REAL TALK WITH DANIELLE - On Healthcare

Let’s rewind to last month. I was scheduled to have toe surgery on August 6th. I called my podiatrist’s office and asked how much the surgery would cost. At first, they told me they were unable to give me a price until the appointment was scheduled. Once the visit was scheduled they told me to check with my insurance. I called Blue Cross Blue Shield (BCBS) and they were unsure until the claims were filed, but could tell me that the cost would almost certainly reach $1500 and would absolutely apply to my deductible. My deductible is $1500 on my current plan so that means basically everything else is covered this year. That was a hard pill to swallow, but my toe was constantly hurting and no other treatment has worked, so my husband and I decided it was worth it to pay. BCBS also recommended that we call the hospital to ask for how much the claims would cost. Again, we were redirected to call our insurance company. This was just the start of many back and forth conversations.

The day of my surgery came. I haven’t had surgery since I was two years old, which I don’t remember, so I was pretty scared. I really didn’t like the idea of a knife cutting my toe open. Already anxious about the procedure, I was not in a good state of mind to be making decisions about finances. Granted, I could have told that to the woman who came to my bedside and informed me that the $1500 charge needed to be collected before the surgery took place. But I felt pressure to do what the hospital staff was asking and this tiny old woman from billing likely didn’t care about my decision-making capacity. And who was I to question this payment at all? It was not my job to know when payment was due. It was also not my job to know whether or not the surgery cost $1500. It was the hospital’s job to crunch the numbers and tell me exactly what the cost of the surgery would be, and to confirm with BCBS whether those numbers would reach my deductible. I have a receipt for that $1500 payment, and besides this, the BCBS website stated that I reached my $1500 deductible shortly after the surgery. So I thought I was good to go, right? You probably see where I’m going with this...

It has been a month since the surgery and I have received a whopping total of $1407 in bills from Leonard Morse Hospital. So in total, I have paid and now owe almost $3,000. Is this a joke? No friends, it isn’t. I investigated further with BCBS, who informed me that I had only been responsible to pay $229 for the surgery. I asked, “Why would the hospital have charged me $1500 unless BCBS confirmed that was the necessary amount?” The representative didn’t have an answer for me. Knowing that her job is to call the hospital, I had her do it, and I waited on the line for almost 2 hours with her until she told me she had to give up and call me back.

A few days later, BCBS called the hospital and the billing department identified that they made a mistake. Meaning, Leonard Morse Hospital overcharged me by $1271 and would not be refunding the money if I had not pressed BCBS to coordinate with them. Even worse, I called the billing department to ask when we could expect the refund and they quoted four to six weeks. Their reasoning for this was in order to review my other accounts to confirm that I had not missed any other payments. Were they fucking serious? They overcharged me and now I’m the one who needs my financial history to be reviewed? Oh, hell no. I couldn’t take it anymore. So I asked my husband to call again because, frankly, men are given the runaround much less frequently than women. The answer he got from the hospital was “if you don’t like it, you need to call your insurance company and change your deductible.” Helpful (not). When we called the doctor’s offices at the hospital to inform them that we couldn’t pay the doctor’s bills until the hospital paid us back, they were completely unfazed, stating that the reason it takes 90 days for late fees to be added to the bill is because this happens all the time at this hospital.  

Let me be clear - I’m absolutely calling out Blue Cross Blue Shield and MetroWest Medical Center’s Leonard Morse Hospital in this blog post. Sure, they are enormous companies with tons of unwarranted legal protection when it comes to finances. Sure, they probably don’t give a shit about posts like this because they will continue to make tons of money from innocent people trying to receive adequate medical care, who are so anxious from the lack of communication from these resources that they give up trying to correspond or learning what they actually owe. But when it comes to fairness in medical care, I have to fight with the system every day for my own clients as a social worker, and I refuse to be the target of negligence because these companies want to play hardball. I understand that the representatives at the billing departments of every hospital are underpaid and undervalued, but that does not give them the right to sass me when all I’m asking for is to be refunded in a reasonable amount of time. Let’s not even get into how quickly that $1500 was zapped from my bank account. I also very much believe that my podiatrist is fantastic at his job, and I want to be able to pay him and the anesthesiologist for their services. But I simply can’t do that because I’m $1271 in the hole, which is what I said to the front desk woman at my podiatrist’s office before sobbing in the waiting room prior to a follow-up appointment last week.

And to get to the really big picture here, this type of negligence and failure to adequately manage patient finances is completely normalized not just at this hospital, but throughout our entire medical industry. Most people don’t work in social work or health care, and many people are not good at managing money. Having both of these skillsets gave me an advantage in even identifying the problem. But consider the average Joe or Jane who is making a decent salary, but pays 30% of it toward rent (if they’re lucky), knows nothing about how to talk to medical staff, and is too busy taking care of their family to give a shit about learning that skillset. And, again, this is just identifying this issue. After that has happened, it takes an unprecedented number of hours waiting on the phone for a snarky representative of each company to pass the buck, and say “it wasn’t my fault”. By this time, we’re either pulling our hair out, yelling at the representative (who still will not help us), or giving up on ever seeing that money again. It’s ludicrous and a very accurate representation of how patients are treated because of the way we have monetized healthcare in this country.

I also want to acknowledge that I am extremely privileged to have the kind of money that allows me to make a $1500 payment and still be able to put food on the table. These kind of medical expenses can create real hardship for individuals and families, and I think that might be the thing that bothers me most. This hospital is not going to suffer even remotely from losing the money that it is withholding. But for many families, the loss of an extra $1500 in a month would mean going without food, electricity, or other basic needs. I’m so frustrated by this disregard for the people who are struggling because I see these real life consequences of systemic issues every day working with my clients in the Department of Mental Health. Many of these individuals struggle with homelessness, poverty, and isolation in addition to medical issues. They quite literally cannot afford to be victimized by the healthcare system.      

I have faith that the people who read this blog will be familiar with my experience. I have heard so many stories of people getting screwed over in their medical treatment or by their health insurance companies. So what the hell do we do about it? Friends, this is where I ask you for your help. I need you to share your stories too. If you know what I’m talking about and you relate, then please share this blog, and write your story in the comments or in your posting. Hell, write your own blog if you feel the spirit move you. Just do something if you know this story to be true in your own life. The only way we raise any attention to these kinds of matters is by talking about them. No, we are not going to change American healthcare by posting about it, but we are definitely not going to change healthcare by doing nothing about it. I am actively going to be seeking out publications that will help share this story during the next few weeks. I want to start a dialogue. Let’s talk about how upsettingly common it is for hospitals and insurance companies to have poor money management that ultimately creates the most negative effects on the people they serve. Let’s do something about it together. #myhealthisnotyourbusiness

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