In August, some kind unknown soul decided to give me a little nudge to make me literally fly off the handle (of my bicycle) and my hand was broken.
After the cast ritual and eventual cast removal, was asked to go to physiotherapy by the hospital.
All we got was a piece of paper with 11 clinics which were supposedly on the same insurance umbrella!
So we selected 2/11 based on proximity, called the insurance company, confirmed that they were both good for our coverage and chose one because they mentioned rates that were slightly lower than the other place.
Now, no actual exact $ commitment was made by either place because they said "we don't know what we will charge you till we evaluate you, etc. etc."
Based on what they actually did, which was a finite time spent, (looking at the others in the room with hand problems)and there was no real variety to the treatment. Just a rotation of toys to play with for all hand folks.
They did do a great job and did all the wax stuff and eventually got my hand to a point where I decided that no more physio sessions were required. So, not faulting the actual physio doctors.
Never paid anything for the visits, because it was supposed to be covered for 30 visits post surgery and went only for 12 or so between October end to December.
Life goes on and the whole thing is forgotten and bang, we got a bill for ~ 600 bucks mid march!
We are still wading through phone calls trying to explain and get explanations from people. San is doing a much better job of getting answers than me simply because I am deflated by this whole episode. My faith in humanity (or the insuring fraction of it) is shaken to the core!
It was not easy to :
a. get the insurance guys to tell me what would be covered before the physio started
b. get the physio folks to tell me what the cost would be
c. find out what I would end up having to pay before starting the sessions (using all my years of mathematics training this would imply the answer to be b-a where both b and a are quoted in US dollars)
That is as crazy as it gets. Imagine walking into a barber shop, sitting down on the chair and you say "haircut", he "nods" and he starts cutting your hair. Then you walk to the counter and he charges you $128.97 when you expect it to be 10 bucks! Heck, he could charge you anything he wants!
Now the insurance company lady is telling me on the phone "Sir, you are responsible for your payment! It is your responsibility to know what you have to pay from your pocket !"
I wanted to strangle her on the phone. How? How does one find out if we keep running in circles between the doctors and the insurance folks with a chicken and egg argument?
Doctor : we don't know what we will charge you till way after we have treated you
Insurance : we wont know what part of the doctors bill will be covered by our insurance till we see the bill
doctor and insurance to patient : You are responsible for covering the balance of what we do not cover on a bill that we cannot determine at the time of treatment!
The best part is the bill we got for 600+ bucks after the original surgery from the anesthesiologist. This dude apparently does not work at the hospital and he came from another hospital in the middle of the night to knock me out.
Really nice of the old chap, except he is not under my umbrella, and it is supposed to be a big umbrella in California!
Now how is a person who is under extreme pain and is hardly conscious expected to ask an anesthesiologist "by the way, are you in my plan? I am at this hospital because this whole building is under the Holy Blue Cross! but are you a Blueman Crossalic?"
Seriously, it would be great as a "responsible person" to know what I am getting into. If an educated person like me who can ask questions and possibly cover this bill over a few months, can be stumped like this, imagine the plight of a lot of people in this country!
Scary!
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