Beware hospitals and their ER

[this_side_up]

It is no wonder the insurance industry announced this week that healthcare will cost 8K per person in 09. What is the possibility of fraud and corruption between the hospitals and ins. companies? They make the huge salaries and bonus and we get to pay for it while they enrich themselves any way they can.

I broke my arm, shoulder and clavicle and went to the local
ER rather than having spouse drive me 50-60 miles north. If left up to me, we would have gone north but the weather was horrible with snow/ice and the drive would have taken 3-4 hours one way, to say nothing of bouncing around on the ice/snow lumps on the highway.

Had xrays, a pain shot, very short visit from the ER doc, a Rx for pain pills, and went home in a cheesy dysfunctional arm sling which we replaced 2 days later with a $12 Ace sling from RiteAid.

I never received a bill from either the hospital or the ER doctors group.
I did receive a statement from the hospital that showed the total charge and in big letters This Is Not A Bill. I figured they'd get around to sending an itemized bill. Wrong!

Needless to say, I've pretty much been out of it due to pain and physical limitations and physical therapy which does exacerbate everything.

So today I received a statement/bill from the ER doctors group showing
medical code for the doctor and the charge for that and some kind of charge for the xrays. In addition, they charged $325 for a long leg splint.
They also showed what the insurance paid and my balance. If they had sent me an itemized bill within 2 weeks of discharge, this 'erroneous' billing mistake never would have gotten to the insurance company.

What's that all about? Fraud? Or did they take inventory and find they were short 1 leg splint and chose to bill me for it? Their billing office closes at 5 eastern so I will call tomorrow and see what they have to say.

I then looked at the hospital statement. It says if you want an itemized
bill, call and ask for it. So I did. The woman said they do not send out itemized bills. I said it says on this statement, if ya want one, call and ask for it. The woman was sniffing condescendingly disdainful when she said
she was printing it out right then and would put it in the mail.

GRrrrrrrrrr. I feel a go-for-their-throats letter bubbling inside me. What IS all this bs about - Let them and the ins. do their thing and trust them and just pay the balance due and don't ask questions? Especially since healthcare for 09 will be 8K per person.

The day after the ER, I called the ortho office to make appt. They were not answering phones. Left message. It took 1.75 days for them to call back. I said I need to make appt. She said what's your name and the name of your insurance company - I will check with the doctor and get back to you. She called back 4 hours later and said he won't see you unless you've had a CT scan already done. I said fine, set it up and schedule the office visit. So, the scan was done 4 days later and I saw him a week later (New Year's Eve).

3 days (Xmas Eve) after hospital discharge, I called the office and said I'm running out of pain pills and have only 7 left and that will not last for another week before I see him at the office (NY's Eve). The original hospital Rx was for 20. I was told that he could not write an Rx because he hadn't seen me yet. I asked well then, how could he insist on, much less order, a CT scan when he hadn't seen me. No answer other than I should return to the ER for another Rx.

I did so and that doctor gave me hell for coming back. I had a terrible
time controlling my temper and told him don't you dare try to put this
off on me. It's not my fault I cannot get in to see the ortho doc until
New Year's Eve.

He went and consulted with someone and returned and again
tried to lay it on me as being a pill-seeking idiot. That is when I stood up
and I almost lost it. He says, well, we really don't want to write this
but we will and we don't want you coming back here again for more
pain pills and the pain should be decreasing, so make these pills last until the office visit.

Finally the office visit. Luckily, I brought my copy of the scan with me because they could not find their copy which the radiology company assured me had been mailed the same day they mailed my copy.

That idiot doctor was snide, rude and LOL about whether or not I needed
surgery. I guess he was wondering if he could possibly squeeze in another surgery in Jan or Feb or if he was already overbooked.

So......beware. They really are out to get We, The People any way
they can.

Mods: i couldn't decide if this should be in health, gd or economy.
Since it is all about money, here we be. And since the bank and housing and stock fraud and corruption........

[elleng]

1. Sorry to hear this, this side;

get well.

[this_side_up]

3. Thanks!

It's been a trip I never want to repeat. :)

Things are getting better, working on increasing range of
motion. I'll be happy if I can get 90%. Even 85. Anything
but surgery. That just isn't worth it.

But, if for some reason I do have to go the surgical route,
it won't be here with that hospital or that asshole doctor.

