Just went off on someone from the hospital

Ezscriiibe

Okay, I know this poor woman is only following "policy" or "procedures," and I told her as much. I apologized to her for the fact that she gets the brunt of my vent, but it in no way directed personally toward her.

I am to go into surgery tomorrow for my lumpectomy and for the sentinal node biopsy.

I get this call about 20 minutes ago from someone from "Pre-registration."

She said she just wanted me to know that they have taken care of all the pre-registration stuff. (Thank you very much, I appreciate that. . . .)

Then she said, "We also checked with your insurance company regarding what they cover."

"Oh? Okay. Thanks."

"Yes. Insurance will cover everything except $82.86."

"Oh, great, okay, thanks. I expected that it probably wouldn't be 100% . . . ."

"Yes, and we need to know if you will be paying that when you get here in the morning."

"What?"

"Are you capable of paying the entire amount before surgery?"

WTF?!?

"What if I say, 'no'? Will the surgery still happen in the morning? Will I have to reschedule?"

"No, no, it won't stop the surgery. It doesn't matter, they will make some kind of arrangements with you."

"Then why are you calling me AT HOME the evening BEFORE surgery to ask me this question if it 'doesn't matter'?"

Why is it even coming up AT ALL BEFORE surgery if it doesn't matter whether I pay at the time of service or if I get billed and make payment arrangement? Do you really think someone going through something like this, or any surgery, doesn't have enough to be anxious about?! It's not like the insurance DENIED the procedure! They are just, as with every single procedure I've ever in my life encountered only covering XX amount. 

I actually said at this point, "I find this "policy" repugnant."

And I do. Everyone knows that for most doctors or specialists visits that you pay a copay, generally at the time of service. But as many surgeries as I've had in my life (and I've had a few recently) I've never once have had registration call me at home to attempt discuss the difference between what insurance will pay and whether I am prepared to pay it prior to surgery. 

In fact, I signed a piece of paper Monday that said I was aware that I may be responsible for such a difference and that I might be BILLED FOR THE DIFFERENCE. That they are attempting to collect ahead of time just rubbed me the wrong way. 

/rant over

otter

Rant away.  But, IMHO, at least they called to let you know how much your insurance would cover before you got there.

I wasn't sure how much of the cost of my surgery would be covered by insurance.  I knew the coverage would be good, but I just figured I would deal with my share when the time came.  So, I wasn't all that surprised when I arrived (with my dh) at the surgery check-in desk at 6 a.m. and was asked to pay the $75 deductible right then.  It never crossed my mind to be p*ssed off about that, and to wonder if they would refuse to do the surgery if I declined to pay them then.  Maybe I was numb, having spent a near-sleepless night in a motel across the street and still feeling sorry for my poor boob that had been "stung" with a radioisotope injection and marked with a Sharpie the afternoon before.

I guess I've been through this stuff (hospitalization, inpatient & outpatient surgeries) enough times that it seemed like handing her that $75 payment was the least of the problems I'd be dealing with that day.  The final "bill" for my left mast/SNB (no recon) ended up being over $21,000; and the $75 I gave that clerk was all I had to pay.  I thought I got off pretty well.

I understand you're more upset about the timing -- a call at home the night before, and a request for payment up-front before the surgery -- than about the fact that your insurance expected you to pay $82.86 toward your surgery.   Rant duly noted.   Hugs coming your way:  {{{Ezscriiibe}}}

otter

Ezscriiibe

Thanks, Ottter. Hugs accepted.

I would not have given it a second thought if they has said, "The copay will be $82.86" as we were checking in. I probably would have done what you did.

But you're right, it's the idea that they called me at home the evening before over something that didn't matter  anyway, but has the potential to cause anxiety and stress. 

And it was the way it was asked, too. "Are you prepared to pay. . . ." 

When I asked her what would happen if I said, "no," she said, oh we'll bill you or work out a payment plan." You mean, work out a payment plan right now?

"Yes, If you can't pay in the morning, when can you pay?" Seriously. That just hit me the wrong way.

It was only $82.86, but what if it were $830? or $8,300? I would be in panic mode! I would be freaking that they would have to reschedule until I can come up with a plan, tonight, before I even go to bed, to figure out how to pay $8,300.

