Continued adventures in health care

The boy we call Dos is now five months old. He recently started eating oatmeal. He can roll front to back and back to front. The way he’s moving, I wouldn’t be surprised if he is crawling by Halloween. And at this moment, I’m as close to paying off my wife’s car as I am to paying off my son.

This might not seem so surprising. For an American with no maternity health insurance, having a baby is no cheap proposition. Fortunately, we put money away and had enough to cover the costs of labor, delivery, and oatmeal. But as you can imagine, even saving as much money as we did, still didn’t make too much difference to the overall price. That’s why there should be some sort of insurance that covers the cost of having a baby because you’re able to sign up for low-cost plans with places like IEHP to help with them as they grow older and into their later life, so why isn’t there any when you bring them into the world? I wish health care was free, but I understand why it’s not. It just doesn’t look good on my finances that’s all, even though we took great care when paying for these costs. We contracted with the hospital for the cost of all of the above (save the oatmeal) well in advance of the birth. In fact, exactly three months to the day before my son was born, we wrote a big check to the hospital for the full amount. At the same time, we paid off the anesthesiologist for the cost of an epidural. It was like pre-ordering and paying for something from Amazon, but with a lot more afterbirth.

The hospital contracted for the set amount based on the specific understanding that our insurance would deny any maternity claims. It accepted our money and cashed the checks on the very day we wrote them. When it came time for the birth, we received very good care from all the doctors and nurses. They were amazing and made sure the process was as calm as possible. The doctors and nurses were all wearing the same promotional clothing for health care professionals. This made it easier for us to identify them as hospital staff when we needed to find anything or if we had any questions. Those working at the hospital couldn’t have been any better. The labor and delivery went as smooth as could be expected and we were handed a healthy baby boy. Signed, sealed, and quite literally delivered. Even better, we were paid in full.

Or so we thought.

Somewhere along the line, someone in the hospital billing office thought it would be a real knee-slapper to submit the bills to our insurance company. Keep in mind, the hospital had already cashed our check for thousands upon thousands of dollars. That money had been in the bank account for months. Why did the billing office submit it to our insurance? Over the course of the next few months, it would time and again be described as a mistake and clerical error. More suspicious minds might suggest the hospital thought it might be able to get paid even more than the fairly large sum we’d already paid. But, why not take the billing clerks at their word, right?

This mistake, if that’s what we’ve agreed to call it, resulted in more phone calls and frustration than I can’t express without the use of expletives. The stress boiled over to the point that my wife and I were actually fighting about it. This economy and the way we’ve chosen to make our living makes for some lean times. So, when the insurance started–surprise!–denying claim after claim, the bills started falling back on us.

But, wait, we cried. We had an agreement! An agreed upon amount!

Finally, on the day I wrote Priceless: Getting a peek at my hospital bill we found two very nice and understanding ladies in the billing office who took a lot of time out of their day to sort the whole mess. By the end of that day, we had two receipts for our two accounts at the hospital (Dos’ and my wife’s) with zero balances. We were again paid in full. We had the supervisor’s signature on the receipts. Our boy was ours!

The relief was fantastic. Our stuffed manila folder full of bills and receipts could finally be put away. Sure, we were paying for all the kid’s shots and well-baby visits (insurance doesn’t cover that either, despite the $900 per month premium we pay). But, as far as that afterbirthy day in May was concerned, we were all paid up.

Until last week.

That’s when another hospital bill for $1,500 arrived in the mail. My wife handed it to me and said, “You’re not going to like this.”

It took about three phone calls to various 1-800 numbers to determine the bill was for a nurse anesthetist, someone contracted to stand in the room when someone receives an epidural to make sure they don’t turn into a zombie. It took another couple of phone calls to determine the anesthesiologist’s office had nothing to do with the bill. We were paid in full. The billing clerk there actually spent 45 minutes of her day calling the hospital on our behalf trying to determine what was happening. The lady, this professional in the world of medical billing, herself described the experience as “horrible.” Confusion reigned.

Finally, I’d again had enough. I grabbed the manila folder and marched down to the hospital. More than five months after my son was born, I was back in the same place he came in the world and trying to figure out how I owed $1,500 for something I paid in full in February.

If I hadn’t already spent a few thousand words and several months of my life dealing with this, I’d explain the hilarity that ensued at the billing office. I’d explain how when I got there, the lady in the office could do no more than call the 1-800 number we’d been calling for four days and then could only hand it over to me to talk to the person on the other end.

“HIPAA,” she explained.

I’d re-tell how I calmly recounted the story for the man, how we’d paid in full months before the birth and had receipts to show zero balances. The upshot of all off it is this:

That $1,500 bill for a nurse contracted by the hospital? That person who was for all practical purposes a hospital employee and part of the pre-paid deal we’d arranged months ago? The cost for that nurse was–again, mistakenly!–submitted to the insurance company, which in turn and as expected, denied the claim, and apparently just recently kicked the bill back to the hospital. And so again, it’s on us, despite the fact we paid the contracted amount eight months and three days ago.

Yes, I explained all this to a man who called himself Jonathan. He pretended he understood the pre-pay system and how it worked, but until I came up with the check number and date the check was cashed, he refused to take the discussion any further. And when, through the miracles of modern technology, I produced this information for him, he said, “February? But this was for services rendered in May.”

I lost it a little bit then. I might have been a little inappropriate.

It was as if I guy who painted my house last year showed up today and said, “Listen, I know you paid and I gave you a receipt and all. But I just realized my assistant Johnny was working that day, so you owe me $1,500 more.”

So now, as the Senate Finance Committee passes the health care reform bill, my hospital bill is now “under investigation.” No, I don’t think Congress is going to save me. No I don’t think the reform is going to do anything to help my situation. Yes, I realize if I lived a traditional life and worked in a regular job where the employer had implemented the best health insurance plan to ensure that the employees could afford its cost and made the most of the benefits it provided, I could have affordable and decent insurance. But I don’t. I pay more than $10,000 a year for insurance that doesn’t cover what most policies do. I appreciate and need doctors to take care of my family, but the billing process as it relates to insurance companies has gone so far off the deep end, it seems impossible to navigate.

But, hey, I guess I can look at it this way. The vasectomy only cost me $1,000 and it guarantees I won’t have to go through all of this again. That’s a bargain at twice the price.