Maureen, your cite doesn’t discuss a correllation between awards and malpractice premiums at all. In fact, it specifically says that it DIDN’T investigate the relationship between premiums and malpractice awards.
Yeah? How come I can get my insurance cards copied at a doctors office, I can send in faxes, copies, and so forth, and the same fucking office calls me two or three times to say they haven’t got their information?
Very few insurance companies have capitation anymore, particularly east of the Mississippi. This is rather like your quaint way of refering to CMS as “HCFA”, which it hasn’t been for two fucking years. Which is in line with sending out bills for services two or three years late, I guess.
Oh, this is charming…
First of all, the vast majority of people in this country have NO CHOICE about their medical insurance - they get what their company gives them from year to year, and that can change year to year.
For the last five years I have specifically ASKED FOR an acutal COPY of the policy, NOT the standard “summary” which HR publishes. I did this because I needed to know if there was an exclusion for injuries suffered during general aviation activities. The first year I was told BY HR that no, I couldn’t have a copy. I pitched a fit. The second year I was told I could have a copy, but did not receive one. For the past three years I have a received a copy. Oddly enough, the one I received last year had no exlusion for general aviation, but specifically excluded any injury or illness caused by war or terrorism. Which means if some nutjob blows up a truck bomb on Michigan and Lake in the Chicago Loop and I’m injured by flying glass all medical and rehabilitation costs will be MINE to pay. What this means is that I am covered if I fly a Cessna 150 into the side of a barn through my own stupidity, but screwed if extremists injure me while I’m sitting at my desk at work. Um… this makes sense?
Anyhow - my experience has been that getting an acutal copy of what your actual policy is, is about as easy as resolving a billing dispute with a large hospital.
So… people don’t know what’s covered because they can’t find out - even when they ask for the information
How the FUCK is the average working stiff going to be able to do anything to affect that? Can YOU prevent YOUR company - the one you work for -from outsourcing a task? Do you have any control over ANY company you have contact with, to prevent outsourcing? Are people living in Flordia responsible for hurricaines - shouldn’t they do something to prevent them? Do you blame your neighbors for meteor strikes, too?
You are also demanding that people think in a logical, rational manner about circumstances that are highly emotionally charged. If a loved one is dragged into an ER on stretcher, fountaining blood, with selected body parts arriving on ice in a second ambulance they are NOT going to remember all the details of their insurance coverage - you’ll be damned lucky if they remember where the put the fucking little covereage cards.
Granted, not all admissions are as dramatic as that.
My husband spent a little over a week in the hospital last February. Mind you, I work for the fucking industry so I know a little about how things run. While the docs in the ER were working on him I was in the little side office handing over the insurance cards, checking for SS# accuracy, name spellings, making sure they knew he was on MY insurance (I’ve had two situations in the past where hospitals INSISTED the insurance had to be under HIS name as HIS policy when we told them up front the insurance was through MY job) and so on and so forth. Mind you, all the while I can hear my husband yelling in pain and puking and calling for me because he’s scared shitless and in agony. Uh, yeah, I’m going to remember all the fucking paperwork details :rolleyes:
Anyhow, we STILL recieved bills charged to his name, not mine. I STILL had to fill out multiple copies of forms stating we had no other insurance and send them multiple times to all the providers. I STILL had to send copies of the insurance cards around multiple times. Well, we did all that. We were very, very, very careful to keep an eye on everything. I checked his chart for doctors names I hadn’t met (my husband was actually delirious for a few days - in other words, he was in no condition to remember who was in the room or not). I collected business cards. I asked the nurses who had seen him for what. I asked about where lab work was done. About the billing address for the ER. Everything.
Well! Back in the beginning of April we thought everything settled and wrote checks for what insurance didn’t pay for. End of problem, right?
This Monday we got THREE FUCKING BILLS for “lab services”!!!
