[cancer] Remember my billing problem?

Remember my billing problem? The one I talked about here: [ jlake.com | LiveJournal ] Fundamentally, my hospital and my insurance carrier cannot seem to agree on how to bill my oncologist visit of 1/7/2013 as in network. Despite the fact that they have been in network for every visit in the prior years, and they have been in network for every subsequent visit in 2013. Just not that visit, which has resulted in me being repeatedly billed for out-of-network charges as patient responsibility.

As of yesterday, I am up to my thirteenth or fourteenth phone call, and about twenty-two people spoken to on this problem. (I have kept written notes on all of this, I just lack the patience to go back and count it all up right now.)

Back on 2/27, after raising some fairly serious heck, I was told this particular claim would be “taken out of patient pay status” until it could be resolved. So of course, on 4/16, the hospital mails me a bill on which this same out-of-network charge has reappeared once more as “Patient Responsibility.”

Mind you, my visits to my oncologist since the misbilled visit of 1/7/2013 have all billed correctly. So clearly they got the problem sorted out. It’s just that somehow between the hospital and the insurance company, they can’t straighten it out for that 1/7 claim.

I suppose I could just pay the $129.72 that’s now due. (It seems to have been adjusted downward from the original $283.59.) I have the money, in part thanks to the exceptional generosity of so many of you reading here. But I will be damned if I will spend it to resolve the mutual incompetence of the hospital and the insurance company.

I politely lost my temper with the billing office representative yesterday. I pointed out to her that she was about the twenty-second person I had spoken to on this matter. I pointed out that I was a late stage cancer patient, and I was going to be damned if I had to spend the last months of my life chasing the same damned bill over and over again when the problem at hand was not my fault and not under my control. I also flatly told her that if this couldn’t be resolved in the next phone call, I would open a complaint with the Joint Commission (the body here in Oregon that accredits hospitals) as well as with the Attorney General’s consumer fraud division, and the Oregon Insurance Division.

She said she would have a supervisor call me back. I suggested she inform them that I was very irritated, and prepared to go very public with this. I believe the rep took me seriously. Whether her supervisors do or not is another matter, though the words “Joint Commission” do seem to have a strong effect when talking to a hospital here in Oregon.

I have call notes and a paper trail for every step of this problem. I will have no difficulty documenting my complaint.

But I should not have to.

Per my earlier post linked above, the fundamental problem appears to be a billing zip code mismatch between the hospital and the insurance company. This is not something I have any control over whatsoever.

You know what? In a single-payer system providing not-for-profit universal coverage, these problems wouldn’t exist. I wouldn’t have spent a dozen hours on the phone, making notes, and worrying about this one single misbilled oncology appointment. So the next time some conservative blowhard sounds off on Obamacare and how we already have the best healthcare system in the world, I have a half-inch thick file of bills and call notes which I will cheerfully shove up their ass so they can go enjoy the best healthcare system in the world first hand.

And good luck to them resolving the billing around their treatment.

22 thoughts on “[cancer] Remember my billing problem?

  1. Alexis says:

    In a single payer system, you just document that it’s their problem and THEY have to fix it. As it should be.

  2. Alexis says:

    Eventually you run out of energy and just give up fighting, which is obviously the point. I firmly believe they deliberately collect millions of dollars for bills they know that they should pay out on simply because people lose the ability to fight with them. If it is mental health coverage you require, that moment comes much sooner. If you don’t have someone to advocate for you, you’re screwed. That is how it is specifically designed.

  3. Mark says:

    This makes me sad. We have had similar problems after recent hospitalizations and follow-up care. The insurance company told us that sometimes their computer system “glinches.”

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