I Hope They Never Find Him

I saw a pulmonologist at the Post-Covid Recovery Clinic at Rutgers in February. When I made my $40 copay, I forgot to tell the hospital to submit the bill under my wife’s policy; I’d lost my own health insurance because I was too sick to work. (Thankfully — I could still be covered.)

The insurance company paid the bill by accident. Or rather, they paid $176, the amount they apparently considered appropriate for a 20-minute telehealth appointment with a medical resident and his supervisor. A few weeks later, they realized their mistake, called the hospital, and asked for their money back. 

The hospital got in touch with me: you owe us $842 dollars. Their price for the appointment, including the copay, was — IS — $882 dollars, if you’re paying the bill without insurance company mediation.

I asked them to rebill under the correct policy. They did. 

— Insurance company: that policy expired.

— Hospital billing office calls me back: your policy expired.

— Me: no, it didn’t. It’s current.

— Billing office: the insurance company says it expired.

— Me: …

— Me: … 

— Me: … what policy identification number was it billed under?

— Billing office gives me the number. It checks out.

— Me. That’s the ID number for the current policy. It’s not expired.

— Billing office: Oh. Well … you need to appeal the denial with the insurance company.

At this point, I should have gotten my butt in gear immediately. But I was already negotiating with the insurance company over several other issues.

• I’d been trying for months to get reimbursed for appointments with an out-of-network therapist. The therapist made a mistake on the bill, the insurance company rejected it. My job: find out from the insurance company what had to be on the bill; explain it to the therapist; get the bill from her; fill out a new claim form; send it to the insurance company.

• Another doctor’s office, another $40 copay. And then they ran my credit card for another $127. Why? “the insurance company says you have a deductible.” The doctor was in network. There was no deductible. I had to contact the insurance company and get them to pay the bill — and then get the doctor’s billing office to refund me the money. (I still have to check my bank statements and see if that money ever came back.)

• Long Covid messed up my vision; things double and blur, my eyes snap in and out of focus, the more tired I am, the worse it gets. The folks at the Long Covid clinic sent me to an occupational therapist who sent me to a neuro-optometrist who did a bunch of tests and prescribed glasses that helped … some … but it cost me $2,000 out of pocket. Insurance company: nah. 

And in the middle of trying to work through all of that, I had some kind of allergic reaction. I still don’t know what triggered it. 

My neck was so puffed up I felt like a toad trying to look big and unappetizing, my ankles and fingers were swollen, and I was short of breath; then I started having chest pain. The GP sent me to the ER, where they checked my blood pressure, listened to my heart, drew blood, looked worried … and repeated the procedure every hour or so. Eventually they found me a bed so they could keep waking me up all night for  more blood draws and more blood pressure readings. 

(I hate that cuff on the blood pressure machine. It’s so tight it makes my fingers tingle, every time.)

Morning. Someone brings breakfast for the lady in the bed next to me; I realize it’s been 24 hours since I called the GP. Could I possibly get some coffee? Nope: no food or drink until they can get me in for a nuclear stress test. Noon rolls around. 3 pm, the resident on the floor says I can have ice chips. 

Reader, I cheated. I let the ice melt and then gulped the water down.

Soon after, an orderly appears to wheelchair me to the test, but it was another two and a half hours before I could eat. 

The upshot: my heart is fine. They have no idea what’s wrong with me, but I’m not going to drop dead of a heart attack, so … I can go home.

Eventually I persuaded my GP to give me antibiotics. (I’ve ridden in this rodeo before.) I started to recover. Slowly. Many, many weeks of slow recovery, punctuated by functional capacity testing that left me even worse off.

Remember that bill I mentioned a few paragraphs upstream? It’s in collection now.

Since February, I’ve seen several other doctor in the same system as the Long Covid clinic. The billing office, instead of crediting those copays toward those visits, applied them to the bill for February. So in their minds, I’ve paid them $440.

Between my copay and the $176 insurance forked over, they called the bill settled for $216.

I’ve already paid $264 more than that. But they sent the bill to collection to scrape another $442 out of me. As much again as I’ve already paid. More than four times what the insurance company will pay.

Oh, and those other copays? The ones that they credited to this bill? Now I’m fielding phone calls about those. 

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On average, health insurers deny 17 percent of claims. United Healthcare, the biggest health insurance company in the United States, rejects claims a third of the time.

During the three-year tenure of the CEO who was assassinated two days ago, profits soared from 12 billion to 16 billion. 

I’m not proud of it — but yeah, I’m rooting for the guy who shot that CEO and hoping he manages to disappear forever.