Little tip to anyone asking me for money - do NOT send an “invoice” stating, basically, “You owe me $125” with no explanation of what for. Know why? If I don’t know what it’s for I ain’t fucking paying for it! That simple. I call these places up - “What is this charge for?” If the answer is “I don’t know - but that’s what you owe us” the next request is for a supervisor because If I don’t know what it’s for I ain’t fucking paying for it! Telling me “well, you should know - don’t you keep track of your bills?” (which I have actually gotten over the phone) earns you a bitchslap - I have a TWO FOOT TALL pile of paper regarding this week in February, multiple charges from multiple people adding up to well over $30,000 (most of which insurance did pay for, thank God) and YOU are asking ME to match this piece of paper - with no date of service, no explanation of services, nada - to just one thing in that pile? FUCK YOU!!
Here’s the kicker - this lab (I still don’t know WHAT lab this is, or what they were testing) is charging my DENTAL PLAN!!! Or trying to - actually, they’re charging it to the dental plan I had in 1998. HOW THE FUCK DID THEY GET THAN NUMBER??? I double-checked the cards in my wallet - they’re up to date. I’m very careful to destroy old cards. I could not have given them that number - where they fuck did they get it?
Then I call the insurer - which happens to be Blue Cross Blue Shield. I find out they have NO RECORD of me being covered since 1998. What the FUCK? Who the hell has been eating the premium money taken out of my paycheck these last 5 or 6 years??? The lady said - “are you sure you’ve been covered at all since 1998?” I said yeah - you folks have paid over $30k just in the past couple months, you wouldn’t do that unless I was covered, right? She said I should check with my employer - “Who do you work for?”
Blue Cross and Blue Shield.
Seems some minor functionary in the Great Bowels of the System accidently deleted my record as a member - sometime between April and now.
Oh, and by the way - why DID that lab wait until the end of July to bill me when everyone else managed to do so by early April? I haven’t paid the fucking bill because I didn’t receive it until this week!
How can the lab billing office have the dates of service, my name, address, phone, and SS# number correct - but have the dental plan number from six fucking years ago which even I don’t have anymore?
And why won’t this fucking lab tell me what the charges are FOR???
I work for the fucking industry and even I can get this shit to work right What chance does Joe Smith have?
So take your “patients are dumbasses” attitude and fucking shove it sideways up your tight, prissy little asshole you selfish piece of slime-covered shit. The system is fucking broken, for everyone. Your self-righteous attitude makes me ashamed to be in the same industry as a arrogant little functionary such as yourself. I’ve worked billings in a clinic, I’ve billed “HCFA” back when it was really HCFA and not CMS (and you’d have more credibility if you had your goddamned terminology up to date - with asshats such as yourself it’s no wonder bills are mailed late, you’re so compeltely behind and in the past), I’ve talked to people on the phone both when people are admitted and when they’re in arrears and I tell you even the worst fucking deadbeat does not deserve the sort of wide-brush condemnation you are tarring them with. I guess it just fucking does not occur to you that people are under enormous stress when admitted at times, or maybe they are literally not focused/competant to either worry about or correctly fill out paperwork initially.
You must live in some sort of fucking paradisical world where you have never suffered illness or injury, never lacked for money, or had to choose between food and medicine. How fucking fortunate for you, you little piss-puddle hopped-up bureacrat. Oh, you can’t IMAGINE why people don’t pay $5? Did it ever fucking occur to you to ASK them??? Sure, you SAY there are places they can go, people they can ask for help - GOD FORBID you be one of them! When I was sitting in a seat like yours I have a list of agencies and phone numbers tacked to the wall. When someone in tears said they just couldn’t pay the bill I would GIVE THEM phone numbers and contacts, addresses of agencies to visit in person. Fucking hell - we had a program going to provide BUS FARE to help people get help. But OH NO - it’s not YOUR responsibility, it’s not YOUR problem.
If people didn’t need help of some sort they wouldn’t be in the fucking hospital in the first place! GAH! Are you really that stupid? But I guess it’s easier to kick someone lying in the gutter than to help them up, isn’t it?
