Another Hospital Racket Revealed

 

by Pa Rock

Victimized Senior Citizen Journalist

I have had two hospital visits this summer, one in early June and the other in late July.  Both of the visits were for a procedure called a heart cath and each resulted in two stents being placed on arteries.   At my age I am seasoned enough with medical processes to know that even though I have Medicare (parts A, B, and D) as well as a full. back-up policy through a well known national provider, a few "surprise" bills are still likely to show up with a demand for a personal payment from me.  I received one of those this week from the hospital visit in early June.

That visit had involved an overnight stay, though the hospital insists that even though I arrived before noon on day one and was not dismissed until after one p.m. on day two, (a stay of 26 hours), it was not regarded as an "overnight" stay.   I had not been told to bring my regular medications to that visit, and the hospital provided one dose per medication as though I was at home.  One medication they gave me was a prescription eye drop in each eye, a process for which they opened a new container of eye drops.  As I was checking out on day two, I asked if I could have the remainder of that container, and after some looking around by staff, I was told that it had been inadvertently thrown away.

Whatever.

When the bill arrived this week it showed that the original bill had been north of seventy-four thousand dollars and that there was a balance of just over six hundred dollars which I owed.  Being the cheap and cantankerous S.O.B. that I am, I picked up the phone and called the hospital billing department.  When the very nice lady who answered the phone got my name and account number, she pulled up the bill on her computer and said - before I ever had a chance to state my complaint, "Mr. Macy, I am authorized to cancel forty percent of that bill if that would help."

Damn skippy that would help!   But I still wanted to know why someone as overly insured as I am would be paying anything at all.

What did each of my two insurers pay?  I asked politely.

Medicare had paid just over eight grand and had "adjusted off" nearly sixty-four thousand dollars.   I asked what "adjusted off" meant, and she told me that Medicare has a contract with the provider - in this case the hospital - that puts a limit on what they will cover per procedure.    And that eight grand was all the hospital would get from them - the rest just disappeared into the ether.  My other insurance had paid a flat rate of $1,600.

Okay, then where did the more than six hundred dollar balance come from. (That had been the nut of my question all along.)

The extra was for the meds that I received in the hospital  five pills and two eye drops - and an aspirin.  The lady rushed to assure me that the aspirin had ONLY been three dollars.  Medicare, she said, had a policy of not paying for any medications which are not given intravenously.  

I wound up paying the 60% of what the hospital charged for the pills, but if someone had had the decency to tell me to bring my own meds, I would have saved that needless expense.  So I am telling you:

IF YOU ARE ON MEDICARE, TAKE YOUR OWN DAMNED MEDS WITH YOU WHENEVER YOU SUSPECT YOU MAY BE IN THE HOSPITAL LONG ENOUGH TO NEED THEM.

And:

WHEN YOU RECEIVE A BILL FROM A HOSPITAL, CHALLENGE EVERYTHING.  THE PERSON ANSWERING THE PHONE MAY BE AUTHORIZED TO CANCEL A PORTION OF THE AMOUNT DUE.  YOU WON'T KNOW UNLESS YOU MAKE THE EFFORT TO CHALLENGE THE BILL.

Growing old ain't for sissies!