Recently, I got pulled into being a health-care advocate for a relative. I’ve done it before, and I know that I can succeed at it. But it’s tremendously time-consuming plus it requires loads of psychic energy. That’s why I haven’t posted about it until today. It started with a phone call about some ominous symptoms, casually described. It took a few more phone calls to determine just how ominous the symptoms were. That was when I went into health advocate mode.
First, to locate the right doctor. Numerous calls to a prestigious medical center, but no assurances that the right doctor was there with the right specialty. Then, more calls to the billing department to determine what, if anything, it would do for a patient who has no health insurance. Finally, a price quote that left me gasping—and that was strictly for the initial examination. I was told by a helpful person that once the patient had been rejected by state Medicaid, the medical center would consider giving some kind of discount. But meanwhile, the most eminent doctor, recruited after a worldwide search, was still in visa limbo. And it would take at least three months to be rejected by Medicaid.
We did not have time. Another doctor at the medical center couldn’t see my relative for several months. No good.
I went back to doctors we had seen 20 years ago, before we had graduated to the eminent medical center. The generalist still recommended the same specialist. The specialist could see my relative immediately. But my relative would be treated as a new patient, and there was no upper limit on how much would be charged at the initial examination. My relative could not even get in to see the doctor without authorizing a credit card payment in advance.
Did I mention that I don’t live anywhere near this relative? That the doctor’s office would not take my credit card over the phone to pay for the visit? That my relative might not have enough funds to pay for that visit? And every group of phone calls I made to doctors’ offices had to be followed up with another call to consult with my relative?
The appointment was made, and the doctor relieved everyone with a relatively benign diagnosis, consisting mostly of “WTF” and “looks okay, but strange, so go see this other specialist.”
Then the office told my relative the charge was $1,100, but their credit card machine was down that day, and so my relative would not be charged. Instead, a bill would be mailed. I called later that day and heard the same thing from the office, which again refused to take my own credit card information, saying they couldn’t be responsible for it.
A few days later, as I was beginning to make the next round of phone calls to try to determine the costs of the unique exam the other specialist was to give, my relative received what looked like a bill for $736. Huh? A discounted charge, perhaps? When my spouse saw the piece of paper, he immediately recognized it as a credit card payment receipt. Despite what they had told my relative, and told me later, the doctor’s office had gone ahead and done the credit card payment after all.
So it was back to calling the first doctor’s office, to find out what had happened. But no, I had to call the billing office. Did that. The billing person handling that doctor was gone for the day. Next day, out that day. Next day, not the right person after all. I must call the office manager at the doctor’s office. The office manager was busy. The office manager would call me back. And so on. Finally, we had our chat, and the office manager promised to look into the billing. Turned out that $736 was a mistaken amount charged accord to a four-years-out-of-date billing schedule. It wasn’t a discount on purpose. But the doctor’s office had accepted that amount as full payment. Any further discount would have to be discussed directly with the doctor. At that point, I decided that a 33% discount was good enough. Especially because it had already been paid. The time to argue that you don’t have the money to pay a medical bill is before you pay it.
Meanwhile, I had put in numerous calls to both offices to determine the correct name of the exam to be done by the second doctor, its likely price, and to ask for a discount in advance. To my very great astonishment, the second specialist agreed to take about one-tenth of the usual charge, a mere $75 for what usually cost $700. Fist in the air for a big win. That win only took about six phone calls over several days.
We’ve already done the pro forma application to Medicaid, including a depressing personal interview, and have been told that my relative will likely be rejected. So when the eminent foreign doctor finally gets that visa, we can go back to the prestigious medical center, where we’ll be lucky if the doctor does not want to re-run all the same emergency tests just taken. Hopefully, by then we can get a discount.
There is more to this story, but I don’t imagine that this kind of tale makes particularly entertaining reading. This is what medical advocating is all about. Endless phone calls. Endless quests for information, for recommendations, for discounts, for getting strangers to see your side of a difficult situation and cut you a break. Wouldn’t universal health care be a lot easier? Yes. Because then, the people who get paid to do medical billing do all the work. Not the patients or their advocates.