Medical Billing Deserves Its Own Circle of Hell

While covid’s Delta Variant has wormed its way into our midst and I am constantly adjusting my approach to nearly every situation, we are once again hearing about the workload of healthcare professionals. They are true heroes working harder than they ever expected to.

High medical costs are enough to send you to the hospital!

I recently had my annual physical, which had been delayed by six months because I wasn’t going in until I was fully vaccinated. I have a new doctor and can’t sing his praises enough. I loved my last physician but she retired and I had to find someone new. The doctor is insightful, caring, and was pleased with all my efforts to stay healthy. I floated out of the office and returned two days later to discuss my lab reports. For that, I was in the office for ten minutes from signing in to walking out.

A month passed, and I knew there was likely some co-pay because my insurance provider never covers all the lab work. And from there, I’d like to hit pause amidst my praise for healthcare workers and move on to the vilification of the billing department.

$725! According to my notes, I received the bill on a Saturday, and I rang up the billing department at 8:03 on Monday morning. I wanted to make sure the agents had settled in with a cup of coffee before they received a Patrick Brown phone call, which is actually nicer than a Patrick Brown letter. I was careful not to eat anything so that my “hangry” blood sugar would provide me with enough edge to express my displeasure.

“Good morning. This is Patrick Brown and my account is… Let me begin by saying that this is going to be that call that ruins your entire week.” After a lot of clicking and tapping, I was told that billing was not at fault, but my provider had denied the co-payment. I knew this was a ruse because the insurance company was working from what the county-wide clinic’s billing department had sent them.

“Oh, no,” said “Britt’neigh. (I’ve named her Britt’neigh and suspect that her cubicle is adorned with affirmations that get her through the sadism of medical billing.) “We can’t do a thing at this point. YOU will need to contact your insurance company and TELL THEM to reevaluate.” I knew Britt’neigh was sending me on a wild goose chase, but I’d allotted the time, and when I called her again, I’d be even crankier.

I phoned up my provider and spoke with a very amusing agent in the South named Jo-Ann who appreciated my story-telling ability and confirmed what I suspected. The clinic had submitted erroneous billing information in order to collect more money, and she confirmed that had the billing department done THEIR job 10 minutes ago, THEY would have reviewed and re-submitted. And on a final note, Jo-Ann was appalled that a doctor’s visit is billed at over $325, and she admitted to having seen some outrageous billing in her day. Jo-Ann asked if I were getting Cadillac quality healthcare. Perhaps, but the billing department is the jalopy on blocks.

I told her that I was going to call the clinic’s billing department as soon as I hung up, and that I was going to have someone for breakfast. Jo-Ann said that after six minutes with me she had no doubt and wished she could be a fly on the wall.

Whit’nee sounded exactly like Britt’neigh, but insisted she could help me because Britt’neigh was occupied. Whit’nee was familiar enough with my case that I’m convinced she was really Britt’neigh for there was no way that my previous conversation could have been transcribed into the record with such detail that quickly.

There was more clickety-clack and back-spacing and, “OH! I see what happened! Your preventive annual physical WAS covered, but there was a non-covered medical issue discussed during the exam.”

“WHAT wouldn’t be covered?” I asked.

“It appears that you discussed acid reflux.”

“Yes, we did. Why wouldn’t that be covered?”

“Because it’s not part of a standard physical exam.”

“And just why NOT? This new doctor was going over my medical history and mentioned that acid reflux was in there and asked how it was going. I told him that as long as I kept my weight under control, didn’t go wild with the menu, and avoided onions as much as possible that I didn’t have any problems.”

“Well, that was it!” Eureka! Voila! Mystery solved! Nothing more to be said. Whit’nee acted like she’d just discovered a new disease AND its treatment.

“What was IT?” I demanded. “He asked me a question about my physical body DURING my physical exam. I answered it matter-of-factly, nothing else was said about it, nothing was DONE about it, and now you’re charging me money.”

“I’ll be happy to re-submit to insurance.”

“Please do; and now for the other charges.”

“Oh, you made an office visit two days later.”

“To discuss my labs, part of which I have to pay for out of pocket, and I had told the staff when making the initial appointment that I wanted my labs ordered BEFORE my physical so that you all didn’t sneak another visit in on me. I was told that because he was a new doctor—a new doctor looking at my OLD medical records within the same medical system for the past five years—that I was considered a ‘new patient’ and I’d have to have a ‘pre-exam visit,’ then the labs, and THEN the physical. In reality, I had a physical exam without him knowing my lab results, followed by labs, and a ten-minute follow up to tell me what was already posted to my chart. And now you want to charge me the cost of an airline ticket from Portland to Rome.”

“That’s our policy.”

“Well, your policy is steeped in corruption and moral failure, and though you’re following orders, it’s no excuse. You’re part of the system and should be ashamed. Since I know that you’ll turn me over to collections if I refuse to give you something, I’ll pay you for the labs and this highwayman second visit, but I’m contesting the other charge.”

“We’ll notify you within thirty days as to the result of your appeal.”

I knew good and well that this lone agent behind the curtain that went by more names than Tom Ripley was going to flag my record, put it aside, and bitch to everyone that Britt’neigh, Whit’nee, and Charlotte-Shayleen ran into that some cranky old man had ruined her week. And for that, she’d show HIM!

And, of course, I bitched about the situation to everyone I saw. Did it do any good? Well, I learned that two other families in this community have experienced the same billing, the same attitude, and the same excuses from the very same clinical enterprise. And now I’m sharing it with you, readers. I’m sure this happens more often than we realize.

In today’s mail I received the formal notification that after “careful review” the clinic’s billing department has “found that their original billing was accurate.” I knew they would. The other people who have shared their stories with me told me to expect this outcome. As I reflect, there was a moment when I thought I’d missed something during my physical. There was no rectal prostate exam. Apparently they’re leaving that to the billing department.

© 2021 by Patrick Brown