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Saturday, Aug. 2, 2014

Grassroot healthcare reform.

Posted Tuesday, August 18, 2009, at 4:50 PM

This isn't going to be exactly what you expect but it is about health care and it is about changing things.

I requested a copy of my statement for some recent treatment I received because the insurance just had it listed as $XXXX.XX for June and $XXXX.XX for July. I was trying to be a responsible patient so I called them and asked how the billing was broken down. They did not know and suggested I contact my medical billing office.

I just got the detailed statement and it is sitting on my desk as I write this. I know what doctor submitted the bill, but after that it is all multiple entries of short abbreviations that mean very little to me. What about changing detailed bills so the PATIENT can understand it? Maybe we could catch billing errors. (not that they EVER happen)

What also surprised me is that the insurance company did not seem to be concerned that I could not double check things. Since computers can only compute what people put in and since people are human (meaning they can make mistakes) why would they not want someone double checking this stuff? How many millions are lost or gained by this?

Maybe every error the patient finds, it could be applied to their deductible. Wow! We might even MAKE money! If nothing else, overall health costs might be reduced if the patient took responsibility and had a decent chance at understanding the billing.

I realize that more patient questions could increase payroll needed to explain it, but either it would create more jobs or they would explain it better in the first place. What a concept!

This will probably disappear into the internet black hole, but I had to vent a bit.


Comments
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I think on balance it's a wash. For every error in your favor there's probably one that you didn't get charged for.

Having said that you are EXACTLY correct in that billing is a huge morass that can confound even "experts". There is an entire industry devoted to nothing but coding and billing. I get a headache every time I open the CPT codes(which by the way change every year).

-- Posted by Tim Baker on Tue, Aug 18, 2009, at 9:27 PM

Not only is there an entire industry built around coding and billing...there's one built around correcting billing discrepancies.

-- Posted by Thom on Tue, Aug 18, 2009, at 9:42 PM

After reading all thos wild comments perhaps it's time for all of us fix a big sack of popcorn, get a 6 pack of RC Cola and a couple of Moon pies then tune in to a 2 hour documentary at at http://video.google.com/videoplay?docid

As you view it, ask yourself "Why is Obama wanting to do these things?" In the opening of the film he is suggesting a Homeland Security Force, he wants it equal in power and equipment to our military! Why? We're the land of the free and the home of the brave! Or Are we??? We already know that he is wanting to do away with our 2nd amendment rights. WHY?? All the data I've seen on nations which took away the citizens weapons, the crime has increased! Could it be that the powers behind him have plans for us which will be easier to implement if we are not armed? Could that also be the reason for the homeland security force?

Recently the USAF recalled certain recently retired O-4s and E-7s to active duty for a 30 day period. Their job was to get retrained on recalling other recently retired military personnel in case of a national emergency. Whether this has been in effect for some time or is a recent program I do not know but it could certainly be used for setting up a "Homeland Security" force.

Why do you suppose Hillary withdrew from the race? Could it be that we remember too much about her from when she was ruling the roost with Bill? Also BO is a much more polished speaker who, if the hearer doesn't analyze what is being said, can present a very convincing speech!

How did an unknown "Neighborhood Organizer", who allegedly has spent close to a million dollars on Lawyers rather than producing a legitimate birth certificate proving that he is a natural born American citizen become our president? The US constitution requires that a person be a natural born American citizen to be eligible to fill the office of President of the U.S. If he is a natural born American citizen why does he continue to not produce a legitimate birth certificate?

Yes, this film clip probably has some minor errors in it, it covers a lot of ground and therefore has a lot of opportunity for error. The film leads us to believe that the World Banking System is the power behind Obama. And I tend to believe that also, I think that is the real reason that Obama bailed out the banks with our money, after all, it does appear that he owed them a "Payback". Notice the list of names they show and the organizations they are members of. Think back to when those people were in the news and how they ruled!

God told Abraham that he would make a great nation of his offspring, the Jews are that nation. He also told Abraham that he would bless those who blessed the Jews and curse those who cursed them. The Old Testament is full of instances where he did just that. A few years back Obama wrote a couple of books, in one of them he said in essence that if push comes to shove he would side with the Muslims. In the past America has always stood with the Jews, and God has blessed us. The Muslims goal in life is to annihilate the Jewish race. This is the first time America has ever had a President who wants to bring God's wrath on America.

