Thursday, July 28, 2016

Healthcare insurance, part 75,992...

Healthcare insurance, part 75,992...  Just finished processing a small pile of EOBs (explanations of benefits), medical bills, and statements, and I feel the need to vent.

The document tally at the moment for Debbie's injury in May stands at 57.  All of these arrived in the mail; not one provider can do it electronically.  Once again I found the three things (EOBs, bills, and invoices) utterly impossible to reconcile with each other.  That means, of course, that I have no idea which ones are right.  I have absolutely no way of telling what I should be paying.  Everyone I've asked at the hospital commiserates – but can't really help either.

On the two occasions when I thought there might actually be an error (these were both with previous incidents, not Debbie's most recent injury), upon digging into them with the help of the hospital business staff we discovered items that weren't disclosed on any of the documents I received.  No matter how skilled I was at dissecting EOBs, bills, and statements, I'd never have been able to figure those out on my own.  What a mess!  It's as though you go to the grocery store and nothing is marked with a price, plus the store just added on random charges that they didn't bother telling you about – but expected you to pay nonetheless.

This situation isn't entirely Obamacare's fault, though the reporting requirements it added certainly contributed.  This all started, I think, with the standardization of insurance billing process – something that sounds good in theory, but in the end created an entire industry of “coding” (see ICD-10 codes), a nightmare mess of separate billing, and absolutely zero ability for the consumer (the patient) to select a provider based, even in part, on price.  The separate billing is like something out of a bad Hollywood script – except it's reality!  The last time Debbie visited her surgeon for a post-surgery followup, we received the following bills (and an allegedly matching EOB for each): the surgeon, the surgeon's office, the X-ray technician, the radiologist, the lab (for blood work), and a charge I have yet to figure out.  That's twelve bills and EOBs, for a 30 minute followup visit.  I have to believe there was more effort expended on the billing than on the actual visit!

What really rankles at the moment is this: because of Obamacare, I have no way to opt out of this craziness.  We must participate, or be penalized (and it's  a big damned penalty, too!).  That doesn't feel like America to me.  The government is dictating how we get our healthcare, and if I don't like it (and I don't!), I can't do anything about it.  That's a system that belongs in some place like China or North Korea, not here...

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