A healthcare story and rant
In the beginning of November, I went to the doctor's office twice to have a problem looked at.
The start of my troubles was that the doctor's office gave me a hard time with my insurance. They had never heard of the short-term insurance I have (which I had bought on eHealthInsurance) and apparently this fact made it difficult for them to accept it. It required a fair amount of cajoling to convince the doctor's office that yes, my insurance is real. This surprised me because I thought there was a system by which they could fairly quickly confirm that a given insurance plan is real.
Then I was allowed to see the doctor and a few weeks passed.
I received from my insurer a letter asking me to give specifics about my claim. Questions like, "what symptoms did you have?", "what procedures did you have done?", etc. I would have expected the answers to these questions to have been included in the report that the doctor's office sent to the insurer. And honestly, I didn't see why they would need to ask these questions.
Out of laziness, I let that letter gather dust for a week or so.
Last Thursday, I got a call from my doctor's office. They had also received this letter, and they too seemed to be puzzled about why they received it. Naturally, they just wanted to be paid. I explained to them that I just hadn't gotten around to dealing with it. I asked, "what do I owe?" Apparently only the billing section of the hospital could tell me, and I was given a number to call. Knowing how these things work, I asked what info I will need to identify my bill to the people on the other number. I was given a patient number, a cert number (which is just my insurance number) and my claim number.
So I call this other number. I explain my situation to them, and at this point I'm sounding and acting pretty frustrated. I let them know that at this point, I just want to pay my bill and not think about the problem any more. I am told that my balance is $0.
So then why are people calling me? I am told that my insurance has yet to send them an "explanation of benefits". In any reasonable system, my insurer would have sent the explanation of benefits, a document describing what stuff is covered by my insurance, when the billing office asked for it. Instead, they withheld the EOB until I dealt with that questionnaire. Since I never did, the hospital assumed that the insurer would pay 100% of the cost, thus my balance was $0, thus apparently the billing office didn't see a reason to bug me and instead it was the onus of the doctor's office to follow up on payment.
So essentially this is a deadlock in healthcare administration, where neither hospital nor insurance will progress without my personal intervention. I solved the situation.
Trying to make my good mark in this rube goldberg machine that is our healthcare system, I tred to call back my doctor's office to tell them that the billing people just want the hospital patient number, not all those other numbers I was given.
I got to a machine telling me that "the original caller cannot be identified because it was an outgoing call."