Let’s talk about how our Mondays went, shall we? I spent a lot of the day on the phone with my former healthcare provider from 2014. As some of you will recall, back in January of that year I spent four days in the hospital before checking myself out and limping off back to work. Well, during each of those four days, some doctor I’d never met before walked in and said, “How are you feeling?” Every one of those four days, I said,
“Okay, I guess.” Then the doctor left. No examination, no discussion. It was a different doctor every day. At the time, I didn’t think much of the visits. Until, that is, I was billed a total of $672 plus $138 collections fee by those four doctors, about six months later. It turns out that these trauma doctors have a nice little scam going. Not only do the insurance companies not pay for these stop-and-chats, they also restrict the total amount that can be paid by one of their insured victims to $70 per stop-and-chat. So the doctors wait until the deadline to submit the bill is past, then they submit the bill. The insurer rejects the bill. It wasn’t going to be paid anyway — but if the bill is submitted on time then it can be “adjusted” by the insurer from $168 to 70.
So with the rejected bill as “evidence of debt”, the doctors then take the patient to court for the money, because of course I’m gonna pay what amounts to less than a single car payment to keep my credit rating from diving into the Marianas Trench, right? It’s a completely brilliant way to make a few thousand bucks every hour.
Except this time they picked the wrong fellow with whom to fuck. I’m gonna have my day in court about it and if I lose I’m going to put these folks “on blast”, as they say, with as much publicity as I can obtain from all sources. This is precisely the type of windmill at which I was born to tilt.
So that was my Monday. Bark’s Monday? It was different from mine.
He was in Las Vegas, working with the great people at Exotics Racing to prepare for this weekend’s AER race at Watkins Glen. Of course he got his own race car in which to train. But check this out… out of consideration for Bark’s well-known Ford fondness, the car they gave him was not a run-of-the-mill BMW or Audi or even Porsche. Are you ready?
THAT’S RIGHT. Surely this is a form of Ford fanboyism so blatant that our valued commenter DeadWeight will spontaneously combust upon seeing this picture. Speaking personally, I hope he does not combust; he goes a long way towards keeping TTAC honest. But if he does, we’ll know why.
The “Brand F Prototype” wasn’t the only car that Bark drove, but if you want to hear more you’ll have to check out Jalopnik in the near future.
Please keep us updated on your medical billing adventures. It is so interesting to hear from someone who is actually reading his bills and fighting the garbage the medical-insurance complex throws at him.
Seconded. After working in transitional care for Medicare recipients under the ACA, I have very little hope for the future of our healthcare system as it stands currently.
On paper, the initiatives to cut Medicare spending through quality improvement looks like a great idea. In the real world, it is a complete clusterfuck. A lot of organizations are making money hand over fist by “consulting” health systems, ACOs, and Physician’s groups on this transitions. That’s not even taking into account the transitions to EMRs, consolidation of companies, and other IT issues.
This has saved Medicare a few dollars, but the cost has been passed onto those with private insurance. My Blue Cross HMO premiums have been stagnant for the past 5 years, but my deductibles have increased from $500/$1000 to $2000/$4000.
Right on with your windmill tilting with the insurance industry.
An important piece of background info, so entrenched in today’s politics and society, is the fact that in 1946 the US Congress granted the insurance industry a one year exemption from antitrust regulation to enable it to recover from WW II. The insurance industry promptly tied up the termination of the exemption over the interpretation of the punctuation in the original legislation, in spite of the fact that the authors of the legislation testified under oath that it was their clear intention to limit the exemption to one year only. The exemption continues unabated to this day.
In an earlier decade I had reason to study macro trends in capital formation and erosion. One of the biggest and most noticeable trends was the massive erosion of capital out of traditional merchant (investment) banks (prior to the end of the Glass-Steagall Act and hence the subsequent combining of merchant and traditional banks).
Guess where the capital was accumulating, on a massive scale? The insurance companies, which have amassed so much political power that they will likely ALWAYS be exempt from antitrust. The votes they need to maintain the status quo are already bought and paid for.
