Medical Billing Woes

Well, this was a mistake, on a 97 degree day I was paying bills for July (always a problem for me, see Paying Bills), and I decided to try to straighten out one of my pending medical billing problems, since the mail included a letter from a collection agency concerning the bill.

The bill was from Swedish Medical Center, for $72, for "ongoing outpatient care" with a date of service of 11/28/2006. Now my insurance provider, WSHIP, has a contract with Swedish, so after I've paid my out of pocket deductible and copays of $1,000 a year, I don't pay any more for medical care during the year as long as I stay with the providers on the list. (If you've been in cancer treatment, this will make sense to you. If you haven't, it may not. It's a whole new vocabulary out there in Medical Billing Land.)

Since I always manage to reach my deductible each year during the month of January, I was pretty sure this bill was a mistake--by November I have paid my out of pocket max and I shouldn't owe anything.

This bill has been sitting in my "to do" pile for a couple of months, but those of you who read this blog regularly know that I've been busy with medical problems during the past little while and haven't had time to get to it.

But, as I've said before, we cancer patients amuse ourselves with these phone calls, so today was the day to clear it up, I thought.

I called Swedish, and talked to Julia. She said my insurance company had paid $30.60 on the bill, leaving a balance for me to pay of $41.40. Any error, she said, had been made by my insurance company.

Before calling WSHIP, I checked for an "explanation of benefits" from WSHIP for that date of service, but didn't find one that matched the amounts. So I called WSHIP and talked to Jackie (Jacki, maybe).

Jackie was very helpful, as the folks at WSHIP generally are, and she told me that WSHIP did not have a claim for that date of service that matched the amount. There were two charges for 11/28, both for my radiation oncologist, and those had been paid.

So, what to do?

This is where it gets really weird, but it always gets really weird when dealing with medical billing. I called Swedish back and talked to Julia again.

This time, she said that, despite the date of service on the bill, that claim was for January 30, 2007.

"That's how the billing system works," she said. "There's nothing I can do about it. I've brought it up with my supervisor, but there's nothing we can do about it."

When I asked how I was supposed to confirm the date of service on the bill, there was a long silence. A very long silence.

I won't be paying that bill any time soon.

A note on letters from collection agencies: This letter, like all collection agency bills, says that I have 30 days to dispute the bill. If you get a letter from a collection agency, whether you think it is an error or not, don't ignore this. Send a letter--this is not the time for a phone call, you need to start a paper trail--and say that you dispute the bill. In this case, I will give the collection agency the info from WSHIP and invite them to call WSHIP to confirm.

I will, however, be sending another letter to the head of Swedish. He never replied to my first letter, published here as 15 Phone Calls, but he has sent me form letters asking for money.

How about if I offer him a deal: You (Dr. Einstein is his name) sort out the billing department so I don't have to waste my time with unsolvable (by me, anyway) problems like this, and I'll leave Swedish a donation in my will. Seems like a fair trade here--we are dealing with an illness that is going to kill me before too long, and I'm really not at the top of my game when it comes to ridiculous situations like this.

Will Swedish send a collection agency after me for $41? You bet they will; they already have.

Read more:

How Cancer Patients Spend (Waste) Their Time

Medical Billing & Insurance Woes: "Payment reduced per sanctioning policy" and other mysteries

@ Jeanne Sather 2007.