I've been pretty good about posting positive things lately. Heck, I've had posts that are nothing but telling the world I'm grateful for things. But today... I'm cranky.
Sure, I'm still very grateful for lovely moments with Bookworm (she woke me with coffee! And then, later in the day, she bought me more coffee.)
And yes, I'm also grateful for a generally good life.
But, I'm really cranky about the amount of time I've spent today working on medical bills. While I'm not happy with the size of the bills (who is?), that's not what's making me cranky.
We are a family of four mostly healthy people. All of our doctors (including some, but not all of the dental professionals) work at the same organization. That ought to make things pretty simple, right?
Some of the complexity comes to use courtesy of HIPAA, which requires the clinic to create a separate billing account for any mental health care charges one might have, so that no one seeing a regular medical bill can tell that you've ever seen a mental health care professional. But that ought to mean we have two accounts to deal with.
Nope. We've got ten, or is it fourteen? I can't even TELL how many separate accounts we four have with our health care providers. I get upwards of six bills at a time. All of them from the same folks -- but with different account numbers.
I'm not kidding. I get two separate bills from the C**** Physician Group. Golf Pro gets three separate bills from teh C**** Physician Group. Bookworm has one of her own from the C**** Physician Group. And, even though one has labs done right there at the same clinic where the doctors' offices are, they get billed through the C**** Foundation Hospital -- so I have one account with them; and for some reason Golf Pro has somewhere between one and three, but they show up on one bill. Of course if you are actually in the hospital and see a doctor, the Hospital doesn't bill you -- C**** Physician SERVICES bills you. But wait... if you see one of the dental surgeons, they have their own separate account numbers (still under the C**** Physician Group name... ). I'm lost before I even look at the bills.
But you know, one can slow down, and take one step at a time, right? Look at each bill as just another bill. How bad can that be? I mean, I can (and do) put all the little payment slips for the same billing entity in one envelope and mail them together (yes, I've put five different slips in one envelope going to C**** Physician Group, each with a separate payment via a credit card). So why does it take hours?
When they bill you, they don't tell you which doctor you saw. And, they don't necessarily allocate your co-pay to the charge you thought it applied to. And though they swear that they allocate any payment not designated as a co-pay to the oldest outstanding charge, they don't actually do that. Heck, sometimes they split payments between accounts! (If they can do that, why can't they just send one freakin' bill???)
And they usually divide up any given payment between several charges.
And.... if you've actually paid a charge off with a payment, that whole thing disappears from your next statement, so you can't SEE that the payment was allocated to a given charge. We were actually all caught up for several months -- our co-pays kept us fully paid. So, we didn't get statements at all. That meant that I never got confirmation from them that they'd received and allocated the whole payment for any payment we made.
This has meant that I have to call the patient accounts office monthly to request detailed statements that actually reveal most of the information you might need. Those statements take weeks for them to produce. And today, I found one in which they'd allocated part of one of my payments to a charge that had been fully paid for by insurance.
Of course one of today's bills included two co-payments, but didn't actually include the charges for which those co-payments were made!
This complex slight of hand with the payments sometimes means that they don't, in fact, allocate the whole payment -- which leaves a few dollars here and a few more there just... hanging out there. Of course, if a payment hasn't been allocated to a charge -- they don't count it as having actually been made when they tell you the total amount you should send in. It'll count on the next statement (maybe),once they 've allocated it. And sometimes... they change the allocations -- so that something you were sure was paid off, isn't anymore, and something else has some or all of that payment as a credit.
It's so confusing that I've taken to making up my own spread sheets. They show the charges, the insurance allocations, and my payment allocations on one worksheet -- and the payment I've made and their allocations on a second worksheet (just to verify that they line up, which they don't always do). So, in paying their bill, I seem to have two worksheets for each of those nine, er, ten, um, fourteen?? accounts. It's a pain in the *ss. But it saved me over $500.00 one year (they'd actually failed to fully allocate that much).
This doesn't stop them from threatening collection. There was a $12.78 charge for something to do with the lab (I think it was the charge for the phlebotomist doing the stick (the tests get billed by someone else). I'd paid it, by sending in the statement with a credit card number etc. Then I got another bill, and paid that. But they'd hauled off and allocated both payments to a different account anyway. So then, I got a call warning me that the account in question was about to go to collection.
And forget about making things work out if you're using Quicken to keep track of things. "Reconciling" a statement is just plain impossible.
This makes me very cranky.
I don't mind paying my bills (much). I have even almost gotten over the gross injustice that is our mental health care coverage. But I really resent having to put in a full days work each month just trying to figure out the bill. If I thought for an instant that I could trust them to really allocate the whole payment every time, I might just write the checks -- but I've learned over and over again that I can't trust them to do that.
I wish I could bill them for my time.
If continuity of care weren't so darned important to me, I swear I'd drop them and go in search of medical professionals whose business office has any respect for their patients at all.
It makes me wonder -- is this standard for the medical industry? or just the special behavior of our local medical professionals' business office?