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Thursday, November 18, 2010

Medical Billing is Insane

For all the talk about health care reform, I hope somebody can fix this: I’ve had a few appointments, procedures and tests in recent months (no big deal, all pretty routine) and as the bills started coming in, it suddenly hit me how weird the whole business is. Nobody has ever told me what was and what was not covered (I’m with HMSA, for context), what it would cost or with whom I was really doing business.

Imagine if you go to L&L Drive-In and the menu over the counter has no prices, the counter has no cash registers. You order a teri beef plate, pay nothing up front, eat your meal and go. Then, three weeks later you get a bill stating that the plate lunch was $100, but $80 of that was covered by your employer-provided Food Insurance, so you only owe L&L $20.

“Fine,” you say, and write a check.

Then you get a bill from the macaroni vendor for the mac salad.

Then one from the shredded cabbage company.

Then one from the Styrofoam container people.

Then you get a bill from Amalgamated Kitchen Services for meal preparation, because, in this analogy, L&L has subcontracted the cooking to an outside vendor.

You’d rightly think that this was insane, and a horribly costly and inefficient way to run a business. You might even refuse to go back to a business that was so opaque and complicated, one that peppered you with unexpected and seemingly arbitrary charges for weeks. Admittedly, my analogy is a bit simplistic, yet it’s basically what my experience has been like lately and, I’m guessing is consistent with what many of you have experienced. We all just shrug and write the checks. We don’t really have any other choice, do we?

Figuring out why that might be the case seems like a good starting point for true reform.

Posted on Thursday, November 18, 2010 in Permalink

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