Here's a Harrowing Story of a Family Trying to Pay More Than $400,000 In Coronavirus Medical Bills

Illustration for article titled Here's a Harrowing Story of a Family Trying to Pay More Than $400,000 In Coronavirus Medical Bills
Image: Ariana Drehsler/AFP (Getty Images)

It’s become almost trite to note that the ongoing covid-19 pandemic has exposed the inequality baked into our day-to-day lives, but enlightenment hasn’t exactly led to reform. Take one of America’s most hallowed traditions—health insurance companies, as well as some hospitals, which continue to do their best to financially, emotionally, and psychologically ruin the lives of people who have depended on them for medical care. No wonder some large for-profit hospitals as well as insurance companies have profited handsomely off of the pandemic.

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As the New York Times reported, some families are dealing with nightmarish situations in which they’re saddled with tens of thousands of dollars—or more— in medical costs related to covid-19 care, as insurers reject claims for covid-related costs and hospitals skirt recently enacted federal rules on the amount they can charge.

Here’s just one family’s harrowing story, via the New York Times:

Shubham Chandra left a well-paying job at a New York City start-up partly to manage the hundreds of medical bills resulting from his father’s seven-month hospitalization. His father, a cardiologist, died from coronavirus last fall.

For months he has spent 10 to 20 hours a week working through the charges, using his mornings for reading through new bills, and his afternoons for calls to insurers and hospitals. His spreadsheet recently showed 97 bills rejected by insurance with a potential of over $400,000 the family could owe. Mr. Chandra tells providers that his father is no longer alive, but the bills continue to accumulate.

“A large part of my life is thinking about these bills,” he said. “It can become an impediment to my day-to-day. It’s hard to sleep when you have hundreds of thousands of dollars in outstanding debts.”

As the New York Times noted, “things were supposed to be different for coronavirus patients”—meaning, people’s out of pocket costs for covid-19 care were supposed to be zero, or minimal. Congress had even, as the Times wrote, “barred [doctors and hospitals from] ‘balance-billing’ patients—the practice of seeking additional payment beyond what the insurer has paid.” But these efforts, the Times wrote somewhat dryly, “have fallen short.”

More, via the New York Times, which has been compiling a database of medical bills submitted by readers:

Those bills show that some hospitals are not complying with the ban on balance billing. Some are incorrectly coding visits, meaning the special coronavirus protections that insurers put in place are not applied. Others are going after debts of patients who died from the virus, pursuing estates that would otherwise go to family members.

Hospitals and insurers say that they have tried to adapt to the different billing guidance for the pandemic, but that confusion can arise when new charge codes are created and new rules set up quickly.

Coronavirus patients face significant direct costs: the money pulled out of savings and retirement accounts to pay doctors and hospitals. Many are also struggling with indirect costs, like the hours spent calling providers and insurers to sort out what is actually owed, and the mental strain of worrying about how to pay.

While hospitals and insurance companies are quick to blame “new charge codes” and “new rules,” it should be fairly obvious that this is exactly how our health care system—if we can call it a system versus, say, an extractive industry—was set up to operate.

Senior reporter, Jezebel

DISCUSSION

sorvex
Sorely Vexed

The whole system is irredeemably corrupt.

A routine visit to the doctor or ER can result in a hailstorm of bills from all directions, typically arriving many months later, when the patient has likely forgotten everything that was done. This makes it much harder to dispute whether some procedure or other was performed at all.

There’s no readily available pricing at point of sale; you only discover the cost of everything afterwards, when it’s too late to refuse.

The price of everything is jacked up, often by thousands of percent. During a recent hospital visit, I was billed $150 for the exact same brand I use at home that costs $20 for 50.

Even if you take the time to select only “top tier,” “premium provider,” “total care,” or whatever stupid brand name insurers use for their pet providers (the ones they assure you are fully integrated into their systems and offer “maximum coverage,”) you still get pelted with rejections for charges some insurance-company “doctor” who’s never met you decides are “not medically necessary.” Wait, I thought it was unethical to diagnose a patient you haven’t examined. Not if you work for an insurer, apparently.

Finally, the “miscoding” scam is as old as time. It’s one of the most common bullshit excuses used to deny coverage. Seemingly, none of the enormous “healthcare” companies like LabCorp or Cedars Sinai, or UCLA can do medical coding with a damn, because they always fuck it up - if you believe the insurers. And their incompetence is somehow your problem.

If healthcare was a car, you’d buy it without knowing the price; be invoiced months later for each component individually, including a bunch you never asked for and aren’t sure are even present; and if the dealer or the finance company screwed up the paperwork, you’d have to make it right from your own pocket. And you’d never know when the last bill was coming, or if it got lost or wasn’t sent, until your “debt” is in the hands of collectors and your credit’s fucked.

America’s healthcare industry would be shut down under RICO laws, if it didn’t own 90% of Congress. Hell, even when Congress tries to apply some milquetoast restrictions (like during a pandemic), the insurers just say “cool story bro,“ extend their middle finger, and continue on as usual.