Exemplary vs Complacent

We all hate dealing with the health care system.  I mean truly HATE...  but its a necessary evil.  We need them.  And sometimes, we need them desperately.   We moan about costs and rules and regulations but when faced with something serious, we certainly change our tune.   

I had an accident in March.  The accident, a fall from a fairly substantial height, could truly have been life threatening, actually it could have been life ending, but I was blessed to walk (sort of) away with ONLY broken ribs, bruises, and minor lacerations.

The myriad of complicated tests completed by the hospital confirmed that internal organs, including circulatory system, heart, lungs, spleen, liver, kidneys, etc, were not ruptured or damaged and that there was no obvious cranial or spine damage.   I am appreciative of the level of care I was given that night.  And because by the time I arrived at the hospital, the pain was so intense that I could not catch my breath, I was extremely grateful for the pain meds that I was given to allow me to rest.  I am thankful for their compassion and concern and patience with my panic.  I really am.

With no reason to hospitalize me and my pain under control, I was sent home and told to rest... no core activity for weeks.   I was told recovery would be gradual, should be complete, and could take 6-8 weeks but because of my existing health issues, they were unsure if that timeline would hold true for me...  maybe a little longer, maybe not.

Fortunately, the bulk of the healing process was slightly shorter than the hospital's billing cycle.  (do you think they do that on purpose?)

The hospital bill totaled almost $25,000.   I was shocked!   SERIOUSLY!!!  For four-ish hours in the emergency room with what turned out to be no serious injuries?  But they could have been.  They could have been serious...  even deadly.

Once I AGAIN reflected on how lucky I was, I admitted my appreciation that the tests could be done and could verify that no serious damage was done...  Again, I was truly thankful for the service and compassion they provided.

I sighed, pored over the billings (there were several), determined the amounts I was responsible to pay after insurance paid their part and the appropriate adjustments were made, and paid my part.

Thankfulness kicked in again.  I considered the total cost of the accident, the portion that my insurance took care of, and the tiny part (comparatively speaking) I had to pay.

I learned three things from this experience...  check the ladder BEFORE using it, quit complaining about insurance rates, and that I actually DO know the difference between broken ribs and pulled ribs (which I experience on a far too frequent basis) without an x-ray.

Fast forward...  I receive a bill from the hospital saying I still owed another $850. 

Puzzled, I called the hospital billing department to inquire about this outstanding amount.   Of course, they pointed the finger at the ins company.   I called the ins company and gave them the reason provided by the hospital.  They were confident, unperturbed, and pointed back at the hospital. 

The ins company's service was exemplary, explaining they would sent a note confirming my co-pay was the ONLY thing I should have to pay.  I responsibly noted names, dates, times, and explanations of both the hospital and the ins company, satisfied that this should be resolved.

Fast forward... I receive a bill from the hospital saying I still owed the outstanding $850 WITH the accompanying threat of collection agency involvement.  Collection agency?

Another call to hospital with same explanation given before.  I explained what the ins company said, reading from my notes.  The hospital's response was No, No, NO.... YOU OWE US.   I asked if they could conference the ins company to discuss.  NO.   I asked for a supervisor.  While I waited, I grabbed hubby's cell phone and got the ins company on his phone....

With a cell phone on each ear, I waited for the supervisor at the hospital and brought the ins company, aka Audry, up to speed.  Ins company Audry was as disheartened as I - we see this all the time, she soothed.  Ok, she said, you are ok.... we will get this figured out, she assured me.   Audry was confident and I could feel her strength through the phone.

Hospital supervisor, aka Heather, came on and said she read the notes and then repeated the explanation I had heard over and over.  Ins company Angel Audry (upgraded title) assured hospital Heather that this was, in fact, not the case and went through a list of mathematical notes on the account  and concluded with the amount the patient should pay...  NOT an additional $850. 

Hospital lackey Heather  (downgraded from just hospital Heather) explained that she would need a "letter" confirming the patient's responsibility.  Angel Audry said one was sent....  Lackey Heather said she would look in records.....   (wait for it, waaaiiiit foooooorrrr ittttt)

I am sitting on my bed with two cell phones, one twisted so that voice of one was near speaker of the other, listening to them discuss.   Lackey Heather would not speak directly to Angel Audry, but kept saying my name in her sentences.  I asked if Heather could hear Audry and she said yes.   A privacy thing?  not sure since I was on the phone too....  maybe Heather didn't want to get her shoes dirty talking to Audry while she was sitting on her high horse. 

