Bills. Bills. Bills.
Medical billing. Just saying those two words is enough to make a Delta Force soldier cringe. It’s something all of us who are chronically ill deal with and it’s the proverbial insult to the literal injury of living life in pain. So, let’s talk about that dark and confusing world and see if we can let some light into that Bat-Cave of financial horror.
Chronically ill, chronically billed
Those bills, those bills, those bills! God, they pile up – I’m not talking figuratively either. Medical billers have clear-cut vast swaths of the Amazonian rain forest just to send me a month’s worth of statements. I’m indirectly responsible for the extinction of several thousand insect species, two types of birds of paradise, and one small indigenous tribe. That’s how many letters I get in a thirty-day span, and anyone who sees multiple doctors (like most of us do) knows exactly what I am talking about. It doesn’t ever stop, and it likely never will. Now, the majority go into the trash without even being opened.
Ok, I know that it sounds irresponsible to throw away bills without even opening them, but let me explain to the uninitiated what’s inside those envelopes. Most envelopes contain a three or four-page bill, and on each page it shows you a different total and services rendered. As if this wasn’t confusing enough, there are lines for co-pays, co-insurance, remaining balance, insurance charged, insurance paid, deductible, healthcare portionality, approved amount, Medicare reimbursement, and on and on. There are so many different listings that I just made one of those up and I bet you didn’t even notice – it’s truly overwhelming. Figuring out what you actually owe is more difficult than doing the long form of your tax return, and we pay people to help us with that.
Another reason the envelopes stay closed is because, more often than not, they are for amounts like 12.75, 18.62, and 24.31. If the bill is over 40 dollars it’s rare. That means the hospital or doctor is spending thousands in mailing fees and printing ink to dog me for less than the price of pizza. They love to send those bills, though, and if that wasn’t enough they will send you to a collection agency with names like “Midland Recovery Associates”, etc. That’s right – your credit ruined and a collector hounding you for a measly 18 dollars. It’s beyond ridiculous. Just the money the business spends on the hour the collector works on your account far outweighs what they will recover from you.
Paying in to a broken system
The system is irrevocably broken, and I’m not even going to cover billing errors, out-of-network fees, and my personal favorite – pre authorizations that were later denied because “a pre-authorization isn’t a guarantee of payment.” Really, Medicare? What the H*ll is it then? It’s just a piece of paper that lets them know you’re doing a procedure, as I’ve been told, and although they can use you not getting one to deny a claim, you can’t use getting one as a reason to pay a claim. So, sometimes those full charges show up in what you owe as well. It’s a convoluted world, and you’re the loser always. If that’s not the system being rigged against us, I don’t know what is.
It seems hopeless, doesn’t it? Feels like there’s nothing we can do but eat it and have our credit and finances ruined until we die or the end of time, whichever is longer. Well, I have some good news – wait, “good” isn’t the right word. I have some adequate news. Better. There are one or two ways you can help to alleviate the pressure of medical bills, and a new method for credit reporting that also might just help.
Easing the stress of medical bills
The first thing you can do is call the hospital or doctor as soon as you get the first bill and tell them that you are on disability or you have limited means. They should offer you a payment plan or a reduced bill, it’s even the law in some states. It may only be 20 dollars a month, but it keeps you in good standing and you won’t get harassed by people calling to discuss a “personal business matter” three times a day. Business matter my ass. If I ordered a case of sex toys – that would be a “personal business matter.” This is just plain old greed and harassment of a sick person. I digress. Just offer the doctors whatever you can spare monthly and it should be sufficient.
The second thing you can do, and this one is a pain, is to check all of your insurance EOB (explanation of benefits) statements. I cannot tell you how many times I’ve caught Medicare not paying for something they should have. Appeals take time and effort, but they do get approved about half the time, so it takes away some of the financial burden. Those of you who don’t have any insurance, check your bills from the doctors for those same errors. Also, you can find out if your state offers any assistance in paying for medical bills or even has laws that protect you. Many states do, you’d be surprised.
Last, for those of you who’s credit report isn’t lower than a freshman during rush week, you will be happy to know that VantageScore 4.0 is a new weighting system that institutions will use when determining credit score. It places much less weight on medical bills so that they don’t affect your score anywhere near as much as they used to. Even credit agencies are beginning to realize that medical billing is in such a state of disaster and is so ubiquitously awful that if they rated them on everyone’s credit no one could ever get approved for one of those fancy-schmancy airline miles cards. It’s coming soon, so don’t stress your credit score as much, I know I won’t. Not that I ever did.
I know medical bills are a huge source of stress for people like us, but they don’t have to be. Use some of the things I mentioned and try to give yourself a bit of a break. Fortunately, there isn’t a debtors prison anymore, and it’s against the law to let you die if you come to an ER dying and can’t pay and they throw you in a gutter and have people step over your corpse to get lattes. Talk soon.
On a scale of 1(low) to 5(high), how difficult is it for you to talk about having RA?