Entry tags:

bureaucracy, cameron, cameron health, stories

Billing adventure (long story)
Today is Cesar Chavez Day, and that means we have the day off, and the rest of the world says, "Who's Cesar Chavez?" It was a good day to chase down a $662.50 hospital bill that had been hanging over our heads.

This is the kind of thing where nothing happens without just getting in the car and going to talk to people face to face. You call them up and wait and wait, and when you finally get them on the line they read you what's on their screen (if you're lucky) and you tell them what's on the pieces of paper you've been getting and they say, Well, they're not the same, and you're left no better off.

Cameron had gone to the ER at Children's Hospital a couple times, in August and in November. Both times we got a statement from Kaiser saying we had a $50 copay, but everything else was covered. Sure enough, we got two bills from CHCC for $50 each, so I paid them.

Then, in January, I got a bill for $446.25 for services rendered on 11/12. I sat on it, figuring Kaiser was just taking their sweet time ponying up. In February I got a bill for the $446.25 plus $216.25 for the 8/27 visit! At this point I called Kaiser. They said (see above), "Well, that's not what Children's billed us for. Take it up with them."

And the morning and the evening were the third month, and I got a third bill, saying, We're gonna send you to collections if you don't give us the $662.50 right now. I resolved to write some letters over spring break. But I was putting out so many fires trying to get out of town that I failed to dredge up all the evidence before I left, so I didn't feel like I had enough pieces of paper with me to write the letters.

And that brings us to today.

First stop: Kaiser. Woman at the business office freely admitted that she wasn't the billing manager; she was just filling in at the desk and the real person wouldn't be back for another 30-45 minutes (which I translated as "at least 4 hours, if at all"). She was quite helpful, however; she said that CHCC should not have billed me for the copay, or indeed for anything at all. Since I've already paid the copays to Children's, she advised me that if I ever get a bill from Kaiser for the copay, I should write back saying I'd already paid it to Children's, and KP should go after them for it. So that was good.

I then pointed out the bottom of the February bill that says, We have billed your insurance but have received no response. Please call your insurance carrier for status on this claim. "When I drive up to CHCC after this," I said, "I don't want to get any surprises, so is there anything I should know about before I accuse them of screwing up?" She called the KP Outside Referrals office for me and got their voicemail, so she gave me the number. "Get them to tell you the referral numbers for the two visits, so you can be sure Children's has got the right accounts and visits." "Okay," I said, "But here I am, in the flesh; why don't you just direct me to their office and I can talk to them in person." She was embarrassed to admit that she didn't know where the Referrals office was. That was annoying, but I didn't blame her: she was just filling in, after all, and she'd attempted to look it up on the computer, in vain.

On the way to CHCC I left a voicemail: "Please give me the referral numbers."* Meanwhile...

Second stop: Children's Hospital of Central California (5 miles up the road in Madera). The first person I saw (in the misplaced-modifier-named "Children's Professional Center,") directed me to the cashier. I wasn't too optimistic, but to my surprise the cashier was very helpful. Next revelation: the huge bills were not from CHCC. They were from a physicians' conglomerate in Ohio that manages the bills for the doctors who work the ER but are not actually employed by Children's. She advised me to call them directly. Meanwhile, she said I could talk to CHCC's business office for more help. "Our business office is off-site," she went on, but let me call them."

I couldn't hear very well through the cashier's window, but after she got off the phone she said, "She says you are free and clear as far as Children's Hospital goes -- your $50 payments are processed and you don't owe us anything -- but if you'd like to call her for help with [the Ohio people], here's the number. Or, if you'd like to see her in person, here's the address." And she handed me a map! Nice! Doubly nice: it's in Fresno, about two miles from where I live. In fact, I know the office building well because I used to live right behind it.

Everyone I talked to in person today was very pleasant and very helpful, and with each stop I learned more about what was going on and got closer to solving the mystery. This was not the case with the Ohio people I talked to on the phone. After waiting on hold for at least 10 minutes, "Dawn" tells me, with just a hint of snottitude, that my account was sent to collections on March 27, because "we can't just be sending out bill after bill and not get our payment." I told her, "You haven't gotten the payment because I don't owe this money. You are supposed to bill Kaiser, not me." "We tried billing Kaiser," she simpered, "And we asked them for the ID card, and they never wrote back." Um, what ID card? Several opaque exchanges, then finally I ask: "Do you mean my son's Kaiser card that shows that he has insurance?" Yes. "So, if I get Kaiser to send you a copy of this ID card, then you'll bill them and take me off collections?" Yes.

At this point I am still wondering who is to blame for all this. Does CHCC routinely farm out their care to these conglomerates, I wondered, without providing them adequate patient insurance information?

On to the CHCC business office. "The Atrium" is a fancy little 3-story office building that earns its name, complete with koi pond and glass elevators. I found "Clara" and confirmed that I was the one the cashier had called about. I showed her the bills and said I'd been all over town and had tried calling the Ohio people but they kept nattering about some "ID card" and weren't very helpful. "I just want this all to go away," I concluded.

Clara was the best. By the time I finished telling her my story she was on the horn herself. I could hear the same on-hold messages in her earpiece that I'd been subjected to. I told her, "You're in for a long wait." Finally, after ten minutes or so, she got through: "I'm calling from Children's Hospital..." Ten seconds into her spiel, she stopped mid-sentence. "They hung up on me!" she exclaimed as she redialed. "Now we're going to the back of the line again." Sheesh.

Another ten minutes, and she let them know what she was made of. Jargony-jargony-jargon, and then: "I have Mom here..." (short pause) "At my desk." As if to say, "So don't screw with me, she's not going away until this is fixed." More jargony-jargon, and then: "She gave us the ID card at the time of service, and we sent you everything she gave us. We successfully billed Kaiser for our portion -- they paid us -- so I don't see why you'd need anything else." (Pause. She motions to me to give her Cameron's ID card.) "I'm looking at the card right now, and there's no address on the card anyway, so whether we gave it to you or not it's not going to help you figure out where to send the bill." Jargony-jargony-jargon, and then: "No, Oakland." (Pause.) "Oakland, northern California. (Pause.) All right, so she's out of collections? Thank you very much."

"Okay," she says to me, "'Adam' said they sent the bill to Texas. Who knows why they did that, since they had the same information we did, but now that he knows the right address they're going to rebill it. Meanwhile, you're out of collections." Yahoo! Go Clara!

"So I sit tight and wait for... what?" I ask.

"Give it a week or so. Then you might want to call Kaiser and make sure they've gotten the bill. Meanwhile, you're off the hook." Yay!

I was so happy to have taken care of that mess that I went to Trader Joe's on the way home and picked up some yummies. The end.

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* I never did hear back, although somebody did try to call after I got home and my phone conked mid-ring, so it might have been them.