I know, I know. I'm probably over-reacting due to stress. But it still feels repugnant to me to put someone in that position the night before surgery. Over the phone, no less.

Thanks for helping to talk me down on this one! 

mawhinney

This is a little different than you tale but I can't believe they ask for a picture ID when I go to get a mammogram. Do they really think someone else is going to go through the mammogram for me? I realize that it is probably a legal thing but it seems strange to me.

Maybe we should start a Peet Peeves thread!

otter

Ezscriiibe, I'm sorry -- I should have added this:  I hope your surgery goes smoothly tomorrow (negative nodes!) and your recovery is quick.

It's amazing, what types of things can set us off when we're already on the edge of the precipice.  Long afterward, I can think back and imagine, "Oh, that's why she said that!," or, "Now I understand what he meant."  At the time, though, no such luck.

I think maybe they ask me for a picture ID each time I show up at the mammography clinic, too.  I don't even notice it anymore.

Once during chemo (#4?), when the pre-meds were flowing and my chemo nurse was getting the Taxotere ready, she asked me for my name and birthdate. (It's on the prescription label on the drug; they check to confirm you're the person who should be getting that med.)  Must have been the 4th time that afternoon that I'd been asked for my name and birthdate, and probably the 2nd time that particular chemo nurse had asked me.  We knew each other pretty well from previous encounters in the chemo ward.

So I grinned, and gave her my real name and something completely off-the-wall and totally wrong for my birthdate.  (I think I made sure I was about 25 years old.)  She grinned back and said, "Sounds good to me!"; and hooked up my Taxotere.

otter 

otter

Pet peeves?  PET PEEVES???  Here's mine.  (I'm skipping past the really serious complaints, which were few in number but were lodged officially on the hospital's "customer survey" form I received a few weeks after I was discharged.)

I had just been escorted to a pre-op cubicle for my mast/SNB and was standing there by the gurney in my street clothes.  (Looking for the exit door?)  The nurse handed me a hospital gown, booties, a cap, ... and a plastic cup.  She said, "There's a restroom just around the corner.  We need you to give us a urine sample so we can see if you're pregnant."

...  ???

I honestly thought she was joking.  I had already sworn on the pre-admission paperwork that I was not pregnant, never had been pregnant, and was not planning to become pregnant (or something like that).

So, I said, "I really don't think that's necessary.  I'm 55 years old.  I haven't had a menstrual period for, um, (calculating in my head) ... more than 5 years.  Oh, and I had a tubal ligation when I was 40, and I've been having unprotected sex (with my dh) ever since then, and have managed to not get pregnant.  I really don't think you need to do a pregnancy test."

She said, "Have you had your uterus removed?".  Um, no.  "Then, I'm sorry, but it's hospital policy.  If you're under 70 years of age and still have your uterus, we have to do a pregnancy test."

I grumbled something about stupid policies and wasting my insurance money, but trudged to the restroom and peed into the cup.  A few minutes later, a serious-looking nurse (a *real* nurse?) walked in, and I lit into her about the pregnancy test.  She listened to all my reasons and then said, "Don't worry about it -- I think we can skip the preg test."

otter 

Leah_S

Hospital policy for any woman UNDER 70???????????? Um, don't they know basic anatomy and biology there?

Leah

Lolita

How ridiculous to hound someone about to have an operation for $86.  My pet peeve is that I continue to receive reminders to have a mamogram from the same hospital where I had my bilateral mastectomy two years ago.

cbm

The practice of seeking payment for copays and other gaps prior to services is the rule in my part of the surgical world.  I've always done this prior to annual colonoscopy, so when it started prior to my mastectomies, and then later with oopherectomy and hysterectomy, I wasn't surprised.  In the case of the colonoscopy, I "preregister" at the doc's office, so they tell me to take the check or be prepared to pay with credit card.  For the surgeries, I had to go to a preregistration conference a few days before the surgery and pay then.  When they make the appointment for the conference they tell you to bring your form of payment.

