There are too many tell tale signs that continue to keep pointing the finger at how bad we have become at being American. Being American these days is like saying, "I accept anything, and everything." It seems that if you walk into a doctors office, and over charges it's not his fault. Don't try to fight it or argue about it, because likely the medical biller is not able to identify why the code is what it is, but it is. There are very few that are willing to step outside of their comfort zones and take a closer look. But tonights "Ask Arnold's Segement" was from a man from Newton New Jersey. His son sprained his arm and he needed to wear a sling, the sling cost no more than 20.00 dollars at a most pharmacys.
The doctors office was charging 199.00, the man in question stated, "I was not going to pay 199.00 for the sling, period." He spoke to the doctor, the doctor stated that was the charge according to the code, it went on for another call to his insurance company, but nothing got resolved. That is when the gentleman from Newton decided to call Arnold Diaz and ask what could be done regarding a sling that should cost no more than 20.00, and why he was being charged 199.00, of which his insurance company would pay 111.00. But that wasn't the part that was irking Mr. Diaz or the man who was bieng charged.
As the story continued, Arnold got the insurance company, and of course these are highly trained people, who could think and talk fast, and make other lay man feel as though they "just might not know what they are talking about." In this case as it continued to be spelled out, the medical code was wrong, as Arnold marched straight into the Department of Medicare in Washington D.C. and asked for clarification of why the man was being charged 199.00 for a sling that cost 20.00 if that? The Washington Medicare office stated that the code was actually for a much stronger brace, and that the code was wrong.
Well after all the haggling, and the legal research on behalf of the medical office and the medical supplies office and the code and billing department they as a result had to send other people the letter stating that the code was wrong, and there fore they were sent back the money that people sent in toward the sling, and were given refund checks back. But what I was happy to see, was that some "one" made a difference, rather than being angry, he choose a constructive way of saying, "something is not right with this picture." There is much more of this situation that needs to continue, there are too many costs that spiral out of control and "We the people for the people keep getting pounded."
I don't recall seeing this anyplace in print in our Constituition, and I don't belive we should. We continue to see sky rocketing premiums and with the job market the way it is, there are going to be many people that will be paying out of pocket to see a doctor, (could you imangine?) Another fine point this brought out, was that the doctors office wasn't too concerned, and neither was the medical billing department, so how many other medical coding issues mistakes keep taking place? As many as tax payers will allow, since most of the medical community belives that inherently the "American people are too comfortable to get up and stop the non-sense." Thank-You to the gentleman from Newton who knew that 199.00 was too much to pay for a sling, and to Arnold Diaz for helping to define how far up the line it took to find the era to a rather obvious answer.


Salon.com
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