Sophie's World

7:45 PM As you might have surmised by my post from yesterday, I don't have much patience for the health care bureaucracy. Actually, make that any bureaucracy (including church bureaucracy). Well, as if to taunt me, the kind folks over at Betsy Johnson Regional Hospital, our local butcher shop, uh, "hospital" sent a bill that came in the mail today. This particular bill was for the emergency room visit Sophie had last month when she had a clot in her line. Specifically, this was a bill for the ER doctors (we get billed separately from the ER for the privilege of spending 4-6 hours there). Basically, we're not supposed to get a bill from the ER doctors.

The problem that we have had with BJRH is that although the ER doctors are paid their negotiated rate by our insurance provider, we are charged the remainder, which they are not allowed to do since they are bound by the contracted rate with our insurance company. So, every time one of us goes to the ER (Sophie at least 3 times this year, Elisabeth once--remember the TV?, and myself once), we get this bill with an erroneous charge on it. In fact, one of these bills has now been given to a collection agency, although I have tried to get it straightened out for months.

So, I called the insurance company and explained that we need another one of "those" letters--the letter reminding the ER doctors that they have been paid the negotiated rate and they are not to charge us anything above and beyond that. So, that will be in the mail some time in the next two weeks. In the meantime, I thought I'd call someone at BJRH and see if there is any way to correct this error beforehand, or at least get some assurance that the next time we go to the ER (there will likely be a next time), we won't have to play this game anymore because I'm tired of it. The very nice lady at BJRH informed me that the doctor (who is not affiliated with BJRH anyway but is a private contractor) is probably not part of our network, which is why we are getting charged. Never mind that the very logic of a "contracted rate" should suggest to her that this doctor does, indeed, have some kind of contracted relationship with our insurance company. After several minutes going around and around with her, I finally read her, word for word, one of the previous letters from our insurance--the one reminding the ER doctors that they have been paid the negotiated rate, etc. Finally, we made some headway, and I will (hopefully) be forwarding her this letter (again) soon to clear this up. Now, here comes the best part of all--when I asked if there was any way to prevent this from happening in the future (it must be some oversight somewhere that does not register the doctors as contracted with our insurance provider), she basically told me that I would have to send these follow-up letters any time I get another charge like this in the future. So, the answer is, no, this problem cannot be fixed, it will remain your problem and your responsibility to rectify it every time you go to the ER.

We're looking for a new ER.

Sophie's been great today. Lots of energy and her appetite picked up again this evening. Today at lunch she turned her nose up at a Sunny D, which is her drink of choice at the Grocery Barn, so I figured her taste buds must be affected by the chemotherapy she got on Wednesday.

Susan's been working extra hard these last few days (she is on her way home only now and left early this morning). She said earlier that she would like to get some new pictures posted (I'm not sure that there are any pictures of Sophie completely bald), so maybe by me saying this she'll feel motivated to do that this weekend. I'm sure it'll be a relief to focus on something else besides work!

I finished up Sunday's sermon this morning and got cracking on next week's reading this afternoon. I had been reading ahead this week, but all of a sudden, semester break is over and I've got reading to get done by Tuesday. In the meantime, I need to get ready for Charge Conference and Bible Study (both on Sunday).