I’m Just a Bill
When you’re dealing with a serious illness, it’s the little things that can send you over the edge.
Oh, you might be able to handle the mounting stress relating to children, medical appointments, tough conversations, disrupted schedules, the strain on relationships, even the overall sadness of it all. But then you have to deal with something like a medical bill and you lose it. Words you never dreamed of saying burst forth from your mouth like aftershocks from an earthquake.
Fortunately, I have good health insurance. And with chemotherapy running at about a $70,000 per month clip (I kid you not), my family would be sunk without it. Bills come in at a staggering pace, and somehow, some way, most of them get paid.
But every now and then, one slips through. And that one bill can cause more stress than you could ever imagine.
For example, I have this bill right now that’s driving me nuts. I’ve spent hours upon hours attempting to resolve it. I’ve written letters. I’ve made at least fifteen phone calls. And despite all that work, I’m no closer to resolving it.
The circumstances behind the bill are maddening in and of themselves. I was having surgery at M.D. Anderson Cancer Center in Houston. My insurance, through the State of Oklahoma, had approved this surgery and was treating it as an in-network expense. (This is one of the few benefits of having freaky rare cancers, like I have.) That’s good, because out-of-network expenses are akin to having no insurance at all.
Anyway, on the night before surgery, my son Ford came down with a horrible sore throat. Having no local doctor nearby, we got him some over-the-counter meds and hoped for the best. But as the night wore on, things were looking grim. Ford couldn’t even swallow.
The next morning my wife and I got up at 5 a.m. and headed over to the hospital. LeAnn waited until I was admitted, then rushed back to the nearby hotel room to check on Ford. He was in awful shape, but ibuprofen and water would have to do. LeAnn then rushed back to the hospital and waited for me to get out of surgery. The moment she received word that I was still alive, she sent our daughter Maddye over to wait on me to get out of recovery, then hurried back to get Ford to a doctor.
LeAnn had no idea where to go. But M.D. Anderson is in Houston’s medical district, and there’s a hospital on just about every friggin’ corner. So she chose one. I don’t want to name it here, but let’s just say it hypothetically rhymes with Saint Duke’s.
It was a quick in-and-out visit to the emergency room. Ten minutes with a doctor and a strep test, which proved negative. That’s it.
A month or so later, we received the bill. Actually, it was two bills, one from the hospital and one from the doctor. The total? One thousand bucks. (As I’ve said many times before, “Yikes!”)
Then, a couple of weeks later, we received an explanation of benefits from my insurance company’s “third party administrator”. They’d only paid $32, because the charges were out of network.
I called my insurance company to complain. They should treat these bills as “in network,” because we were in Houston getting surgery that was being treated as “in network.”
“You’ll need to file an appeal,” the tired voice on the phone explained. “And attach all the bills you have.”
So I did. But I first called the hospital and doctor to let them know that there would be a delay in payment due to a dispute on the bill. They noted this for the file. Then about a week later, they began calling my wife’s cell phone at work, urging her to pay her debt. This led my overworked, overburdened wife to urge me to “take care of this!”
It gets worse of course. The letter in response to my appeal came back, indicating that the bills had already been paid. That is, by paying less than fifty bucks on a thousand dollar bill, my insurance company had satisfied their contractual responsibilities.
“They didn’t even read my appeal letter,” I told LeAnn. “Or else they didn’t understand it.”
I wrote another appeal letter, explaining why this was wrong and again attaching all documentation I had. Then I called the third party administrator to voice my concerns.
A tired voice on the other line explained that the rejection was standard procedure. “We’re going to need to see the medical records,” she said.
“What medical records?” I asked. “It was a fifteen minute visit to the emergency room for a strep test! Says so right here on the bills. What other medical records could there be?”
“I don’t know,” she said. “But we’re going to need ‘em.”
“But why?” I, the lawyer, asked. “You’ve already made payments on these bills, thereby admitting they’re legitimate. Why would you need anything more? It’s nothing but added bureaucracy!”
“Sir, I understand your point, but it’s standard procedure. If it’s out of network, we’re gonna need the medical records.”
“Well, have you asked for them?” I asked. “I mean, you have the phone numbers right there on the bills.”
“That’s the patient’s responsibility.”
No need to tell you any more of this conversation. It was like talking to a brick wall. A very tired brick wall.
I then called the hospital to explain why they still hadn’t been paid, to urge them to stop calling my wife at her middle school, and to order the medical records.
“I can’t get you the medical records,” the lady at the business office explained. “That’s another department.”
“You’re in the business office and you can’t get medical records from your own hospital?” I asked with skepticism in my voice.
“Uh-huh. And why are you calling anyway? If your insurance company needs documentation, they should call and ask for it.”
“That’s what I told them, but they wouldn’t do it!”
“They just don’t want to pay for the records. I mean, someone’s gotta pay before we just up and send a bunch of records.”
“Well, there shouldn’t be anything but a page or two,” I assured her. “It was less than fifteen minutes. A strep test. That’s it.”
“We still need to get paid.”
“Listen, can’t you just call my insurance company and work this out?” I pleaded. “Why do I have to be the middleman? Like I’ve got nothing better to do. I’m dying out here. Literally.”
“Sir, we don’t call the insurance companies. They call us.”
She finally gave me the number to medical records. I waited a day or two before calling, in order to compose myself.
“Sure, we can send those records to your insurance company,” the cheerful voice on the phone said. “But we’re going to need your written authorization first.”
“Okay… And how’s the best way to get that done? Can you email me a form that I can print out and fax back to you?”
“I sure can,” said Miss Sunshine.
She then obtained my email information, and we hung up. That was four days ago. I still haven’t received an email.
“You still haven’t taken care of the Saint Duke’s bill?” LeAnn asked.
&$%@#$!@?!!!
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LOL……love the Miss Sunshine image.