It never pays to check the mail.

I went out to check the mail because I could. And it is so good to be able to do things.

But in the mail was a bill from the hospital. I opened it, thinking it would be some few dollars.

Imagine my horror to find that the bill is for $1500. That’s a bit more than your average pocket change. And we’ve already paid almost $700.

I looked through the bill, horror stricken, but unable to call either the hospital’s business office or the insurance. It is Saturday after all.

I called my dad for advice. (R was gone to work.) He said to call the insurance first and then to call the hospital, if I needed to.

I did note one thing, along with the $20,000+ original bill. On June 7th, the “contractual adjustment” (legalese for how much the insurance wasn’t going to have to pay) was over $17K. But on June 20, when the insurance had paid, the “contractual adjustment” was adjusted down, to leave us with the $1500 bill.

Now, if the insurance didn’t have to pay it, why do we? Did the insurance indeed negotiate a $17K contractual adjustment? I wouldn’t be surprised. But why the lowering of the adjustment?

Please note that if we do indeed owe $1500, we will have paid MORE than the insurance company for the surgery we are only supposed to have to pay 20% of. Now $2200 is less than 20% of the original bill but I know, and so should most educated people, that the hospitals and everyone else jack up the price so that they can be adjusted down.

Unfortunately that means that the people who are not insured not only have to pay the true amount that is due, they have to pay the “jacked up” price — the difference between what the insurance pays and the “contractual adjustment.”

I am not sure how we can be expected to pay more than the insurance paid. How is that fair? Especially considering that every two months the insurance has made more than they paid for this surgery. After six years they’ve made $86,000+. (That’s right. $86K+, just for insurance for me and the boys. Which means me.) Even if they’d had to pay the full price on every single time I’ve ever seen a doctor, and I mean by that what the uninsured have to pay, they’d still have been raking it in.

I hope that the insurance can work with me to get this taken care of. I thought the $700 not unfair, before I found out that the insurance is paying less than $2500. Perhaps I need to discuss with them exactly what 20% they are expecting me to pay.

It is outrageous. And wrong.

How many people were employed with the proceeds from the employees of the small office where my husband works? Five? Six? There are only 22 employees. But most are married.

The amount is ridiculous. On several levels.

One thought on “It never pays to check the mail.

  1. And, yes, I know we were blessed that we were able to afford it. But it did put quite a crimp in our pocket books. We felt we didn’t have any choice. And in the case of catastrophic illness, that might have been correct. But the amount is still ridiculous.

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