Here's a New One: The Blind Billing Call

I had a voice mail message this morning, a canned message asking me to call the "patient accounts billing office" at some 800-number.

But here's the catch: The message didn't say WHICH patient accounts billing office. Which cancer center?

I probably have eight different providers (billing jargon--doctors are providers, so are all the places I go for tests, like Via Radiology), so how am I supposed to know which one is calling me so that I can be prepared when I call them back?

Obviously, they don't want me to know.

Is this a deadbeat call? I love those--"We have sent you to collections and we are going to call all your neighbors and tell them you don't pay your bills." I had one of those once, but it was from a credit card collections agency, not a medical center. Credit card companies are foul, but if you have cancer you probably already know that.

Delete that message. If they want me to call them back, they need to tell me who they are.

@ Jeanne Sather 2008.

Comments

[Pam]

I had one like that a few weeks ago. She said that I owed Premiere Health $42.67. She said it was over due and that it was going to collections.
I told her I that don't know what Premiere Health is and that I don't know who she is or what the hell she is talking about and that if owed something, send me a bill!
I have not had a bill or heard from anyone yet.
Pam

[Sara]

Oh, yes, this would trigger my alarms, too.

After my MRI yesterday, I spent a good half-hour wandering the hospital looking for the billing office just so I could have someone who works for the hospital verify that a piece of paper I got purporting to be from a doctor whose name I didn't recognize and asking for $25 and my social security number, among other information, was a real and valid bit of correspondence and not part of some scam. Since it turns out that the guy really is a cardiologist who works for that hospital, and the Commonwealth of Massachusetts requires licensed cardiologists to read EKGs so his name goes on all the ones done at this hospital, and apparently I was EKG-ed as part of my inpatient experience on March 4, the guy who helped me and I figured out that this was just the amount still owing after insurance had paid and that all I needed to do was send in $25. I will blog this next week after I have confirmed that this is the case, because now that I know that this is a legitimate claim from a guy who really is under contract with this hospital as their EKG guy, I feel far more comfortable just calling the office number listed and asking point blank. But sheesh, it really creeped me out to get this form letter.

And I've had horrible phone calls from bill collectors for hospitals and doctors, too. They start about six to eight weeks after whatever procedure has just occurred, you know, in that grey period of time that is outside the thirty days by which all bills are due but during which your insurance company is still thinking about whether there is any way it can get out of paying. After I had my leg cut off, I even got calls from a bill collector who was clearly drunk, and threatening, as late as 8:00 p.m. "Where are you, Sara? Why don't you pick up the phone? I know you're home." (In point of fact, this particular time I wasn't.) "Don't play games with me, Sara. I'll make you pay."

I didn't even know to whom to report this. In retrospect, I probably should have called the hospital, but from two months after my surgery, whenever I had done that for whatever reason they would tell me they had "sent it to collection and no longer ha[d] those records." And I was so stressed and confused -- over bills, not having my leg cut off! -- that I was afraid to say two words to anyone about any of this and just let it go.

Billing is a real area of vulnerability for even the most assertive among us. It's a minefield of incompetence and cruelty, an unconscionably neglected cesspit, and frankly just gratuitous torture inflicted upon sick people when everybody knows few medical bills get paid in 30 days and everything has to go through labyrinthine channels. It also leaves us open to crime -- some of it institutionalized.

[jeanne]

When I go to ASCO--the oncology conference--in June, which I am going to do, if I get a grant to cover at least some of the expenses, I'm going to ask if anyone has ever done a psychosocial clinic trial on the effects of stress over medical bills on cancer patients' recovery and long-term prognosis.

My guess is that no one has, so I am going to propose it, and use some of these comments to illustrate my point.

Thanks, everyone for the examples. Although I am very sorry that you had these experiences. Sorry, but not surprised.

[Sara]

Thank you, Jeanne. And I'm probably not the only one here who would do this for you -- well, for us, too, when it comes right down to it -- but if you need supportive letters for your grant application(s), do give a holler. Personally, I have no impressive credentials, not even a college degree, but I am willing to tell anyone who will listen that I would feel well-represented as a patient to have you attending events like.