[Triana]

2. you know, the repigs can grouse about problems with single-payer, national healthcare all they want

but THERE IS NO WAY it would be any worse than what you've had to go through with this bureaucratic BULLSHIT when you're injured. My Mom and sister and BiL has had to endure similar with Medicare and doctors, hospitals, and insurance. It's goddamned rediculous. NO ONE who is sick, injured, diseased, or dying ought to have to endure the ridiculous bureaucratic bullshit of insurance companies, "healthcare" companies, drug companies, or any FOR-PROFIT institutions - just to get goddamned treatment.

Jeebus H. Friggin Keeerist on a stick!

:mad:

[this_side_up]

4. Yes, it is total bs.

It's all about money and greed.

I know what your family members have gone through and I feel for
them. My brother has gone through the same stuff for years.

There is no way he can work but they keep telling him he's
up for review and they think he can work 4 hours a day.

As if. He died 3 times 14 years ago and they cannot figure
out why he is still alive and why stress test comes out great
when it should be awful. But he has many other problems -
very poor circulation in leg, can hardly walk, abdominal aneurysm that is
inoperable because of his overall bad health and other
problems. He isn't doing any kind of proactive healthcare,
just taking pills and hanging on another day/week/month.

yet, they persist in hassling him. I think this is all just
another part of culling the herd. Stress us out etc and wear
us out with making phone calls & letters etc.

gotta get to sleep.

Thanks for your responses.

[PassingFair]

5. I went through something like this when I broke my ankle.

By the time I had been through x-rays, ERs,
"nuclear scans" and the insurance jungle
my ankle had mostly HEALED ITSELF.

6 weeks of hobbling.

[this_side_up]

9. PITA and they like it like that!

There just isn't any reason for all this bumbling and messing
up.

I could relate stories about 3 pharmacies who are now dead
to me but I won't. Scary indeed.


At least you pretty much healed in 6 weeks. Therapist
and my primary care both say 8 - 18 months and more likely
18 months due to age and the 2 bad breaks in the shoulder
and nasty vertical split in humerous.

[RC]

6. But..., but..., but... Our health care system is so much better than those

communist countries like Canada where there are long wait lines to get in to see the doctor.
:sarcasm: (For the reality challenged)

[this_side_up]

10. BWAHAHahahahahahaha

Thanks for my first laugh of the day!

The screwing up in both small and large ways,
medication mistakes, surgical mistakes etc etc
is becoming too scary for words. Yet the hospitals
and doctors want caps on how much people can
sue for.

Add in bringing in foreign nurses who aren't
quite up to snuff in English, much less medical
slang.

The medical system is terminal.

Gotta go exercise this turkey.

Thank you all for your comments. I really had to vent
yesterday.

Keep an eye out because they won't.

[dixiegrrrrl]

7. Hospital/Dr. tried to jack up Mr. D's bill a few years ago.

The ER doc billed us for every day of Mr. D's 3 day stay, by sticking his head in the room and asking
"how are you doing?" even tho the ER doc was not the primary.
I was a hospital Social Worker at one time.
I handle the bills.
The 3 day stay was totally unneccasary, it was for observation of a symptom which cleared in 12 hours.

Every bill we got I sent back with a note that I was sending it to our insurance company with our explanation of why it was too high, or not warranted, or etc...and kept THAT circle going for 6 months.
We ended up paying almost nothing beyond the co-pays.

You HAVE to question and complain and negotiate everything. Otherwise they just assume they have a sheeple on the line. Sad, but true.

[this_side_up]

8. The thing that gets me

is that the hospital no longer sends out itemized bills unless you
ask for one. Trust us...just pay the balance.

I talked with the ER billing group this morning and they assured
me I left with a long leg splint.

I will begin work on a letter but won't send it until I see
the hospital's itemized bill.

One of my brothers was my mother's executor. One year after
she died, some doctor sent a bill for $250. Brother paid it without
questioning it. If it had been me, I'd have insisted on the
hospital pulling her chart and looking for when and where
this person did something for my mother one time only.
I still think that was a scam.

[CoffeeCat]

11. That's totally contrary....

...to what has been happening in our healthcare system.

You're saying that hospitals are keeping people in longer---to charge them more.

In the past, it's practically been a joke how fast they want to whisk you out of the hospital--after surgery.

With my c-section, I was out 2 days after surgery. Same with back surgery. You could smell the frenzied urgency
to get people out of those beds as quick as possible.

Now...they're wanting people to stay to increase the bills???

Does anyone else get the sense, that many businesses know that the economy is about to implode--and they're desperately
trying to squeeze as many dollars out us---before we're all destitute?

I've experienced this with a couple of companies...they seem desperate to amass dollars, any way they can.