With Hospital Bills, I'm Scarred But Smarter

Philip Betbeze, for HealthLeaders Media, September 8, 2008

I got a bill the other day from Vanderbilt University Medical Center for $144. I don't know about you, but $144 is real money to me, especially with twins on the way for my wife and me. The trouble was, while my wife has had her share of doctor visits, I haven't been to VUMC as a patient since my bout with tennis elbow almost a year ago. No, I don't play tennis, but I do a heckuva lot of typing and mousing, which seems to have aggravated, if not created, the injury. I've had mixed results retraining myself to use my left hand for the mouse, but I've always admired switch-hitters, so I'm kind of proud of myself. But I digress.

Turns out the $144 bill is for an x-ray I had of the arm last November. In case you're wondering, this was a first notice—I thought my insurer had taken care of this charge long ago. In fact, had I looked hard enough, I probably could've come up with the EOB. But I had other things to do. So I got on the phone the next day to do a little investigating. And since I have a handy digital voice recorder hooked up to my phone for interviews, I decided it would be prudent to have a record of my phone call for this nine-month-old bill. The phone was answered on the second ring by a real person—in fact, a really nice person. I'll call her Faye. Faye informed me immediately that the call may be recorded for quality control purposes. Fine. I let her know that I was recording it as well. For, um, quality control purposes.

After taking down my name, address, phone number and billing number, Faye intoned, "How can I help you?"

"Well, I just got a bill from you guys yesterday that's about nine months old for $144," I said.

"Hmm," said she. "I don't understand that, because I'm showing your account with a zero balance."

"That's great news," I said. "I don't understand the bill either, but we're making progress. What would have generated the bill?"

After telling me she didn't know, I asked her what I should do with the bill.

"Tear it up," she said. "It's not accurate."

"OK, no problem, thanks for your help."

And Faye and I went on about our busy days.

What's the point of this story, you might be asking yourself? Well, besides being an entertaining respite in your otherwise stressful day, it's a window into how far hospital billing has come, and how far it seems to have left to go. Several years ago, I had a similar issue with a different healthcare provider in town. It got to the point where, after loads of phone calls back and forth, the hospital sent a collection agency or two after me for the $20 copay it said I owed for a doc-in-the-box visit. Despite my production of a canceled check to prove I paid the fee, the calls, letters—and the threats—kept coming.

Eventually, I just started to ignore them, and they eventually went away. Somehow though, I suspect my otherwise pristine credit score still has this blemish on it through no fault of my own, though I haven't expended the energy to try to find out.

Based on my personal experience, it seems hospitals have gotten a lot better at this. Departments and vendors communicate with each other much better. Errors like my $144 bill still happen, but they can be resolved much more quickly and easily and with a lot less stress on both sides. Based on my professional experience, I see the software and Web-based products that keep the links of the chain in billing and collections tied together. Many of them are very impressive and help alleviate many of these errors before they even get started, no doubt. But that prior disagreement over the $20 copay has left me scarred but smarter.

So I think I'll hold on to that bill from VUMC for a little while longer. And the recording I made of the phone call. Just in case.

Editor’s Note: Our Top Leadership Teams event is coming up this October in Chicago. I know travel is getting expensive, but if you only go to one event this year, this is the one, and I’m not just saying that because HealthLeaders signs my paycheck every two weeks. We’ve got a two-day agenda packed with some of the top leaders in healthcare today, and they’ll be revealing their operational secrets in a series of panels over the course of the conference.

Philip Betbeze is finance editor with HealthLeaders magazine. He can be reached at pbetbeze@healthleadersmedia.com.
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