I was hoping that the new health care law would make bills from my
doctors clearer and simpler. It sure hasn't, at least so far.
I was upset by a bill that arrived the other day for visits to an
orthopedist, including one way back in March of 2009. It wasn't the
tardiness or the amount due that bothered me. It was the language. Some
pipsqueak in the billing department claims that - and in capital letters no
less - "OFFICE VISIT ESTABLISHED PATIENT MODERATE
COMPLEXITY."
Do you know what that means? I didn't either at first. I thought being
moderately complex would be a good thing, yet neither Medicare nor
United Healthcare picked up all the charges from that visit many months
ago and that means the doctor's office is still owed $21.35.
While stewing over the letter, I wondered if my habit of always
bringing The New York Times to read while I waited for the doctor
contributed to my being labeled a patient of "moderate complexity." If
instead, I showed up lugging a copy of the New York Post would that
lower my complexity rating and save me a few bucks?
Another entry on the bill claimed that more than a year later another
"OFFICE VISIT ESTABLISHED PATIENT MODERATE COMPLEXITY," so
add another $21.35 to the amount due. Huh? Is it possible to "establish"
the same thing twice? I did a little research on the Internet and found
there is a ratings system for the complexity of a medical problem. There
are four ratings - straightforward, low, moderate and high complexity. I
now understand a little more about the terminology used in my bill but
must point out the website I looked at didn't put "moderate" or the other
ratings in capital letters. The capitalization issue strikes me as totally
unnecessary and very irritating.
I got steamed again when I looked at the last entry on the bill. It
alleges that on May 24th of this year a "SUBSEQUENT OFFICE VISIT
ESTABLISHED PATIENT EXPANDED." (There are those damn caps
again.) Although I really like this orthopedist, is someone on his staff
trying to tell me that I'm fat? Yes, I could stand to lose 15 pounds or
more, but I've never been asked to get on a scale at his office, so where do
they get off claiming I've "expanded?" Is it possible video cameras on the
premises record old men like me struggling to still get into their size 36
pants? Shame on them if that's the case. Hell, shame on them anyway
for lots of other reasons.
While I have no way of telling whether the various charges listed in
the bill are correct, I will pass on the information that it's cheaper to be
expanded than moderately complex. Being categorized as a tubby only
cost me an extra $14.22 instead of the $21.35 charged each time my
complexity was found to be moderate.
There was one other odd thing about the language of the bill. Near the
top it said "due from self." Are they saying that the money due - a total of
$86.78 - I owe to myself? Should I write myself a check for that amount
and cash it? Is this how the new health care law is supposed to work? Or is
it possible there are still some kinks to be worked out in our medical
billing system?
(Posted September 8, 2010)
