“There is no real ending. It’s just the place where you stop the story.”

― Frank Herbert

Monday, April 7, 2014

Thanks ever so much, Mr. President.

Some of this will be old news if you have read some of my other posts, but I am aggravated beyond all endurance, so I am going to start at the beginning.

For years, my wife and I had an HMO in terms of health insurance. It had high copayments, high coinsurance, and high deductibles. It cost us about $500 a month.  But it did, at least, pay part of my medical expenses, which are not light.

Then along came Obama Care.  The state of Georgia decided it couldn't afford the HMO any more, and gave us a Health Expense Reimbursement Account.  They put $800 in it, and after that was spent, you had to spend $5000 out of pocket before it paid anything else.

There was a huge uproar and a teacher revolt led by a housewife in central Georgia. The state bureaucrats said nothing could be done until 2015. But lo! This is an election year and the Governor decided thousands upon thousands of mad state employees might not help his reelection campaign. So he "fixed" insurance.  Just how, none of us were sure but he went on television and told us it was fixed, at least for this year.  He's got a record as a man of his word, so I settled down to see what would happen next.

I have to have a bunch of lab work done every three months. The HMO paid for it.  But my doctor told me the last time I went in there, that she didn't think my insurance would pay for it, and if it was billed out to the LabCorp , a company that does lab billing, it would cost a lot. She said if I just paid them up front at the office it would be $35.00.

But that sounded wrong to me. My insurance was supposed to pay for it, so I asked the doctors office to send the bill to the insurance company.  They sent it to LabCorp, which filed it with my insurance. Then LabCorp sent me a bill for my "fair share" which I got today. It was for $587.00.

Does something seem wrong with this equation?   $35.00 if you pay cash at the doctors office, but $587.00 if you file your insurance?

Well, one thing I am good at it is raising hell about stuff like this.  So I intend to devote some of my time the next few days to sending copies of this bill, with an explanatory letter, to every state and federal politician I can think of, to the Governor, and to the Insurance Commissioner. I'm also going to the doctors office tomorrow and ask them what is going on with this.

It should be a lot of fun making as much trouble as I can.  Of course, I may only make trouble for the underlings and flunkies, I can't touch the Supreme Grand Panjandrumum's at the top of the heap.  I may not even be able to make any trouble at all, but it won't be for lack of effort. And I am certainly not going to pay LabCorps bill. Not this side of Hades.

20 comments:

  1. Just crazy. When we lived in Fla. the hospital near us, and Disney, gave a huge discount if you paid before you left the hospital, E.R. visit. The reason was they didn't have to play the waiting game to be paid by the Insurance co. or the State/Feds.

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    1. I don't think that anyone here has any idea of what is going on with health insurance. My wife gets our insurance through her employer, the school district. But the school district has to buy the state policy, there are no options. Now, thanks to Obama Care, even the state doesn't know what is covered and how it gets paid. Georgia is in an uproar because people are paying for their insurance through payroll deductions but insurance claims are being denied. I would also like to know why the same basket of services costs $35 if you pay the doctor, but $587 if some bizarre parasitic healthcare company bills it out to your insurance.

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  2. Harry,


    (captaincrunch)


    the systems screwed beyond reproach.

    Just' pay for your medical in cash if you can and pay the extra osamacare tax. Take heart in knowing that at some point it will all crash inward on itself like the Soviet Union in the early 90's.

    None of the politicians will listen. They are all in the pockets of the insurance companies. It began with forced automotive insurance and that was very lucrative so forced healthcare insurance was the next logical step. At some point after every ones pockets are picked clean and the insurance companies don't feel like paying out any more money the final step will kick in.
    The final step is the british (I typed british in lowercase on purpose) national healthcare system will be enacted along with all the 'humanistic stuff' like infanticide, euthanasia for senior citizens that are no longer producers and stuff that would make Dr. Mengele and other Nazi's very happy.

    This is a no win scenario.

    Most americans are happy to pay the extra tax as long as they have their cell phones, flatscreen TV's, drugs and alcohol.

    As history has shown, at some point it will end and it will end badly.

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  3. On a philosophical level I agree. Because of my daughter's health issues since she was a baby, I have long experience of dealing with insurance companies. I don't always win disputes but I win more than I lose. The most useful bureaucrat is the state insurance commissioner but sometimes the others will help. Lots of times an insurance company will try to hose you just to see if you will roll over for them. At any rate this is one of the more bizarre problems of the many l have had to deal with.

