Down the Road a Piece

By MILT GROSS | Mar 24, 2013

Oops, another billing error

Those mistakes keep showing up, and sometimes not to our good. No one has ever phoned to say, “Oops, we billed you in error and we’re returning your money.”

Not yet.

I was at home, luckily, the day a tow truck pulled up to repossess our Plymouth.

I dug out the latest check that showed we were paid in full, the driver apologized and left.

A couple of years later a car showed up in our driveway. The driver said he had come to repossess our stereo. Same response, showed him the checks, and he apologized and left.

While we were having supper at home a few months after Dolores’ successful surgery at Massachusetts General Hospital to remove a potentially fatal brain aneurysm, the phone rang. It was a bill collector from the hospital. She demanded payment of several thousand dollars, which we didn’t owe. She said we should look at our statement.

I explained that we didn’t keep hospital billing statements at our supper table, and after a “warm” discussion, I hung up the phone. The next day I phoned the hospital and was forwarded to the hospital administrator -- the top guy, the one in charge. He apologized and said we needn’t be concerned and that he would deal with the bill collector.

No more demand calls from the hospital.

About a year ago, a Medicare statement arrived, showing that the agency had paid some $600 to a local hospital for a surgery for Dolores that hadn’t occurred.

During several visits to the surgeon’s office prior to the scheduled surgery, Dolores had told them that she had high blood pressure. She could have saved her breath.

On the morning the surgery was scheduled, two not comforting things occurred. First, a nurse couldn’t find a vein to insert a needle for some horrible purpose -- the purpose for all needles. Dolores offered to do it herself, but the nurse told her that wasn’t permitted. Which Dolores already knew.

Then the crew prepping her advised her that she had high blood pressure, the reverse of Dolores’ statements at the surgeon’s office during her earlier visits. She explained that she was aware of that situation and had informed the surgeon’s office several times of it.

I waited in a hallway for an hour and a half or longer before the surgeon appeared to explain that because of Dolores’ high blood pressure, he wouldn’t be able to perform the operation.

I waited for awhile long while they deprepped her or unprepped her or whatever they needed to do before she could come out to the hallway so we could go home. While I waited, our primary care doctor walked past, recognized me, and asked how things were going. I explained what the surgeon had told me, and our doctor said not to worry about it. If she waited a year, the problem would likely go away by itself, he said.

After awhile, Dolores appeared, and we went home.

I was relieved. It’s always nice when a surgeon doesn’t have to whip out his sharp instruments and dig in to cure your problem and charge you a million dollars for said whipping out and digging in.

That was a good feeling, but a forthcoming Medicare statement showed they had paid for the whipping out and digging in that hadn’t happened.

Recently, a couple of newspaper articles explained the correct way to handle such false billing, payment, or fraudulent billing and paying by Medicare. Number one, call the doctor. Number two, call the hospital. Number three, notify Medicare of the non-whipping out or digging in and the fact that someone had charged Medicare for that non-treatment. Worse yet, that Medicare had paid it.

We had done all that without even reading the articles. We had phoned the surgeon’s office. He definitely had not billed anyone for the procedure he hadn’t performed. We phoned the hospital. They had not done the billing, and it must be the surgeon’s fault. There, now we knew.

No one had billed Medicare for the operation for which they had paid out some $600.

We phoned Medicare, reached a real live person -- an oddity in itself, received the proper form to report the false -- fraudulent? -- billing and Medicare payment, and mailed the completed form back to Medicare.

They responded. We received two separate statements from Medicare showing the amount they had paid.

What a relief to see how much our following the rules had helped the government save money. Recently another news article reported that Medicare had paid out some $60 million dollars. I don’t recall the time period, but they had paid that much out.

What a relief. Our false -- fraudulent? -- billing had only cost them $600.

Probably another boat payment for the surgeon after expenses.

My father had once advised me to keep financial records for approximately 200 years, because one never knows when a billing error may occur.

He was right, of course, except for one detail. Keeping those records usually solves such problems.

But not always.

I think the surgeon should at least offer us a ride on his yacht.

Milt Gross can be reached for corrections, harassment, or other purposes at lesstraveledway@roadrunner.com.

Milton M. Gross Copyright 2013

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