Continuing with the healthcare in America topic. This topic may be boring to most, but if you
are between the ages of 55 and 65 and happen to be unemployed or self-employed
in America, there is no way you would know be interested in healthcare. Of course, if you are poor enough to be
covered by Medicaid, or rich enough that you assume money grows on trees, you
probably don’t care either. I’m lucky
enough to be smack in the middle of all those metrics so I do care, and care a
lot about healthcare, and especially the cost of healthcare in America.
Another example of the how broken the system is happened to
me this week. Let me call them “billing
errors” or at least that’s how everyone I talked to this week ended up
referring to them.
A couple of months ago, my wife and myself went to do our yearly
wellness physical exam. At the time we
both had different healthcare insurance coverage. Belinda’s coverage is a more comprehensive plan
than mine. It covers major illness and
accidents as well as preventive coverage.
In my case I have two policies.
One, a high deductible that I have to cover me if I need to be
hospitalized or if I have a major illness or accident. Another that covers preventive healthcare and
routine doctor’s visits. With all this
coverage, you would think we would feel quite relaxed about heading to the
doctor.
The visit was good.
Great outcomes for both of us. Cholesterol
in the normal range. All metabolic
indicators, perfect. Nothing to
complaint about. As we were walking out,
the nurse asked if we wanted to get the flu vaccination. “It’s free” she said. I was planning to have it anyway but Belinda
always hesitates to deal with needles so she was planning to pass the
offer. I mentioned that for the sake of
the grandchildren we should be vaccinated and did I say it was free? Don’t know what did the trick but she agreed
to be vaccinated at the time.
We went home happy with the results and happy to having done
something to maintain ourselves healthy.
Two months later, the bills started arriving.
Belinda was being charged the full cost of the doctor’s
visit. Not only the physical exam but the
vaccination as well. The vaccination was
even divided into the flu vaccine itself ($40.00) and the immunization
administration ($54.00). From “free”
to $94.00 felt like robbery. And also
the charge for the physical exam was only partially covered, when her policy
claimed to cover preventive health procedures at 100% without deductible. I called the clinic and the insurance broker
that sold us the policy. The outcome? Still not fully resolved but the clinic
claims that they called the insurance and they had told them that the immunization
was not covered at all, and that Belinda’s policy did not cover preventive
healthcare. The insurance broker checked
the statement and the policy and concluded that the clinic had made a filing
error thus they would need to resubmit with the proper code for it to be
processed correctly. Still waiting for a
positive outcome.
In my case, I also received a bill from Quest Diagnostics
for blood work in the amount of $682.48.
Almost seven hundred dollars for measuring my cholesterol and blood
chemistry? Of course, I had to call the doctor. First, the blood had been drawn at the clinic,
not at Quest. How did my blood end up at
Quest and now they are billing me directly?
The clinic said that it must be that Quest did not have my insurance
card when they processed the blood. And I
asked, why would they have it when I never went to Quest to request the
service. It must have been an error.
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