Thursday, April 8, 2010

Blood from a Turnip

* Stringham high: Planting!
* Stringham low: Cold front after a week of gorgeous warm weather.
* Stringham super-high: Daffodils in bloom.

(By the way, as soon as I can find the time, I'll have pictures up of what we did last weekend around the place. It was a lot!!!!)

So, I've done this before with emails, but now with my blog. I'm ranting a bit, but now you get to be my "witnesses" to what I have to deal with. And this is just one more way for me to help show that I'm documenting my plight and making efforts, in case things keep disappearing from other people's records (see below).

Pushed and pulled in so many directions. Got a call yesterday (Wednesday) from the collections agency (IMC), from J. She tried to get me to settle, by knocking off “a substantial” part of the bill from Beltway, but I’d have to pay quickly and in a lump sum---more than $7000--to not get it to adversely affect my credit (and other nasty implied things). The entire bill is $8666.60. That may seem like a substantial amount knocked off to her, but not substantial enough from where I’m sitting. So I told her Mike was at work and I’d have to talk with him about it, that I’d call her back today (Thursday).

Long story short, I ended up making more calls yesterday and more this morning and have just finished spending about an hour and a half on the phone this afternoon with Dr. Lee’s office, IMC, and MHS (for Medicaid), you name it...

I’ve been told by MHS that there is now no record of Dr. Pearce’s bill in the system…no record of me calling in about it or of them sending those letters to him, nothing, nada, zip, zilch. I’ve been told that I should contact his office and tell them to resubmit that. When I called IMC, they basically asked if that meant the bill was supposed to be resubmitted, and I said that’s what I took from what MHS told me. Then the gent at IMC seemed to ignore that bit of information and go straight for the Beltway information. So I explained that C at MHS was still researching information there and was supposed to be getting information for me and calling me back today or tomorrow. On a later call, J (at IMC) asked if we could pay nothing on the bill. I didn’t want to get caught in it and required by law to pay for it by agreeing to settle, because another $7000 is just more than we can handle right now. I explained that we’re already just barely making our bills, and she asked if we couldn’t do anything for it. I said I’d have to talk to Mike again because we’re paying bills this weekend. She said she thought that was why she had waited overnight for me to call today, so I explained that because of Mike’s work shift, we have limited time to have any discussions and that he goes to work, comes home, we eat, go to bed, then get up and he goes again—that we know there is no way we can pay a $7000+ bill and we’ll have to discuss whether it's possible to pay even a smaller amount but that I still doubted it.

She said she’ll put the account on hold for the weekend and said that two things need to happen or they will have to mark the account as unpaid and Beltway will sue the account: the diagnosis needs to be changed or I need to pay a substantial amount on the bill. Well, I know there’s no way we can really pay a substantial amount on the bill. I explained she’s really been the first one to mention that the doctor would be the person who would need to change the diagnosis, etc. So I asked her how that worked. She explained, then said that in her 20 years, she’s only seen that work a couple of times. (Still, I figured, it’s my best hope. I’m not going to go into hardship to pay something I’ve been told I’m not supposed to pay. This is where it gets tough…I want them to get their money, and if I had the money, I wouldn’t mind paying it, even working out a payment plan (hard as that would be), and with an insurance company, I know that’s what we’d be obligated to do. But we have MHS (Medicaid) telling us that we should not pay it, because those providers are in the wrong for trying to bill me in the first place.)

But J emphasized that “the ball was in my court,” that I can’t just sit back and do nothing (which is ridiculous, really, when you think about it.) They’re telling me I’m supposed to act in spite of the research that MHS is doing. I can’t just sit around and do nothing. Right, because that’s all I’ve been doing, nothing. I’ve spent so much timing making phone calls to MHS and IMC and medical provider billing companies (who know nothing and care nothing except if you are paying, they don’t care about the details, unless the details are who is paying them, how much they are getting paid, and when they are getting paid) that I am now about a half a week behind in my editing—my livelihood—the ONLY way they MIGHT be able to squeeze blood out of this turnip. But I’m spending so much time on the phone with them doing THEIR jobs that they’re making it very difficult for me to earn enough money to pay my existing bills, much less come up with something they hope to wrench out of me. What a joke.

