SAGA OF A ^#*;%$##%^*@ED UP MEDICAL BILL

(NOT MY BILL)

My ongoing health care problems and doctors’ visits and procedures have provided fodder for my writing for a number of years now.

I have insurance coverage under both Medicare and Medicaid. The former I enrolled in in 2006 when I was awarded Social Security Disability benefits but am now qualified for that coverage since I have been officallly an old fart for over five years. The latter coverage was obtained in 2007 and continues to the present since my income falls within the guidelines for eligibility in the state of West Virginia.

Of course that is why I tout Medicare For All as the most practical solution for the nation’s health care coverage woes.

Yet the wheels of health care justice grind exceedingly slow.

My present tale entails my bout with bladder cancer in 2014. Towards the end of June I discovered blood in my urine one Sunday morning. The following day I saw my family doctor who sent me for tests while getting me an appointment with a urologist for a few weeks hence in July. None of the tests provided conclusive evidence of any cause but there were several possibilities. For the best possible diagnosis my urologist scheduled me for a biopsy on September 11, 2014, a Friday. The following Friday I met with him to learn the results and determine any future actions. At that time he revealed I did show a malignancy but one which he was able to cauterize for elimination at the same time. The recommended followup was to have a cystoscopy quarterly for two years, then semi-annually for another two. After that period, without further difficulty I will need to undergo one only every year.

If you’re not sure what a cystoscopy is, I’ll recall how my late older brother described it. “That’s where they stick a camera up your dick”. Crude, but accurate. So I have faithfully appeared as scheduled since then for the procedure in the doctor’s office under local anesthesia. No recurrence to date though bladder cancer does have a high rate of recurrence.  By the way, the blood in my urine was the only symptom I ever experienced. I had no pain, no intrusive treatments over an extended time, and no real agonizing about my potential fate. Sadly, the vast majority of cancer patients have things much worse.

Now my urologist’s office was on the campus of one of our local hospitals, but apart from the main facility and with its own entrance, and he was independent of that ever growing conglomerate. But in 2016 for whatever reason he and his partner sold their practice to the hospital. I have continued as before with no change whatsoever. Because of my coverage I never even saw a bill from him or the hospital. That is until last week.

My last previous cystoscopy was Sept. 28 of 2017. I received a bill showing total charges of $1257.00. After payments and adjustments the total demanded of me was $1019.00.

Other than receiving any bill whatsoever what disturbed me was the area set aside for “Account Summary”. It listed my primary coverage as “Medicare Non-Patient” and my secondary coverage as “Private Pay” What “Medicare Non-patient” even means is beyond my pay grade.

One other thing of note on the bill is something that effects many Medicare patients. One of the charges was $894 for “Operating Room Services.” Funny, I didn’t recall going into an operating room within the hospital, though I admit I am far more familiar with them at this hospital than I care to think about. Indeed, last May I had outpatient surgery in one of them to correct a deviated septum. (No, other deviancies of mine were not addressed simultaneously.) As part of the check-in protocol I provided both my Medicare and Medicaid enrollment cards.

That type of charge I have learned prior to my personal adventure is perfectly legitimate. If a hospital owns a physician’s practice, no matter how remote from the hospital itself, if the doctor performs certain procedures or minor surgeries there the hospital can legitimately bill as if you had physically been on their premises.

I have also used that hospital’s services on different sites away from the main building on other occasions. Subsequent to my 2013 toe amputation I had follow up treatment at the hospital’s Wound Healing Center in rented space about two miles away. About a year ago it moved to a new building on the campus and in both June and October I visited weekly 3-5 times for treatment. One visit, and only one of the 3 in October brought a bill for about half the overall charge of nearly $400. At that time the Account Summary showed “Private Pay” for both primary and secondary coverage. I called the business office demanding, in a nice way that they update their information which was already on file. I never received another bill.

On Monday, with the current bill I called for assistance, explaining the situation and voicing my concerns. The representative saw that I was right and responded that she would make the needed corrections. I needed no more than perhaps a dozen or so cusswords to accomplish this. Yesterday another bill came in the mail. It was dated Monday so it very likely was in the works prior to me talking to Tina on Monday. It was quite different. It still had “Medicare Non-Patient” as primary coverage but now with Medicare Part B as secondary. It also showed different amounts for both payments and adjustments. Whatever Tina had done Monday could not have resulted in this. It also displayed a total due of $99.32, a great improvement, of course, but still not the zero amount I expected and which I have faced for all prior procedures.

So I called back. I got a different rep and when I explained I had spoken to someone just the day before she told me she would be transferring me to a “specialist”. (Aren’t hit men considered specialists?) Anyways after a brief time on hold a woman picked up. Within 30 seconds the call abruptly ended. I redialed immediately and I asked the person who answered to reconnect me with the specialist. Her line was busy so I left a message. When by 3 p.m. today my call had not been returned I called again. After a fairly short time on hold (Have you ever noticed that the music you so often hear on “hold” sounds distinctly like a bad ’70’s porn soundtrack? Not that the porn was bad, though it could have been, but the music used was nearly universally atrocious. At least that’s what my friends tell me.)

Lo and behold the same woman finally answered whom I was cut off from yesterday. We had a long conversation. Rather I spoke at length voicing my concerns in a number of areas of the bill I had received as well as complaining about the Andrew McCutcheon trade, the escalating price of groceries, and how my parents had sent me to live with a pack of wolves when I was 7. Every so often  she made these noises suspiciously similar to sobbing.

Bottom line is that the corrections may take 30-45 days to completely process so I may still see another uncorrected bill before then

The bright spot is that I have another cystoscopy slated for late March. Maybe Allen Funt will be there for a new episode of Candid Camera.

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Comments

  • Betsy  On February 21, 2018 at 6:32 PM

    I just read where having a hobby that you regularly engage in increases your life expectancy. Seems like you have found yours!

    • umoc193  On February 22, 2018 at 3:45 PM

      If by hobby you mean my constant bitching about various aspects of my life and life in general I suppose you may be right! LOL

    • Little Minx  On February 24, 2018 at 11:42 AM

      “Hobby” sounds a tad dismissive. I prefer to think of UMOC as having an incipient new career!

  • umoc193  On April 24, 2018 at 6:51 PM

    Just yesterday (April 23) I had another phone encounter with the billing office. When I called I identified myself, gave my account number, and told the rep to go ahead and escalate my call to a supervisor because I knew it would eventuially lead to that and I wanted to save time.

    When the supervisor got on the line I told her i was calling about a bill I should never have received, did not owe, and would never pay.

    She agreed with me! So hopefully no more bills or collection letters.

    The amazing thing was I used absolutely no cuss words. LOL

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