My Outrageous Medical Bill

No, it was not a large amount. I am not going to discuss some complicated life-saving surgery that can run into the hundreds of thousands of dollars. The outrages here are matters of fairness and proportion. Allow me to elaborate.

In the summer of 2002, I was asked to get a CT Scan (sometimes known as a cat-scan) to examine the state of my kidneys. I would experience complete renal failure three years later, but things had not become nearly so far advanced at the time in question.

Had I been thinking as carefully as possible, I might have asked the specialist if we could not wait another month or two for the procedure. As it turned out, I got the CT Scan in the month that overlapped my COBRA insurance coverage and my Honeywell retirees' coverage, managed by United HealthCare. If anything, I had paid overlapping premiums, with the former cost coming out of my pocket and the latter, out of my company pension.

No matter; both carriers promptly took advantage of the transitory nature of that month to deny any liability for the cost of the procedure. Before I knew it, I the doubly-covered patient, found myself with a bill for $551 from the diagnostic lab.

Now, the lab had performed the service as requested, so they had a reasonable expectation of being paid. Where they were incorrect (even if not unreasonable) was in assuming I was the one who should pay them, in light of my insurance carriers' denials.

I knew I was right, and I knew I was covered, so I steadfastly refused to pay the bill, even as I sought to get one of the insurance carriers to honor my legitimate claim. Of course, all this folderol still left the lab unpaid for its service, so they sicced a collection agency on me. Once word of that got out, the good people of AT&T, under whose auspices I had a credit card, informed me that my card was cancelled, effectively immediately.

Still, I continued to battle the insurance people, even as I held off the threats from the collection agency. I'm sure all of this did my overall credit rating no good whatsoever. Finally, after jumping through a number of hoops and showing absolutely irrefutable evidence to support my case-more than once, as it turned out-I got the weasels at United HealthCare to admit they were liable for the charge.

A while later, I got a notice from the Insurance company regarding my $551 bill for that long-ago CT Scan. They stated they had paid the lab the princely sum of $147.

I should point out that, while I still do not claim to fully understand how these things work, I was even more ill-informed that I am today. I looked at the $147 advice of payment and decided to throw in the towel at last. I was tired of fighting and just wanted to get the damn thing done with for good.

I called up the diagnostic lab, identified myself, probably mentioned the small payment from United HealthCare, then asked them how much I owed. Nothing, they told me, the insurance payment had cleared the record.

In other words, claim denials aside, an insured person would have been charged (or had his insurance carrier charged) $147 for a procedure a person unfortunate enough not to have insurance coverage would have had to pay $551. That was more than three and a half times what the insured person would have been charged. If this was not a flagrant case of kicking the poor when they are down, I don't know what is.

Okay, I understand that insurance companies can expect to negotiate a lower cost for a given procedure, based on volume and supposed reliability of payment. By the same token, an uninsured individual should not expect to get that sort of a discount. Yes, yes, I understand all that business quite clearly. But a difference of over three and a half times between the lesser and the greater amount is nothing short of obscene.

Since most of the recent health care legislation has yet to kick in, it is difficult to determine how, if at all, it will address this outrage, but, if it doesn't, then something or someone else should.

Sources

Medicinenet.com

Own experience