Earlier this year, while one of my daughters and her husband were visiting us I started getting bladder spasms. This had happened to me once before when I first had my Foley catheter in place for six months until I had surgery to solve the problem. If, for some reason, the catheter gets plugged up and the bladder is unable to empty it starts to spasm which is a very painful experience and can be dangerous if things begin to back up into the kidneys. It was 10 P.M. when they drove me to the Blake Hospital ER on a Saturday night. When we got there we found the waiting room crowded with what were clearly indigents and tourists. After checking in at the desk, we managed to find three empty chairs and started what was apparently going to be a long wait.
Around midnight someone came to me and said they needed to have a urine sample and I was taken to a small room where a lady gave me a container and pointed out the door to a rest room. I did the required with great difficulty and returned to my seat in the waiting room, At this point I still had the spasms but, over the next two hours it seemed that things were slowly improving . Around 2:00 another person came looking for me and said they needed a urine test. I told them I’d given a specimen about two hours before and they left to find what happened. They returned and told me the specimen appeared to have been lost or misplaced and they needed another one. I went through the same process again and, on my return, the three of us got our heads together and agreed this was ridiculous. We had by then been waiting almost five hours and had not had anybody look at me or try to help me so we went to the desk and told them we were leaving.
We’d only gotten part way to our car in the parking lot when we heard a shout and saw a young man running toward us and telling us to stop. When he caught up with us he said we couldn’t just leave but, if we insisted, I had to sign a form that he handed me on a clip board. We explained why we were leaving and he told us that a weekend night at the ER would always find it crowed and, if we had wanted immediate attention, we should have called 911 and had the EMT’s pick me up. I told him the last time I’d done this they had charged Medicare $655 for a ten minute ride and I was trying to save the government some money.
A quick look at the form on the clip board made it clear it was a very complicated release which, if signed, removed the hospital from any and all liability, etc. What he didn’t know is that my daughter is a lawyer and, after she read it, she said we wouldn’t sign it and he started pleading for us to do so – one got the impression he felt he would be fired if he didn’t get it signed. She finally told him O.K. but she would have to make some changes and took a few minutes to scratch out things and add others and finally told me it was now all right for me to sign it and the kid accepted it.
Well that’s a long introduction and maybe an unnecessary one but I’m trying to emphasize how nutty our health care system has become. Move ahead about five months and I get an “Explanation of Benefits” from Medicare which shows that the hospital had submitted a bill totaling $1,102 for my visit to the ER. Medicare shows that the charge was approved by them but they have only “allowed” and paid $ 83.42. “What the Hell!” I think. “This looks ridicules. Even though they only paid peanuts, the hospital never should have submitted a bill. Something doesn’t smell right.”
Every time they send such a report they enclose a separate page reminding us of all the things we should do and how to do them. One is a request to report a suspected fraud and, although I don’t believe this is a case of fraud; l am convinced the hospital was totally wrong in charging for a visit at which I was not helped, even though the amount paid was minimal. So I call the number given on the form and, after a long wait, have an unusually lengthy discussion with a lady who has to check with someone else a number of times to make sure she’s handling this important issue correctly. Finally she returns from one of these interruptions to tell me that there is nothing they can do about this. I’m shocked. I ask her if they are simply going to ignore someone having attempted to be paid for service not provided. She tells me that the system for determining payments is very complicated and, in an instance like this, makes no provision for challenging the payment and, if I think it is wrong, I should check this with the billing department of the hospital! “Yea,” I think, “That’s going to have me spend another hour or two on the phone and get me nowhere.” I give up in disgust.