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Friday, October 30, 2009

Tootsie vs. Healthcare

Okay, the boxing gloves are on.  How many rounds, and whether Tootsie will win, is another story.  This story began yesterday (actually last March when YnB broke her wrist) when I received yet another new medical bill.  Can anyone guess how much it costs to fix a broken wrist?  Well, neither can I because the bills just continue on and on.  I think we're up somewhere in the $15,000.00 range, but I'd have to sift through all the paperwork, and I have no interest in doing so.  All I have been concerned about has been how much it has cost ME, which has been my total out-of-pocket for the year - $5,500.00.  (For those who are not familiar with U.S. Healthcare, this does not include the astronomical monthly premiums) Yes, that's stomach turning isn't it?  That doesn't even include Mr. YnB, he has his own policy.

This new bill comes from medical supply company wanting in on the piece of action.  They have already received $3,000.00 from BC/BS which apparently wasn't enough.  They'd like to choke out another $500.00 from moi.  Would you like to know what it was for?  I thought you would.  Now, this is not a joke, nor am I exaggerating....it's a bill for 7 screws, 2 drill bits and 1 metal plate all of which are in my wrist and the surgeon claimed are so small that the airport metal detectors would never pick it up.  Albeit, there must have been some extremely precise instruments involved in manufacturing these small things, but what are the chances they weren't made here in the states, but maybe let's say, China?  I feel pretty confident they are not made of gold nor platinum, but even if they were......$3,500.00?

I actually wrote the check out, but my conscience said "WHOA....hold on a minute there missy.  Think about what you're paying for before handing it over without a fight."  Damn it, my conscience is right and I'm not going to take it anymore!  We need that money more than that greedy company does, and they'll have to deal with me first before they get their dirty little hands on it that easily.

So, there it is.  Tootsie's ready for a fight.  (Not until next week though, she needs mental preparation and some practice rounds first. This is one of them.)    

Have you ever gone any rounds with the health care industry?

21 comments:

Bearman said...

When I had my Kidney stone mine paid up for the emergency room and the drugs. I think I was out $200.

Mine pays up or my friend Bruno pays a visit.

nonnie9999 said...

one of my finest moments was dealing with an orthopedic doc after a car accident. i didn't get a lawyer (mostly because i just didn't feel motivated enough to pick up the phone, so i decided to see what would happen. the funny thing is that, if you ignore insurance companies, they will respond by offering you a bigger settlement. but i digress...) i had been going to physical therapy at the orthopedic's office (i had been a patient there a couple of times before). my car insurance policy covered most of the bills, but when all was said and done, they insisted that i owed them over $2000. i called them and put on my oh-i-am-so-sad voice. through my quivering lips, i explained that i wasn't working (true), didn't get an attorney after the accident (true), and that i knew that attorneys usually work something out with the docs so that their clients don't have to pay the full amount. tearfully, i said that i had no money, so if they wanted anything out of me, they'd either have to accept my discover card, on which i only had $1000 available (a big fat lie), or i could only pay them 5 bucks a month until i got to the total amount. they agreed to settling for $1000. i got a settlement from my insurance company (the guy who hit me raced away and was never found) and paid off the balance on discover. i didn't have to pay 1/3 to an attorney, so i probably made out better than if i had gotten one. of course, i had to get a new car, since my old one (which was completely paid off) was totaled, so i wound up a bit worse off, but at least i screwed a doctor out of some money, so that made me feel better.

it's my understanding that, as long as you're paying something, they can't sue you or send your account to a collection agency. call the surgeon's office and tell them you will pay them 5 or 10 bucks a month, or you can settle now for $200 or $250, which you'll pay in full now. everything is negotiable, and the worst they can do is say no.

Matty said...

I don't have BC/BS, so I'm not familiar with their protocol. My insurance pays 100%, so I never have a problem. But, there are avenues for contesting medical bills. Read your BC/BS guidelines, and if that doesn't help, write them a letter protesting the cost. It wouldn't hurt ( no pun intended ).

yorksnbeans said...

My beef is not with BC/BS. They have actually been very good. All bills so far have been paid promptly. What I'm so irked about is this medical supply company that isn't satisfied with the $3,000.00 they have already received, but want to squeeze out a bit more from me. I just can't imagine that such small screws and a tiny plate could cost nearly that much no matter how specialized they are. What kind of profit margin are they working with???? That's my question.

Ocean Girl said...

