We recently represented a client with a particularly challenging case: the passing of a beloved parent, after a difficult medical journey. And a bill of almost $300K. Needless to say, the family was upset, but moreover, they were furious at being misled about the cost of their loved one’s care, since they had been told on multiple occasions that their insurance would cover all the costs.
When Pathfinders was first hired, we did what we always do: met the client and carefully documented as many facts as possible. We then devised our strategy, including who within the medical center we would optimally work with. This last step is crucial, because when we find someone in an organization who is willing to go the extra mile, we make quick and effective progress. In this case, we were pretty sure that the personnel the family had already spoken to had no insight or power to reduce the bills, so we tried a different approach, and found a wonderful administrator who was sympathetic and smart. Within days she had uncovered the problem: the claims department had made a large error. They had appropriately covered the medical costs at the Medicare rate, but instead of zeroing out the rest of the balance (as they are supposed to do), they had passed along the cost to the family. Once they were alerted, they quickly resolved the issue, and the family’s bill was cleared.
This case highlights an unfortunate dynamic that happens all too often: when faced with medical bills, people spend countless hours going in the wrong direction, costing them time, stress, and success. This family had complained all the way to the top of the organization, sending emails to everyone they thought had power to fix the problem, but their complaints were being ignored. Understandably, they were livid with everyone involved. But… if they had simply targeted the right person in the business office, the mistake might have been uncovered in the beginning. And everyone would have been happier with the outcome.
We’re happy to serve as billing advocates for our clients, and we’re thrilled when we resolve a case with such great results. But you don’t have to be a medical advocate to get similar outcomes. Any savvy consumer could have done what we did. Sometimes we get so caught up in our anger and frustration with our broken medical system that we forget that there are still good people within it who can and want to make a difference: the real key is to stay persistent, patient, and polite – and find them.