Bad Penny

Due to full-time employment benefits and a mother who provides me with a secondary (AKA back-up) insurance policy, I am a very lucky cancer patient. Many young adults don't even have one health insurance policy. I am not going to bore with you my rant on how health care costs in this country are outrageously high or how the health insurance industry can act unconscionably in regards to choosing who has coverage and who doesn't based on family health history (death panels? what?!?). Maybe another day. Needless to say, prior to my cancer diagnosis, I used to complain about my employer's health insurance coverage. I don't complain anymore. All I'm going to say on the topic of health insurance coverage is that I am very, very lucky.

But I am going to tell you the tale of when a bill slips through the cracks. In August 2008, when I was initially diagnosed with breast cancer, I went to the fancy hospital located in northern Ohio. I met great doctors, my body underwent a variety of tests, and then I had my mastectomy. All standard medical procedures which were billed to my insurance company. Due to deductables and out-of-pocket-for-the-year, I owed some money. The bills began to arrive in late October. My wedding was in late of October of that year. My cash flow was tight due to the cash needs for wedding and honeymoon-related expenses. I called the hospital billing department to discuss a payment plan, and was informed that as long as the bill was payed in 120 days, I would be fine. Phew! This meant I could put off paying one medical bill immediately and in its entirety, as other cancer-related bills were arriving daily from my local hospital, the local doctors, and outsourced laboratories.

I created a spreadsheet to help me manage my health-related bills. I color-coded cells denoting who was paid and who needed to be paid next. I had columns for check numbers and dates of service. I was more organized than ever before, and all while undergoing chemo (which began soon after our return from the Caribbean).

The problems arose when I began to disseminate the policy information for the secondary policy. I spent hours on the phone calling different billing departments, asking them to resubmit my charges to this "new" insurance provider. By new, I mean new to the cancer coverage, not new to me since I had been covered by the policy for many years.

When I called the fancy hospital up north, my 120 days were just about up. I had paid some of the total amount but not all of it. I thought I had enough time, but whoever took my call did not send the charges to the secondary insurance company, and by not submitting the charges, the bill was sent to collections. Arghh!!!! To make a very long story as short as possible, between the end of February and the beginning of May, I wrote a letter of dispute to the collection agency, regularly telephoned the hospital's billing department who told me everytime I called that the problem would be fixed, and evaded phone calls from the very friendly-sounding chap from the collection agency who just wanted to chat about my bill. Oh and the amount in dispute was about $150, not very much at all.

In May, I got fed-up with the run-around from the hospital; especially after I'd been informed by one lady that I had been talking to the wrong people. One morning, I demanded to speak with a manager. I explained the situation for the Nth time. Luckily, the manager was extremely sympathetic. He reviewed my case, told me he would do his best to retract the amount from the agency, and if not, would then just remove the amount owed from my account. Basically, whatever he did, the result would be me no longer owing the amount. Sounded good to me, and true to his work, in early July, I received a letter from the manager stating that the amount had been adjusted off my account.

Yesterday, I opened a nondescript envelope. I almost didn't open it. The envelope resembled a magazine renewal notice. No such luck. It seems the original collection agency sold my account to another collection agency and this agency would like to collect my $150. How does a non-existent amount move to a new company? Due to my organizational skills relating to only health-related paperwork (the rest of my life in paper is a complete disaster zone), I retrieved my July letter from the manager. This morning I called him. Luckily he remembers me, and in fact, thought he would never hear from me again. We chatted. He is going to investigate for me. Seeing how the amount was erased from my files, so it shouldn't even exist. He is appropriately concerned and confused by this new development. I should hear back from him tomorrow, or Thursday at the latest.

Trauma at Target

Over the past year and half, health insurance has not caused me much stress. Exchanges with my insurance company have been relatively smooth, a few bumps but nothing major. Due to the ongoing nature of cancer treatments, a case worker was assigned to me so I have regular human contact which is handy whenever a potentially confusing issue arises. My case worker has been invaluable in my cancer/doctor/insurance journey.

With my next surgery scheduled for Tuesday, I needed a physical in order to be "officially" approved for the procedure. My now healthy body passed with flying colors. While at the clinic, I was shown paperwork with my insurance information, and it looked fine to me. How wrong I was.

About an hour after leaving the facility, I am shopping in Target, enjoying a stroll through the underwear section when my phone rings. Of course, I can't get to the phone in time, and soon receive a cryptic message from an employee at the facility telling me to have her paged when I call back and her work schedule for the next few days. I return the call immediately. Turns out the woman works in the billing department, and is calling my insurance companies to get approval for the procedure (which was done months ago by my doctor's office). Without going into too much boring detail, she tells me she couldn't understand my different insurances and that I had almost needed to pay the hospital $5000 before my procedure. But, after leaving me the message, she soon deduced that I had two insurance policies, and was on the other line with my primary plan. The entire conversation unnerved me since she seemed to have little understanding of what I assumed were basic insurance transactions. And she chided me for never telling my primary insurance company about my secondary. Since the issue of introducing my two insurance plans had never come up before, I don't know why I should be scolded for it now.

About ten minutes later, I remembered that the procedure had been pre-certified by my primary insurance company, so I called her back. In the meantime, she seemed to have gained a better grasp of the situation. But I was still concerned, so I called my case worker. My advocate could already see the report of the call, and assured me that all would be fine. Especially since I have a history of a malignancy (guaranteed coverage!) and the procedure is outpatient (no pre-certification is needed). Go case workers!

So in conclusion, twenty-five minutes later, I am still in Target. Through all of these conversations, I am wandering from the underwear wall into the sock aisle (good discounts), passing through women's wear, and finally sitting at a table in the cafe area. Yes, I was the annoying person talking about extremely private issues on a mobile phone in a public arena. In my defense, one of the reasons why I kept moving through various areas in the store was to be where no one else was shopping. Except that during my movements through the store, with a cart, a large Early Gray tea dripped large drops of brown liquid on the front and arm of a new white sweater. After wrapping up my conversations, I found all kinds of delightful products to ease my pain. Thank goodness for shopping therapy, I feel much better now.