Furious

I never really posted about it here, but when our son was born this past November, the delivery didn’t go quite according to plan. Actually, that’s a bit of an understatement: we had planned from the beginning to have a natural childbirth at a birth center with the help of a midwife. No epidural, no hospital, no inducement. What we got was exactly the opposite. It was an outcome necessitated by some minor complications, done out of concern for the health and safety of both mother and child. In the end, there were no problems, no C-section necessary and the delivery went very well.

Even so, we were a little scared because we had no health insurance. The wonderful people at Blue Cross and Blue Shield of Kansas, the administrator of my employer’s group plan, saw fit to throw us off the plan on some technicality the week my wife got pregnant. Both my employer and I had specifically asked Blue Cross about whether such a technicality existed before I signed onto the group plan, and multiple representatives assured us there was no trouble. Only once I had signed the paperwork did they conjure up the very thing we’d asked about and use it to throw me out. Of course, despite our searches, there were no individual health plans available that covered maternity. We were stuck going out-of-pocket the whole way.

For all that, the hospital we ended up birthing at treated us very well. They offered us a flat $4,300 “case rate” for delivery services if we paid by the time we checked out, so of course we did. The doctor’s services were covered by the money we had already paid our birth center for midwife services, which of course we didn’t use. A couple of separate bills came after delivery for labs and “hospital services”, but these were all pretty reasonable. A couple of months after our son arrived, the only bill we hadn’t yet received was the one from the anesthesiologist for my wife’s epidural.

Since we weren’t expecting to give birth in a hospital (or even get an epidural) until a matter of hours before it happened, I had to scramble on that day to try and figure out what I was going to owe for all of these services. The day after delivery, during a discussion of the charges, the hospital’s financial officer told me that I could expect the anesthesiologist’s bill to be in the neighborhood of $700. Obviously, like most hospitals, they subcontract anesthesiology out to specialists, so they couldn’t just give me a final cost. I did my own research on the Internet and found anesthesiology for planned vaginal delivery should cost anywhere from $400 to $1,700. Further, the Health Care Blue Book guide to fair healthcare pricing reports a $744 average cost in our zip code for anesthesiology services associated with childbirth. Putting all this together, I figured on setting aside $1,000 for it.

The bill finally came on Saturday. The charge? $3,450.

My jaw just about hit the floor, and I think I acquired an instant blood pressure headache. $3,450? What in the holy blue fuck? The invoice listed no price breakdown, just a single line item entitled “anesthesia for planned vaginal delivery”, suggesting nothing out of the ordinary. But with a cost five times higher than the estimate provided by the hospital — the people who actually contracted the anesthesiologist’s services, I might add — and twice the highest reported rate that I could find anywhere on the Internet, something clearly had to be wrong.

Adding insult to injury, the invoice had a big red stamp on it labeled “This account is overdue!” The second page of the mailing was a letter informing me that this would be the first of three collection attempts, after which the account would be turned over to a collections firm. Fucking excuse me? This is the first correspondence that I’ve ever received from you nitwits. Before this, I didn’t even know which anesthesiology firm the hospital had contracted with — meaning I couldn’t even have called ahead to inquire about the bill’s whereabouts, had I been so inclined. Which I wouldn’t have, because I’ve routinely received doctor’s bills as much as six months after services were rendered. As far as I’m concerned, just shy of three months is nothing out of the ordinary.

The second page also revealed that the anesthesiologist’s records indicated that we were a self pay / private pay patient. Yeah, that’s true, which makes the $3,450 charge even harder to understand. I could almost see them charging an insurance company this amount, because that’s (unfortunately) standard practice in the medical industry. Typically, from what I understand from connected sources, doctors massively overbill insurers because they know the insurance company will come back with a response like, “No, we’re not going to pay that much, but we will pay [x] amount instead.” The [x] amount is usually more in line with the actual cost of service, so everybody at least thinks they get what they want. But if the anesthesiologist seems to already know that we’re a private pay customer, why would they charge us the insurance company rate? Is that even what this is?

Of course, being that it was a Saturday when this bomb arrived in my mailbox, the anesthesiologist’s office was closed until Monday morning. This had the effect of ruining my entire weekend, as I’ve been able to think about little else except for a mental rehearsal of the phone conversation that I’m going to have to drag out of bed early to have come Monday. I did leave them a message on their voicemail, for all the good it does — I’ll probably be calling them before they even have a chance to listen to it — and now I wish I hadn’t, because I was fairly pissed off in that message, although I didn’t curse them out or yell or anything. As much as it infuriates me, I’m looking at probably having to be as nice as possible, maybe even beg, if I want them to reduce this charge. I feel like I’m begging for a mugger to please kindly pull his knife out of my back, because I’d prefer not to bleed to death if that’s all right with him.

I’m not sure that writing this has had any real effect on my mood or outlook, but at least it’s been an outlet for me to at least blow off some measure of steam. (A session with a particular type of video game might also be cathartic.) I intend to post back after Monday morning’s phone call with the latest in the ongoing situation, although it might just be to report bad news. I might, conversely, wind up with a good outcome and feel dumb for posting this. Fate tends to play games with me that way. In this case, I’ll gladly eat crow and suffer humiliation over my rant than pay $3,450 fucking dollars.

And the irony of the fact that this bill arrived within an hour of my posting yesterday’s Xbox acquisition deliberation hasn’t escaped me. Any time I think I’m getting a financial windfall, be it a bonus, a raise or even a tax refund, some out-of-left-field, never-saw-it-coming charge always swoops in out of nowhere to take it all away. The leaking roof in our old place in Naples, or some catastrophic automotive issue that needs immediate attention, or a medical bill. It’s always something. I guess I should be glad that the catastrophes always seem to happen right when I get some money to pay for them, but seriously. It’s getting really fucking exhausting, and is slowly affecting me mentally in such a way that I feel as though I don’t deserve, or at least have to desperately hide, any good news I ever receive.

It’s funny how a lot of this kind of shit can be traced back to my employer, though. Like the fact that we lost our health insurance in the first place, which all started because the company decided they wanted to save themselves a few hundred dollars by switching providers. Yeah, I really appreciate that. Or the fact that the substantial tax refund I once expected for this year will now be less significant, thanks to the fact that my employer is a month behind on their payroll and issued my now-dissolved corporation a 1099-MISC for the year, meaning that I have to claim all of it as self-employment income and get taxed out the butt for it. Yeah. Really appreciate that too.

Okay, this is no longer helping, so I’m going to stop writing.