A few months ago my mother-in-law broke her leg. She went to our local hospital's emergency room. Treatment was given, healing commenced, and she's actually walking on it now. All good. Except now here come the bills.
More than $30,000 from the hospital. Another grand from a doctor. A grand and a half from the anaethesiologist. Half a grand from the radiologist. Another grand from the hospital for stuff they presumeably forgot the first time. Really? All this for a simple broken leg? How did we ever get to a place in society where such a thing could happen, and people (ANY people) would think it is normal?
My mother-in-law is uninsured. Luckily for her, she has read my book How to Survive Hospital Costs Without Insurance. So before she signed the admission form, she modified the "promise to pay" clause to read,
Of course no hospital ever honors that stipulation, until you hold their feet to the fire, which is what my book teaches people how to do. But that's not exactly the subject of this rant. I'm not here to discuss the hospital right now, I want to shed some light on the sub-contractors like the doctor, the anaethesiologist, and the radiologist."...pay all valid charges subject to Blue Cross Blue Shield schedule of fees."
Hospital admission forms nearly always have a clause which authorizes third-party providers to give you treatment, and to bill for their services. The question becomes, how do you get these third-party providers to recognize the contract you have with the hospital, and force them to accept payment at the same rate of discount you have pre-arranged with the hospital?
The hospital has sent you this huge bill. Even though you've requested a detailed statement readable by a layman, the best they've provided still has "miscellaneous charges" or unintelligable charges amounting to thousands of dollars. How do you know the third-party provider's charges aren't already in the hospital's own bill? For that matter, how do you know the third-party provider really did anything at all, or even has the right to charge you?
If you send them the same sort of correspondence my book teaches you should send to the hospital, it is quickly evident the third-party providers have never seen that contract and are, for the most part, very reluctant/resistant to honoring it. Which got me thinking. People just assume everything is right, when many times it is not.
Now don't get me wrong, if these third-parties provide a service, they deserve to be paid. But if the average amount providers accept from BCBS is 12% to 15% of what they commonly bill uninsured patients, and if you've limited your liability to what they would otherwise accept from BCBS, then a $1,500 bill becomes more like $180 to $225. That is, provided they actually have a right to bill you at all, and haven't already been paid by the hospital out of what the hospital expects to get from you.
Here's what I did for my mother-in-law: I sent each third-party provider a letter, on her behalf, that basically said,
Seems simple, right? But it turns out none of them can do it. What's more, under commercial law, once you've demanded it, if they can't produce the contract upon which their claim is based, then they don't have a leg to stand on to collect from you."Please produce a copy of the contract which obligates me to pay for your services."
A couple of them responded asking her to sign a waiver giving them permission to disclose her private records.
In the response I designed for her, she returned their waiver to them refused for cause, without dishonor. She chastised them for trying to trick her into authorizing them to do something which they would otherwise have had the right to do without her authorization, if they were in fact lawful contractors of the hospital. And she reminded them the clock was still ticking for them to produce evidence of their claim.
Bottom line, these people are going to end up not getting paid, and believe it or not, that really frosts me.
Once I saw things clearly, this challenge was the only lawful route available. It's a lawful challenge that has been around for thousands of years, and for very good reasons. But apparently the third-party provider and the hospital have no mechanism in their procedures for allowing the third-party provider to satisfy the challenge. Why not? Can it be for any other reason than ignorance of commercial procedures?
Evidently, no one (or almost no one, at least until I came along) ever asks for evidence of the obligation. Why set up procedures for something that's never going to come up?
Now this is bothering me on a deeper level. Why doesn't it come up? Why is the general public so ignorant of their rights, and so easily put at a disadvantage?
The only answer I can think of is public school. In the very beginning, the only way government could convince parents to voluntarily give over the raising and education of their children to someone else, was to offer a better education than the parents could provide. Gradually though, the quality could be shaved away. As people became less educated, they were easier to fool. Now, people are so stupid they'll send their kids to schools teaching Common Core, and just be glad they have a sitter for most of the day.
These people will probably always be sheep, easily led to be shorn or slaughtered. Further, they'll never understand people who see the big picture, and the sheep will scorn those of us who know better, and think of us as part of the problem, not the solution.
Only occasionally will someone wake up, and that's why I maintain this site.
Okay, I feel better now. Rant over.