To make the game even more stacked, insurance companies are allowed to set rates based only on the profit and loss of their insurance activities. Yet they are allowed to hold our premiums off to the side, and to make large profits off of investing policy holders’ premiums, none of which needs to be figured in their ability to reduce rates and still make money.
This piece of rottenness has become so deeply entrenched in US politics and economics that it is almost never mentioned as the single entry point of rising healthcare costs. There are about two dozen countries around the world with as good a set of public health outcomes as the US (we are not the world leaders, surprise), but almost all of them deliver those results at a far lower per capita cost than is the case in the US.
Keep me posted on your quixotic battle…I am more than willing to serve as Sancho Panza to your Don Quixote, if I can be of any further assistance.
As it is, I have at least shown you “where the bodies are buried”. Hope you rip them a new one, and don’t just stop at your own bills.
Maybe you can become the Farago of The Truth About Insurance…we certainly need one.
+1000. Until Warren Buffet came along, most property/casualty insurance companies actually *lost* money on their underwriting operations, but the profits from investing the premiums they were sitting were gigantic enough to dwarf those losses.
Buffet decided that underwriting needed to make money, too…which is why and how he’s a multibillionaire.
With the way gawker seems to be gutting its sites of anyone worthwhile, I wonder how much longer Jalopnik has to exist.
I genuinely feel for everyone that has to consider finances when receiving medical attention. It’s an incredibly stressful time to begin with - having to worry about cost on top of that must be terrible.
We used to have to do that with our pets, until I wisened up and got insurance for them. I couldn’t comprehend that sort of thing for humans ðŸ™
I hope you’re feeling better this week, Jack.
My wife had surgery some years back, spent roughly 18 months getting all the bills taken care of through insurance and co-pay. Finally clear, right? Nope. Got one more for several hundred dollars. For a doctor neither of us could remember. I double checked all records (by that point had a medium file box full of records and receipts), nada. They apparently waited over 18 months before submitting the first bill for services supposedly rendered. So I called, politely asked as to who and what. Got a standard “we’re the collection agency, you’ll have to contact the doctor’s office for those details” response. So I then politely told them that they would need to file with the insurance company first. They responded that the insurance company didn’t accept any bills over one year old. I then politely informed them that neither did I. We got several more “reminders” in the mail, then nothing. Credit record is still clean, AFAIK.
Still got something that’s potentially out there from a more recent car wreck. We had two difference insurance companies fighting to claim they weren’t responsible, so this final ~$400 bill was bouncing around awhile and never got paid. Haven’t received any reminders in a while, so maybe it just disappeared.
Can’t believe they are taking you to court for what is a pretty blatant scam. Why risk blowing the entire scam on one @$$hole who doesn’t pay. Probably 90% of the other people pay, so let one go and move on? Good luck.
and I’m surprised your new fan over at TTAC hasn’t found his way here yet.
Hang tough Jack ~ I too went down the rip off medical bill rabbit hole , keep us posted .
Mark’s ride looks like fun ! .
-Nate
Jack — There may be an easier way for you to emerge victorious by using your former insurance company’s contract with these “providers” against them. It is something I have used a bunch of times. The short version is this: most big insurance companies’ contracts with providers say that if the provider makes a billing error that prevents payment of the claim (e.g., waiting to bill the insurance company) the provider is prohibited from seeking payment from the insured (you here). However, as a third party beneficiary of the contract between the insurance company and the provider most people do not have the ability to know what the terms of the provider agreement are. If you have any questions about how to bluff your way through this process, shoot me an email.
I actually am sorry that, Jack, are having the issues you are with out FUBAR health system, and it is, by any rational person’s standards, totally FUBAR.
The health insurers, pharmaceutical companies and other Big Medicine groups keep winning against the middle class, year after year (as does Big Finance, Big Corporate Prison Complex, Big Agri - ADM/Monsanto/Carghill/etc. - , thanks to our hopelessly corrupt legislative & executive branches of government and captured regulatory agencies (I hope one day that both the left & right can agree that some dorm of revolution is necessary at this juncture if the nation is to be “done no further harm to”).
