Our Health Scare Crisis
August 17, 2009
Most people think the birth of their child as a memorable and joyous event, and for us, the birth of Brennan 5 months ago brought an amazing and vibrant boy into our lives. However, there’s always a dark side to every good thing—in this case, it was having to go tread through the health care system.
Even before Brennan was born, a number of events occurred that left a bad taste. During the first trimester, Kathy’s spent a lot of time researching and seeking out an OB that she was comfortable with. Fortunately, she found someone locally that she liked, who was affiliated with a major prestigious academic medical center. The first major fiasco occurred when due to a miscalculation, she was sent for a sonogram too early and another one was scheduled a few weeks later. Since we had a high deductible health plan, we had to pay for everything at the discounted rate.
Not only were we billed for the first useless sonogram, the hospital billed us the full amount for both tests, repeatedly ignoring their contractual obligations with their insurance carrier. After multiple phone calls and hours of wasted time and aggravation, and months later, it was finally resolved. What helped was the fact that my wife is a medical billing and collections expert. Imagine if you had this happen and you had no idea how to read EOB’s (explanation of benefits).
Next, our doctor’s satellite office was closed down with less than a few weeks’ notice, and we were on our own to find another OB. They told us to call the OB department at the medical center to get assigned a new OB. This brought flashbacks from Kathy’s first pregnancy, when she had to find new OBs twice when doctors dropped her insurance.
She called the OB department to inquire about another doctor, but they never called us back. She eventually found someone else through a friend’s referral. Getting the old records sent to the new OB was a nightmare in itself.
When Kathy went into labor, we went to the hospital and went up to the labor and delivery floor. The nurse was told that the contractions were every few minutes. After filling out some forms, we were told by the receptionist at the triage area to have a seat (with a pointed finger and no eye contact).
After waiting another 30 minutes, another nurse who just happened to be walking by saw that Kathy was having a major contraction. When she found of how frequently, she rushed us into an exam area, to be examined by a doctor, who came by about 30 minutes later. When the doctor realized that Kathy was fully dilated, we were rushed into the labor and room immediately.
The delivery itself went smoothly and quickly. Our OB was not on call that night and a colleague was covering. The baby came out so quickly that another OB that happened to be on the floor had to cover for the covering doctor.
It’s almost a given that whenever we interact with the health care system, more often than not, it can be an unpleasant experience. What’s even worse is that almost routinely, billing errors by either the doctor’s office or the insurance company increases the hassle factor multiple times.
Recently, my wife was sent a letter from her old insurance carrier that her last visit to her doctor’s office was not covered. It turned out that although the new insurance information was given at the time of visit, the doctor’s office had billed the old insurance company. When called about this mix-up, the receptionist essentially said that that’s not possible—that they had the correct information on file. My wife explained that she had a denial letter from her old carrier for the date of service. Another few hours wasted due to this simple "mix-up."
This may sound somewhat radical, but if I do get very sick in the future, I’m not afraid of the illness, or even dying. What I am scared of, is to be subjected through our health care system.