Reporting, Recording and Relaying - But Always Telling It As I See It

Saturday, October 3, 2009

I know what's wrong with health care, and I can fix it

I recently had surgery to repair a hernia. Having now some fist hand knowledge of the health care industry I can safely say I know what is wrong. It is not the pricing, the quality of care (excellent by the way) or docs who have no time. The problem is the paperwork.

Since my procedure we have been inundated with mail. We get letters that are described as "Explanation of Benefits," "This is not a bill" and "this is a bill, so pay it or you are going to a collection agency and you can fight with them. If you don't think you owe this, well, good luck contacting us let alone speaking to someone who actually gives a shit about your problem and may accidentally hit a wrong keystroke while typing in your information that may cause us to realize you didn't pre-approve the procedure so now, instead of the $247.00 you owe us $22,000."

My wife and I are both college educated, fairly intelligent people, her more than I, of course. But for the life of me, I cannot get my head around all the fucking paperwork. We get separate bills from anyone who even looked at me in the hospital, even the nice older lady who helped me on with my hospital socks.

The idea is simple. The hospital will be have one shot to get your billing straight. They get one first class stamp per patient, so they have one chance to get it right. None of this submitting claims to the insurance carrier who pays whatever the hell they want after some huge-ass discount, leaving you with a balance. This will be done over and over. Then, the hospital/doctor sends this balance onto you, all while you are trying to understand the explanation of benefits and letters that are not bills. AAHHH!

The problem with this of course is that it would cause millions of layoffs for the paper-pushers, as I'm sure their are mid-west towns built around feeding and housing these people, like the old mining towns in Idaho. Oh well, we need some more places to visit and what better than an old insurance town.

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