency room services at my local hospital that memorable month. Turns out in both cases the charges were not turned in to the insurance company before I was billed.

Sometimes there are just "duh" moments on somebody's part, where codes are wrong and insurance won't process a claim until those codes are corrected. Sometimes there are genuine goofs, where charges are double-billed or payments aren't noted. It's not easy to compare the bills to the EOBs. Dates of service don't match; reference numbers don't match; descriptions of service don't match. Where I find problems, I use highlighters on the EOBs to flag discrepancies, and write the claim number, check number, payment date and date of the EOB on the bill. This seems to be a good thing for me to do when my meds keep me awake (sick, I know). I have a 3-in-1 printer and so far the copying function has been dedicated to straightening out financial statements. I send out lots of photocopies and so far things have gotten resolved with me going to debtor's prison. On the whole, though, getting the mail isn't nearly so exciting as it was when I was a kid!

I don't know what I would do without insurance - I get myself worked up enough over bills that are screwed up but that will be sorted out eventually. I will not get started on the whole issue of health insurance and medical costs in this country, as the level of inequity is so appalling it makes my blood boil.