Hopefully, that is.

So, we got the latest round of bills a week or so ago, and I finally got around to attempting to handle them on Tuesday and Wednesday of this week.  It did not go well.

We have three bills, one for $429, another for $48, and a final one for $9.  We thought it was going to be more, but it turns out that the insurance did in fact cover some of the doctor’s payments (yay PPO gold plan!).  However, when we received the bills, all they stated was the amount owed, and which company to remit the payment to.  No information was included regarding what care the company or doctor provided.

So, I call the providers to get more information.  They can’t tell me what care they provided as they do not have access to my medical files, which are apparently kept with the hospital.  Since I had no idea who the providers were, and had already paid my hospital bill (which I assumed included doctors’ salaries), I was told that no hospital in California employs doctors, they are all independent, and I should have known that’s how I would be billed.  I asked if I was ever told that all the doctors would be independent, and was told it’s been that way for 20 years, so there’s no reason I shouldn’t know.

Next step was calling the insurance company and attempting to figure out if I was being billed correctly.  They also could not tell me what I was being billed for, just which claims were submitted and which had been paid.  Additionally, as I had been admitted to the hospital, the emergency coverage copay didn’t apply, and I was responsible for the 20% copay on all services provided by all care providers.  Apparently this is entirely legal, since the provisions protecting people in California from being balance billed end once the patient is admitted to the hospital.

The last piece is that the hospital and the doctors have up to a year to file additional bills.  I can’t imagine going to a client and telling them I forgot to bill them a year ago, so they need to pay up now.  You just write that off.  But doctors and hospitals are allowed to, for some reason.

Suffice it to say, I could appeal, but I don’t feel like the amounts are unfair (I did get major surgery after all, and the doctors were great), I could ask the hospital for a full accounting, but I just want it over with, so we’re just going to pay the companies and hope this is the last of it.  But I think it really highlights that there are a lot of reforms necessary to the way we pay for medical care in this country.

I want to pay, and have the resources to pay, but the hospitals and the doctors are making it very difficult to determine what I owe, and for what services.  They are (intentionally??) opaque, which leads to distrust, and the multiplicity of providers and bills is surprising and confusing.  It’s additionally frustrating in an emergency situation – no signs are posted in the emergency room warning patients that the doctors are all independent and will bill independently, all the correspondence and intake and discharge papers are branded by the hospital, and you only find out when you get a variety of bills from a variety of caregivers.

I’d like to note that I have family in the medical field, and my insurance agent is my roommate.  I have resources, and so far everyone is surprised that the doctors are billing separately.  I don’t really know what should be done, but I really don’t think we’re doing it right as a country.

Any doctors out there frustrated with how we bill for services in the US?  Anyone have any ideas how to make it better?  How do we feel about single-payer?