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Medical Bills Can Be Hazardous to Your Health

Posted: 11-12-2016
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Medical bills are driving up my blood pressure and causing me anxiety.  Despite my best efforts, I simply cannot understand what I am being billed for.

For three months I have doggedly tried to understand a medical bill from West Virginia University Healthcare Physicians for a routine outpatient medical visit.  The visit lasted 30 minutes.  Figuring out the bill has taken considerably more time.  Here is the bill:

Office visit:                        $124.00

Insurance payment:          – -19.21

PB-INS contractual adj       -37.99

Amount Due:                      $105.22


I was a liberal arts major in college but I can still do basic math.  If the office visit is $124.00, and the two deductions (insurance payment and contractual adjustment) equal $57.20, shouldn’tmaxine-cartoon-medical-bills the owed amount be $66.80 instead of $105.22?  And what the heck does “PB-INS” mean anyway?

If Dante were alive today, I am sure he would add another level of suffering to the Inferno:  figuring out medical bills.

I started my quest for answers with the number on the bill for West Virginia University Healthcare Physicians.  The lady who answered my call said she had no idea why the bill did not add up and suggested I call Medicare.  There is no reference to Medicare on the bill.     I suggested a billing specialist should know the answer and not send the client to another agency.    She connected me to her supervisor who was equally confused and promised to get back to me.  I never heard from her again despite my three follow-up calls.

Undaunted, I started the process again.  I ended up being transferred all over the system again. At one point someone explained a double minus sign  (“- -$19.21 insurance payment”) is actually an addition to the bill because two minuses equal a plus.   Thus the $19.21 should be added to the total, not subtracted.   I replied this billing sleight of hand was really, really sneaky. How could anyone be expected to know a double minus equals a plus?  The billing specialist replied (I KID YOU NOT!) that “any fifth grader knows two negatives equal a plus.”

I answered using my best mathematical logic:  “Let me speak to your supervisor.”

The supervisor admitted that statements should be better formatted.  She  blamed the computer billing company for the lousy format.  In fact, everyone I talked to about this bill said it was the fault of the billing company gremlins and good luck in getting anything changed.  Apparently finding someone with the authority or the concern to change the billing format is more difficult than finding a doctor who makes house calls.

I won’t bore you with more details, as I am sure every medical consumer can share a horr
or story or two.  A friend in Maryland shared a medical bill she recently received.  She simply could not figure out why a single procedure on a single day performed by one doctor involved 4 different “General Surgery” fees at $1000 each and  two “General Surgery “fees at  $300 each for a total of $4600.00.  Here’s the kicker:  my friend is a doctor.  If someone who has spent 35 years as a physician can’t understand a bill, what hope do the rest of us have?

Medical bills need to be more understandable.  We expect doctors to take the time to carefully explain medical procedures.  We should demand billing companies show the same consideration when it comes to billing procedures.  Telling puzzled consumers to go find the answers themselves is unacceptable.   Billing information should be presented in understandable terms, not like my friend’s medical bill which explains “payment from BCBS of MD (Local XW) & out of.” There should be a uniform format for all medical bills that has been vetted and reviewed by consumers.   I asked a representative from University Healthcare Physicians if they had a consumer advisory board to suggest such improvements. They don’t.

I just received the third billing notice for $105.22.  The billing technocrats are certainly persistent.  I wish they were just as persistent in making medical bills understandable.