Smallest Victories, Biggest Battles

Winning the smallest victories can sometimes feel like conquering the biggest battles.

Like countless other Americans, I recently found myself doing battle with a medical practice over some questionable billing. I consider myself lucky as I have reasonably good health insurance that covers a good deal of expenses. In addition, my employer offers partial deductible reimbursement which comes in handy.

After paying approximately twelve thousand dollars in medical bills associated with the birth of my child, I began receiving notices of a bill due to the OB/GYN practice that provided prenatal care and delivered my child. I knew the billing was incorrect as we were required to pay for the expenses in question upfront, to the tune of two thousand dollars. In addition, we were being charged $1,500 for a fifteen minute follow up appointment for which a physician simply looked at my C-section scar.

Immediately, I began contacting the physician’s office to resolve this matter. Countless voicemail messages were left and never returned. My husband phoned and spoke with someone who never called him back as promised. Our insurance company, who paid approximately eight hundred dollars towards the bill, phoned to obtain further details and no one called them back. And all the while, I kept receiving notices that I was past due on this bill, encouraging me to set up a payment plan. Every time we were able to speak with a representative, they provided different information for the services.

The practice itself had experienced serious turmoil and we were unfortunately caught up in the process. Around 24 weeks in my pregnancy, the practice split, losing three doctors. We were assured by mail and in person that the quality of care would not be affected and while the wait times might be slightly longer in the beginning, it would be resolved in a timely manner. Unfortunately, that wasn't the case. Over time, we found ourselves waiting two and three hours to see a physician for a scheduled visit. Complaints were made; we requested our down payment of two thousand dollars back, so that we could perhaps find another practice with less wait times, but we were denied this option.

At thirty seven weeks, my daughter was born due to high blood pressure issues on my part. The doctors assured us there would be no difficulties, thirty seven weeks is considered full term. But they were incredibly wrong. She was in the hospital neonatal unit for two weeks and while she finally made her way out of the hospital, we were left to pick up the emotional and financial pieces. We often wondered if the lack of staffing by the practice and desire to speed up the process to move on to the next patient resulted in our daughter being born too early with breathing issues. Our frustration coupled with the feeling that we didn't receive the best quality of care only made this questionable billing and inability or unwillingness on the practice’s behalf to communicate even worse.

And then one afternoon, I received a letter indicating that if I didn't pay this questionable bill, I’d be written off to collections. All of the frustration, rage, and anger that had been building up related to this matter suddenly emerged. I began scouring the internet for the Public Relations or Complaint Department for the hospital that owned this practice. There would be no more voicemail messages left, no more fruitless conversations with representatives who were unable to assist in figuring out this bill. After putting up with less than quality care and paying twelve thousand dollars in medical bills, they had the audacity to threaten sending this bill to collections? Within minutes, I was on the phone with the Public Relations Department, recounting the story, expressing frustration in great detail. The next day, I received a phone call from the new Practice Administrator, apologizing for all of the difficulties and assuring that she’d resolve the matter in a timely fashion.

As expected, there were no phone calls returned, but I had an ace in the hole. I was in possession of the Administrator’s direct phone number and email address. There was no way I was backing down or let them write this bill off to collections, ruining a credit score I’d worked for so long to maintain. My phone calls continued to go unanswered, so I left a message and sent an email indicating that I would call and email every day until this matter was resolved. If it wasn't resolved and I was written off to collections, I vowed to take legal action against the practice. I followed through, beginning a campaign of daily phone calls and emails. An email was sent every morning and a phone call made to the Administrator’s direct line, not leaving messages, calling back until she answered the phone. She informed me that the Billing Department was working on it and I’d have to wait for her to call me back. I consider myself to be a polite person with good manners, but even the nicest people have their limits and I’d reached mine. They were unable to explain the charges, provide dates of service, and continued putting me off with the threat of being written to collections looming in the background. I could have cared less about the issues associated with their practice split.