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  4. LabCorp may have done the lab work and was not preferred in your network which means you would not get the discount. When I see my explanation of benefits I am amazed at the "regular" cost before my in network price. Then there can be layers of preferred with one having a better benefit than the other. There can be hundreds of dollars difference. It doesn't make sense.

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    1. It may be something like that. I tried to call my doctors office this afternoon. I got a long series of menu options. I chose one. I got voice mail. I called back. I listened to all the menu options again, I chose another. I got voice mail. Finally I just faxed the whole thing to them and said "take care of this or stand by for heavy rolls." They know me, so they know I'm not kidding. But they will be mad because they TOLD me just pay the $35.00 and I said "that's why I am paying big insurance premiums, so I won't have to pay the $35.00 dollars." So this time I may have put the "front toward enemy" backwards and blown myself up. Why pay for the insurance if I am not going to use it though?

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  5. Might I also suggest you send a copy of this letter to Harry Reid. He thinks folks like you are just plain "liars" when it comes to Obummercare. Good luck to you, and give em hell! --Troy

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    1. I better not get started on that guy and what he said. I wondered when I heard it how it was possible even for a rich guy from the desert to be that out of touch with reality.

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  6. The gap between the $35 and what you were billed seems off. When I offer to pay cash for something it's usually off the books but it's not that sort of a discount, something isn't right.
    Your story gave me a flashback to when my Dad showed up at an insurance companies headquarters and started setting up a tent in the lobby. Suddenly everyone he wanted to talk to was available when they had never responded to a letter, returned a call, nor taken a call in over 2 years.

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    1. nowadays they would call the swat team and shoot your dad in the back, then say he had a weapon and was pointing it at police.
      deb h.

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    2. It may be like Kathy said. I know my brother T had an operation in California. He was covered by state insurance, Blue Cross, because he was a policeman. He went through his bill, item by item. He found something called a "beside kit" listed on his bill for $700 dollars. He asked the hospital what it was, and it was that little plastic basin and cup they give you, that costs about $5.00 at Walmart. T called the insurance company and wanted them to pursue the hospital for fraud. But the lady from Blue Cross told him to forget it, that it was standard operating procedure in California for hospitals to grossly overbill people with insurance to cover all the people who had none and didn't pay their bills. She could not understand why he got mad, since it wasn't costing him anything.

      I have a feeling this is going to turn into a rats nest but after I got over my initial outrage I felt kind of glad. I hate what has happened to health care but I haven't had anything I could sink my teeth into. Now I do.

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  7. The real problem is that nobody knows the true costs of health care is that nobody really pays. Either the "poor" get "free" care in emergency rooms, or we get care through "insurance". I'm 63, and I still remember a time when "insurance" was rare, hell even for a lot of drivers! Seriously though, the layers upon layers between the patient and the providers, along with gummint BS is why things are so crapped up. NOTHING is free.
    1957 summer I was six years old, had serious emergency surgery at local hospital. Spent 10 days there after ambulance,home Dr. visit prior (yes that used to be a normal occurrence),2 more home visits later....the bill was less than 4000 dollars. No insurance, bills my father worked his ass off to pay over a few years. Even accounting for inflation, that bill today would be considerably less than if I had the same issue now.....with a lot less real hands on care.
    Sorry to ramble, but people have to realize that healthcare is anything but until you approach as you would buying anything. You get what YOU pay for. If you don't want the crap that goes with all the bullshit layers, rid yourself of the layers.

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    1. Glenn555, you are exactly right in what you say. I know how it works here. If you are a rural person who has lived here all your life, and you have an accident the hospital makes you take out a payment plan and pay the rest of your time on earth. I know this man who had a toddler that got burned really badly. They had to airlift her to Atlanta. That was 15 years ago, and every month he sends them a small check. But I know people who work at the hospital here, and they are always mad because the Mexicans come bopping into the emergency room, and never pay one red cent for their care.
      What the hell?

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  8. Give 'em hell, Harry!!
    There's a lot going on under the radar, and most of it is corruption.
    Those thousands of dollars go to someone, somewhere. After all, even Imelda only had 6,000 pairs of shoes.
    i just became eligible for medicare. Before that my individual insurance was 1,000+$$ per month. Last year they paid out 74$ total out of over 12,000$ dollars received! What's wrong with this picture??
    Last year I went to the pharmacy and was told the insurance would only pay for one dose [monthly injection- which formerly came ten doses per vial--of course it is now 45$ for ten vials instead of twelve$ for one larger vial-- more greed].
    I got all ten, but first said have the insurance pay what it will on the one vial.
    Well, they only would pay 50 cents!
    So I paid it all myself. Over one thousand dollars minus 50 cents leaves them with quite a profit, wouldn't you say?
    It is also typical for labs, et cetera, to overcharge seeing how much they can roll you for.
    I'm always thankful that hell is rumored to be a big place--I just hope there's no room for me!
    in re cap'n crunch's comment--there is an old french saying; 'offer people a choice between sandwiches and liberty and they will take the sandwiches every time.'.
    The barbarian is not at the gate, he is inside after having waved sandwiches at the people on the ramparts. He has been welcomed with open arms-- at least with the arm not occupied with a video game control or texting on an obamaphone.

