Just a couple of things to be miffed about today:
– A friend posted on Facebook an excellent example of what’s wrong with medicine in this country: It’s not that you can’t get care, it’s that our medical care is so divided up among multiple people trying to make a buck while multiple insurance coverages do their darndest to avoid paying for it that we’ve created a bureaucratic nightmare.
Go to any doctor’s office, any medical center, you will find that a major part of their operational overhead is the billing department, dozens of people, or hundreds, dealing with the mutiplicity of codes, claims, forms and god knows what else involved in just getting paid.
Single payer — that horrible socialistic option — would sweep all that away. One form, one bill, one check, end of story.
Anyway, my friend’s tale of woe in her efforts to get her insurance company to pay the bill it was contracted with to pay:
Oh. My. Goodness. The insurance issue that was “settled” yesterday morning? Pfft! They called back yesterday afternoon and left a “case number” . Call back this morning, they say there IS a copay due because the followup mammogram and ultrasound weren’t performed at a “free standing” facility.
I pointed out that my brochure says “no copay,” that the hospital in question is the “preferred provider” THEY insist upon, AND that the initial mammogram, performed at the SAME facility, was covered in full with no copay! So they tell me *I* have to call the facility and tell them that they have to file a corrected claim coding for TYPE of service rather than PLACE of service (as they did with the initial mammogram) and include proof of authorization.
I try, and get the run-around from hell. Medical Billing tells me I have to contact the doctor who interpreted the mammogram and performed the ultrasound and have her, on her official letterhead, issue a new bill showing both the old coding and the new coding.
So I call medical records to pull up the file and find out just who that doctor was, and they tell me it’s not a billing problem, it’s a coding problem. So I call medical coding, who tells me that’s not their problem, but it might be someone else’s, and they transfer me . . . to her answering machine.
Two hours later, I’ve got her on the phone, and she tells me . . . (wait for it–you know it’s coming) . . . it’s not a coding problem, it’s a MEDICAL BILLING PROBLEM! At this point, I’m hoping that they can’t produce an authorization, at which point it becomes their problem, their mistake, and they can’t bill me or my insurance.
Who says our system ain’t broken? What they’re ALL waiting for is me to throw up my hands and decide that the fifty bucks isn’t worth the aggravation.
But I’m not gonna, because they suck hundreds of bucks out of our wallet every month (with matching hundreds from Tommy’s employer) just so we don’t HAVE to pay that fifty bucks. Asshats.
– On another level, Dana Milbank at the Washington Post has a good column (click) today in which the Catholic Church takes Rep. Paul Ryan to task for his proposed federal budget slashing programs for the poor while giving money to the rich.
Ryan claims his budget is based on his Catholic beliefs, but he has a rather unique twist on those beliefs. Christ preached giving to the poor, but Ryan thinks what Christ really meant was for the poor to stand up and have dignity from their own labors, unhindered by any welfare or other programs, such as job training or food assistance.
So does this mean he would prefer they starve in dignity? OK, that’s a bit extreme, but one still wonders. It’s really awfully nice that Ryan knows what’s best for the poor.
The Catholics — and I was brought up Catholic — seem to think when Christ was saying “As you do to the least of my brothers you do unto me” he wasn’t really talking about giving to the rich.
It is interesting to see Ryan, a self-proclaimed Catholic, telling the Catholic Church it doesn’t know what it’s talking about.