:smack: :smack: :smack: :smack: :smack: :smack: :smack: :smack: :smack:
I think most of that above post should be directed at the OP, Killuminati your body or whatever. GAH! :mad: FURIOUS!!! :mad: And some towards Liberal
excuse me… I’m off to foam at the mouth and rave incoherently in this corner over here until I cool down…
Actually, I WAS one of them. Portions reposted for your convenience:
http://boards.straightdope.com/sdmb/showpost.php?p=5096361&postcount=22
When our daughter was 6 months old, she suddenly developed an infection so bad that she clinically died. She was revived, but the infection coursed throughout her little body, attacking first one organ and then another. To this day, we don’t know exactly what was wrong with her, but she spent several weeks in intensive care in one of the best hospitals in the region. We had no insurance and no money. Thanks to the kindness of friends and family, we were able to travel to the hospital and stay with her. After almost a month, she was released, and we had no idea how we would pay, but we hunkered down and set up a budget to scrape together enough to pay $20 a month or so. The total bill was 5 figures, a huge amount at the time and a formidable amount for us. After a couple of weeks, we received a letter from the Baptist Childrens Fund (we were Lutheran) informing us that our bill had been paid in full and wishing for us God’s blessings.
Unfortunately my mother has **too ** many similar stories involving Dad’s bills. Dad passed last December and she is *still * fighting with the bills. Often bills shows up listing her as the patient. Or having her SS# where Dad’s should be. Once I spoke to a person at the billing department. I explained that this was literally the 5th time we had been on the phone trying to resolve the problem. I asked her to read back to me the information and asked her to explain what she understood the situation to be. She got it right on the phone, but two weeks later we got ANOTHER bill with the wrong information on it.
Have I got some stories to tell on this one!
First, about hospitals’ willingness to take “anything, even $5 a month”.
It ain’t so in Omaha. My daughter’s crappy insurance left her with about $3000 to pay after gall bladder surgery. She paid one payent of $50 (yes 10 times what OP says “any hospital would be willing to take”) and was thereafter dunned by the hospital’s billing office.
When she explained that this was as much as she could afford to pay, the snotty woman told her to "put the rest on a credit card, get a bank loan, hit up your parents; I don’t care. Just get it paid off in 30 days or it goes to the collrction agency.
I told daughter to just keep sending $50 bucks at the end of every month, which brought more empty threats; until Month 3 when the $50 was sent back with a demand for immediate payment or the matter would go to the collection agency.
My second story has to do with a surgeon who tried to collect a bill from me that he forgave in my ex-wife’s bankruptcy proceeding.
What had happened was that one of my children from my first marriage needed surgery.( The ex had custody.) My divorce decree dictated that I kept both my children from this marriage on my insurance and that the ex and I should each pay half of the deductibles and co-pays.
I paid my half of the uninsured bill, but the ex declared bankruptcy, listed her half of the bills among those she wished forgiven and, since nobody from the doctor’s office showed up to object, the judge included that bill in her Chapter7.
The ink wasn’t dry on the bankruptcy decree before the doctor’s office went hunting for “Deadbeat Dad”. My curent wife took THAT call, told them to go to Hell, and was told that my credit would be ruined. Nothing ever showed up on any credit report concerning this–Doctor’s office manager was just trying to pull a fast one by trying to discredit me with the new wife as a despicable deadbeat, but the new wife knew better and let her have it. The doctor had no legal right to that money. He gave up his rights it by not objecting to its being included in the bankruptcy.
And Finally… The $10 overpayment. No,wait, make that a $20 underpayment.
Long after he attained nominal adulthood and was no longer insurable on my group medical policy, my stepson needed medical attention for his sprained knee.
Since, as usual, he was broke, I agreed to front him the amount of the bill at the local minor-emergency clinic.
After the knee had been wrapped, and meds dispensed, the clinic presented me with a bill that I immediately wrote a check to cover.
About a week later, I received a $10 check in the mail from the with an explanation that I had been overcharged that amount. The check ended up “somewhere”. ( I freely admit to being an incompetent check handler, which is why my paychecks and tax refunds, if any, are all on direct deposit.)
End of the month, I got a bill for $20 stating that I should not have received the check, and that in reality I owed them another $20. After much heated discussion, I agreed to tear up the $10 check, if ever I found it in the Limbo of “somewhere in this rats’ nest of a desk”, but I wasn’t sending them any more money until I saw a detailed itemization of all charges. My original bill was somewhat vague.
