Thursday, January 5, 2012





                                            orchids- Longwood Gardens

    Regret. A word for big mistakes, and small oversights. I thought I was careful. My blunder, financial. When the doctor told me I should get an echocardiogram, I let them make the appointment. They named several nearby facilities, all having basically the same words in their names, just in different orders. I picked one on a road I am familiar with.

    I asked how much it would cost. The lady who made the appointment called my insurance company for me and tried to get this information. Fifteen minutes later, she gave up. I was told it shouldn't be too much and most insurance covers it.

    Of course I didn't let it go at that.  I went home and looked up my insurance info online. I had to add info and set up a password. I made sure the place I was going for the testing was covered by my insurance (in-network). And I found out that my insurance covers 80% of procedures-AFTER I reach my $1,400 deductible. But I still didn't know how much this procedure would cost me, so I called the facility and asked them. They didn't know how much it would cost and gave me the number for billing. Billing told me they couldn't give me a number- I told them my deductible and said I'm going to be paying for this out of pocket I need to know how much it is going to be. They said the number is so inflated they wont tell me because it isn't the number I would ever pay anyway. And then told me there are payment plans that can be set up to make it easier to pay.

    I didn't find any of that reassuring, so I called my insurance company. It took a while to weave through all the junk where I talked to a machine and said this or that and pushed this or that button, and several times it didn't like what I said, and made me repeat and pick something else, but eventually it connected me with an actual person. The person I reached quickly repeated all the info I had found online, 80%coverage after $1,400 deductible, and while I was in the middle of asking a question hung up on me.

   Alrighty-So I got to start the whole dialing and talking to a machine process all over again and tried to think of a different category for my question in hopes of getting to talk to a different person this time. Ah..a much better person, one who listens and then responds. She was very helpful, reassured me that echo bills come across her desk all the time, and no they aren't in the thousands but in the hundreds of dollars. And that there was a surplus of several hundred in our account (because we hardly ever use any of our health benifits) so it is possible that they would apply that to it, and I could end up paying nothing. She also helped me find the cost estimator on their website. And there I was able to see that my test would cost $200 dollars. Whew did I heave a sigh of relief. Okay I had all the info, it would be reasonable to have this test done.

    So imagine our shock when we got the bill. $3,219.68. After insurance adjustment-$1,290.64 due. What?????!!!!! I still can't believe it. I mean this was a 15 minute test, just ran the ultrasound thing over my chest area. We thought it must be a mistake. We had to wait several days because of New Years holiday to find out what was going on. My husband called our insurance ( he got to do the long talking to the machine process) but eventually I got on to ask the questions myself. I mentioned the cost estimator- she said it's an estimator not exact- I said, I get that but um $3,000 extra is more than a little off. I may have screamed that part. (I kept getting worked up and then having to bring myself back down again.) She said well it wasn't just a basic echo, it was 2d complete, and was recorded. (I didn't ask for it to be recorded, it didn't say anything special on the form, it was recorded so it could be looked at later because no doctor was there for it.). Okay I said so how much more does that sort of echo cost. She looked it up and then said, Oh. I said how much more- about $34 she said. I asked her why I was being charged so much. I told her I couldn't pay this much, I never would have had the test done if I had known it could cost this much. She said our insurance was applying some surplus account money to the charge so it should end up costing us about $700,  she didn't know why I was being charged so much but that it has to be paid- the insurance company has an agreement with the facility to pay a certain amount for a procedure- it is all about the code for that procedure, maybe this was a special code. I should call the facility and double check that the right code was put in.

  I call the facility. Again they switch me to billing department. Matter of fact tone, she scoffs at me. Like how could I ever be surprised over such a thing. I had my test done at a trauma center, of course it would cost me more than it would anywhere else. I said over a thousand dollars more? She said, "Oh yes. We don't do echos here for less than $2,000 and that is for a standard echo and you had a 2D complete and it was recorded" (lucky me.) Thinking of the future I asked her if this would also be true for an MRI. Yes, at least $1,000 more at a trauma center. She said I could call and ask the amount of one if I decided to have one (she said it like it was an easy and obvious thing to call and get a price. I felt like screaming that is what I tried to do for the echo! And no one would tell me _ _ _ _!) I then asked her if she had the adjusted bill saying we owe $700 now instead of $1,200+, she said no, it shows here you owe us the full amount. She told me I could set up a payment plan, and that I had 90 days to pay then it goes to a collection agency, and she hung up.