    When we lived in Rhode Island it came out that the legislators were receiving kickbacks from Blue Cross -cost of doing business in that particular state-- when the legislators went with a different insurance company for state employees.
    Was anyone prosecuted or even admonished? No!!!
    I will say that the health insurance there was one of the best we've had anywhere. It really did serve the people who were enrolled. Despite the legislature.
    Well Harry, you really got me rolling. I am so mad about the corruption but see no way out. It is like watching a train wreck.
    thanks.
    deb h.

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    1. Especially for older people, or young couples with kids, this is all difficult to deal with. It was bad enough before Obama Care. Now , no one knows how anything works, and the chaos is just not something you can work through. I doubt it will get better.

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    2. chaos provides perfect cover for even more thieving. it's like war.
      deb h.

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  9. Do you not us the VA for most of your medical needs? Or is there not a VA facility nearby? Most of the folks I know with military service use the VA for as much as they can when it comes to most medical stuff.

    As an aside, a buddy of mine with a history of skin cancer had trouble getting insurance. He threw $5k into a health savings account and then bought a policy with a $5000 deductible...by doing that it only cost him about $175 a month for insurance. If he broke a finger or something he would have to pay the full amount (since it would be less than $5k) but if he had a bypass, aneurysm, major surgery, or other catastrophic event he'd be covered. Under O-care that policy was considered 'not good enough' and now he has to pay 3x what he used to pay for a policy that isnt as good.

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  10. Zero, when all this started with Obama Care, I thought I would be clever and get in ahead of the game. I'd never messed with the VA, even though there was a brand new VA office in our county with a clinic. But I went and got the paperwork (mounds and mounds of it) and both my wife and I applied. This was about four months ago, as I recall. I have gone by there to check and see if there was any word on us, and the lady working there says so many people have applied to the VA that the system for processing the applications has just ground to a halt. So I asked her for at least a guess. She asked me how old I was. I told her and she said "honey, you may not live long enough for your application to be processed."

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  11. Harry,
    Looking at what is happening to your health system from afar I am just gobsmacked!!
    Some bas--rd is pocketing all of the money from the system, I am not even American and I feel pis--d off on your behalf! I know that there is some overcharging in the health system here in Oz (mainly in the multitude of tests that Doctors like to order nowadays) but overall our private and government insurance costs are a fraction of the amounts that people have mentioned above in their comments. Also it is not rocket science to try & get insurance, you have 2 choices, either go with the Government medicare system which is paid for by deductions from your salary, or take out extra Private health Insurance from one of the many private companies. From what I have read your system is now so broken thanks to Obama that nothing less than a total & major overhaul of the entire health system will work and I am afraid I can already guess what the chances are of that happening.

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    1. I tell you the truth, Sgt. Everybody saw this coming months ago, but nobody seemed to be able to stop it. My brother the cynic predicted every single foible of this nonsense months before they happened, and so did a lot of people in government and business. The system was terrible before all this, and now , as you can see from what's happening to me, it's just flat broken. Nobody knows what's going on, so nobody knows how to fix it. The medical professionals are working under the mistaken impression they can just send out bills and people will slavishly pay them, because that's what has been going on for the last forty years. But that's changed. Now people know that nobody is in charge, that the system is broken beyond repair, and that many, many people are not paying their bills so those that do are getting hit with higher bills to make up for those that don't. A lot of thoroughly decent people are just deciding to say to hell with you, hospital, or doctor, or radiologist. I'm not paying these jackasses from this LabCorp thing. I'll go to small claims court if they want to, so even if they win and I have to pay or go to jail, it will cost them more than they got out of it.

      I just got through reading a book about Roman Britain, and what happened when the Empire began to collapse and the Romans pulled out.
      Things just fell apart. That's what is happening here now. It's a bad time to be living here, and a really bad time to be 20-35 years in age, since the governments only plan for staving off total collapse is to milk these people through fees and taxes to keep the creaky carnival staggering along the road.

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