Wednesday, January 21, 2009

I just called to rant

Forgive me, folks, it's been a while but I only call in here to rant these days. this time it's an eye doctor rant. Well, really it's a general health service rant with larger implications for the productivity of the American worker and the health and emotional well-being of patients, providers and the billing departments of medical facilities in general.

In November I went for my annual ophthalmologic check-up. (It was actually more like eighteen months because my ophthalmologist quit the practice and I had to wait months for an appointment with the remaining doctor who was over-booked and kept re-scheduling but that's not germane to this story.) I knew I'd need a new prescription so I offered to pay for the refraction but the administrator said they'd check with my Insurance and bill me if they didn't cover it. I paid my co-pay and sailed off to go through the tests. I passed all with flying colors except the eye chart when the doctor determined I'd need either contacts with progressive lenses in both eyes or two different prescriptions for the left and right eye. The only way to decide what was best for me was for them to order a bunch and try them out and for this I would need to pay upfront a non-refundable fitting fee of $200.
$200 seemed pretty steep to me, especially as that's what I paid at my last visit to go through the same thing. But heck I need to be able to see so I paid and set up an appointment and four weeks later (contact lens technician very busy) and three different types of contacts later we had a winner. The left eye prescription stayed the same and the right went up a point. For this I paid $200? Unbelievably, yes. I thought everything was good for another year. Ha! That's when the billing ordeal began.
On December 19 I got a bill for $45 for the refraction and $135 for the contact lens fitting. I called the billing department at 3:45 pm: Our office is open work days between the hours of 9 am and 4 pm. Please call back.
I called back at 9:10 am:Our office is open work days between the hours of 9 am and 4 pm. Please call back.
I called back at 9:30 and spoke to X who explained that I had to pay "$45 for the refraction and $135 for the contact lens fitting". Yep, I know, that's why I was calling. I explained I'd already laid out $200 for the item on the bill. I had the receipt in front of me and I knew I had to pay for the refraction but why was I being billed $135 for something I'd already paid for? X told me I'd have to ring the doctor. Despite sharing a party wall and a central dialing number she couldn't transfer me, so I would have to hang up and redial and listen to the options again: Press 1 for billing, 2 if you are a medical professional........
I duly spoke to Y in my doctors' office who a) didn't know why X couldn't transfer a call and b) why I was being billed. Y promised to fax through I copy of my proof of payment.
I thought the whole episode was a time waster but ultimately I wasn't concerned because I'd sorted it, right? Wrong.
Thursday last week I got a second bill. Identical to the first except it was marked Past Due.
I picked up the phone and took off my mild-mannered English accent, replacing it with "snotty Brit". This time I spoke to Z in the billing department who explained that I had to pay "$45 for the refraction and $135 for the contact lens fitting". Yep. I got that EXCEPT I HAD ALREADY PAID IN ADVANCE and THE DOCTOR"S OFFICE FAXED YOU CONFIRMATION. Z said she go check and put me on hold. Next thing I know I'm speaking to the administrator in the doctor's office. What do you know? It seems they can transfer calls. Amazing. I explain AGAIN why I'm calling and I'm told I will have to speak to the Office Manager. The Office Manager is busy she will call me right back. She calls me right back 5 hours later. She explains that I had to pay "$45 for the refraction and $135 for the contact lens fitting". AAAGH. I take a deep breath and tell her I have already paid $200. that's more than the $135 and the $45 together. She says I must speak to the contact lens technician who unfortunately has left for the day.
Friday I speak to the contact lens technician who professes not to understand why I'm being billed for her part but tells me I have to pay $45 for the refraction. I explain again, patiently, that I will do that but they need to explain to me why I paid $200 for a $135 coded item. She doesn't understand. She will speak to the Office Manager again and call me back. I explain I want this sorted today, before the weekend so it is not dragging into another week. She promises.
Monday and Tuesday I am too busy coughing to ring and check.
Today, Wednesday, I get a call from the administrator in the doctor's office: "Wow, you sound sick. I had that last week. Anyway. You were right about the $135, we've told billing, but you still have to pay $45 for the refraction"....
But I already paid $200. Why did I pay $200 if the amount you're charging is only $135?
..... "I don't know, I'll have to check with the office Manager and call you back".....

All this time, all this energy, all the paperwork and this isn't even an isolated incident. I went through the same thing over a co-pay I'd paid in cash (luckily I held onto my receipt) last year. To prove I'd paid I left phone messages with the receipt number, emailed, faxed and registered-delivery copies of the receipt and the drama only ended when I sent an email to the billing department expressing my fury at being harassed and hounded for a $15 co-pay I'd paid in advance and cc'd it to the President and press office of the hospital concerned. I got an apology.
My point is that if you work 9-5 there is no way you can sort out this sort of healthcare administrative problem without taking time away from that job. And that's just inefficient.

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