-- Posted by Brown Biscuit on Tue, Aug 18, 2009, at 10:44 PM

Brown Biscuit

What in the world are you smoking? Take your tin foil hat off and come out into the real world.

-- Posted by GoTitans on Tue, Aug 18, 2009, at 11:09 PM

Oops, looks like that link isn't working. Try Googling "The Obama Deception". Several links will come up, take your choice of any of the full length movies.

And to answer your question Go Titans, I do not smoke nor wear a tin hat and I AM IN THE REAL WORLD.

After you view the documentary I think you may change your tune, it is not singling out any party or president. It is just telling us where the power lies. If you've been around more than 40-50 years I believe you'll agree with me. Each year we've gotten farther and farther away from our constitution and the majority of Americans don't even realize it or who is pulling the strings, Whether we have a Demoncrat or Repuklican in power it doesn't matter, the same group of elitist are pulling the strings.

-- Posted by Brown Biscuit on Wed, Aug 19, 2009, at 12:27 AM

I think you have got it right and clearly see things for what they are brown biscuit.

Most people allow time to slowly weather away the correct reality of what is actually happening and they become deceived by the adversary.

-- Posted by Blessed Assurance on Wed, Aug 19, 2009, at 7:39 AM

Wow! Did this get sidetracked?

The original concern was NOT a political comment. It was aimed at asking the medical profession to make things a little bit clearer than bog mud when it comes to billing statements. They may need to abbreviate and develop their own jargon internally but surely software can be created to translate it back into an understandable language.

It is worse than reading a legal brief. At least there you THINK you are starting to understand it before you realize before you realize that the first part negates the second part, even thought the third part reverts back to the first part and the.......

-- Posted by stevemills on Wed, Aug 19, 2009, at 8:55 AM

Our last major medical expense was a billing nightmare. Because part-time workers are not offered insurance, we were among the uninsured who are responsible for paying all medical fees.

As a result I requested and received detailed breakdowns of all medical costs. I can be very persistent when it comes to getting people to explain things. These are a few of the errors I found:

Payment Plan Penalty:

When paying the bill, I had to sign papers accepting responsibility for procedural fees. I noticed that on one document that if i did not pay when services were rendered a 30% add-on would be included. That means if I had to establish a payment plan the service would cost me 30% more that it was worth. In our case a $24,500.00 surgery would cost us $35,000.00.

Emergency Room fees:

Paid ER in full at time of visit, Three weeks later received a separate bill from the ER's attending physician's office for treating the patient in the ER. Hospital claimed that although all fees were paid in full and they do compensate ER doctors, those doctors may render separate bill that the hospital is not privy to.

Bill Paid in full at time of procedures, but payment office computer does not talk to main computer and a transcription error caused a balance due. When initially questioned, was told to talk to collections department. A second call resulted in talking to a young woman who took it upon herself to find the problem - she did and not only corrected the error, but found a $1.57 error that she also corrected.

Hidden fees:

Requested a full disclosure of fees, so could pay at time of procedure, received itemized cost breakdown and paid in full. A "specialist" in that field then rendered a bill for his services to read the results. When questioned he demanded payment as it was his due. Further discussion and examination led to _"Whoops, I included the hospital's fees on my bill too." They had already been paid to the hospital. The hospital claimed they had no idea that their specialist rendered a separate bill for his services and as a result could not include it in the itemized fees request.

Double Billing:

Hospital charged for use of equipment (that they own) and was used by their paid technician. But on a separate billing from hospital assigned doctor received (from his medical office) the same charge and fee for that equipment and use. Explained that I would only pay the fee once and had already paid the hospital the doctor removed the fee from his bill.

As a member in poor standing of the employed, but uninsured I have had to scrutinize every medical bill received to ensure that I am paying only for what I receive and only pay it only once.

A single medical procedure generated over 15 separate billings, received over a period of 4 moths. Illness is stressful enough without that added pressure of having to monitor all charges and deal with "professionals" who seem to be offended when questioned about their billing.

