Wednesday, April 11, 2012

The Author, The Mom & The Frustrated CSR: The Creativity Killer

In this time in the U.S. people are still struggling financially.It puts financial strain on families and honestly children can add to this stress. Stress is the creativity killer for a lot of people. For some it is an inspiration. I have found that though I would love to stay at home and write all day. However, I must go to work in order to feed my five year old. However, my job has caused me to go and educate those who go into the emergency room. Granted it is VERY annoying, when bill collectors call your house from these 1-800 numbers trying to get you to pay your bills. You know that you owe them money, and you know that you don't have the money right off. So you avoid them, because most the time you hear "Well you still owe this and you have to come up with the money some how or we are going to cut you off." Trust me I hear this a lot as a CSR for Medical Billing. However, please understand I am not a bill collector. I am really calling in to HELP YOU out. So I thought I would take this time, as an author who has to write most of my book at work and has my creative streak ruined by someone who obviously doesn't know how medical billing works. I hate to say it, but the rudest people are out in the Sarasota Florida area. First, I will educate you on general hospital billing.

All Hospitals
  • If you are going to the ER and it really was NOT an emergency and all they gave you was a band-aid know that band-aid is going to cost you around $300.00. The Emergency room is going to cost you about 100-300% more than a doctor visit. WHY: Because all the services given to you: the nurse drawing blood, the doctor coming in and placing your band-aid on your boo-boo. The X-ray for your hand even though you know you didn't need it but they had to make sure. Everything gets processed right then and there. No waiting days to hear back. So the cost is going to go waaaaaay up. So if you don't want a $300.00 band-aid don't go to the ER. Make an appointment to see your doctor.
  • When you register for the ER/Surgery and you start listing phone numbers for your place of employment and two References and their phone numbers YOU ARE GIVING THE HOSPITAL PERMISSION TO CALL THESE PLACES/PEOPLE. We will call your place of employment (on a dialer system, we don't actually dial your number) or the references that you put down. So if your reference is your mother and we leave a message for you with her (because by HIPAA laws we CANNOT TALK TO ANYONE BUT THE PATIENT EXCEPT IN A COMMUNITY PROPERTY STATE WHERE WE MAY TALK TO YOUR SPOUSE! <--- We will come back to this point.) do not cuss out your CSR who unfortunately was dealt your mother's number on the dialer because YOU put her number down.
  • KNOW IF YOU ARE IN A COMMUNITY PROPERTY STATE!!! Community Property State means that basically if your hubby/wifey dies YOU are responsible for ALL their debts/riches automatically. FLORIDA... and I do repeat b/c the rudest people ever are there FLORIDA IS NOT A COMMUNITY PROPERTY STATE. So what does this mean? This means if we call your house to speak to your hubby/wifey WE CANNOT TALK TO YOU ABOUT THE BILL. Do not just tell your CSR "Well I am his wife/her hubby." That does not matter we by HIPAA law, CANNOT TALK TO YOU. But there is a fine silver lining to this. PUT YOUR HUBBY/WIFEY ON THE PHONE AND HAVE THEM GIVE THE CSR ON THE PHONE PERMISSION TO SPEAK TO YOU. And there you have it, from now on, we can talk to you about the bill all you want. It does not matter if your name is on the Insurance. That has nothing to do with it is Wednesday, the 15th at  3 o'clock. Seriously. I have had more complaints and arguments about this and then they say. "Well then I'm not giving the message." or "Then you must not want your money." or they simply just hang up. Well let me tell you the favor you just did to your spouse. First of all, we have to call back because we have to get in contact with the patient to notify them that they have a bill. We have from 60-150 days to do this. So yes, you will be getting a call back. We are NOT collections, so if you continue to do this to your spouse, their bill gets PAST DUE and after that 60-150 days it will go to COLLECTIONS and then you have RUINED YOUR SPOUSE'S CREDIT because you didn't give them the opportunity to pay their bill because you were mad we couldn't talk to you. 
  • Lastly people, KNOW YOUR OPTIONS and what questions to ask. There are three ways that you may pay your bill, and depending on the hospital you went to, some give discounts for PIF & SIF. These mean Payment In Full and Settlement In Full. Sometimes if you go to the hospital with cash, there is a discount. Sometimes if you ask your CSR is there a Settlement offer there might be one. How ever, be prepared to pay these right then or within 30 days. They will not give it to you if you do a PIF or a SIF in a payment plan. If you cannot afford this ASK for a PPA. PPA stands for Payment Plan Arrangement. Sometimes your balance is so high that even this may be too much for you. If you are on a limited income and Medicare did not pay (Oh by the way Medicare has a co-payment, this is about $1,500.00 so if you have not met this yet more than likely this will be your balance left over that you are responsible for.) ask if you qualify for FINANCIAL ASSISTANCE. You can try your state, your county and the facility itself. Exhaust ALL your resources before you just give up on your bill. Sometimes you have a balance left over because when the offsite billing office (thus why a CSR is calling you and not the accounting department from the hospital) was given your account to finish billing the CSR was not given your insurance information. Just give it to them, it might pay off your balance. 
  • Requesting an Itemized Bill, does not mean that you get it right then. HIPAA laws say that we cannot EMAIL, we cannot FAX because these are places where anyone can get your information and violate your privacy. Itemized Bills are not given instantly. For non-community property states, we have to send you an authorization to release information form. So the fastest way if you have insurance, is to CALL YOUR INSURANCE. You pay them hundreds of dollars, make them work for you. Ask them for your Explanation of Benefits or EOB. Tell them to give it to you, because they should have given it to you after they paid on your bill. It tells you what they paid and what they didn't and if you want to know WHY they didn't ASK THEM! It is their JOB to tell you!
So if you are out there, and you go to the hospital, you don't know who is on the other side of your line. They did not call you punching in your numbers, they are on a dialer system that randomly picks a number to call. So if they call your mother, your place of employment, your cousin, baby's daddy... you know why. If they tell you that you owe a balance. Ask questions, be informative but most of all, know that the person on the other line may  not just be a CSR calling you, it may be a mother, father, uncle, daughter or a fellow author who is trying to write as they work to earn a living just like you, and you've just become the creativity killer.


Scarlett Rains, Author said...

Hi. Just stopping in to let you know I posted some of your wisdom on my blog today and put your link in to send folks your way. Hope it helps.

S.D. Lewis said...

Thank you so much!!! I apperciate it!

Fairday Morrow said...

What excellent advice. I think getting information from people who are in the know is the best! Thanks!


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