When it comes to US healthcare, I feel like it is such a personal issue that I cannot butt in. I can say though that it is happening right here in Malaysia. We have government hospitals that we pay RM1(30cents) for treatment and of course we get nothing but more heartache and torture. Or we can go to private hospitals and get the best of treatments, but they'll talk to you only if you have insurance or pay in advance the expected costs times two. They'll of course return the non-chargeable balance. We have become the US when we are still third world!

yorksnbeans said...

OG..that sounds even worse than the U.S. Twice up front!! Yowza! I guess everything is relative.

Lynn said...

you're preaching to the choir on this one sister...i can definitely relate! our family has had three catastrophic illnesses in five years. we dont get ahead of one before another one sneaks up.

the way i see it is this way: if you have insurance in america,like i do, youre totally screwed! if i didnt have insurance i'd be off scot-free but since i do...i pay out the arse! don't cha just love american healthcare? PEOPLE, it's a BUSINESS now.

dave hambidge said...

So, is britland NHS so bad?

nursemyra said...

I am so glad I live in Australia

stopannoyingme said...

When I had my penis reduction surgery, the insurance company was reluctant to pay. So I went to their corporate office and threw it on the table.

They paid the bill and gave me bus fare home.

yorksnbeans said...

I need some clarification.

1.) Was this a detachable penis reduction surgery which enabled you to throw it on the table?

2.) Did they decide to pay because it was a botched reduction and what was thrown on the table was grotesquely small and disfigured and they needed you outta there as quickly as possible?

stopannoyingme said...

1. No. This was grade A American beef. (I would estimate 6 or 7 pounds).

2. No. Even by reducing 3 pounds, that still left me with 3 or 4 to throw on the table. They wanted me out of there because I almost put the CEO's eye out when I threw it on the table.

I have pictures but my legal agreement prohibits me from sharing them.

bschooled said...

6 or 7 pounds? Aren't you being a little modest, TL? I mean, it had to have weighed at least the equvalent of a limb...

YnB, I'm sorry to hear about this. Sounds painful both physically and on your pocketbook.

It's times like these when I'm glad to be living in Canada.

FJ said...

My narcolepsy has kept me in constant hot water with my insurer....true.

Joanna Jenkins said...

Whoa, I got sidetracked with "detachable penis reduction surgery". Were you saying something.....

:-)

xo

delicate flower said...

TL is throwing that penis on everyone's table ! Ouch....

I take care of my ex-husband,who is in a nursing home and help w/ all of the bills.. We have a yearly battle over a bladder ultrasound which Medicare says isn't necessary or alternately is 'miscoded' by the hospital.. Medicare then tells me we're under no obligation to pay the Doctor. Of course since we need this Dr. we can't NOT pay.

I'm pretty bright yet I can't figure out the Medicare billing sometimes so I feel the greatest sympathy for the elderly or impaired who have to figure out the mumbo-jumbo...

Right now we're paying for 3 ambulance transports that BC/BS and Medicare say are unnecessary ( how you get an non-ambulatory individual w/ 3rd degree burns back and forth to Dr after surgery is beyond me). I'm sending them $10 a month.. and wondering if they're going to offer any breaks? It was a 3 mile trip and back for $350 times 3!!!! They covered the ones to the ER and hospital ( three times) but not the ones for followup care. Additionally the bills for a major skin graft/8 day stay combined w/ second graft/3 day stay (first one didn't all 'take') which caused him to contract a nasty bacterial diarrhea taking him back to hospital for 3 more days in the infectious ward! UGH>

yorksnbeans said...

You are an angel for continuing to care for your X. How did he burn himself?

delicate flower said...

He was trying to light a cigar and dropped a match down the side of his wheelchair- thought he'd tossed it over the side. His MS has caused him to lose sensation in most of his right side so he didn't feel anything or realize what was happening until he was fully on fire. Mercifully he was able to drive the chair quickly in the building to get help and more so, the lack of feeling meant that he felt much less pain than normal. It has been a long recovery period for him. But he's fine now.

It's an odd situation and basically there is no one else to care for him. Our sons weren't old enough at that time and not around as much... so I help with everything the 'home' doesn't do...

yorksnbeans said...

How awful!

delicate flower said...

yep, it was rather unpleasant.. but he has a sense of humor so we talked about favorite songs: Johnny Cash's Ring of Fire, The Doors' Light My Fire, Talking Heads' Burning Down the House.. etc.. the nurses weren't quite sure to make of him.

yorksnbeans said...

That's marvelous that he still has a sense of humor!! :-)