    Ugh. I felt so sick. I still can not believe this. I am desperately hoping (we are calling our insurance company back today) that it is at least the modified 700 number, the 1,290 number I can't even wrap my head around.

    Oh, and the fact that I tried so hard to find out how much this procedure would cost ahead of time, because I knew we couldn't afford much. And that I still messed up. I still made some stupid error that resulted in this cost. If I had known our local hospital was a trauma center and that, that made some sort of a difference I would have gone somewhere else. I didn't choose it specifically (I didn't even know the facility was within the hospital when the appointment was made.) it was just that it was on a street that I knew, thus was easy to find. I knew the hospital was on that road, but so are many medical and dental facilities.

    If only- one teeny tiny decision- here instead of there, and this would have been $34, or perhaps even free. And despite my efforts, it is my fault. I feel like I am robbing my family.

   But then I have to step back, remove myself from that space, from that heavy distraught feeling. I have to let it go. It hangs there, it doesn't dissipate, but I stand outside rather than within it.  It is done, this has happened, the situation is, what can I do now? Not make this mistake again. Not go to the writer's conference this year. Try to squeeze this money out of other areas of my life. Feeling distraught and sick over it, that wont help at all.

Upside?
          -My heart is fine, normal. So if it wants to skip some beats, or thunder along for several seconds here and there no big. And both the perpetual exhaustion, and chest pain with exercise, are gone now. Because I am fine, I more regret the expenditure as it was all unnecessary, but ultimately if the test had been shown justified- abnormal results, um that would not be in any way comforting.
          -Possibly an upside- I now know beyond a shadow of a doubt that stress and anxiety do not make me feel any dizzier. It comes and goes whenever it feels like it, and to whatever degree, regardless of my state of mind.
         -Gee if I do get worse, I have now met my deductible- our year stops sometime in June- so I will have 80% coverage if I get an MRI, and I now know not to have one at the hospital. So that knocks at least $1,000 off the price right there. I don't intend to have one though. I'd have to be sure something was really terribly wrong (not just off) before I would get such a test. And I have every intention of being terrifically well instead.
        - I still couldn't resist putting pretty orchids at the top of this post. A.k.a, this is a sucky thing, I feel I have been treated ill. Allowed myself to be tricked, used. I have been a fool. We have worked hard to cut back on all our spending, yet I have offered up our resources unnecessarily. Stupid, stupid, stupid. But this isn't an insurmountable thing. Everything, anything, could so easily be much worse. Live and learn, I get more chances, today is a new day; and like Anne of Green Gables would say, it doesn't have any mistakes in it (yet). And I don't take simple things like movement, my ability to walk, or dance (when I can dance without feeling sick) for granted anymore. It is a fine and remarkable thing to be able to move about the world.

I apologize for the randomness through which I approached tense, swinging back and forth between present and past tense without regard. Ah to be freely reckless with something :) . Oh and I suppose I should apologize as well, vaguely, for the myriad of grammar-ish mistakes I am aware of but not going to take any time to attempt to fix. Really, as I am sure anyone could agree, been here writing this far too long already. I am not however inclined today to apologize for all the grammar-ish mistakes that I have made but am completely unaware of. No. I want to take a moment, and a few deep breaths, and not hold myself accountable, for being stupid, and unaware. A space to feel okay and free to not know, and not feel consequence. I do try to know better but I often don't. And rather than apologize to you, I am going to forgive myself for it.







2 comments:

"The Happy News Lady" said...

It's not you or your mistake. The medical plant is a universe of it's own. Sadly robbing anyone it can. Glad you broke thru one of their schemes and told us on planet earth so now we can watch for similar.

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