What annoyed me more than anything was stumbling over the fact that I could not select or meet my anesthesiologist before surgery, and that anesthesiologist group practices here are all out of network.  So basically I didn't hire or have a say in selecting the one who then billed me three thousand out of pocket out of network dollars, and nearly killed me on the table.  Next surgery, different hospital, I demanded to know who the anesthesiologist would be and what he would charge.  Not our deal so we don't know, the hospital said.  The intake clerk literally said to me," that's not how they roll."

For my money, I'd like all the info up front--but I want to understand who and what I'm paying for as well as who's the boss of them.  These providers don't necessarily want you to know that they are responsible for the grounds and maybe the office clerks, but just about everything else is quite often outsourced and independently incorporated. 

Ez; thinking of you and hope it all goes well.   

Warmest,

Cathy 

Jaimieh

I had a mastectomy, chemo, herceptin ($4000 each), exchange surgery and removal of my implants and the hospital that I went to asked me for my deductible each and every time. 
They can see my deductible is $4000 and each time after the first surgery they wanted $3872.68 or they would cancel my surgery.....I let them have it each and everytime....

pj12

About seeing a Drivers license: The reason asking for ID is now standard came along is because people without medical insurance would/could "borrow" the insurance card of a friend or relative or acquire one via identity theft and get medical care under someone else's coverage. It is the same as using a stolen credit card to buy a TV. Either the insurance company was cheated or, if they caught the error, the hospital was stuck with no one to bill.  This used to be a big problem... the ID thing has helped.

I was scheduled a month out for knee surgery at an out patient surgical center.  My co-pay was going to be $40.00.  Beginning a month ahead they began calling me wanting me to pay over the phone immediately.  They called 3 times before I told them to stop... that I would pay on the day of the procedure.

It's just become a business, not a profession or a service anymore.

pam 

irish47

I had a bone scan yesterday following my surgery on Tuesday.  Any of you who had one  know it is claustrophobic and a bit scary.. The camera is enclosed in a big panel which comes down to about an inch from your face and then slowly passes down your entire body.  Anyway the radiographer spent the entire 20 minutes gossiping loudly with her colleague and giggling, didn't once ask me was I ok.  I felt completely ignored.  She also didn't warn me about the bright green pee I was going to pass from the pre scan injection.  All the other staff were so pleasant and polite.  I made a point of relating the experience on the customer satisfaction card  I was asked to fill out. It feels good to bitch sometimes!

frosty1

irish47 - love the bright green pee!  My biggest pet peeve is being ignored.  They are too busy talking with their co-worker to pay attention to the patient (or customer).  I've had a bone scan as well and it is a bit claustrophobic.  The least they could do is walk you through it.  When I had an MRI done last month, the staff was great and talked to me the whole time, telling me what the noise was and how long it would last and how much longer I had. 

LINDAGARSIDE

Hi everyone.  I don't have a pet peeve yet but I'm guessing I will have one soon.  LOL.  As soon as it happens, I will post it so we can all laugh and vent a bit.

A question about the bone scan...can you like on your stomach for this procedure?  It would be easier for me (should I have to have a bone scan) if they let me like on my stomach as I can keep my eyes closed and pretend I'm somewhere else...like a nice sunny beach with a yummy drink and a great novel.  For some reason this is not so easy to do lying on my back.  Could this be my dyslexia kicking in?  LOL.

lvtwoqlt

Ezscriiibe, i had virtually the same thing happen to me when I was scheduled for the last procedure in my reconstruction. I had worked with my plastic surgeon to get the surgeries done before the start of January (when my insurance deductible started over), this surgery was December 20th. I got a call from the billing dept the day before my surgery. They wanted me to pay over $100 prior to the surgery to the hospital. I told the lady as nicely as I could that this was the 4th procedure I had in their hospital since April and I met my out of pocket maxium at the time of my main surgery in June and I didn't think that I was responsible for any additional payments. I politely asked for her supervisor to check into it. The supervisor called me back about 10 minutes later and appologized for their mistake.

