Head first towards everything


Dear Medical Establishment, Your Billing Practices Suck

First the hospital tells you it’s best to pay for your medical procedure up front, as they will give you a discount if you do. Awesome. You pay it. Then you get a bill from the hospital saying that you still owe. You call and ask, and it turns out that first figure you paid was based on their estimate (read: educated guess; also: shot in the dark) of how much your insurance would cover, which of course they overestimated because why the fuck wouldn’t they?

Then comes the flood of bills from every doctor, nurse practitioner, anesthesiologist and specialist who even sneezed in the general direction of your fifteen minute medical procedure. And you start paying like crazy, thankful that —at the very least— you don’t have to pay the exorbitant amount the insurance is getting billed for these services.

And then after you’re done paying all of those, it turns out your first visit with the doctor (the one where he didn’t really see you, but his nurse practitioner did) hadn’t yet made the billing rounds yet, but now it finally came through and guess what? You owe some more money on that as well.

Needless to say, this is a case of terrible user-experience.

I won’t go into how the healthcare system is entirely broken in this country, or why. I’ll leave that for another discussion. My concern here is the fact that, from the point of view of a customer/patient/user of services, the medical establishment’s billing practices are simply insane. There is an obvious need for these professionals and institutions to charge for their services and cover their expenses, but I can’t imagine there’s some kind of government requirement for it to be frustrating, confusing and downright frightening for the customer. After my recent experience, I’m half convinced that there is such a requirement.

I don’t know about anyone else, but I get the impression that half of the bills are arbitrary, opportunistic attempts to legally mug me out of my money because hey, you required a complicated medical procedure, and I’m gonna make up some charges because what the hell do you know? I’m sure that’s not the case, but it certainly feels that way. Why else would the same handful of professionals and offices keep sending different bills for different items at what seem like random time intervals? Why not just one consolidated bill per professional/office?

And why aren’t these bills detailed in a clear, layman’s language?


Are you kidding me?! Fuck whoever decided that the above qualifies as an explanation that would satisfy an average layman’s need to understand why there’s a $190 item on their bill.

At the very least, a patient should get a report at the end of the procedure letting them know who worked on them, what each person’s role was, and when the patient can expect a bill to show up for that professional’s services. It’d just be courteous, man. Nobody’s budget appreciates a random medical bill for a procedure performed over two months before, especially after already having paid multiple times and to multiple people/entities, before and after the damn procedure.

“Oh, joy! Another unexpected medical bill for that colonoscopy from eight weeks ago!! This is the best day ever!” Nobody in the history of forever.

Not a single person has uttered those words who meant it without the words completely smothered in the kind of sarcasm that can make grown men cry.

I won’t even attempt to give the impression that I understand the complicated processes that the healthcare and health insurance providers have in place in order to wrangle what must be massive amounts of data regarding who owes whom and how much. I don’t have a solution to this problem. At best, I could come up with a fictional report like the one I described above, but it’d be naive of me to produce such a thing without first understanding the data infrastructure the medical establishment uses in order to charge their patients and insurance providers.

I just know that better care needs to be paid to the patient’s overall experience regarding the delivery and payment of medical bills. I’m sure it would result in better public relations, increased satisfaction for the patients and —I dare say— quicker payment.

“Oh, look. That bill we were expecting from the anesthesiologist. We can finally get that over with.” Me, not surprised by another medical bill, in an alternate universe where I was told beforehand what bills I should expect and when