The concept of medical insurance has similarities. If you have insurance, you get a discount, presumably, on services rendered. One of the most obvious differences is that you pay for groceries & drug store items & even clothing store items at time of purchase. There’s a price tag attached, you read that tag, & know—yea or nay—whether you’re willing &/or able at the time to spend that amount of money. Medical insurance, on the other hand, is a paid-ahead-of-time cost which, in turn, allows you to partake of services most often without opening your pocketbook at the time of those services.
What's quirky here is that there may be additional charges attached to those medical services, even though you already pay to partake of them. You don’t usually have any clue, however, what additional costs will be until AFTER the fact ... & at that point, you’re powerless to say yea or nay because you’ve already utilized what you’re paying for, so you’re expected to pay.
Is everyone following me? I surely hope not because I’m having a real hard time knowing where I’m going, nonetheless having a bunch of folks going there with me.
Here's an installment from the, “I can’t believe this” department—I scheduled lab tests my doctor prescribed, tests expected to explain a certain concern. Mind you, my husband & I have what he calls “the Cadillac plan.” If it ain’t paid for already, it’s probably not needed. This particular test is 90%covered with insurance ... not bad, unless the test happens to cost an extraordinary amount.
I thought it wise to get a general idea of how much I might pay out of pocket. I had to get pre-authorization from another company for insurance to pay as much as they pay. I was told I’d need “procedural codes” to get the costs of, well, of the procedures. Easier said than done. No one seemed to know procedural codes, even though everyone was able to book me, & charge me, for the procedures. Finally I found someone with the details. Then I had to find out who could take those codes & translate them into monetary amounts. Who could do that?
My doctor’s office didn’t know. They didn’t have the information & suggested I call the insurance company. The insurance company didn’t have the information, but said the service provider would have it. The service provider said, no, they didn’t keep that data, but the insurance company would have it.
What?! I had to explain, with forced patience, that I’d been given the run-around more than a few times already, & SOMEONE had to have these costs. After all, Someone would ultimately know what to charge when all was said and done, wouldn’t they? Finally a woman in the Financial Office—the Financial Office, mind you!—transferred me to someone else in the Financial Office because she “couldn’t give me that information” because ... well, because she couldn’t.
I was handed to Rosalyn, to be exact. Rosalyn, though a perfectly delightful lady, seemed at first to know even less than anyone else to whom I’d spoken thus far. She continually stressed that if I didn’t have insurance, she could tell me exactly what the procedure would cost. However, she didn’t have costs for the procedure if I, the patient, had insurance.
I took a deep breath, frustrated beyond belief, & asked, “Well, who DOES have the cost for those of us with insurance?”
“No One,” she answered.
“No One? NO ONE?!” No One has the cost for a procedure for which Someone will charge me ... & therefore, that Someone will obviously have the cost in hand to be able to write my bill? Does this make any flippin' sense? Are you still with me?!
I finally got Rosalyn to give me costs for folks without insurance so I’d at least have a ballpark idea of what I was getting my wallet into—or, more accurately, what I’d be taking out of my wallet. Rosalyn then said, laughing—by this time, we could do nothing but laugh at this ridiculous conversation—that the prices she quoted did not include radiology fees. Those were separate.
Well, of COURSE they were.
And did Rosalyn have those numbers? No, she’d have to transfer me to Radiology Precertification. Since that was where I had started all this, I declined the transfer.
So let’s go back to the card-for-everything concept. Cards give us discounts—somewhat like insurance—but we usually know the cost of a product or service before buying it, don’t we? And even if we don’t, there’s always Someone that can give us an answer, so we know whether or not we can afford to buy.
I mean, do we see a new dress & just take it ... to be billed later? If we do ... who knows what our new dress costs?
Apparently—NO ONE….
I’ll probably be charged more BECAUSE I have insurance. When there’s talk of health care costs, apparently NO ONE is smart enough.
I’m famous at 54, dadgoneit, and I demand to talk to this individual named, “No One.”