Of course “final” notices and several “last and final” notices arrived but no detailed explanation of why I should owe another $20 ever arrived with them.
My credit report never made mention of this incident despite many written and oral assurances that I faced certain “ruination” for my non-payment.
I agree.
Too many people have this misguided notion that they have a “right” to force someone else to pay their healthcare bills. In my book this is completely immoral. If you get a medical bill, pay it. If you don’t have the money, try to work out a payment plan. Or get a second job. Or take out a loan. If you’re broke and have bad credit, file for bankruptcy. But don’t force your neighbor to pay for it…
Calm down. I’m not east of the Mississippi. I’m in Calfornia. And capitation is alive and well out here, thank you, very much. Not to mention, ARISA takes a back seat to our crazy assed laws. Also, I haven’t been a biller for about 10 years…I’m a nurse. So, sorry I was unaware of the name change. I’ve been doing actual patient care. The thing you seem to think I know nothing about.
TeaElle and I were talking about what we would do, were we able, to change it. That’s what I would do. It’s a hypothetical. You need to slow down and realize, I am not trying to say “patients are lowlife scum for not paying me.” I’m simply trying to say “look, not every biller out there is an asshole.”
The ladies in our business office do their best to make sure the information is correct, and make corrections when information is received. They work hard at doing a good job. It was offensive to me that they’re being lumped in with the assholes you have run into. Just as I’m sure you would not want to be lumped in with a bunch of fumble fingered morons who dont know what they are doing, yet are in the same career as you.
Yup, the system’s messed up. But I didn’t break it, I just try to work in it. So I’d appreciate it if you quit blaming me for it, thank you very much.
In another example of outright medical billing idiocy…
I visited a dermatologist in May (which is a soon-to-be-forthcoming rant). After two weeks, I received a bill for $20, which the insurance company apparently decided was my share of the cost. Fine, whatever. The bill has the option to include a check or provide a credit card number. I fill out the bill with my credit card information and send it back immediately.
Three weeks later, I get another bill for the same thing. I ignore it.
Two weeks after that, I get a third bill for the same thing. I call them up to ask what has gone wrong. I tell them that I sent them my credit card info already. The billing clerk I was speaking to looked up my file, and confirmed that they had received my reply with the credit card info two days after I sent it - now five weeks ago. She further informs me that they hadn’t run the card yet, but that they would send me a reciept once they had charged it.
What kind of idiotic, dysfunctional billing system sits on credit card information for over a month, and then generates two new bills for the charge for which they have an available credit card to charge?
An online check reveals that they still haven’t charged my credit card, so I’m awaiting the next bill.
How is asking your health insurance company, which has agreed to pay your medical bills and to which you pay premiums, to pay the bills an immoral act? Why else would you or your company be giving them money?
How is bankruptcy not forcing your neighbor to pay?
Medical bills can easily be outside of the range you can ever expect to make or save, in a lifetime. Are you really willing to scrimp and save for the rest of your life, and quite possibly further endanger you health, in order to pay off a bill? And many of those who have had recent medical emergencies are in no position to take a second job, even assuming they still have the first one. Who would offer them a loan? I agree with payment plans, I think they have benefits for both patient and medical provider, but many billing offices will not accept them.
mischievous
Which is entirely my point. It needs to be possible. There are ways of instituting checks and safeguards against price gouging that don’t require that one hospitalization generate bills from as many different medical billing companies (who are making out like fat cats in this situation and employing assholes like the OP who could give a shit about the real people represented by those billing codes and procedure explanations) as there were departments involved in their care, which mean that patients and their insurers have – as Broomstick put it – two foot high piles of paper to wade through.
One hospitalization, one bill. Categorized by care provider, itemized for every single billable procedure, medication, supply, consultation and service. Broken down line by line so that it is understandable by humans without a glossary of billing codes, and simplified so that each hospitalization generates one insurance claim.
