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Friday, September 29, 2006

What sneaks!!

For almost 2 years now, we have enjoyed my husband's wonderful health. Yes, my friends, we are closing in fast on Greg's 2 year post-transplant anniversary!! It is amazing what you can learn in those 2 years about healthy, happiness, and what is truly important in life. Even after all this time, we are still learning things we never even thought were possible - like how the hospital transplant clinic is a bunch of sneaks!

Now that I have your attention, I will bring you into our little family and let you know one of the transplant hospital's dirty little secrets. How do I know about it? Well, upon a recent bill, we happened upon this information and the hospital did nothing to cover it up when we argued our bill. First, we hardly ever receive a bill from the hospital because our insurance was paying everything except the copay. As you may remember from an earlier post, our health insurance has changed due to a split in my company and as of September 1st, we are now with United Healthcare. That is why we received this bill, because they needed to know who to charge their little sneaky expenses to and had out of date information.

The bill stated that every Monday, since the 1st of September, we were being charged $68.30 for respiratory services. Interesting since my husband hasn't been to the transplant hospital since July. Upon questioning these charges, the dirty little secret came to light - they were charging us $68.30 every time Greg sent in his spirometry readings through the phone line to the hospital. Per his release post-transplant, he was told to do his spirometry twice a day and send it into the hospital once a week so that he, and the hospital, can monitor his lung functions. He was receiving praise upon his last visit as hardly anyone sends those in anymore. We had thought other patients were getting lazy and Greg was a "good boy" for sticking with the routine. Well, every time he sent one in our insurance was charged $68.30!!! No wonder other people stopped sending them in!!! Let's see: 2 years post transplant x 52 weeks per year = 104 weeks. Now, take that 104 weeks times $68.30 and we have spent $7,103.20 just to send the data to someone's computer at the hospital!!! No one ever told us we would be charged per submission. We thought they would pull up the data should he ever become sick and need it on hand. Needless to say, my husband has decided to no longer submit his spirometry numbers but he will continue to do it twice a day for the rest of his life. If he ever notices a significant change, we can then send it to the hospital... Otherwise, we will hold onto our $68.30 a week thank-you-very-much!!

1 Comments:

Blogger John P. Burke III said...

Shannon—Thanks for sharing your story. It is unfortunate that you had to experience one the many shortcomings with our health care delivery system. Tele-Medicine is a wonderful new method of receiving health care. It improves the efficiencies and removes the logistical barriers that many persons experience in an attempt to receive quality healthcare. However, as you point out, consumer beware. As a double lung transplant recipient who works for the nation’s largest health insurer and regulator, I have the luxury of understanding the dynamics of the health care delivery system and the scenarios, like yours, that are played out by health care providers. I try to keep in the back of my mind that health care delivery is a business designed to make a profit. Whenever, I am told to do something by a health care provider I ask the questions necessary to determine the actual utility of the proposed service. For example, (and I don’t propose that anyone else do this) after several people feel ill and passed away from the procedural complications from receiving a bronchoscope procedure, I stopped getting the routine bronchoscope prescribed by my health care provider. When I informed my doctor of my decision, her reply was that the procedure has questionable utility and if I had an acute decrease in my PFT that I should then have the procedure done to determine if rejection is occurring. I guess we all learn as we weave our way through the health care delivery system.

10:14 AM  

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