The madness continues. And intensifies.

I write a lot of fiction.  It’s fun.  But fiction, as the adage goes, has the disadvantage of having to be realistic.  Reality has no such constraint.

We talked with the American Fork Hospital billing people a couple of times this week.  And honestly, you can’t make this stuff up.

They called us Tuesday, wanting to talk to us about payment arrangements.  We were expecting their call.  They asked us the usual questions about how much we could pay every month (we don’t know) and whether we were going to apply for Medicaid (we are not), etc.  We told them we were going to be paying for everything ourselves.

That pleased them.  The gal said “you get a 25% discount for paying in cash.  You also get a 15% discount for paying within five days.”  That pleased us.  We asked, “so, is that 5 days from the day we get the final bill, or five days from Friday?”

“That’s five days from Friday.”

Now, get this, people.  We checked in on Friday after 11pm.  We count that hour as a day, apparently.  Then we have Saturday, Sunday, and Monday was a holiday.  This was Tuesday.  It was five days right that minute.

“So we have to pay you today?” we asked.

“Well, <reluctantly> I guess I could let you have until Friday.”

“What’s the final bill?”

“I don’t know.  It’s still being prepared.”

“So even if I wanted to pay you today, I couldn’t.  When will you have the bill ready?”

“Probably by Friday.  Maybe not, but probably.  Definitely not before then.”

And Jeanette laughed into the phone.  This didn’t faze whoever this was.  Apparently patent absurdity is so normal that they can’t even hear it any more.  We asked them what happens if the bill isn’t ready by Friday.  Did we lose our discount?

VERY reluctantly, they said, “I guess I could extend it to Monday.”

“So, if you don’t have the bill on Friday, you can extend the time to pay until Monday?”

“Yeah.  I guess I could do that.”  As if she were granting us a great favor.

Now, at this point I should have said “No, no.  I don’t want any favors.  I’ll pay you Friday.  I’ll make a number up, and put it on a check, and deliver it to you, and you can give me my discount.  If it’s not enough, I guess that will teach you to get you bill together faster, or develop a billing procedure that makes some sort of rational sense.”  But I didn’t.  Alas.

So here’s where we are.  They’ll knock 25% of our bill off even if we have to pay in three installments over the next couple of months, interest-free.  They will also take monthly payments, but in that case they’ll add 8% annual simple interest.  And it will take them more than a week to get their bill together.

This is not because everything is billed separately.  The radiologist will bill us separately for the x-rays (2 thereof).  The ambulance will bill us separately.  THE ER DOCTOR will bill us separately.  The hospital cannot, in under a week, figure out what to bill for inserting a line and administering saline and morphine, and splinting Gabriel’s leg.

People have asked me why I’m taking so much time blogging about all this.  Well, this is the reason.  I think most people haven’t the vaguest clue how completely cocked up the entire medical system is, and I’m not, in the main, talking about the medical part, which is complicated but that’s because bodies are.  The billing part is far, far more screwed up than any other piece of the system, and it is on this that I’ll focus more attention as we go along here.

They see several hundred people a month in the ER.  Yet they cannot produce a bill in less than a week for a procedure they perform HUNDREDS OF TIMES A YEAR , even if we take out all the other moving parts.  This is roughly like a restaurant taking a week and a half to send you a bill for a hamburger, even if they don’t have to bill you for taking up table space, for the waitress, or for drinks and fries.

It’s not stupid.  It’s worse than that.  It’s evil.

I was, in fairness, warned.  But I didn’t believe it could be as bad as people said.  And it isn’t.  It’s worse.

10 Responses to “The madness continues. And intensifies.”

  • Tiffany Berg says:

    Chris – I’m loving reading your blogs because I lived it! Oh my can I relate to what you’re talking about – people DO NOT and CAN NOT understand until they have extreme situations happen to them. The red tape, the time spent, the inconsistencies in billing, the phone calls, the falling through the holes, the stress, the pulling your hair out while trying to actually survive the physical challenge of whatever landed someone you love IN the hospital, IN the dire straits . . . you just have to have a sense of humor. AND, tell others. Because at some point changes will be made. And, it will be because of the information shared as to WHAT changes will be made.

    Let’s stop the insanity in our country – seriously folks. There has to be a better way than how we’re doing it now.

    - Keep writing!!!!

  • Catherine says:

    Once again I have to share my experience, which was totally opposite. When I had my last baby the hospital had our bill figured out and we paid before I even checked out. Maternity care is probably more standard than most other hospital-related care, which simplifies the billing process I’m sure.

  • Catherine says:

    And, as in all things, it is probably helpful to speak to someone pretty high up in the billing department rather than the regular staff.

  • I chatted with my husband, who happens to do some of the billing in the ER at a different IHC hospital and he says that the fact that they don’t have the bill 5 days out is ridiculous. In his Er they have bills usually the next day and certainly two days out.

    The ambulance bill will be separate because the ambulance company is a whole separate company and it’s possible that they won’t have the Dr’s bill because he doesn’t actually work for the hospital (he’s an independent contractor) but the bill for the IV, the x-rays the morphine etc… they should have all that.

    I second Cat’s assessment, talk to the manager.

    • chrisjones says:

      The bill from AF has arrived. It’s bad. Not as bad as it could have been, but bad. Still nothing from the ambulance or from Primary, as of this writing.

  • Lorraine P. says:

    Unlike you, I did have insurance. There were 4 of us injured, all taken by ambulance, then life flighted, dealing with 3 different hospitals and 2 insurance companies!! I was on the phone on a daily basis dealing with all this crap and trying to keep track of it all for over a year!! I knew all the billing people on a first name basis. Medical bills are not a fun thing to deal with! Good luck with it all!

    • chrisjones says:

      Yeah, I’m beginning to think that not having insurance is, at least from a complications standpoint, better than having it. Of course the bill will ultimately be higher, but the overall process won’t be quite so byzantine.

  • Carol O. says:

    After three separate admissions to the hospital within a month, for which I paid the $400 co-pay every time (thanks to supportive parents), I discovered that I was eligible for a discount on the co-pay itself, and any other additionally billed services. Did they make this retroactive? No, sir – once they get their mitts on your cash they’re never going to part with it. The lesson I learned? NEVER pay up front for medical services. People who are being responsible get abused by the system.

  • Lyaylya says:

    i don’t think it is respectful for your capmony to automatically pull a person credit without them knowing until the end of a conversation that is depriving our rights. It shouldn’t have been done unless we actually wanted your service so for future reference tell your sales reps to ask is it okay before they start checking into peoples credit (it should only be done when they accept your service) Thank you I hope to hear this matter is corrected in the future

  • I love these articles. How many words can a wordsmith smith?

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