In a recent comedy of errors, my husband dropped a glass, stepped on a shard without shoes resulting in a severe cut/stab wound in the sole of his foot, then he rocked forward and stumbled, breaking two toes. The pain caused him to fall and bang his head on the kitchen wall and the marble kitchen floor, after which he lost consciousness for just a moment or two. He went to the ER via ambulance, and was there for about five hours. We received nine bills for this incident including:
[ul][li]Ambulance services[/li][li]Laboratory services for the blood work that needed to be done before sedation could be administered (?!?!)[/li][li]Pharmacy services for the saline IV, pain/sedative meds and nausea meds to combat the queasiness caused by the pain meds[/li][li]Radiology services for the x-rays of his foot and CT scan of his head[/li][li]Services of the radiologists (2) who read the x-ray and CT scan[/li][li]Services of the ER doctor who “supervised” the ER resident who supervised the intern[/li](The intern and resident did all the work, examining my husband, ordering his tests and meds, calling for consults and setting his broken toes. The supervising doc billed $235 for seven minutes of his precious time, during which he did nothing more than explain in very general, patronizing terms everything that the resident and intern had already gone over in depth. That bill rate, incidentally, means that he could make over $2,000/hour, far more than the supposedly money-grubbing lawyers that doctors love to hate so very much.)
[li]Services of the anesthesiologist who consulted about – but did not administer – sedation and pain management[/li][li]The surgeon who apparently can supervise his surgical resident telepathically[/li](Again, the resident did the actual work – removing the glass from my husband’s foot – and the surgeon himself never so much as stuck his head in the door of the room but signed off on the chart and is therefore entitled to $450.)
[li]Hospital services - the basic ER fee, the supplies fee for the IV tubing and the needles and the buttless gown and emesis basin, and, presumably the interns and residents who did not get to bill separately even though they’re M.D.s too.[/ul][/li]
That’s ridiculous, and our insurance company – who have 9 chances to screw up now rather than just one – and the billing companies – 9 separate companies with 9 separate idiots like the OP answering their phones – and everyone in the industry who is responsible for this state of affairs needs to hang their head in abject shame.
And be relegated to a new career answering the complaint line at Preparation-H.
First of all, don’t patronize me. Second of all, introduce me to the attorney who files a lawsuit over a $75 misbilling claim. Come up with one and I’ll believe that this is an issue and not a strawman you’ve pulled out of your butt. Third, prove to me that billing disputes have any correlation to malpractice insurance premiums.
Fourth, and most importantm I specifically explained the “useless argument” point: successful lawsuits will always “drive up costs” or (more frequently) be used as the excuse to raise costs, no matter what industry we’re discussing or what type of lawsuits we’re discussing. But that is not a reason to limit people’s ability to turn to that option when a dispute cannot be settled in another way. People have to have a right to sue when the non-adversarial options do not remedy their problem.
So we can talk about how awful it is that people sue and what a terrible effect it has all the livelong day, but people are going to sue. It’s a given. (Unless certain political interests – fat from the trough of insurance industry money – have their evil way.) What we ought to be talking about is reducing the incidents that lead to those lawsuits, like the 98,000 fatal medical “errors” each year in this country. Instead of bitching about people suing, how about bitching about the fact that the medical professionals who are charged with overseeing review processes are still slow to act when one of their own evidences the kind of incompetence that ruins (or outright steals) patients’ lives?
TeaElle, submitting one claim for all services performed isn’t possible unless all providers are hospital employees. Since this is rarely the case, we’re stuck with multiple claims for services.
Many consulting physicians such as radiologists; specialists such as cardiologists, neurologists, surgeons, OB-GYNs; and the like work for their own practices, who then bill for the services these doctors provide. Moreover, one practice’s doctors may service multiple facilities. It’s not uncommon for one city with two (or more) hospitals to be served by one radiology practice, for example. If the hospital billed for the radiologist’s services, the accounting would be a nightmare for the hospital and the radiology practice, and the benefit to the patient would be minimal.
The system of independent contractors does work to the patient’s benefit, because a relatively small facility doesn’t have to recruit and retain a large variety of specialists on its own. Specialists can be called in as they’re needed, and they can bill for the services they perform, rather than the hospital jacking up its costs to cover the salaries and benefits of specialists who may not have that much to do.
