2/12/09

"Pay Us For The Pain", As Played By Guy Tweedy

So now the bills are starting to pour in. It is ironic that the disease that is killing you kills your finances (and your family's finances) first.

Almost as frustrating is that the bills come in with no explanation of what each itemized amount is for... you get a date of service, but no explanation of what the service was.

So for instance, I went to see my oncologist on a particular date: we got his opinion on what should be done next (I should take truly horrific toxic drugs and see which dies first, the cancer or me - and no, he doesn't ever suggest alternatives, and yes [insert face like smelling rotten eggs here] I could get a second opinion but the next doctor will say the same thing**) and he had his lab draw blood for some tests for vitamin and mineral levels, etc. That's it.

Now I get a bill for that date of service and there's about 8 different amounts billed but no explanation of what they are for - and the billed amounts total to thousands of dollars. Thousands.

A little less than $400 was for the doctor's time with us. Wouldn't YOU like to make around $1,000 an hour for repeating the same thing over and over? Because it was pretty clear that that is what this guy does - he just says, "This is what I always prescribe for people in your situation," and that is that.

Well, okay, specialists make a lot of money - whether they are good at their job or not. They've got medical school to pay for, and specialist office drones they have to hire to push papers around to the 800 individual health insurance companies (which all have different forms and processes and negotiated discounts), and insurance premiums to pay in order to avoid being sued for treating people like they don't matter. So cough it up and stop complaining, or we'll stop perforating and irradiating and dissecting you.

But that was pretty much the smallest part of that bill, a bill which otherwise did not identify anything about the charges except that they were charging outrageous sums for... whatever it is they feel like charging for. Air pumped into the room, maybe? The $900 cotton ball they taped to my arm after taking my blood? Liquor distilled from the stamens of rare flowers grown in pristine mountain snow, hand-harvested by cloistered monks in Tibet and transported by Yeti so that the doctor can calm his nerves after having to actually talk to a patient?

Now, am I supposed to just assume that blood tests for my creatinine and glucose and hemoglobin levels are going to cost as much as $1,500 each, and just write out the check for my portion? Or is this an exercise (for which I will be billed) designed to make sure I keep my mind distracted from my unpleasant prognosis by forcing me to spend all the hours between doctors appointments in sitting with the phone glued to my ear***, listening to a) 'inoffensive' pop music as interpreted by Guy Tweedy And His Euphonium Orchestra, or b) endlessly repeated canned recordings assuring me that my insurance company values me, but they are too busy to talk to me right now, so please hold indefinitely, or c) the customer service rep, who really has no way of knowing exactly what most of this is for, she has no idea why I didn't get an itemized bill (for these or any other services I've been billed for) but she can put in an order on her computer for an itemized list to be sent to me as soon as the computers are back up, although she isn't sure when that might be.

I've got 38 bills listed by my insurance company so far, for things done in December and part of January alone, none of them itemized in either the bills from the providers or the website accounting of the insurance company's billing records (they have date of service and location, sometimes the name of a clinician, and amounts billed, but that's it). If I want to find out what the service actually was, I have to call and wait on hold for the customer service rep of each individual business office of each individual doctor or clinic or lab or hospital or technician or pharmacy... who may or may not be able to tell me what the bill was for. At one point I got a nearly $6,000 bill that both insurance company and clinic insisted was a mystery beyond their ability to explain, but they were sure that eventually it would wend its way through the system and they'd be able to tell me what it was for eventually.

I am also told that there is over $6,000 (different $6,000 from the above) still owing for bills that I didn't actually receive - so obviously I don't know what services those are for, either, and they can't tell me because I don't know the account number(s), since I never got the (unitemized) bill. There will be more bills coming in for December and January over the next few months. They won't be itemized, either. I'll have to call in on those. By then I'll be getting unitemized bills for services received in February and March. Oh, and also there are a couple unitemized bills for services done back in May and July of last year, services for which I already paid but there was an adjustment 'that (they) had to do by hand', so now I owe more on those. Thanks for checking in.

Yes, we have The Best Health Care System In The World. We know this because the politicians have been passionately and sincerely asserting this in their speeches every election cycle for at least the past five decades. Pay no attention to Big Pharma and the insurance companies behind the curtain...

I may not need to worry about the cancer. It's the raised blood pressure that's likely to get me. Or fatal ennui brought on by too many hours of Guy Tweedy And His Euphonium Orchestra.


** No, the next doctor did NOT say the same thing. The next doctor treated me like a real person with feelings and a life, which was refreshing. Of course, I haven't gotten the bills for that yet, so I don't know if that costs more.

*** This is a shortened version for dramatic effect. My mom is taking over most of the work involved with the billing issues, so soon she will be the one with the Tweedy version of "Tie a Yellow Ribbon" endlessly repeating in her head. THAT is true love, the sort only a mother can know...

7 comments:

The Violet Hoarder said...

I've just been going through the same thing, but for a much smaller amount of money. Ah yes, the comfort of the Euphonium orchestra, and the know-nothing customer service rep, and the gibberish on the forms. (Let's emigrate to Vancouver.)I guess I try to comfort myself with the fact that I have insurance--however terribly flawed--and can go see a doctor when I get. So many in this country can't now. But it doesn't really take away the frustration. I'm glad your mom is dealing with all this. Set it down like a stone, and focus on deep breathing and getting stronger. You have one of the most resilient and wonderful senses of humor I've ever encountered! It may be what keeps you sane over the next weeks and months (and years and decades). NO ONE knows what's going to happen...especially doctors. So, why not create your own ending and believe in it? (But it's sure OK to have moments of anger and fear and all the other stuff that goes bump in the night. That's just human.) Close your eyes and feel the soft, slow rumble of spring!

Glorious Hats said...

Oh my, the Violet Hoarder sure is a wise woman.

Yep, I wanted to rant "how the heck do they expect to get paid when the bill is not itemized?" The auto shop gives us an itemized bill, why not the person body shop?

Well, glad you are able to articulate so well and got it out.

Your mother has to be an amazing gem of a woman. I am picturing a lioness stalking and taking down a fast moving big horned animal.

Yay! Eileen's mom.

Hugs to both,
Jane

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mrspao said...

Hooray for your mom! It sounds like a complete nightmare.

Carrie K said...

You know Yeti's belong to an extremely strong union.

Wow, if the cancer doesn't get you the billing will. Any health plan that we get is going to be just as awful but at least it'll all be online and possibly - just possibly, an itemized list of charges might happen.

Thinking euphonious thoughts for you!

pao said...

There are some things about the health care system Stateside that never fail to make me boogle. The non itemised bills has just been added to the list.

Still at least sorting out what the bills are for gives you something else to think about. :)

Laughingrat said...

This is dreadful. I don't know how these &$*@(# sleep at night, except maybe on a pile of money. I'm sorry that you have this to deal with on top of everything else.

For a minute I thought the doctor you mentioned *was* the second doctor, so I'm relieved to see that no, second doctor is still awesome. Whew.