So, glutton for punishment that I am, I got off the phone with J at IMC and immediately called Dr. Lee’s office. First time through, I couldn’t leave a message in a general mailbox and didn’t know who the hell’s extension to leave a message on, so I called back again. Got a different message, this one saying the office was closed. Thought I may have gotten to a general voicemail box but wasn’t sure, so after leaving a message, I called back to check. (I figured I didn’t care if I left 20 messages, so long as one of them got someone to call me back with Dr. Lee’s information tomorrow.) So I called back immediately, and someone answered, even after the phones were already shut down for the night. I guess they got tired of hearing them ring. lol. People can only ignore a ringing phone so many times. I explained my conundrum and was told by the lady who answered that she would patch me through to Linda, but Linda might be home for the night but I could leave a message. I was tickled pink. That would be fantastic, I said.

L answered! L and I had a lovely chat. For a half hour, she and I discussed my issues and the back and forth I’ve been going through, and possible ways to work with Beltway Surgery Center if necessary. She explained that Dr. Lee is on vacation until next week (of course, just my luck!), but she and C (a nurse there) think that maybe it’s not the coding but a letter of explanation that might help. L is going to call their billing department first thing tomorrow morning to find out if they’ve had problems with their bill getting paid by Medicaid, because usually if their bills go through, so do Beltway’s, and vice versa, she said. And then she’ll figure out what we need to do from there, she said. We may be able to get Medicaid to pay for this, after all. Or we may not.

But L has connections. Linda knows people I can talk to at Beltway if we ultimately find out from MHS that, for some reason, we are liable for the cost of the surgery…not just the people who answer the phone at the billing center, no, but real live human beings who may be trained to do more than read from a decision tree and ask you if you are paying (Yes? Great! Will that be credit or check?—No? Well, you know, this is your responsibility because your insurance company has failed to pay, even if your insurance company was Medicaid. Are you sure you can’t pay?—You will pay? Great! Will that be credit or check?—You won’t pay? You know this will be turned over to collections and can hurt your credit if you don’t pay. We can send you an application for financial aid or let you talk to a social worker if you’re really sure you can’t pay.—You will pay? Great! Will that be check or credit?—You can’t pay? Would you like an application for financial aid, or would you like to speak to a social worker?—Financial aid application? Okay, I’ll send that out in the mail to you right away. Remember that you have to have that filled out and returned within 10 business days or this account will be turned over to collections and your credit will be damaged.)

Anyway, L is fabulous. L is helpful. (I can’t stop singing the praises of L.) She even had the nerve during our conversation to ask how I am…right in the MIDDLE of the conversation, she asked how I was doing, and how my vision has been doing. It’s after hours, and she’s supposed to be going home already, but she actually stopped to take time to ask how I was. L has restored my faith in people, at least for a little while. (I cried while I answered, I was so touched that she cared to ask and actually listened.) Anyway, L (I’m singing her name in my head to the tune of “Lo-la! L-O-L-A, Lola! Lo lo lo lo Lo-la-a!”) is going to make some calls and find out some things and call me back. She didn’t tell me I owe her office money (she’s checking on that, and if I do, she’s going to try to figure out how we can resolve the issue) and have to pay right away, and she didn’t tell me to sit tight and do nothing while she researches. She told me she’ll help me along the way.

(To be fair, the folks at MHS have told me that, too, but they now seem even more lost and confused than I do…I mean, they lost all record of one of my bills and of me calling about it numerous times and of them sending out numerous letters to the provider, for pity’s sake!)

Anyway, tomorrow, M and I go to the courthouse to see if there’s a way we can get some free legal aid if necessary if all this doesn’t get cleared up. I want it to show that we have done our due diligence and tried everything within our power (and even beyond, I think) to get these issues resolved.

So, all in all, it was just another day...I used to get paid well to be a project manager and do this sort of thing, making sure all parties involved were informed of what the others were doing, bridging the gap, keeping things properly greased up so the cogs and wheels were all moving along properly. But now I’m the project manager of something that should never have been such a project in the first place. (Is this what happens when we let the inmates run the asylum and no one knows HOW to take responsibility?) I’ve got at least two teams working “for” me and one team opposing me, and finally, I have competent “employees” on the case, but it has taken this long (4 1/2 months) for me to find out the right questions to ask, the right avenues to pursue, and for me to have the somewhat-restored mental wherewithal to understand half of what’s going on. So, yeah, I love being a project manager, I really do. Even better, I like getting paid for it, like I used to. But now it actually COSTS me money because it takes time away from my editing, you know, the little bit of blood that sometimes seeps through this turnip...

Well, at least things are looking brighter… Cheers!

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