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Constant readers will recall the issues I had with confusing bills (shoulder surgery?) from Brigham and Women's Hospital.
Well, rejoice and be glad, because now it's the turn of Dana-Farber and the Winchester Hospital Cancer Treatment Center!
I had gotten and paid bills for $20.00 for each of my chemo visits to D-F. "Cool," I thought. "These are only costing me what a co-pay at the health plan would be!" But no. I am now receiving bills AGAIN for each of my chemo visits. Each of these details the actual chemo treatment itself, and depending on what happened at each visit, each is slightly different. For example, the time they had to look for a new vein in three different places and call in a phlebotomist was a lot more expensive than the time the blood draw nurse hit the right one immediately.
And Winchester has billed me for three radiation treatments at three different rates, all occurring on my first visit there -- when I received no treatment at all, just went through the simulation process. I am sure this is yet another issue of the codes not keeping up with the technology.
Bravest is adopting a very lassiez faire attitude to the whole thing. On his recommendation, I am paying everything and assuming that the parties responsible will eventually sort it all out and reimburse us if we are owed anything. After all, B&W just sent us a refund for an over-bill from his thyroid surgery in March of 2010.
As you probably know, each element of the treatment, and each entity, does its own billing. Thus, you paid your co-payment of $20 for the chemo for seeing the doctor/NP/nurse. Then you are billed for the actual chemo treatment and what goes on at each treatment (e.g., phlebotomist vs. nurse finding the vein=more expense=larger bill), and, for the radiation, there is a bill for each treatment as well as a different bill for when you see the radiation oncologist.
ReplyDeleteWhen I asked about how my radiation treatment is billed, I found out that the 3 initial planning appointments are the most expensive, and each actual treatment is much less expensive. For me, this is good, as we will max out our catastrophic coverage with everything I'm having this month, and there will be relatively little to pay for the 11 treatments I have in January. The checkups I have with the radiation oncologist every week are billed separately.
From my experience with Tsvi's treatment in 1997, I would recommend that you match up your bills from the various providers with the EOBs from your insurance. That year, we were double-billed for a chemo treatment for him, and I only found it because I asked the oncologist for a detailed bill and matched it up with the EOB.
I realize that this checking is something you would have to do, but if you don't want to do it yourself, you might want to have your sister or a good friend sort it all out. There is no reason why you should pay more than you have to for your treatment, or pay too much because of an error and have them sort it out!
I think part of the problem is that it never occurred to me to ask, "How is this billed?" And when I have asked questions about specific bills, it usually takes some research on the part of the biller to figure out why the bill is the way it is.
ReplyDeleteIn the case of the Winchester bill, I am seeing three different items with three different amounts, all labelled "radiation treatment" and all listed as happening the same day. They are separate from several other items that also happened that day, and that would appear to cover the simulation and mapping. They don't match up at all with the EOB for that day.
I plan to take the bill with me today, but I'm not optimistic about an explanation. I suspect it's a coding issue, just as B&W's anesthetists apparently don't have a code for "lumpectomy" and so bill for shoulder surgery.
And yes, we always check the EOBs and ask for explanations of discrepancies.