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Ah the Price of Dealing with Medical Insurance!

July 7, 2023

Summary: We all spend too much time as patients wrangling medical billing. Here’s one creative approach to accounting for that. Disappears with single payer, of course.

Billing the Hospital Billing Department
The New Yorker
July 3, 2023
By Kendra Allenby

Late-stage capitalism getting you down? Try this fun, D.I.Y. fix—sending your own personalized bill to the hospital billing department:

Dear billing department,

Below are the fees that you’ve incurred. Please pay the balance at your earliest convenience.

Phone calls pre-procedure: To make double, extra sure that the procedure is going to be fully covered by insurance. (Am assured that it will be.) An hour and a half at $300 per hour: $450

Initial phone call post-procedure: Asking why this huge bill showed up after I made double, extra sure that the entire procedure would be covered by insurance. Forty-five minutes at $400 per hour: $300

Follow-up phone call: To find out that the incorrect code was used in billing the procedure. Forty-five minutes at $400 per hour: $300

Misc. phone calls (three): To get the code changed to the correct code. Two hours and fifteen minutes at $400 per hour: $900

One more phone call: To get assurance and e-mail confirmation that the code has been changed and that I will not receive additional bills in the mail. Thirty minutes at $400 per hour: $200

Mug: Smashed when the third bill arrived in the mail. One mug at $47 per mug: $47

Fee for sterile disposal: Of mug. One mug at $347 per mug: $347

Fee for lost sleep: Over the huge bill that should have been entirely covered by insurance. A hundred and thirty-two hours over six months at $300 per hour: $39,600

Therapy to treat anxiety: Resulting from a six-month protracted follow-up on a bill that I never should have received in the first place, plus anxiety spikes upon repeatedly seeing additional bills in the mailbox. Twenty-four sessions at $200 per session: $4800

Tylenol. Couldn’t hurt: One pill at $300 per pill: $300

TOTAL COST: $47,244

My dog has negotiated your rate so that you are only responsible for a percentage of the total cost. If you choose not to go with my dog’s negotiated rate, you may be responsible for the total cost of the fees.

ADJUSTMENTS (as negotiated by dog): -$10,014

CURRENT BALANCE DUE: $37,230

Congratulations, you saved $10,014!

Comment by: Jim Kahn

Exactly right, sadly. Excellent dose of humor for a vexing situation.

We’ve all experienced this (I know I have … e.g., hours of calls regarding vaccination for foreign travel, and many letters and calls and emails to get reimbursed for an urgent care visit, and … and …).

HJM discussed research on this issue in late 2021.

About the Commentator, Jim Kahn

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Jim (James G.) Kahn, MD, MPH (editor) is an Emeritus Professor of Health Policy, Epidemiology, and Global Health at the University of California, San Francisco. His work focuses on the cost and effectiveness of prevention and treatment interventions in low and middle income countries, and on single payer economics in the U.S. He has studied, advocated, and educated on single payer since the 1994 campaign for Prop 186 in California, including two years as chair of Physicians for a National Health Program California.

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