The Assertive Cancer Patient

'Maxed Out'

I just finished watching a really excellent documentary called "Maxed Out" about America's debt, both personal and national. I was, of course, watching it to see what it had to say about serious illness and bankruptcy and debt, and there I was disappointed.

Although it was obvious that some of the people who appear in the documentary got into financial trouble after the death of a spouse or a serious illness, very little attention was given to this aspect of bankruptcy.

However, one expert on bankruptcy who was interviewed at length, Elizabeth Warren of Harvard Law School, probably has the information I'm seeking, and I'm going to look for an e-mail address for her tomorrow.

One thing we Americans take for granted--that if you have cancer or another serious illness you are probably going to have to file for bankruptcy and may lose your house--is not taken for granted by people from other countries such as Canada and the UK. Or Germany.

In the United States, we seem to have a very Darwinian approach to economic survival: If you are sick, well, you somehow deserve to go down the tubes financially, and then socially, and then in every other way.

@ Jeanne Sather 2008.

Cutting Medical Costs

Cancer center waiting rooms are a great source of old magazines.

Yesterday, while waiting for my blood draw, for lack of other reading material, I picked up a back issue of Money mag (November 2006).

Two articles caught my eye, one on how to avoid being the victim of a scam, and the other on saving money on medical bills, "50 Ways to Cut Your Health-Care Costs."

No. 4 is "Look for mistakes." That's the statistic I referred to yesterday, that as many as eight out of 10 medical bills contain errors, increasing the bill by an average of 25 percent. I have to say, in all the years I've lived with cancer and wrestled with medical bills, I've found a lot of errors and only one was in my favor.

So these aren't just random errors. Don't pay any bill until you are SURE that it is correct.

Most of these suggestions wouldn't work for cancer patients, who probably don't have the energy to implement them, and I can't really see too many of us taking suggestion No. 1, "Ask for a deal." I would have had a hard time negotiating the price of my mastectomy before surgery. At that time, money was the last thing on my mind.

However, No. 15, "Don't be denied," about appealing insurance co. rejections of any bills, is a good one, as is No. 25, "Go postal," about ordering prescription drugs by mail from your insurance plan. I started doing that when I went on disability almost two years ago now, and it saves me a lot of money on co-pays.

Consider No. 26, "Split 'em up." Pills cost about the same, no matter the dose (antidepressants like Paxil, for example). And some pills can safely be split in half, saving you half the cost or half the co-pay if you buy pills that are twice the dose you need. Don't do this one without checking with your doctor, as some pills cannot be safely split. And you need the doctor to write a prescription for the higher-dose pills.

And my favorite, No. 46, "Wash up." Simple, regular handwashing can keep you from getting sick ans save you money. This one is especially important for cancer patients, who may have low blood counts. Remember to change hand towels often (a wet towel harbors germs), and don't touch the door knob with your clean, still-wet hands on the way out of a public restroom. Half the people who use public restrooms don't wash properly afterwards. (I use a paper towel to open the door.)

And while you're at it, make sure the doctors and nurses around you are washing THEIR hands.

Yuck! Wash Those Hands!

Yuck! Wash Those Hands! Take 2

@ Jeanne Sather 2007.

Medical Bills: Errors, Padded Bills, and General Craziness

As I've said before, I have trouble mustering both the energy and the focus to sort out medical billing problems. So I tend to let them go for a month or two, or longer, until I have a batch, and then I deal with them all at once on a day when I've got a head of steam up.

So on the Monday before I left for the beach, I gathered up a stack and went to the phone. I always make these calls from my landline, as I don't want these folks capturing my cell phone number--I never give that out to medical providers, only to my nearest and dearest.

Here's how it went:

Bill No. 1
This was a bill from Quest Diagnostics, a lab which runs my tumor marker tests now that I've switched doctors. The bill was for $102 and change. I talked to Tim and discovered that Quest didn't have my insurance info (don't ask, I didn't), which is why they kept billing me.

I gave Tim the info and now everyone is happy. That was an easy one.

Bill No. 2
This was from Via Radiology, for an MRI. Cost: $1,415. I talked to Michelle, who said that my account had just been sent to insurance a few days before I called, so not to worry about the bill.

That's two down.

Bill No. 3
This was an old one, for a mammogram on 3/20, cost $79. Provider: Seattle Radiologists.

I talked to Dana, or maybe it was Dara, can't read my notes now, and she had a completely wrong insurance company for me. Somebody on the provider side entered the wrong info into the system, apparently, and they were merrily billing the wrong insurance, month after month.

I gave Dana the correct insurance info., and, again, everyone was happy.

