Checking blood and hospital billing headaches

This morning I ran Gracie up to get her blood checked. We are waiting on the results now but Gracie had a great time. She met a little friend that was also getting blood taken. They spent 10 or 15 minutes coloring together in the waiting area. Gracie had also drawn a picture for her "friend" (Kerrie sp??) at the blood clinic. Kerrie is often the one that draws Gracie's blood but she is also the one that always gives Gracie a prize or has conversations with her while she is waiting. We also took some rice crispy squares to the staff there, as we are not sure how much longer we will need to be going there and they have been so good to us. In the mornings, Gracie often asks if we are going to the blood or cancer clinic that day. She is really excited to see her friends all the time. Anyway, things went pretty smoothly and we had a fun time again.

After I got home, I decided to call one of the hospitals that we have been dealing with about a recent bill they sent. They were trying to bill me $170 when I had already paid the last statement they sent me in full (all $1,600). I should back up here and remind you that I am an accountant. Accountants tend to be detailed about money and generally have a basic understanding of billing practices. I am no exception to that rule. In fact, I make it a rule to not pay medical bills unless I have detailed bills regarding the service performed, dates, etc. I keep a spreadsheet of how much they billed me, how much they billed my insurance, what went to deductible, copay, etc, how much they tried to charge above my insurance companies established limits, among other things. Often this seems like a bit of overkill as there is no real way to measure that they are charging you a fair rate. It is not like I could just go to the hospital down the street and ask for a better room or a better price for chemo drugs or a different specialist in retinoblastoma. However, I keep the information as a matter of principle and it has paid off a couple of times at least.

Anyway, back to my story. So I called the 1 800 number for the hospital and started talking to a billing clerk. I told her that I had questions regarding my most recent statement showing a balance of $170. I explained that I had paid $1600 on Feb 2 to clear my entire account (at least the portion that they had billed). She replied that I had paid $30 on a $200 account and so had $170 left. I assured her that I had the bill detailing that in front of me but that my most recent statement had $1,600 (including the $170 in question) and I had made that payment. Again she told me that I had paid $30 so had a $170 balance. I explained that there were several service dates on my most recent statement and that I had paid the amount in full and the hospital had applied my payment to the accounts but must have different amounts due than my bill showed. Again, I was wrong as I had paid $30 so had a $170 balance.

So I asked that she walk me through the service dates that I had paid or not paid at the hospital. She proceeded to tell me about several recent dates that they were waiting on my insurance company for collection. She still seemed determined that I had only paid $30 and there was no record of $1600 payment. Then she put me on hold for a bit and came back asking more questions about my account. I gave her the information and she seemed thoroughly annoyed but started reading the accounts that I had cleared for the last six months. The second service date was an amount for $170 (shocking- sarcasm definitely intended) but I waited until she read all of my accounts and payments. The payments surprisingly totaled $1,600 and were made on the same day (again shocking).

Then she said, "So you owe $170 because you only paid $30 on the December 4-6 service date where the insurance company said your deductible was $200." I ignored the fact that the $200 was a copay, not a deductible, though I think that distinction should be important for a hospital billing staff member but I had previously tried to explain it to her without much success. I explained that I had never received a statement or bill for the earlier service date, where I had owed $170. If she could kindly send a statement for that date, I would be happy to discuss with my insurance company how they should be paying that amount (I had already paid my $100 deductible for that day). I also asked if she would please apply the $170 to the December service date for which I had received a statement, then this would clear up further confusion. She hesitated but eventually agreed to send me the detailed statement for the $170 service and reapply the payment amount.

I still think that she probably does not understand why I called however, it was a testament to me that I should not just blindly trust any hospital administrative process with telling me how much I owe. A couple of weeks ago, I called a different hospital about a $160 charge that I did not understand. This lady was very friendly and tried to understand why I was confused. After a 10 or 15 minute discussion, she found out that the hospital had charged me twice for the same service and took the charge off of my account. So, while $330 is a small percentage of what my out-of-pocket medical expenses are for the past year, it still is better to not pay for something that was not owing to me.

As always, Gracie is doing marvelously through everything and we are grateful for the concern and prayers on our behalf. I am sure we will post again today with Gracie's blood counts!