Further experience with our health care system. My provider is Kaiser, which has its own doctors and labs in the DC area. But when someone covered by the plan travels outside of the area and has emergency surgery, you get into the complications of our marvelous system.
First of all, Kaiser doesn't take the step of assigning an event code when you call in to talk to them about the emergency surgery. Apparently the call is recorded, but there's no automated link to the bill paying process.
Because fee for service is competitive and individual, Kaiser gets bills for the surgery from:
- emergency room physician
- lab
- pathologist
- anesthesia
- surgeon
- hospital.
Each bill is individually prepared by someone in the relevant office and coded and routed to the appropriate Kaiser facility, or not. So far we've had bills go to Kaiser California rather than Kaiser MD, bills miscoded (according to Kaiser), bills with the wrong tax ID number on them (according to Kaiser), bills that have been delayed in the mail. Each bill seems to be considered individually by Kaiser (they do have a database that the administrative service specialist can check) and I'm informed individually of the payment or nonpayment (through a very poorly designed form). Whoever is considering them in Kaiser does not have an overview of what actually transpired on the ground but is either trying to interpret the fragments or, probably more likely, is mechanically following some rules. It's now been over 4 months and everyone has not yet been paid.
Because there are multiple parties involved (biller, multiple Kaiser offices, me), each of us thinks the problem is with the other. Each automatically believes that we've done our bit, now it's time for X to finish the job. That's part of the "faceless" part of faceless bureaucrats.
It's no wonder that we spend so much on health care.
No comments:
Post a Comment