Lackey Heather's tone suddenly changed....  In all its glory, the "letter" was apparently there, sitting all lonely and ignored....  not acknowledged, not recognized as important, not considered in my "outstanding balance", and not even attached to my "records".  Hmph.   Come down from your horse, Lackey Heather!

Lackey Heather said, covering her A$$, that she did not process these items and that she wasn't sure what happened...  she did try to clean it up by saying that she would alert the billing processers of the existence of this letter, that she would follow up with me when it was completed, and that she would extend the billing cycle so the balance would not be sent to collections.

Trust me when I say I will follow up with Lackey Heather to make sure the balance is zero and request a letter saying that this situation should NOT be an issue with my credit bureau score.

But still, I am grateful for the hospital staff's care, compassion, and concern during my visit.

HOWEVER, the billing department and support staff could use a bit of training/refining regarding the storage of documents, their application to accounts, staff initiative to complete a bit of research into repeated concerns by patients prior to blowing them off, and their ability to apologize.  As you can tell from my thinly veiled sarcasm in the last half of my story, I am a bit bitter than this situation went as far as it did.  HOWEVER, Heather has a chance to earn an apology from me.

Back in the "day", I could almost predict a customer's level of honesty by the decibel number their voice would reach during their attempt to convince me of their version of a situation...  the louder they yelled, the less I tended to believe them.  In most situations, honest information was presented calmly and persistently and lies were presented in a bullying fashion and in excess - sometimes several times a day.   And just as often, their anger is their undoing...  they end up slipping up and telling you enough of the truth to allow their house of cards to fall because with anger comes a lack of control...  oopsy.   

Another situation I experienced regarding health care was during a recent out-patient surgery for hubby.  I was reading a book, sitting patiently waiting for the pre-op prep to be done, expecting to be called back to see him and the doctor before the surgery.  This is what ALWAYS happens and what I was told I could expect when we arrived.   Suddenly, I notice the time and ask how much longer it will be - was there a problem?   They look at their computer, blink, and say he is already in surgery.  WHAT?  I started crying, probably a result of surprise, shock, and frustration.  No pre-op talk with doctor, no seeing him before he goes in, nothing.  I flash to anger.   But... I needed to ask questions of the doctor, I say.  They ask if I want the surgery stopped so I could talk to the doctor.   SERIOUSLY?  I am overwhelmed with this information.   I wasn't called back and they are gong to stop the surgery that we had waited so long for...  no, no.   I sit down and cry, trying to sort this all out.   A manager type person comes over with hubby's nurse, who is horrified, and apologizes, offers a drink, and they respectfully leave.   About an hour later, manager-type brings me an envelope and says they are really sorry about everything that happened and there is a gift inside that hubby and I can enjoy.   The envelope contains a card signed by the manager expressing her apology, her business card, and a Starbucks gift card for $5.  They couldn't fix what had happened and I know that.  It was an emotional event that needed time to resolve itself.  However, putting the price of $5 on it was almost offensive.   I think I would have felt better about the whole thing if they would have apologized, offered a drink, and checked on me again later to see if I needed anything.  After all was said and done, I think the $5 gift card made the biggest impact on me and not in a good way.  I still snort when I think of the gift card...  Neither of us frequent Starbucks.... Can you even buy something at Starbucks for $5?

Heather, I understand...  stuff happens. We make mistakes, have personal issues, work loads, time constraints, limitations set by management, etc, but trust your gut....  sometimes, the customer/patient IS telling the truth and yes, in fact, the problem COULD be on your end... it happens.  No one, and no system, is perfect and most often, a little bit of digging can clear things up - either the truth will come out or the dishonesty will be confirmed.   Either way, you will have done your job, helped another human, and both are the right thing to do...  and most certainly, Karma will log your efforts.  A patient should not have to "tell mom" and force you to look into a repeat concern.  With only a slight amount of effort on your part, I would be singing your praises instead of offering up my thinly veiled sarcasm/frustration regarding your part in this little drama.

Heather, I will give you a couple weeks to clear this up.

United Health Care, hang on to Audry!!  

Audry, I send you additional good Karma for your strength and support!

oh, and Surgical Center, your reparation was a FAIL even though I know you meant well.

Maybe I need some quilting and quilting juice....  I can see that my tolerance level is slipping...