Wednesday, July 6, 2011

Dear Ms. Patient,

I'm sorry to hear you've fired me, and that you're irate you owe me $200.

You've been here 3 times in the last 6 weeks for various issues. Each time, as per office procedure, Mary asked if your insurance or address had changed, and each time you said no.

Last week we learned that not only HAD your insurance changed, but it was to a plan I don't take.

When my billing service called you about this, your reaction was "well, if my last insurance covered him, my new one should." Wrong.

And you just left Mary a scathing voicemail claiming that it's OUR fault for just taking your word on the insurance, instead of demanding that we see a copy of your card at every visit. Silly us, we assumed you'd tell us if it changed. That's why we ask each time.

I also loved the part about you threatening to turn me into the state board and "giving you bad reviews on all the internet rating sites" if I didn't forgive the $200.

This is no different than shoplifting. If you stole $200 worth of merchandise from a store, they'd press criminal charges. I can't do that, but I can turn you over to collections. I don't care if you're stupid, pretending to be stupid, or just malicious, but this is what I do for a living. You were more than happy to accept my treatments, and signed a bill after each visit.

Have a nice day.

29 comments:

skidmark said...

Some of us are honest enough to tell our docs that we no longer have coverage and so cannot afford to come in on the schedule they would prefer. Some docs are willing to reduce fees or work out payment plans.

But not letting the doc know that some change may effect his payment for services rendered? That, as Ibee said, is just downright stealing. In most places committing fraud in excess of $200 will get you time in the Big House. I'm not sure which would be worse - bunking with Bubba or having the collection folks hounding me? Both are scary enough to keep this child honest.

stay safe.

Grumpy, M.D. said...

I do try to work with people who have lost insurance to keep things within their means. But that wasn't the case here.

Solitary Diner (Also Known as The Frugalish Physician) said...

This post (and so many others I've read by US physicians and patients) makes me very thankful that I work in the Canadian system, where we don't have to worry about how patients will pay for their services. We do have to worry about the sustainability of a system that uses an increasingly high percentage of our tax dollars....but hopefully we're at least a decade away from that issue exploding in our faces.

Rathskeller said...

I wish there were some psychosocial historian who could sit me on his knee and tell me if we've become a nation of entitled cry babies, or if there have always been oblivious morons (e.g., "let them eat cake").

Packer said...

So Dr. Do the lights come on for free, does Mary work for free, is postage, internet, machinery, rent free ? You would think it, wouldn't you ?

Anonymous said...

It's patients like this that sometimes make me want to take a job flipping burgers.

LaShaune said...

Reminds me of all the times my boss' friends would call to have their $25 copay waived as "physician courtesy".

Some days I wish for patient courtesy and have my copay waived - just once.

Anonymous said...

It's patients like this that has driven me, and now my husband, out of pt care. There are more than you think who feel entitled not to pay their bills.

BTW - there's a company I read about that actually goes after websites and pts for posting false ratings. I think it's called Medical Justice. (They also help docs with malpractice.) I would do it, just for the satisfaction of it.

Wayne Conrad said...

"giving you bad reviews on all the internet rating sites" if I didn't forgive the $200.

Is that extortion or somesuch?

Bertha said...

Damn. We have no dental insurance at all, but we told our dentist that ahead of time to make sure they'd let us pay them in installments.

PA Honeybee said...

Wow, how irresponsible! I guess she was on autopilot and never actually listened or comprehended what Mary was asking. I think due to the result of the billing issue due to her stupidity, an additional inconvenience fee should be tacked on to her bill.

Cthulhu Sashimi said...

"None of this would have happened if you'd done with me what I do with my customers- don't treat me until you see that I've left you an envelope full of cash on the side table."

Anonymous said...

People should also realize that when you have to send a pt to collections, the collections agency charges about 30% of what they recover.

This sucks all around.

Anonymous said...

I'm surprised she did not have a new address and phone number as well.

Anonymous said...

Imagine my amazement at receiving a bill for consulting services during a hospitalization over 2 years ago. Seems then billing service neglected to bill my insurance (VA) although they had been informed not only of the coverage but also the address and phone number of the office that handles this sort of thing.
Letting a bill ripen for a few years is pretty lame, or maybe they got paid and just want more.

GunDiva said...

This is exactly why I teach my students to insist on seeing an insurance card at each and every visit. There are a lot more patients out there like this than you'd believe.