On a positive note; The Physician/Surgeon who performed the surgery and follow-up was the only one whose billing was straight forward and reasonable. The Surgeon's fees were the smallest of all fees charged and he spent more time and effort than any of the other participants. He is great at what he does and was wonderful to work with.

-- Posted by amalphia on Wed, Aug 19, 2009, at 9:06 AM

moths = months

Sorry about the typo.

-- Posted by amalphia on Wed, Aug 19, 2009, at 9:15 AM

Amalphia, this is a great example.

My bill had multiple entries for the same exact item on the same exact day for the same exact charge "Device Design". Now if I could only understand what it was and why it was charged 7 times. At $560.30 each I would sure like to know.

The next entry was "dose calc" at $252.25 each for 7 times on the same day. I would remember get 7 doses of something so what is it?

It may be accurate, but the insurance company could not tell me so my choice was to call medical billing. They did not know what it was and suggested I call my doctor, who would probably charge me for a visit to explain the bill!

Come on folks. How about a little 'patient friendly' explanation the FIRST TIME!

If stress causes illness, are they not contributing to the medical event?

-- Posted by stevemills on Wed, Aug 19, 2009, at 9:39 AM

Steve,

I'm with you on this one. As a healthcare employee, it's even hard trying to explain things to patients. Medicare requires ABN's to be given to patients when there are possible test they will not pay for. It hard to explain to a person hospitalized with chest pain why medicare will not pay for an EKG, to see if they have had a heart attack. Interesting, but very true. Billing within the medical system is a nightmare and even worse for patients and family members, and this is where most reform needs to take place.

-- Posted by Sharon22 on Wed, Aug 19, 2009, at 9:45 AM

Steve,

Those who know me, know I can be feisty when frustrated. With your "Dose Calc", based on non-medical lingo a dosage calculation would only seem appropriate when calculating the initial dosage for that medication - unless your weight or response to that med changed with every dose. But then they will bill you for each dose - find out which is more expensive, the "dose calc" or the pill. You may be surprised - go with the cheapest!

When requesting an explanation of the billing codes used I found that I did not usually talk with the doctor, as they claim not to be involved with the codes. The doctor's business office manager was the one I dealt with and they do not charge for questions. If they can confound you into submission, then they get the money. A patient learns patience when seeking clear concise answers to billing questions.

I used tools I learned when being certified to teach a class called "Dealing with Difficult People." The "Gentle Art of Verbal Self-defense", a book, teaches - listen to the explanation and take it to its logical extreme. The person usually responds with, "That's ridiculous!" Then you have the start of real negotiations.

I wish you luck. If you want any help (my experience is limited) with working the billing through, I believe you have my e-mail.

-- Posted by amalphia on Wed, Aug 19, 2009, at 10:02 AM

I received a bill from our doctors office and didn't think anything about it. One day I was going thru paperwork and finally looked at the bill...and then the date and started counting backwards to the last time I had my kids at the doctors. They had billed me an office visit for someone else! More than likely a typo of patient numbers, but still...how many people would have just paid it?!

I also questioned my insurance company on some discrepancies after receiving the detailed hospital bill after my child was born. My insurance company said not to worry about it, it was just easier for them (insurance) to pay it than to dicker with the hospital about it! WHAT?! And we wonder why we're in the situation we're in now!

-- Posted by neighborhood mom on Thu, Aug 20, 2009, at 11:01 AM

I had a simple X-ray last week and got a copy of the billing that was sent to my insurance. A certain unnamed hospital (not this one in case your wondering) billed my insurance $495.00 for a Xray. It was nothing just a simple X-ray.... isn't that a bit over the top for doing something that took all of 10 minutes? And I am sure the bill for reading it is yet to come!!!

-- Posted by Dianatn on Thu, Aug 20, 2009, at 11:48 PM


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Steve Mills and his wife have one daughter and live on a farm outside of Bell Buckle. They previously owned two coffee/ice cream shops, currently operate an internet sales company and teach classes, but his primary job involves the paper industry worldwide. Hobbies and interests lie in gardening, photography, recorded music and of course, their pets.