A doctor friend of mine who is decidedly anti-public option just posted an item expressing unhappiness about his experience at the BMV and suggested everyone consider their last experience at the BMV when contemplating more government involvement in health care.
Seeing as how I am my own biggest fan when it comes to the funny, funny things that I say, I wanted to share my response:
My last trip to the BMV was actually fairly efficient. Given my bias against Gov. Daniels, I didn’t want it to be; but it actually seems to be one of the things he’s done more or less correctly.
On the other hand, if it were a pay-per-service operation, I probably would have gotten a boat registration, an In God We Trust plate, a Lincoln plate, and a standard plate along with my driver’s license renewal. These services would have been lumped together in inscrutable groups for purposes of billing, and it would be impossible to tell what rates the auto dealers and the trucking fleets were getting for the same services.
(In the same thread, T observed that his last trip to the BMV was a lot more efficient than his last telephone call to Anthem.)
Bah, Anthem isn’t the problem. It’s medical billing companies. I can’t tell you how many times Anthem has marked the invoice as Paid in Full, then have the medical billing company continue to dun me for services that were agreed to be written down.
I wonder how many people just pay those kinds of bills, instead of questioning them, time after time?
My last experience at the BMV was getting a new Driver’s License. No problems. Not an unreasonable amount of time. Sometimes, I wonder if the bad experience isn’t predicated more upon poor preparation or excessive expectations on the part of the customer?
Some of the medical bills on which I collect have not been the model of clarity. They have an entry labeled something like “Bad Debt – Collection Agency” where they have been assigned to debt collection. The assignment shows up in the “credit” field and the bill shows a “0” balance.
I have to explain that, no, assignment to a collection agency doesn’t mean you now owe nothing, it just means you have to pay the collection agency.
First time some medical billing company assigns that kind of incorrect billing to a collection agency will be the day you hear a really big roar from my side of town.
The issue is where the insurance company has paid the doctor at pre-agreed rates (usual and customary?), even though the doctor charges whatever it is they think a procedure/test/visit is worth to them. The difference between the pre-agreed rates and the charged rates is what some medical billing companies continue to bill for, even after repeated calls from both the patient AND the insurance company.
I just haven’t decided if it is because the billing company is staffed by ignoramuses/incompetents, or that they simply play the odds that most people will receive a bill and just pay it (thus avoiding the pre-agreed insurance rates, and making a larger profit). Hard to tell if the doctor even benefits from these over-the-top payments (probably not).
Just to be clear – in the case I was describing where the bill is “zeroed out,” it’s not a billing error – it’s just unclear. There are basically three kinds of “credits:” 1) Money actually getting paid; 2) “write downs” – usually based on some kind of negotiated insurance rate; and 3) collection agency transfers – this money is still owed, the medical provider is just not trying to collect the money directly.
In quite a few cases, the person I’m pursuing will point to that third kind of credit triumphantly, as if they’ve just played some kind of trump card. This group of people isn’t interested in honestly figuring out what they owe for the services they were provided. They just want to get out of something.
But, in any case, a lot of good could be done if medical pricing were far more transparent than it is now.
Hear, hear to that!
My experiences in Blago-run and now Quinn-run Illinois in registering my car, getting a new driver’s license and then re-registering it were a pretty good model of efficiency. It’s really true — I had a good government experience in Illinois, the land of corrupt and self-satisfied government. (Which is, of course, true, just not true always.)
For a needed emissions inspection, I could look at online video cameras showing testing location activity and estimates of the wait time for various locations in order to pick a testing location where I could be in and out in less than 10 minutes (4:47, in fact. The system tracked it.). I then renewed my plates online (two minutes) and get a sticker in the mail in five business days.
OK, but how about the first time? I spent two hours total in my first visit to get a new driver’s license and transfer my title to Illinois. During that time, I had to (a) prove my identity and residence thanks to Homeland Security; (b) prove that I did not owe tax on the transfer by bringing a new car in from out of state; (c) take a written test; and (d) get my picture taken. During that time, I discovered that I did not have the exact paperwork from Toyota that I needed to proceed. A government employee tried to expedite my issues and, when that failed, offered me his office phone and fax line so I could get paperwork from Toyota on the spot. And the staff were all incredibly kind and happy to help me, not to mention near ruthlessly efficient, as the sooner they got us all processed, the sooner they could go home.
Finally, I misplaced a piece of mail in which the Secretary of State’s office (which runs the DMV in Illinois) asked me to prove I had insurance for a set period of time. When I realized I had not submitted on time, I returned both proof of insurance and a check for the penalty. Five days later, they sent the check back to me! I had complied within a grace period, they said, and my money could become mine again.
All of this happened in big-city Chicago and not in some underused government facility Downstate. I will stack these experiences up against any one of my experiences with private insurance companies or, more recently, the downtown health system where I get medical care and fight over my medical bills all the time.
Anyway, thanks for letting me vent.
-Emily