Summary: We all spend too much time as patients wrangling medical billing. Here’s one creative approach to accounting for that. Disappears with single payer, of course.
Billing the Hospital Billing Department, The New Yorker, July 3, 2023, by Kendra Allenby
Late-stage capitalism getting you down? Try this fun, D.I.Y. fix—sending your own personalized bill to the hospital billing department:
Dear billing department,
Below are the fees that you’ve incurred. Please pay the balance at your earliest convenience.
Phone calls pre-procedure: To make double, extra sure that the procedure is going to be fully covered by insurance. (Am assured that it will be.) An hour and a half at $300 per hour: $450
Initial phone call post-procedure: Asking why this huge bill showed up after I made double, extra sure that the entire procedure would be covered by insurance. Forty-five minutes at $400 per hour: $300
Follow-up phone call: To find out that the incorrect code was used in billing the procedure. Forty-five minutes at $400 per hour: $300
Misc. phone calls (three): To get the code changed to the correct code. Two hours and fifteen minutes at $400 per hour: $900
One more phone call: To get assurance and e-mail confirmation that the code has been changed and that I will not receive additional bills in the mail. Thirty minutes at $400 per hour: $200
Mug: Smashed when the third bill arrived in the mail. One mug at $47 per mug: $47
Fee for sterile disposal: Of mug. One mug at $347 per mug: $347
Fee for lost sleep: Over the huge bill that should have been entirely covered by insurance. A hundred and thirty-two hours over six months at $300 per hour: $39,600
Therapy to treat anxiety: Resulting from a six-month protracted follow-up on a bill that I never should have received in the first place, plus anxiety spikes upon repeatedly seeing additional bills in the mailbox. Twenty-four sessions at $200 per session: $4800
Tylenol. Couldn’t hurt: One pill at $300 per pill: $300
TOTAL COST: $47,244
My dog has negotiated your rate so that you are only responsible for a percentage of the total cost. If you choose not to go with my dog’s negotiated rate, you may be responsible for the total cost of the fees.
ADJUSTMENTS (as negotiated by dog): -$10,014
CURRENT BALANCE DUE: $37,230
Congratulations, you saved $10,014!
Comment:
By Jim Kahn, M.D., M.P.H.
Exactly right, sadly. Excellent dose of humor for a vexing situation.
We’ve all experienced this (I know I have … e.g., hours of calls regarding vaccination for foreign travel, and many letters and calls and emails to get reimbursed for an urgent care visit, and … and …).
HJM discussed research on this issue in late 2021.
http://healthjusticemonitor.org…
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