Wednesday, July 20, 2011

"Payment is Coming!!" - Hospital Billing Down My Neck

Just a tiny little vent.

I had my 3rd round of Rituxan infusions at a local hospital.  The experience was okay and I'm glad that the medication works.  As would be expected, the hospital filed with my insurance company.  I kept checking the insurance company's website to see when and what insurance insurance paid.  That took a little while.

My insurance company processed the claim and I could see exactly how much they paid.  Shortly thereafter I received the EOBs (Explanation of Benefits) which are very important documents for records and for submission to the drug company assistance program.  Now I only had to wait for the hospital bill (hopefully itemized) so that I could submit the information to the drug company who was to pay my out-of-pocket costs for the drug costs itself.

The hospital only prints bills once a month on the 10th of the month.  I received my first hospital bill on May 17.  Yeah!!  Now I can compile all the necessary documents and fax them to Bettina at the drug program.  Since my printer/fax is on the fritz, I send the forms with my mother to fax from her work, something which occurred on May 24.

The next day just as I'm about to call Bettina to double check that she received my fax, she calls me instead.  Since it had been more than a year after I initially signed up with the program, I needed to sign up again.  She would send me a new packet and instructed me to call her as soon as I received it.  She would tag my file in the meantime and could process everything quickly as soon as she received my phone call with the new program credit card number included in the packet.

I receive a phone call from Michael at the hospital billing department.  He basically wants to inform me that I have a balance from the oncology service I received on March 18 and would I like to take care of it.  The balance is $2240.99.  I tell Michael that a program (from the drug company) is paying the majority of bill and request that he please make note of that in my records.

I receive June's hospital bill around June 17.  No surprise, it does not indicate payment from the drug program.  It is too soon.  No worries.

I return from vacation with a phone message from Michael.  I call him back.  He wants to inform me that I have a balance of $2240.99 from the oncology services I received at the hospital on March 18.  I remind him that there should be a note in my file that payment is coming.  There is.  Michael says that the hospital allows four months for payment and that they are required to make four phone calls.

Geez.  Didn't the program pay yet?  I call Bettina to check on the status of payment.  She can not find my file!!  She has no record of receiving any information from me.  Argh!!  We talk and she looks, and looks, and looks.  I tell her that I KNOW she received my fax because SHE called ME after receiving it.  Trying to find something she received in May when she receives 100's of faxes each month is difficult. 

But FINALLY, she finds it!!  She will send it forward to the folks who actually write the checks.  "Good timing, our checks go out in the 2nd half of the month."  Whew!  Good thing that Michael called otherwise I would have continued to presume that payment would be made and my file would have continued to be lost.

July 20 (today):
Michael calls again today.  He wants to inform me that I have a balance of $2240.99 for oncology....  I remind him that payment is coming.  He asks this time if it is payment in full.  I just tell him that it is payment.  I know that I will owe a remaining balance, most likely $271.67 according to the rules of the program.  But last time they did pay a little extra (more than expected), so this time I'm waiting until after they've paid to pick up the rest.

Michael reminds me that the hospital allows four months for payment.  August is that last month and I know that the next hospital bill will be printed in August 10.  I tell Michael that after his last call (and note I didn't expect another call until the beginning of August) that I called the program and that my file had been sitting on someone's desk for a month.  Payment should be coming!!

This is all getting kinda ridiculous.  First I don't receive a bill until mid-May.  Then Bettina mistakenly loses my file under a pile for a month after she had "set it aside" awaiting my phone call.  Michael has called four times already from the beginning of May until today.

I'm sure that I will receive another phone call from Michael even before the rest hospital bill is printed.  Hopefully it will be to inform me of my $271.67 or less balance.  But still for my records, I would like to have a bill which shows the payment the program made and how much I have remaining.

How do you think Michael will react when I tell him that I want to wait until August 11 to pay my balance just so that I can have an undated bill for my own records?


  1. All I can comment is I understand. I truly do understand. Poor thing! There are no words for the hoops we have to jump thru with these diseases and trying to get treatments. (((HUGS)))

  2. Can you access an ombudsman or legal aid or his supervisor? They should not harass you but they do it all the time. Best wishes fighting the good fight. Glad Rituxan is working for you! Mary

  3. There's nothing easy about how billing, insurance, and assistance programs coordinate (or not).

    To be fair, if Michael hadn't called at the beginning of the month, I would not have been clued to know that the hospital hadn't been paid yet until I received this month's bill (which arrived this last Saturday or Monday).

    But the timing of this last call just seems to be purposefully escalated. During the call at the beginning of the month, he did say that they are required to make four phone calls (even if there is a note in my account that someone else is paying).

    It will all work out eventually and in the process, I will have satisfied almost all of my out-of-pocket maximum for the year. That's something.

    I just want to be mistakenly sent to collections.

  4. Just received a phone call from Bettina informing me that the check was sent this week to the hospital. I'll call tomorrow to see if it's been received. There will still be an amount I need to pay, but at least this huge part is taken care of.

    After all of this has been settled, I'll contact the supervisors/ombudsman to discuss the process.

    Thanks so much for the support.

    (and I really need to re-read stuff I type to make sure that I don't leave out important words, as in "I just don't want to be mistakenly sent to collections.")