Bill No. 4: the Padded Bill
Bill No. 4 was a little more interesting. After I saw Dr. Livingston in Tucson in May, I received two bills. One was for Dr. L's services, and I promptly paid my share of that. (I owed a percentage of the bill because Dr. L is no longer part of WSHIP's network.)

But then I got a second bill, for the same visit, for $53 for "hospital charges."

Except that I saw Dr. L in the clinic as an outpatient, and didn't have any tests or anything else.

My insurance went ahead and paid $31.80 on this one, leaving me with a balance of $21.20. But I didn't see how I could possibly owe this.

So I called, and the person I talked to, Cindy, said that the billing system "automatically bills a facilities fee for patients seen at the cancer center." But, since I didn't have any lab work, she would remove the charge.

And what about all the people who don't question their bills?

Bill No. 5
And then there's my favorite, a bill that I've been fighting over for two years now, from the University of Washington Medical Center. I am satisfied that this bill has been a mistake from the beginning, but I was never able to sort it out. And then a couple of months ago, UWMC started billing me for it again, but now it shows that I made a payment of $25.81, which I certainly didn't do.

This means that the money I sent in to pay some other bill was applied to the disputed bill, and now there's one hanging out there that I thought I paid that will come back to haunt me ...

But in any case, when I called and talked to Jessica in the billing office, she said, "You shouldn't have received that bill. It was corrected as of 6/07. Don't worry about it."

OK. I won't.

Don't ask me. I'm just the patient.

However, something to keep in mind: As many as eight out of 10 hospital bills contain errors, increasing the tab by 25 percent, according to Money magazine.

Read more:

Paying Bills

Medical Billing Woes

Paying Bills

I hate paying bills, which is why it is the 10th of the month and my bills are not yet paid.

It’s not that I don’t have the money (I do, barely). It’s that paying bills takes concentration and focus and energy (plus a good pen), and those qualities have been in short supply around here for years now.

Oh, yeah, and organization.

I’ve now learned to put all the incoming bills in one place, a shoebox, and I’ve set up a proper file with labeled file folders for paid bills and receipts—this is especially important since I am self-employed and need to save proof of all my business expenses, plus medical paperwork, and so on.

Even so, when I sit down to pay bills, something like two-thirds of the envelopes I open are not really bills, they are marketing offers of various types cleverly disguised as bills to get me to open them.

My brain can’t handle all this.

In any case, I started paying my June bills on Saturday morning, got about half way through and found a good excuse to quit for the day, and this is the pile of paper that was on the floor. (See photo.)

Now that Connie has shredded it for me, I will, of course, recycle it.

If I could just force myself to sit down at the table for an hour, I could finish paying my bills for the month. I have stamps, so that’s not a problem. I even have 2-cent stamps so that I can use up my “old” stamps from before the latest price increase.

Of course, once I finish the bills, there is a stack of papers that will require sorting out by phone—most of these are medical bills that, as far as I can tell, I don’t owe. But trying telling that to the billing department at your favorite cancer center.

I have one bill from the University of Washington Medical Center that dates back to late 2005. I KNOW I don’t owe this one, but every so often the UWMC resurrects it and starts billing me again.

There’s also one from Swedish Cancer Institute from late 2006. This one is new, but there is no way that I should owe for any part of my care late in the year: I’ve met all my deductibles (I meet them by February every year, as a matter of fact), and Swedish has a preferred provider relationship with my insurance company, which means Swedish can’t charge me for the part of the bill the insurance doesn’t pay. They have to write it off.

Stay tuned tomorrow for an update. Given the response I got last time I tried to sort out a bill from Swedish, I’m not looking forward to this phone call.

Read:
15 Phone Calls

@ Jeanne Sather 2007.

Liz Needs Help

Who helps cancer patients? Well, it ain’t the government. This we know.

Some hospitals provide limited financial assistance for their patients. Many others do not. (At too many cancer centers, a social worker hands over an out-of-date list of possible sources of help. And that’s it.)

If you apply for Social Security Disability, as I did over a year ago, you wait SIX MONTHS to receive your first payment. A disabled person could starve to death in six months.

Anyway, if you are a regular reader of my blog, I’m probably preaching to the choir, so I’ll stop, and just make my pitch:

Liz, author of my favorite cancer blog, As the Tumor Turns, needs help. She’s put a “Make a Donation” button on her blog. If you have a little cash to spare, and especially if you are a reader of her blog, please send it her way.

Here’s the link:
http://spinningtumor.blogspot.com/

And Liz’s explanation of why she needs help:
Busted By Murphy's Law Again

I plan to. We need to help each other.

Jeanne