Tuesday, April 16, 2013

Running Out of Patients (puns intended)

The view from one of my beautiful 2012 training runs
Austin, TX is lovely in late January!

I don't usually use this blog as an outlet to vent my frustrations. After all, this blog really is all about trying to look on the bright side of life. However, I want to share an experience with you and perhaps garner some feedback. 
So here's my story: 

In February 2012 I was training for the 500 Festival Mini Marathon. I was running regularly and had worked my way up to about five miles a day. The more I ran, the more I noticed my legs were hurting, specifically my shins and my right knee. Knowing that shin splints are the plague of the common runner, I laid off for a few weeks, and iced and stretched on a daily basis. My shins continued to hurt. I couldn't walk across a room without them burning. And my knee would lock mid-stride. I couldn't pivot and I was reduced to wearing flats at all times. So I sought medical help. Three doctors, two physical therapists, and 24 sessions of physical therapy later, I was able to resume jogging. My legs were stronger, my leg muscles realigned, and my knee more stable. I was eager to put the whole ordeal behind me and get back to running, hiking, etc. 

Little did I know...

My poor legs after a particularly brutal PT
session. It hurts having your muscles
realigned!
Three months after my last physical therapy session, I received my first medical bill. All I could think was "oh shit, this can't be right." So I broke out my insurance book and reviewed my benefits. Low and behold, the bills weren't right. So I called the various hospitals and let them know I was having insurance resubmit the claims. Then I called my insurance company and explained the situation - basically I was being charged more than $2,000 over my maximum annual out of pocket expense. The woman on the phone with the insurance company was surly and rude and, frankly, pissed that she had to resubmit about 30 claims on my behalf. But, after 90 minutes on the phone with her, she finally made it happen. 

One month later, I received my updated bills. They were still wrong. I was still being charged above and beyond my maximum out of pocket. I once again called the hospitals and told them what was going on. I then called the insurance company and once again explained the situation. I was once again helped by an angry individual who seemed put out to have to rerun claims. But, after about 90 minutes, she made it happen. 

I went through this process twice more in 2012. 

Fast forward to 2013. We are now 14 months out from my initial doctor's visit and 11 months out from my final physical therapy session. I just got another set of medical bills. THEY STILL AREN'T CORRECT. 

At this point, all I can think is the system appears to be broken. 

To date, I have received six versions of my medical bills, - all for varying amounts - spent eight hours on the phone with my insurance company, and about six hours on the phone with hospitals. 

The lesson I've learned from this whole process is an unfortunate one. I've become reluctant to reach out to medical professionals when I'm sick because I'm afraid of the insurance process that will follow. This can't possibly be a good thing. Google should not be an alternative for a visit to my doctor. 

My most recent action has been to file a complaint with the State regarding my insurance company. Once again, I've spoken with the hospitals and let them know what is going on and they have, once again, put my payments on hold. Fingers crossed that someone, somewhere can make this situation better. 

I'd rather not depend on my Google M.D. for all my health care needs. 


No comments:

Post a Comment