Health Care: One Changed Vote

Posted by Todd Cunningham on November 24, 2009 - 4:33pm
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I’m a lifelong, dedicated Republican.  I work hard and believe that people should honor their commitments.  My wife and I have always lived responsibly, and until recently we have enjoyed a perfect credit rating.
 
Until two weeks ago, I was very forcibly opposed to any health care reform.  However, two weeks ago, I was placed in collections by my health care provider, because for the past seven months they have been unable to collect payment from my employer-based health insurance for immunizations which are required for my child to go to school.   
 
Unfortunately this is not the first time we've had problems of this nature.  Because our hospital couldn’t collect payment from our insurer for certain immunizations last year, my wife contacted our insurance company this year prior to scheduling the school-required immunizations in order to verify that they would be fully covered.  She was informed that this time they would be fully covered.
 
But since last April when the vaccinations were administered, our health insurance company has claimed they must deny coverage - and have, time and again - due to certain billing errors made by the hospital.  The hospital claims it has made no billing errors, but has been unable to collect from the insurer.  We have made many phone calls to coordinate between the parties, and even sat down to meet personally with the hospital in efforts to resolve.  The hospital and the insurer have each advised us that they’ve “done all they can do”.  Meanwhile, we've been placed in collections, and our credit rating has been adversely affected. Superb timing, as we were just about to refinance our house, and expand lines of credit to help finance a certain church remodeling project.
 
My first corrective action will of course involve my choice of health care provider.  My second corrective action involves my vote with regards to health care.  I believe it is worthy of great ridicule and scorn that our current health care system would rather waste time playing games instead of providing necessary vaccinations for children which are required for them to attend school.  We all recognize that it is unfair to ask anyone to pay several times over for the same services - once for an insurance premium, twice for an out-of-pocket, and thrice for the damage done to a good credit rating during these tough economic times.  
 
While the cost of health care is already enough to make my blood boil, it appalls me to consider that much of the health care costs we are being asked to pay have been marked up to absorb inefficiencies within the system.  Aren’t they possibly marked up, just a little bit, due to the games played between hospitals and insurers?  After all, I care precious little about whether a medical billing has been coded satisfactorily, but I care a great deal whether my chosen hospital and insurer can effectively take care of me. Something is definitely broken when they can’t cover school immunizations anymore.
 
I wonder if my experience may help persuade other life-long Republicans to reconsider their voting habits as well.  At the minimum, I'd like to advise other hardworking, insured parents who wish to both protect their good credit ratings and immunize their children to consider carefully their choice of health care provider, and weigh the very real risk of being placed into collections when having your children immunized to attend school. 
 
There is nothing standing between you and the one-two punch of inefficient, improper billing procedures by our health care providers and non-coverage by our insurers.  If you think they won't sock it to you, you might think again.
 
And as far as getting the swine flu shot (or any other form of health care) this year, kindly count me out!  I figure I've already suffered enough already.

Posted by D Thompson on November 24, 2009 - 6:01pm
I fought and won a similar situation. I say call the state of teh him office of the insurance carrier and hospital. These piss poor billing practices have to stop.
I worked with the processors and flat out told them I provided every level of detail they required to pay the dang copay for a preapproved consultation.

They have not paid the provider yet, but they aren't billing me and it's not on my credit report.
Posted by Auric Finger on December 2, 2009 - 12:39pm
I too was against health care reform until recently. I went into the ER for a case of food poisoning and was given a CT scan to ensure that it wasn't appendicitis. Turns out they decided to do scan 3 different areas (in the same sitting) for 3x the price and not inform me until after the fact.

At the time I was unemployed and only had major medical insurance, so this is all going to be out of pocket.

No other industry could get away with this type of behavior and not face heavy legal regulation - for good reason.

A. Finger
Medical Billing Specialist
Posted by fred meyer on December 2, 2009 - 12:59pm
Gold Finger