About a week after initial contact with the Administrator, I phoned the practice three times and she finally answered. Sensing frustration in her voice, I asked if she was frustrated that I continued calling her and she openly admitted that was the case. She went on to tell me that it was difficult because I continued calling and she didn't have any answers. That was a turning point. I expressed this was the very frustration I’d felt for months, even before my daughter was born. No one in the practice addressed complaints of ridiculous wait times or tried to resolve any issues, seemingly taking the quickest and easiest way out, including the early delivery of my daughter. Maybe now she understood my feelings and could be persuaded to take this matter seriously and resolve it immediately. Her response was silence for five to ten seconds. Finally, she responded, ensuring me that she would take whatever action and have an answer within the next business day. My family had been dealing with this long enough and we were ready to move on; it was no longer just a financial issue, it had become an emotional issue.

As the day continued into the next, my husband prepared letters to the practice and hospital, indicating our dissatisfaction and experience, in writing, in case we didn't receive a reply. We held the letters until the close of business of the day that the Administrator vowed to provide answers to us. Four o’clock rolled around and I had the sinking feeling nothing was going to happen. I prepared to mail the letters and once again be disappointed in their inability to follow through. At four thirty, I received an email from the Administrator, apologizing for the delays and all of the difficulties, indicating that an adjustment was made to my account and I owed nothing more to the practice.

An overwhelming sense of relief washed over me. I never expected a follow through or this type of resolution. Going up against such a formidable foe and coming out a winner is such an exhilarating feeling. I’d taken on Goliath, just like little David with a stone, and I won.

While I feel like a winner, there are lingering feelings of frustration and confusion. What about all of the other people this happens to? What about the people, who trying to do the right thing, simply pay their medical bills, not questioning? To some people, seven hundred dollars doesn't mean much, but to my family, it means a good deal. I suspect it would mean a lot to other American families as well. Why did it take such extreme actions to resolve this issue? Would they have refunded me or anyone else who paid seven hundred dollars in error or would they have kept the funds? I think we can all figure out that answer. How many people compliantly pay inaccurate bills out of fear of being written off to collections or exhaustion from non-responsive billing parties?

Healthcare is an issue in the forefront these days. Without any conversation about the Affordable Care Act or government healthcare, I can say without a shadow of a doubt that something needs to change. While people should be responsible for expenses associated with medical care, medical entities should also be equally responsible for accurate and reasonable billing. It would seem as those who are trying to do the right thing, going to work each day, paying their health insurance premiums, are those who are paying the price for a broken system. Medical costs associated with the birth of a child or any other issue shouldn't bankrupt you. There are those who don’t pay anything for health insurance and their care is free. There simply has to be a better way. I readily admit that I don’t have the answers, but I do know that something must be done as everyday working citizens, not those in Washington DC that are busy debating and acting like children, throwing temper tantrums because they aren't getting their way, are paying the price.

So while my small victory might seem less than important to some, it means the world to me. It means that I stood up for myself against the status quo, refusing to be steamrolled by technical terms and jargon. I wasn’t going to let hard earned money be taken from my family by a medical entity because they weren’t organized and couldn’t provide accurate and timely answers. You might think I’m the only person this has happened to or that it’s uncommon. I can assure you from speaking with others that isn’t the case. It’s pervasive throughout the broken healthcare system in our country.

Maybe the answer for everyday working Americans is to start standing up, refusing to accept this nonsense anymore. Perhaps we can’t rely on those we appointed to represent us in Washington DC to look out for our best interests. As we all know, their interests are with those who line their pockets, the big lobbies, for which an everyday American, who seven hundred dollars means a lot to, can’t compete.

I can only hope that my story of taking on the medical Goliath bully and knocking him down, coming out a winner, will inspire others to stand up for themselves. Don’t accept the treatment that my family and I received; be empowered, own your voice, and don’t be afraid to use it. Perhaps when Americans begin doing this in droves, the medical and insurance community as well as our government will no longer be able to ignore us, and will finally take steps, whatever those might be, to resolve the continuing healthcare issues in our country.