Convenience a la Mode

Somewhere in New Hampshire a friend wrenched his shoulder while unloading a truck.  As men do, he tried to ignore the discomfort, believing it would go away.

Instead, it turned to pain.  Before long, he didn’t think he could drive a car and had to ask his wife for a ride to the hospital.

Listening to this, not wanting to slow the story or inhibit the telling, I took no notes, but based on where I know they live, they went to either Portsmouth or Exeter.  Whichever it was, as soon as they walked in, they saw a crowd and walked back out.

Somewhere else in Rockingham County they found one of those medical chains that have appeared everywhere in recent years.  This one was Convenient MD, where they received a very nice, soothing welcome from a friendly receptionist, filled out some forms, including billing information of course, and were soon introduced to a nurse.

The nurse worked her fingers around my friend’s shoulder only to admit that there was nothing she could determine for certain without a x-ray, and that the staff’s radiologist had already gone home for the day.  She referred them to a nearby medical center.

Third time’s a charm, and not long after they arrived at the center, my friend had some treatment, some pain-killers, and a sling he wore for barely a week.

All’s well that end’s well as whatshisname put it–except that the story doesn’t end there.

One month later, my friend received a bill for $15 from Convenient MD.  Well, alright, the nurse did spend some time with him and gave the referral.  And it is a pittance.  He did raise his eyebrows at the amount, there on his bill, that Convenient MD charged Medicare–just over $200 as I recall–but, hey, if this is what America wants as a healthcare system, ain’t nothin’ we can do about it.

Except the story doesn’t end there either.

Weeks later, Convenient MD sent him another bill, this time for over $160, and the charge to Medicare was proportionally higher.  My friend was soon on the phone.

After calls to both Medicare and Convenient MD, not only was he able to rip up the bill in front of him, he was told he’d be reimbursed for the bill he already paid.  When he told them that he’d “have no choice but to contact Medicare” (even though he already had), he was assured that it, too, would be “fully reimbursed.”  Days later, a $15 check arrived in the mail.

“Hush money!” I yelled.

“Yes!” he laughed.

“And it was your own $15!”

He laughed again, but he wasn’t hushed.  He made a second call to Medicare to report what happened, giving them all they need to pursue reimbursement if Convenient MD reneged on what they told him.  Put another way:  The ball is in Medicare’s court.

We can only wonder about how widespread this is.  In our privatized healthcare system, the elderly on Medicare must appear as low hanging fruit.  They (we) are less prone to question bureaucratic details, as when my friend simply paid the first bill–even though he noticed the $200 charge to Medicare for a thirty-second shoulder massage.

The second bill was either a mistake, such as confusing him with another patient that day, or Convenient MD, for whatever reason (or haywire algorithm), thought it could bilk him for more–and in the process, Medicare for a lot more.

It’s an old trick, and on the internet it’s called phishing. Nor is it confined to the private sector.

Back in the ’90s, the city of Boston put cameras over busy intersections to photograph plates of cars at the end of those lines that cross as the light turns from yellow to red. Tickets would be sent out automatically.

This was already ruled illegal by courts across the country, but the higher-ups knew that most people would pay the fine rather than take a Tuesday afternoon off work to find their way into a downtown courtroom to contest the ticket.

Those who did show up in court had the ticket repealed. Every. Single. One.

If enough of us keep an eye on the bills we receive and are willing to drop a dime and raise a voice, Medicare’s court should work just as well.



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