It Pays to be Persistant

If you read my previous blog, you would have seen how a simple trip to the ER for what turned out to be nothing generated $2398 in bills. If you haven't read it, you can read it below.

Well after a few more phone calls questioning coding and such, I was able to reduce the $2398 down to $728.45 !!! This took a lot of my time and I am sure no insurance company would even question the bills. Most people, after they got the statement showing what their insurance paid, would not question it either. And that is a problem.

I was miscoded, charged for a service that I was told was at no extra charge, and charged for an ER visit that was unnecessary. Only by being proactive and questioning the why of all these charges was I able to get the hospital to eliminate the unnecessary charges and reduce reduce the remaining charges to something more appropriate for the level of treatment I received.

The cost of medical care is out of control. Insurance costs are out of control. And the two are tied together. If hospitals or medical  providers submit the kind of inflated billing that I received, with all the errors, and insurance companies do not or will not challenge them, then the whole system feeds on itself and the consumer pays. Either in higher insurance premiums or higher medical costs.

So, the next time you get a bill from the hospital, call immediately and request a detail billing showing all procedures, services and  supplies, right down to the aspirin and tissues. with all the relevant coding. There are several sites online where you can look up what the codes mean and you can also check to see what the average prices are in your area. You might be very surprised at what you find.

It Cost How Much?

One day, late in the afternoon, at the end of February, after speaking with my PCP about what I thought might be a blood clot in my leg, I was advised to go to the emergency room at my local hospital. This hospital happens to be a Critical Access hospital, so I knew the charges would be a little higher than your average, regular hospital.

I presented myself to the ER at approximately 4:00 pm. After waiting for an hour or so, I was finally taken to a room, told to undress, had a heart monitor attached and told that a doctor would be in soon. After another hour or so, the doctor arrived. He felt my leg, asked a few questions and said that he did not believe I had a clot, but wanted to have an ultrasound performed to be sure, which he said would be at no additional cost. This took all of 5-7 minutes. There was a problem though, the ultrasound tech and radiologist had gone home for the night. Consequently, he said he would schedule the procedure for the next day. I now expected a nurse to come in to detach the monitor and I would be able to leave. However, I waited another 45 minutes or so before I disconnected the monitor myself, got dressed, hung out for another 10 minutes or so, then told the nurses station I was leaving and went home. ( Of note: not one nurse, doctor, LNA or anybody blinked when I removed all the leads of the monitor. And I never even saw another nurse after the first one attached it in the first place.)

The next day I received a call telling me come in for the ultrasound. I did that and had the procedure done in a very timely manner, 15 minutes top, after the tech had to have the order changed because the doctor had indicated the wrong leg. The tech said that the results would be ready in about 10 minutes and she escorted me out to the ER waiting area. Again, waiting for about half an hour, I was called into the ER and shown a room. At this point, a nurse wanted to do vitals, which I refused, and then registration arrived. I informed the woman that I was just here to get the results of the ultrasound, but she insisted that it was SOP. Finally a PA came in and said that the results were not in yet and that I would have to wait. I told her that I was done waiting. We agreed on 10 more minutes, and after 15 she returned to say that the results were negative.

OK, so now to wait until the bills come in. Boy was I shocked.

Emergency room visit;
 undiscounted price, Level III Facility charge..........................     $657
                                 Level III Professional Fee........................     $437
                                 Ultrasound the next day...........................      $869
                                 Ultrasound reading................................        $190
                            Second ER visit to get the results of ultrasound $245

  Total for no more than 1 hour of service..........................................       $2398

To be fair, these are undiscounted prices, and the hospital does offer discounts. So after discounts:

Emergency room visit;
 discounted price,   Level III Facility charge..........................       $558.45
                                 Level III Professional Fee.......................      $371.45
                                 Ultrasound the next day.........................       $509.67
                                Ultrasound reading................................         $ 71.42
                          Second ER visit to get the results of ultrasound $143.69

   Discounted Total................................................................................    $1654.68

It would be a severe understatement to say that I was pissed. First off, just the dollar amount seemed ludicrous. Healthcare Bluebook defines Level III as SEVERE and the doctor said there was nothing wrong, just an ultrasound to confirm. Then how could I be charged for a Level III ER visit?

And $869 for an ultrasound? Are you freaking kidding me! Then to charge me for another ER visit to get the results? Ain't happening! And what is with those undiscounted prices? Who pays those? Certainly not an insurance company, seems like not even the person who has no insurance.

Well, I have to say, a few phones calls and a well written letter to the Hospital CEO, the Chief Medical Officer, Head of Nursing and the Chair, Vice-chair and Secretary of the Board of Directors works wonders. Ultrasound bill and Second ER visit, written off; first ER visit lowered to Level II (which I still disagree with and have yet to see the bill). Next on the list is the ultrasound reading, which this hospital contracts out to another hospital. I figure since they wrote off the cost of the ultrasound, they can contact the other hospital and have them write off the reading of it (fingers crossed).

So after the write offs, and before I find out what a Level II ER visit will be, my cost is $1001.32 I am hoping to knock this down another couple of hundred dolars. Still a very high price to pay for nothing being wrong.

It's is no wonder why people have to sell their homes, spend their life savings or declare bankruptcy to pay for a major medical issue. The system is broken! Hospitals and insurance companies that operate "For Profit" do not care about you or me, only the bottom line and the stock holders.

Wouldn't people be outraged !!!

Here are some thoughts on the First Amendment for all those who want to restrict Second Amendment rights.

In order to speak publicly in any forum or location, publish an article or letter to the editor in any newspaper, magazine or other print media, publish any thoughts, pictures, memes or ideas on any social media site or publish any video online in exercising your First Amendment rights. This includes participation in any rally, march, demonstration or protest;

1. You must first obtain a permit. In order to do so, you must attend a certified writing course, or a certified public speaking course, or a certified visual media course and submit said certificates to local and/or state and/or federal authorities for approval.

2. You must pass a criminal background check.(NICS with all the same faults and flaws the system has now)  A prohibited person is one who:

• Has been convicted in any court of a crime punishable by imprisonment for a term exceeding one year;
• Is under indictment for a crime punishable by imprisonment for a term exceeding one year;
• Is a fugitive from justice;
• Is an unlawful user of or addicted to any controlled substance;
• Has been adjudicated as a mental defective or committed to a mental institution;
• Is illegally or unlawfully in the United States;
• Has been discharged from the Armed Forces under dishonorable conditions;
• Having been a citizen of the United States, has renounced U.S. citizenship;
• Is subject to a court order that restrains the person from harassing, stalking, or threatening an intimate partner or child of such intimate partner;
• Has been convicted in any court of a "misdemeanor crime of domestic violence", a defined term in 18 U.S.C. 921(a)(33)

3. Said communication will not contain any inflammatory language related to race, color, religion, sex, sexual orientation, gender identity or expression, age, disability, marital status, citizenship, national origin, genetic information, or any other characteristic protected by law.

 4.Said speech or video will last no longer than 3 minutes, and if written will be no longer 500 words. These limits are set because everyone knows that it is unnecessary to speak or write anything longer than that on any subject at one time and that anything longer will only incite strong reactions.

5. All written, visual or verbal (submitted in writing) communications will be submitted to the authorizing agency for approval and will be subject to a three (3) day waiting period before being published or spoken.

6. Violations of any of the above could results in fines and/or incarceration and loss of First Amendment rights.

.

Similar to the rules as for purchasing a firearm. And similar to the restrictions trying to be imposed on law abiding firearm owners.