[jeanne]

Sara--thanks. Me being me, I haven't looked at the application yet to see what it involves, but I hope to be writing it this weekend. If I need references, I will use your name.

I'll put up another post about what I hope to do at the conference--besides give out Boycott October buttons.

[Dee]

One of my friends was supposed to have a procedure at OHSU last fall, but when she got there, they decided they didn't need to do that particular procedure, so they did another one that cost less money. She received her statement from insurance that showed that they paid for the procedure that wasn't actually performed!! So, she had to call her insurance and tell them to dispute the charge because she hadn't actually undergone that procedure. My friend works in accounts payable here at the local hospital, so she knew the procedure codes and knew that her insurance was being billed incorrectly! Unbelievable, huh?

I've had some go-rounds recently at our local clinic. They've gone to a new billing system that is supposedly more transparent. But, get this. I received a bill last spring or summer for $30 or something. Then, I didn't get a bill for a few months. I then received another bill which had some other things on it but then it said I hadn't paid that previous bill! When I called, they said that they put my payment onto a previous visit, for which I hadn't received any bills because insurance was pending, but sometime between their sending of the bill and my paying of the bill, insurance paid for the previous visit, showing a balance, so when they received my check, they put it to that earlier visit, not the visit for which I received a bill. I asked, but look at my statements, I NEVER got any information about this earlier visit, so if I'd known that there was a balance owing, I would've paid it (it was $12 or something). They then gave me a finance charge of about $1, because the bill I thought I paid was now 90 days overdue. After complaining, they reversed the $1 finance charge. But it ended up in me spending several hours tracing my visits, what insurance paid, what I paid, and what was owing. I finally got so frustrated, I brought it to their billing department. They told me how the thing works - that I could indeed never see any statement relating to a particular visit if insurance paid and then I paid a bill for ANOTHER VISIT, which they then posted to the earlier visit which then zeroes out the earlier visit in terms of what's owed. I told them that I liked the other system they had because no matter what, their statements always listed each visit. Now, if a visit is all paid for between the time of the visit, insurance payment and your own payment, you may never get a statement on it. They claim it's easier on their end; it sure isn't easy on our end. Their fix? To tell me when I receive a statement, to make sure I put the visit number on my check so that I know which visit I'm paying for!!!! Why do I need to do all that extra work to be sure I can trace each individual visit and its payments!!! I told her that they should put a note on the statement telling patients that this is how the system works and to be sure that the payment they give goes to a particular visit on a statement, not to some visit for which they've never been billed. Are you confused? I am!

[jeanne]

Dee--Oh, yeah, this is common. What the UW Medical Center does is apply any payment the patient makes to the balance due, so that you can't tell which bill you paid. It is very possible to get a past due notice, and get sent to collections, for a bill that you thought you paid. Also impossible to track what's outstanding.

Or to have them apply a payment to a bill that you are disputing, so then you get another bill for the charge you thought you made, and that you are not disputing. Try explaining that on the phone to some billing clerk who could care less!

Jeanne

[Sara]

See, and I don't even understand how this type of business practice can be legal.

[debutaunt]

I get these all the time. Sometimes I let them just talk to Zoe. This was my favorite: "So what was your plan when you were at MD Anderson?" [meaning - plan to pay my bill]

I told her my plan was to not die.

Finally if they really anger me, I tell them I have lots of life insurance and they will get paid when I DIE! I mean, sheesh, I make payments to six hospitals a month - as much as I can and have never missed. They already got my blood, billed my insurance over a million, what more do they want??

Can't wait to see you!

[jeanne]

Debs--that's good, letting them talk to Zoe.

When we used to get telemarketing calls on a daily basis--always during dinner--and before the do not call list, I used to let Younger Son answer. He was about 10.

And he would say, first thing, "Are you a telemarketer?" And they would reply, "Let me talk to your mother." And he'd just keep it up, "Are you a telemarketer?" until they said yes.

Then he'd hang up.