Granted, it’s a complete pain in the ass to get nine separate claims, but until the system changes, that’s what we’re left with.
Also, the reasons the attending physicians billed when residents performed the services are these: First, residents do not bill for their own services. Second, should a resident have made a mistake, it’s not the resident’s ass. It’s the attending’s. (I’m sure DoctorJ can go into greater depth about this.) The attending must sign off on all care given, and a lot of discussion happens outside the view of the patient. Thus, what you took to be seven minutes of the attending’s precious time could have been quite a bit longer when you consider that the resident and attending most likely discussed your husband’s injuries at some length before and after either one actually saw your husband.
Oh, and the OP is a fuckwit. Persons such as these are a reason why I’m glad I’m out of billing.
Robin
Let me make this point again. (Why I’m bothering, I don’t know.) This is only the case because this is how the industry wants it, and they’ve “sold” it to us as a protection for us but that supposed protection, which could be implemented differently, comes at the price of complication, confusion and a much greater possibility of billing errors that are never caught by the patient because of the endless streams of paperwork they receive which all seem to pertain to the same issue and aren’t written in standard English.
Now granted, in my husband’s situation, the ambulance bill is one thing, but everything else took place in the hospital, and yet, the information was sent off to billing companies as far away as Kansas. If the surgeon who never physically set eyes on my husband can submit his information to a company in Overland Park in order to get paid, he can submit it right to the hospital’s billing department, or the same billing company the hospital uses, for inclusion in an omnibus bill.
But the law – bought and paid for by the industry which benefits directly from the confusion – says that he can’t, and therefore, too bad so sad for the consumers who actually have to wade through all the nonsense.
We’re told that we should be more proactive about our health care, about our insurance coverage, about making sure that our bills are paid in a timely fashion and so on, but the mechanism by which we can do those things is severely broken thanks to the machinations of the self-same interests that preach to us about our responsibilities as consumers of medical care and insurance, and have the cash to buy the politicians that make the rules that keep the playing field tilted entirely in their favor. It’s an unacceptable situation.
Hmmm…I worked three minimum wage jobs. After rent, I had a budget of $7.00 a day. I didn’t have adequate kitchen facilities, so I mostly lived off large $5.00 burritos that I could split between two meals. The extra $1.50 a day was saved for things like toothpaste or the occasional cup of coffee to help me stay awake on those weekends when I’d work six shifts in three days. $7.00 may seem like a lot until you realize that if I had to box of Nyquil for a cold that meant I didn’t have food money for two days. I’d take my birth control pills (provided free by planned parenthood thank god) continually because buying a box of tampons would break me for a while.
I could have done the $5.00. but it would have been one day without a burrito (usually I could find a friend to feed me). If I wasn’t so scrupulous about keeping my affairs in order I really would be tempted to ignore, figuring that things can’t get much worse than they already were.
I know there will always be outrageous examples of incompetance that will be cited when it comes to the medical and insurance professions, but I still have to argue that as a consumer, I can get involved in the process with positive results.
Example- my pregnancies and deliveries. The first bill was from the OB/GYN, at the beginning of the pregnancy. She billed for the expected cost of standard office visits and an uncomplicated vaginal delivery. This bill was due before the 7th month of the pregnancy, and it was paid by the ins co and I. BTW, she actually ended up refunding me a portion since she was not on call for the birth and therefore wouldn’t charge me for it (as well she shouldn’t).
When the big day arrives, there are all sorts of busy bees buzzing around Mommy, and most of them did their own billing! I guess it would have seemed more complicated if I didn’t keep track of who sent what, but I did. I kept all the invoices in a file, and kept track of who had been paid by insurance, who hadn’t, and what was left over.
As I said earlier, only a fool will pay a hospital bill without seeing the itemized version. But frankly, every item on the revised bill corresponded to a procedure or service I received. So what if I had to write one check to the hospital and another to the anesthesiologist, then a third to the chem lab and a fourth to the radiology lab? Big deal.
Maybe I’m just lucky that I haven’t had any terrible snafus in medical care or billing. But saying that it’s too much of a pain in the ass, so fuck you, I’m not paying is childish, stupid and irresponsible.