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May 21, 2011

The third time...

is NOT the charm.  Today, for the fourth time in four months, we received a bill from the hospital where I had my original surgery.  As I mentioned last month, they have successfully billed us incorrectly three times.  They have refused to believe that we know how long I was in the hospital and are still charging us $3,170 that we absolutely, positively do not owe.  Ask our old insurance company, even THEY agree that we are in the clear.

Since discussing this with the billing department three times has gotten us nowhere, Peter is going to try a different method on Monday. For all we know, it was incorrectly coded in the doctor's office.  Given the other mistakes they made with scheduling, and oh, say, attitude, this would not surprise us in the slightest.  Just a few of the reasons I am so happy that I am no longer seeing that doctor.

Now I'm nearly at the point of laughing myself silly over the whole thing, but I'm not quite there yet. Why?  Well, because including the above amount, bills totalling the outrageous amount of:

about $52,000

are still outstanding.  So, really, the $3K is a drop in the proverbial bucket.  Now you must be wondering how I haven't lost my mind and why I am not sitting here tearing out my hair (well, what you can't see...). Perhaps because as far as we understand, we owe little to any of that total.

The above amount includes $17K for the implant exchange for which hospital has yet to bill our OLD insurance company, $3,170 for the above-mentioned idiocy, $8K still being debated by the insurance company vs. the plastic surgeon (a continuation of care issue) and (are you ready for this) $23K (plus) for the radiation treatments that were incorrectly coded (at a different hospital) as being treatments for Peter rather than for me.  Three appointments were submitted correctly, but the rest (despite me giving them my insurance card with my i.d. number) were incorrectly submitted and thus rejected as they need the "appropriate procedure or diagnosis for sex."

I did get a tiny laugh over the diagnosis for sex bit, but other than that, I'm really over hospitals either not wanting to bill or not billing correctly. Despite the fact that I probably should lose my mind over the insanity of it all, I am trying to maintain a selse of calm and look at it from a different point of view.  I've realized I have many questions and not sure that anyone can answer, but here goes:

  • All of that being said (or written), how is it that mistakes like the above are made constantly and no one seems to care?  
  • Do they (hospitals, insurance companies, mailmen who deliver said bills) not understand how financial issues stress people out while dealing with medical issues* or getting on with their lives after said issues?  
  • Do they not understand that we have better things to do than correct their mistakes month after month after month? 
  • How is it people aren't fired for continually making said mistakes?
  • Do hospitals not want their money?  
  • Is there a statute of limitations on hospitals submitting claims to insurance carriers?  (No joke, I am actually worried about the old insurance carrier rejecting the implant exchange hospital's claim since they have waited so darn long.)

These are all questions that I think I would love to see answered...then again...


*Just for clarification, I am not actually dealing with medical issues, but KWIM? I am healthy, remember?  I am perfect, got that?  There is no "C" on my chest and hopefully no one else thinks of the topic at hand and then immediately thinks of me...if you do, then stop!




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No, you're right, I don't know how you are not going insane. Unbelievable. Truly unbelievable. I must say I'm amazed at your positive attitude. Hang in there.

For giggles, I always ask for an itemized statement for any major surgery/stay/event (i.e. childbirth - did you know the 1 ounce tube of Lansinoh is $12. Yes,$12. I went through 6 tubes). I once caught a $43 fee for a pulse ox recheck on my daughter for an ER visit. They had never rechecked her pulse ox, and I told them so. And twice now, I've been billed the full MD fee because while the hospital was covered under BCBS, the MD was NOT. Really? My kid can't breath and I'm supposed to call the ER on the way and say "Hey, I know the ER is covered, but is the MD?" I fought both and won. Let's see...the dermatologist who removed a mole (with a razor blade and covered it with a band-aid) billed it as a surgery. I called my insurance company and told them it wasn't a surgery; that I could have easily done it myself in the privacy of my bathroom with a Bic disposable. The poor woman on the other line had a small convulsion and said "Ma'am! Please! That's dangerous and you could get an infection!" Really? The $150 fee for an outpatient "surgery" isn't blackmail?! Other dermatologists don't bill it as a surgery. It took her 3 seconds to remove the mole. Well, I lost that battle, because that's how she billed it and it's acceptable. The best part? The dermatologist sent the removed mole it to the wrong lab that's not covered under BCBS and then told me it was my responsibility to make sure it went to the right lab. $400 in lab fees not covered.

It's all paper pushing and hiding and honestly, I'm beginning to think most of the fees are the result of paying for the incompetencies of the paper pushers and not the actual medical event.

I'm sorry this is the way it's been for you. My stories are small in comparison and didn't affect my life anywhere near like your blip did. But like you said, no "C" to carry around on your chest is a good thing! Keep fighting them. Half the time I think the insurance company and billing company assume you won't fight it and will just pay it. Geeze. Do you want to pay for Pete's nonradiation radiation?? (really, sorry, that one made me giggle just a little) Have a nice little glass of wine before you make that next phone call to billing and insurance...

Oh my effing god Jen!!! WTH! Wouldn't it be nice if there was someone given to you - as in hired, but by the insurance, or hospital, who could handle all of this crap for you? I'm so sorry you have to deal with it yourselves. It stresses me out just reading about it. Ugh.

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