Tuesday, March 8, 2011

Medical Bills

We are getting very close to the year anniversary of Fred's accident, and you know what medical bill I'm still dealing with???? Swedish. He was flown to Swedish the evening of his accident because it was the best place for him to be, a level one trauma hospital, connected to Craig Hospital which only handles brain injury and spinal cord patients. There was some thought put into what hospital to send him to by the doctors here. I believe it was the right choice for him at the time, and they attended to him when he was in the most uncertain and fragile portion of his recovery.

Right now I feel like the left hand is not talking to the left as we try to sort out the bill. He had his accident on a Tuesday, and by Friday they were talking about admitting him to Craig the following week. In retrospect, this is REALLY fast when it comes to a brain injury. Less than a week after he hits his head, he can go to a rehab hospital because his physical injuries were not that bad, but his head injury was really bad. I have been reminding myself of that lately, and I have to because he has had such an amazing recovery. He was really hurt, and even a week or two post accident they were still saying it would be great if he could return to work within a year. The doctors in the ICU were asking what he did for work during the first few days after his accident, and I told them he worked at a computer and they shook their heads and said how brain injury patients tended to get headaches if they sat in front of a computer for long periods of time. I have pushed some of these things far back in my memory, and it takes effort to bring them back because they were scary and not fun. The happy thought is he had an amazing recovery and defied all the odds and statistics.

Back to the bill. His final night/day at Swedish was Sunday night and Monday afternoon he was admitted to Craig, which only admits on weekdays. He wasn't ready to admit on a Friday and by Monday he was just scraping by as being ready. The whole bill dispute comes down to a matter of precertification. If you are lucky enough to never have had any major medical experience, it is basically the hospital calling your insurance company to say you are in need of such care and your insurance company agrees to pay for some portion of your care. The hospital never called the insurance company for his final day at Swedish. Who do I need to talk to and explain I could not have checked him into a hotel at this time??? He was still a risk to himself, trying to get out of bed while still unstable on his feet and not remembering much. Luckily, I have been able to talk to the rep from the insurance company that works with the company he works with, and she is trying to get it all resolved.

We are so fortunate to have health insurance while going through all of this, but it is so frustrating when the medical billing companies and the insurance companies can't work together and figure it out. The cycle currently goes like this: the medical billing company calls be about the bill (which is exactly for his last day that wasn't precertified; therefore, I am not paying it), I call the rep at the insurance company that they called me about the same issue we just talked about, the rep calls the hospital (different company than the billing company) about sending the paperwork they need to pay the bill for his final day. A few months go by and we repeat the whole process.

No promises, but I might just throw a party when this whole thing is resolved!

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