"How Are You Going To Pay For This Baby, Ma'am?"

As I've mentioned before, I have quite the disdain for our crummy healthcare system in America as well as my own "consumer driven" health plan. Ever get that feeling that Dwight K. Schrute is hard at work in your HR department? Me too. Since they chose the new company health plan, apparently some of my fellow employees have had some trouble adjusting to the new method. In 2006 and years prior, we had a more typical health insurance plan - co-pays and premiums, premiums and co-pays. The kind we've all come to know and love. New for 2007 were the "consumer driven" health plans, that put more of the control and responsibility in the hands of the consumer. The main difference was that with the old method, you payed and payed and payed, little by little. With the new plans, you could end up with some large bills, and need to pay a sizable chunk of cash without realizing it. Well anyways, I thought I'd share our not-so recent experience with our OB/GYN's office.

We were maybe 4 or 5 months into our pregnancy. Though we didn't have many options, we were happy with the OB/GYN office we had found. Great doctors, friendly staff, good location, plus a few magazines for men in the waiting room. All in all, we were quite pleased. That is until the phone calls started.

It was the doctor's office calling, specifically, the billing department. But why were they calling? Their billing structure is to bill you for the standard delivery + anything extra AFTER the baby is born. Prior to that, things like check-ups, tests, bloodwork and ultra sounds would get billed to our insurance account. Our bills, small thus far, were paid. Why were they calling to harass my wife about our bill? They said that they wanted to set up a payment plan, and start billing us now, dividing out the standard delivery fee into monthly payments based on the time remaining before our due date. How about.... No. This was your plan - one big bill at the end of $3,000+ - not ours. Now you want to change midstream? No thanks. We'll manage just fine.

My wife politely declined, and called me - giving me the earful that they were due. She was mostly just put off by their inference that we would not be able to pay the bill despite knowing 9 months ahead of time the approx amount due and when. We pay our bills, our credit report is clean, and they have always gotten their money in-full and on-time. "Maybe it was a mistake", I offered in an effort to bring the tension down. Maybe it was. Maybe not.

The following week, two more calls. Both times she declined and hung up, growing more furious with each one. I couldn't blame her. Their implications were rude and unfounded, at least from our point of view. Far too often, miscommunication like this stems from simply not telling the whole story and explaining oneself. Why can't people just be honest? And up-front? If you are going to change the terms of an agreement - midstream - don't you think I'd like to know why and expect a reasonable answer? (Can you tell that I am not a credit card holder?) Another week, another call. This time we got some answers.

As it turns out, for the first time in the history of the practice (decades old), they were having to send bills to collections. What?! And all of the accounts in collections share something in common with us - my employer (and thus, my health insurance plan). Ah-ha. In years prior, the insurance company picked up varying amounts of the big delivery and hospital bills and the insured only owed a small, manageable fraction. Now, even families who had been through this process before were caught off guard by the large lump sum payments that they owed after delivery. As a result, the OB/GYN's office was pro-actively calling clients with our same insurance policy generously offering to set up this payment plan to reduce their risk of non-payment later on.

We finally had our explanation. Our answer was still a firm, "NO", followed by, "Stop calling us about this. We already have the money set aside. You'll get paid, after the doctor performs the procedure."

Universal Health Care looks better and better all the time.

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mdoneil said...

If you already have the money set aside you may want to pay them now if they will give you a discount. If they knock 20% off for cash now that would be a very good deal.

I do that all the time as I have a high deductible indemnity plan and a healthcare spending account. I've never been given less than a ten percent cash discount if I agreed to pay at time of service.

I then submit the bill to my insurance and any part that they don't pay comes out of my pre-tax HSA.

(not) the Jet Set said...

Thats a great tip! I don't know if that works the same with our HRA (slightly different than the HSA), but none the less, we should have asked for a discount to do their payment plan. Even if they bill us through the insurance company, we may have been able to negotiate a lower rate.

Bad for us, as the baby has been born and the bill paid long ago. Good for you, dear reader, if you are getting the runaround about paying early, ASK FOR A DISCOUNT!

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