Healthcare Fraud, Just Down the Block

A short story about why I’m so annoyed today:

In the beginning of January, I took advantage of the new provisions in Obamacare to go to the doctor for my yearly, free, routine physical. Before I went, I called the doctor’s office to confirm they would bill the visit as my yearly free physical. When I went to check out at the end, they told me it was indeed covered by my insurance, that I didn’t need to pay a single cent; consequently, I didn’t receive a receipt. The visit itself was, as many doctor visits are, annoying but otherwise uneventful.

Uneventful, that is, until April when I received a bill from in the mail for $81.96. The doctor, you see, billed me for a “sick” exam and not for my free routine physical, covered under Obamacare. Annoyed, I assumed it was a mistake and called the billing office the next day to rectify the situation. I spoke with a billing expert named Heather; she assured me it was a simple coding error and that she’d taken care of the problem.

In May (despite our move), I received another bill from Chase Brexton (the healthcare provider) for $81.96. Even more annoyed now, I called and spoke with Heather, yet again. Yet again, she assured me she would call the clinic, confirm it was a routine physical, and rescind the bill. You can guess what happened in June: another bill in the mail, another testy conversation with Heather, still bright and bubbly and seemingly concerned as she ever was.

I ignored July’s bill. In August, when I called to complain, I told them I’d be reporting them to the Maryland State Attorney General’s Office if I received one more bill. Last Thursday, I received the latest bill. On Friday, as a courtesy, I called Chase Brexton to inquire, one more time. They promised to call me back by lunch. Friday afternoon, after they didn’t call me back, I called the Attorney General. On Saturday, I received the complaint/investigation forms from the Attorney General, and I sent them in this morning.

It’s annoying to call the Chase Brexton billing office once a month, and it’s a pain to fill out the investigation forms. I am, however, completely capable of dealing with it. The fact that I know what I’m legally entitled to in terms of my healthcare means I’m able to fight for it.

What about the hundreds of people who don’t know what they’re entitled to, or might only be willing or able to call the billing office to complain two or three times, or wouldn’t know that such fraud should be reported? Forty percent of Americans find their medical bills so confusing that they don’t know what they’re being billed for, if the amounts are correct, or how much they owe. Of those 40% who don’t understand their bill, far fewer than half call the billing office for clarification.

I seriously doubt that I’m the only one on whom Chase Brexton has tried to pull this trick. In the same vein, I’d wager many of us have paid bills we didn’t have to–for some people, if only to make the bills stop coming. This is just one example, and for a variety of reasons, it’s not a big deal. But that doesn’t mean it’s not wrong.

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