My billing supervisor used to ask people "you wouldn't go to the grocery store without money, would you?" In an emergency, we'd see the patient and bill them, but otherwise the patients were expected to produce a current insurance card and copay before they were seen. At first, there were some upset patients, but once we got them "trained" it was smooth sailing.

webhill said...

Remember my story about how the client threatened to libel me on the Internet, and I told him I was notifying my attorney of his intent to commit libel, and he said "what you talkin bout, libel? I ain't libel for nothin, bitch!"? Well...ahem.

Anonymous said...

I guess pharmacy has it right on this part. We bill insurance at the time of filling the prescription. If the claim is denied, we know right away. However, we still have to argue with the patients because they say "I just used it at the doctors office and they took it"

Alex Dreamz said...

I find it annoying that my husband's primary won't see him if, for some reason, he doesn't have his copay on him (he's forgetful) - I find it highly irritating to receive a FIRST bill that says I'm 90 days past due (due to insurance slowpokes) - HOWEVER.... Having worked medical billing, I understand the reasoning behind both. I'm beginning to think that everyone on the planet needs to spend 6 months working in a medical/dental office, just so they can understand the repercussions of their actions/inactions/downright stupidity every time I hear a story like this one.
Of course, that also means I need to go spend 6 months working for the garbage company, so I'll be more understanding when they "forget" to pick up my trash, too, doesn't it? (sigh)

kristophine said...

Re: whether there have always been oblivious morons...

Not only have there always been oblivious morons, but at any given point in history, the vast majority of people are oblivious morons. It's why people studying psychology start to look shell-shocked after a year or two. Once you realize that not only is everyone else a giant idiot, but so are you, things start to look less rosy. The form your idiocy takes is highly culturally dependent, but its presence is universal and invariate.

...then you slide into Skinnerian behaviorism and feel a sense of comfort, because if we act like pigeons and rats, at least we can be trained for our own good.

Signed,
getting the hell out of psychology.

Anonymous said...

kristophene, precisely why after getting my Master's in clinical I went into construction.
The confusion level is the same but the pay's better.

C said...

my dr asks to see my insurance card each time I go...my only possible statement in defense of this woman is, if she works for a big bureacratic employer(?) with a big bureaucratic insurer, and she gets all kinds of updates and documents from personnel, maybe they mailed her something and she totally missed it and she cannot cope with: a) having to change doctors AND b) having this bill. For $200 you would think she would scrape together the cash because this will mess up her credit rating.

Anonymous said...

Was the $200 for just one or all three of those visits? If the latter, sheesh, she's getting a heck of a deal!

Anonymous said...

I'm in favor of a website where medical professionals can give "reviews" about their patients! Damn that HIPAA policy! Where would we be without sites like yours Dr G!? This is my therapy.

Anonymous said...

My doc's office not only asks for my card each time but also for my ID, which at first I resented, but considering a man here in Milwaukee just had heart surgery under his brother's insurance (brother claims he knew nothing about it but I have my doubts), died at the hospital, and the insurance is saying, "We're not paying this you're on your own," I can see why they insist. It had never occurred to me that someone would commit that kind of fraud.

Whosit said...

This happens in my office ALL the time. They are angry that we don't magically know that they changed insurance or their phone number.

spectrummom said...

When I first opened up my office, I wasn't on every insurances' list of docs. We told people we'll give you the bill, you submit it and bring us the check. No other cost. Had a local Reverend's wife KEEP the check and say she wouldn't give it to us because we charged too much. She got paid for seeing the doctor! How much better does it get?

Anonymous said...

Despite living in 'the system' for a while, since I came from the time before people used insurance, and not being sick enough to use what I contributed through my job and having to deal with frequent changes and copious amounts of junk mail, I can see where she might be 'surprised' but surely the good woman has to realize that physicians and other health care workers should be paid for their talent and expertise? Unless, she never thought of it before, she's as guilty as the robber ripping off the joint, or holding up a bank.

Christie B. said...

I'll have to keep this story in mind when my daughter's pediatrician's front desk staff are constantly asking to see my insurance card. It makes me a bit grumpy to be trying to juggle my daughter, the diaper bag, possibly the car seat and then be asked to forage for paperwork that I know they have a copy of right in front of them - especially since it seems like if I had replaced my insurance card in my wallet I'd also be able to answer "yes" to a simple question of whether my insurance had changed. Actually, it does seem like without verifying with the insurer the card isn't particularly good proof of coverage anyway.

 
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