Tuesday, September 9, 2008

GRRRR health care!

You know this is going to be a rant if it's related to health care.

I mentioned somewhere recently (sorry can't remember where) that we're having a problem with the hospital where my daughter stayed overnight for her 2nd sleep study, the titration. Normally that's done in labs but due to her age (4 years old at the first sleep study, 5 at the second 9 months later due to change of insurance) the pulmonologist required it to be done in a hospital. She had her tonsils & adenoids out (and a 4-day stay in the PICU for a massive lung infection and inability to maintain oxygen saturation) and still had bad sleep apnea, turning blue in the lips and fingertips for the next 2 years in the study process, diagnosing the apnea and averaging 60% oxygen saturation.

Here's the timeline of events:

October 3, 2007: 2nd Sleep Study for CPAP titration at K*** Hospital

August 11, 2008: We receive a bill from K*** Hospital for the above study for $1,998.00. In the history category, there is NOTHING regarding insurance filings, payments, NOTHING.

August 11: I immediately call our insurance company TWICE, take names & reference numbers. They send K*** a certified letter saying they are billing us illegally and that by Arizona Revised Statute # whatnot, K*** did not file within the legal time limit and so no one was responsible for payment.

August 11: I then immediately call K*** and let them know the insurance names and reference numbers and the certified mailing number so they do not bill us again.

August 13: A whopping two days later, K*** sends us to collection. After ONE bill and a certified letter! We receive a collection notice from a debt company. We notify them of the certified information, all names and numbers. They do not care.

August 25: We walk-in to the K*** corporate offices and have an impromptu meeting with the representative and supervisor. We learn they never processed our daughter's change of insurance until 3 months AFTER the CPAP. Their fault of course but they can't admit to it. We see their computer notes; they refuse to push the print button for our copy without a subpoena. They agree to put a hold on the account with the collection company and do an investigation to find responsibility and say if they think it's their issue they will leave it at that. (Right.) They ask for up to a month and say we can call and check on the situation at any time.

August 26: I call and let them know the pediatric pulmonology office, who arranged, authorized, and scheduled the study to be done at K*** Hospital, had the updated insurance information the ENTIRE time. I politely and respectfully told them the information so they could include a discussion with the pulmonology office as part of their investigation. They agree it could be helpful and will call and talk to them.

September 9: I have not heard from anyone since above date and call to check in, make my presence known. C* is busy, can't take my call right now so I speak with L*. Computer notes show her that they finished the investigation and C* should have called me. The only call that was made according to the notes was to the hospital itself to see if they had the updated information from us when we checked into the hospital the night of the study. L* says C* may have notes she hasn't put in (like calling the pulmonologist). I have a gut feeling she never did.

September 9: Yep, I called the pulmonology office and thankfully the person who arranged the authorization and K*** appointment last October called me within minutes. Nobody from K*** has EVER called them. Our original insurance issued an extended authorization for the October sleep study good for payment two months past when the new insurance took over. She also verified they had the newer insurance information the entire time. She is irritated and says she will immediately notify their auditor what K*** is doing. She does so--as the auditor has her call me back for more details from off of the bill.

A friend from church came by with a certificate for Sterling and another item (more another time) and I retell the K*** tale; she asks if I know that so-and-so's father is the director of the hospital and to let him know what's going on because they know all about me from church.

Oh, this could get good.

1 comment:

  1. if worse comes to worse hon take it to the attorney generals office if they are billing you illegally which they are. i had to do that when some idiot stole my identity and i finally let them take care of it, it might work for you i hope so honey you sure have had more than your share of stupid people hugs and love