As for Bark, he is a Raging Ford Fanboy, and despite my often pitched bitches about it (but only when he really lays it on thickly, which happens to be often), he’s absolutely entitled to his fetishes/partisanship/OCD biases, as we all are, and believe it or not, I’m (here I go all BTRS ALL CAPS) VERY GLAD, AND NOT JEALOUS OR RESENTFUL, THAT HE WAS ABLE TO WRING THAT TRACK MONSTER OUT (even I would LOVE to if given the opportunity).
p.s. - Jack, you have 30 days UPON RECEIPT OF A SPECIFIC SUM BILL for medical charges (not the date alleged services were provided) to dispute the charges on said bill, in whole or part.
You should do it in writing, registered mail, return receipt requested, and you need not cite any particular reason AFAIK.
This prevents the potential future debt collector, be it the provider or a wholesale bulk debt collector who “buys the debt” from automatically claiming that the bill is not subject to dispute as a matter of course due to to your failure to object to it within that crucial 30 day window, and will ensure you get to have a legal hearing in court on the merits of the charges, and not be merely subject to a pro form judgment for the claimed amount due.
Make sure the registered letter goes to the correct address.
http://www.bronxlawguide.com/credit7.html
No. The *white* phone.
I’VE GOT IT!
Thank you!
Good luck fighting them. Have you let your 2014 insurance company know of this? I almost guarantee you this violates your insurer’s contract with the billing physician, and I personally know that Anthem investigates and regulates asshole billers that try this garbage. You are a third party beneficiary of that contract. If you know these docs do this to Medicare/Medicaid patients as well as yourself, you would be an excellent Qui Tam plaintiff and collect a portion of the recovery.
When my wife was going through residency, the administration sent down a mandate that every patient needed to have a quick talk with a staff physician before they were allowed to leave. The residents didn’t like it, but we’re too scared shitless to say anything.
During my own visits to my local clinic I’ve noticed the doctors have many ways of increasing their RVUs. The way to address this is to tell the doctor you came for one issue, and NOTHING else is bothering you.
Some of the WIERD consults are driven by defensive medicine practices to reduce litigation exposure. But being under anesthesia is a bad time to discover a hidden heart defect. Young and/or fit people can hide some scary stuff under their pink/warm/dry appearance.
I spent 4 days in a Hospital in Chicago with viral meningitis in Dec. Once I was admitted, and while I was on infectious disease lockdown, every 8 hours or so the a doctor, with a few students in tow, would stop by, suit up in gloves/breather/smock along with the pupils. He’d ask me how I am doing, maybe a couple other questions if that.
When I saw the breakdown from insurance I saw it was like $300 every time they came by. I don’t think Aetna allowed that much, maybe $125. At any rate they paid just about everything in my case, maybe on account I was out of town. Except the Ambulance bill, they refused to pay $1500 for Chicago EMS to take me from O’Hare around the corner to the closest Hospital like 5 miles away. Chicago EMS is still trying to get that money from me.
Bark’s review on TTAC today was a nice piece of trolling. Hugbox journalism at work there.
If you mean the Dodge Journey rental review I thought it was droll satire.
*shrug* the Journey is old at this point. not much new to say about it.
I was genuinely maddened by some of the response to the V6 Mustang review. That was my response to the response. 🙂
Not sure how I missed this, but based on the latest avoidable contact… Congratulations on marriage 2.0?
My penance for working in insurance & HR in the 90’s and early 2000s is to work in healthcare now. Moral hazard is a phrase being bandied about these days. I have witnessed some truly cringe-worthy bedside consults like what Jack described. If a cardiologist comes to your bedside and doesn’t whip out a stethoscope to listen your lungfields & at least 4 cardiac points on the front of your chest, glance at your neck, inspect & touch your ankles & wrists, then yes you may the victim of a driveby consult. YMMV should never be part of healthcare.