Monday, September 10, 2012

Dear President Obama...

Mr. President:

I learn something new every day.

I'm one of your avid supporters, President Obama, and someone who has benefited enormously, albeit catastrophically, from the Affordable Care Act, most specifically the Pre-Existing Coverage that was made available for me to purchase.  (An aside -- in your campaigning, it would help people to understand PCIP better if they knew that it was not "welfare," that enrollees pay their way.  However, I confess to having blown, all by myself, the national budget for this program, and it is only September!)

I'd be even more avid in my support if you'd push for real and true reform in your next term in office.  That's right -- the public option, true universal coverage, deep, real reform.

But there is also in me a conservative streak, though I prefer to consider it basic common sense.

The medical details are irrelevant in this story of abuse of the health care payment system:  On July 10, 2012, I required emergency transportation from a doctors' building to the emergency room of the hospital across the street.  Well, to call it a "street" is a stretch, since it was more like an alley.

There was no need, as there was no time, for even the taking of basic vital signs, no i.v.s started, nothing. They just put me on the stretcher, took the elevator down to the ambulance, loaded me into it, crossed the alley, and delivered me to the emergency room.  In the interim, they managed to muck up information such as the office we had come from and the reason for the emergency transport.  (The guys said "dislocated shoulder";  In actuality, it was sepsis.)

Because I have passed the catastrophic limit for the year, most of my medical charges are being paid at 100% by PCIP -- for which you have my deepest gratitude.

I still make it a habit, however, to peruse each and every Explanation of Benefits form that comes my way, and there are some almost every day.  It's been that kind of decade.

The EOB for the ambulance ride arrived in today's mail.  PCIP payed them a whopping $963.00, exactly what they billed.

I thought about ignoring it.  Why should I care?  I'm at 100% coverage, my health is "catastrophic," and I had just spent two hours convincing a radiology practice that they would likely get paid if they would file with PCIP and not the insurance company I had four years ago.  But, still, I found myself reaching for the phone.

The first two times I dialed and explained why I was calling, my call was disconnected during the complicated transfer to the billing department.  The third time, I think the Obama-like steel in my voice made the call go through like magic.

I discovered that a nifty way to inflate an ambulance charge is to alter the address of origin for the "pick-up" or rescue, or whatever they choose to call it.  The Big Ride.

My home address was "inadvertently" listed as the originating point of the ambulance ride across the alley. My home address, of course, is in a different city -- not too far away, but still...

Call me a cynic, or nuts (though you'll not catch me conversing with an empty chair), but I suspect this inadvertent confusion of addresses happens with some frequency among the shadier members of the rescue community.  I suggest that anyone taking The Big Ride and facing a huge bill as a result obtain the paperwork designating starting and ending points.

They're going to "investigate" my claim.  I asked them to please reimburse a goodly amount of that charge to PCIP.  I'm doing what I can, President Obama!

I hope your ribs are okay -- I saw that tremendous bear hug you got at the pizzeria this morning!  Good thing you didn't need an ambulance!

Your supporter,

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