Next day, I go in to sign the paperwork and show my drivers license to get ready to go to same day surgery, and what does the admitting clerk do, opens up my folder and asks for a payment of XXX imediately. I was not so polite this time. I told her that I had this conversation the previous day with billing and I didn't owe anything due to my out of pocket max being reached in June and I wouldn't pay anything prior to my claim being filed and processed by the insurance company. She looked at me with a blank look, tried to pull up my information but the computer wouldn't cooperate. I started naming off the dates and procedures that I had undergone that year (stero biopsy, bilat mast with recon-2 day hospital stay, and exchange surgery). She did look at the paper file and realized the mistake and pulled out the paper that said I owed the money and tore it up infront of me, then told me I could go to the waiting room and wait to be called to go to same day surgery. My blood pressure was slightly elevated when I got there. If I wasn't scheduled for the surgery, I would have walked out right then and there.

Sheila

CoolBreeze

I think you were just stressed over the surgery and took it out on the person who called you.  I read your post three times and can't find one thing to be upset over.

But, I understand how nerve-wracked you are before surgery, and I'm sure she does too.  I work in a school and I guess the only people more upset about nothing than pre-surgical patients are parents who think we are messing with their kids. 

Hope all is well!

Alaina

Otter,

I have to laugh about your story about the pregnancy test.  It perturbed me as well when I went in for my port surgery, but for different reasons.

Prior to the surgery, I spent about 2 hours doing all kinds of pre-op paperwork and listening to various hospital staff tell me important things to try and remember about the surgery, etc.  Each and every one of them asked me if I was pregnant.  It's like they were working from a well-memorized script.

I had already peed in the cup, I figured just so they could just sugar levels, and whatnot, make sure I didn't have a raging infection floating around or something.  No one said it was for a pregnancy test.

I had also signed several sheets of paper saying in 12 different ways I was not pregnant, not intending on getting pregnant, not a spiritual candidate to host the 2nd coming of Christ, LOL!!!

So imagine my shock/surprise when I got the hospital bill for that days surgery and there was a (rather expensive) pregnancy test itemized there!  I'm like, why have me say it 12 times and sign 10 times that I'm NOT pregnant if you're just gonna test me ANYWAY?

But then my friend told me the story of HER friend, a woman in her mid40s who went in for a hysterectomy.  She got the same barrage of questions, paperwork, etc concerning pregnancy.  She said all the right things and signed all the forms, and went into surgery.

When she woke up from the anesthesia, she wondered why she didn't have any bandages or scars, or feel sore.  Turns out, she was pregnant!  SURPRISE!  They obviously couldn't do her surgery.  Her pee-test came back inconclusive somehow, so they took her under and did a more sensitive blood test while she was knocked out, which confirmed, she was with child.

Can you even imagine?  So now, I just go with the flow with all the questioning.  :-D

JulieC

Alaina -  "go with the flow" - that's funny.  I had to do pregnancy tests for both of my surgeries.  They didn't charge me for the first one and the 2nd one was $75.  If I had known that, along with the costs of several other items, I would have stopped at Walgreens and picked up my own EPT test.  Should have taken my own duct tape, too.  The surgical tape was very expensive. LOL

The things are kind of funny now, but were rather irritating at the time.  Ez - it would have been annoyed to have them call before the surgery to get their money.  There could have been a slim chance that the surgery didn't happen and you would have had a difficult time getting a refund.

Hope you are doing better now - Julie

Ezscriiibe

CoolBreeze, it was the idea that I had to be called at home the night before that was (and still is) repugnant to me.

When I went in to registration the day of, I looked around and saw all sorts of posters and such that said, "We do not deny treatment based on blah blah blah, or ability to pay." Now I'm quite used to that, and pre-pays, and co-pays. It's not the idea of the payment, but the timing and the manner of the communication about it.

I would have even been okay with a note in the pre-registration packet they sent that said: "The insurance on this surgery will pay all but $82. We prefer payment prior to service. Call XXXXXX if you need assistance with payment."

But the idea that they are calling surgical patients the night before (this call came in around 7:30 pm) that irks me. Especially when if you COULDN"T pay, it didn't even matter!

Yes, I know I was stressed over the impending surgery, but that's my point. There were so many different ways something like that could have (and should have) been handled. 

And yet it wasn't.