The Days of Our Lives: Episode 2

Off the keyboard of RE

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Published on the Doomstead Diner on June 14, 2015

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Discuss this article at the Medicine & Health Table inside the Diner

Another Week has passed in the Last Great AdventureTM for RE, negotiating the Dysfunctional Health Care System of the Fascist States of AmerikaTM.

medical_billsAfter the visit this week at the office of the Pro From Dover who is supposed to carve up my neck and fix me up at some point, two NEW Projects emerged which I need to resolve before Signing on the Dotted Line for all the charges that are going to be pitched out for such a Surgery.

First thing is to get the Subrogation between the two Insurance Companies (my own Insurance and Workman's Comp Insurance) properly set up.  This has to happen because in the event I win my Workman's Comp case, all the bills that currently have been paid for by my insurance or myself will need to be reimbursed to me and my insurance company ex-post-facto.

Second thing is to nail down precisely WHAT the costs are for this operation?  All I have right now are the charges the main Pro From Dover drops on the Bill, but there are many more.  Anaesthesiologist, Neuro-Monitoring Dover Pro, Assistant Neck Carver Dover Pro, and the Hospital costs themselves.  There probably are other ones not yet identified too.

All of this we have been detailing out Inside the Diner in the thread evolving from Episode 1 so far.  Balance of this article comes from that thread.

From JDW:

Heh, you're not the only one, Micheal Snyder just published this:


From Surly:

Right on time.

50 hospitals charge uninsured more than 10 times cost of care, study finds

From Eddie:

 I mentioned the story of how my son went to the ER in Del Rio to get checked out for a bit of heat stroke, right?

The actual treatment rendered consisted of starting an IV and giving one bag of fluids.

The bill? Ten thousand dollars. Seems they like to diagnose heat stroke using an MRI and a CT Scan on a healthy 24 year old.

From RE:

I just finished composing two emails to my Insurance company, which of course can only be sent on their proprietary server.  For "security" reasons of course.  ::)

However, a minute after sending them that way, I sent the same two emails to myself through two of my many email addys.  ;D  So I have my own record with the time and date stamps on them.

In addition, for the reading pleasure of the Diners following the Days of RE's Life Soap Opera, here are the two emails:

Note:  I have changed names and numbers for legal reasons in this version.  Changes are in BLUE  :icon_mrgreen:

First, on the Workman's Comp Subrogation issue:

I have spent the last several month undergoing diagnosis for an injury I suffered at work.

I was informed by the billing department of one of the doctors that the claim needed to be "subrogated", so I called up ALLWRONG Insurance a couple of months back to find out about this.  The representative on the phone told me there was nothing I needed to do, my claims were being paid.

I was informed again yesterday the claim needed to be subrogated, and that ALLWRONG Insurance said I had never called about that, which is not accurate.

The Insurance company for the Workman's Comp Claim is Mutual of Deceit.  The Claim Number is 666-FUCKYOU.

Further information regarding the case can be provided by my Lawyers Dewey, Cheatham & Howe.  They can be reached at (666) SHYSTER.
Please let me know when this has been properly handled.

Thanks for the fine coverage you have provided so far.  Without it, I would not have been able to get diagnosed.

Second, on the reimbursement rates for the Pro From Dover's list of charges:

I have been diagnosed with a neck injury and will need spinal surgery.

I have been given a list of 2 possible proceedures that might be undertaken, and the prices the Pro From Dover charges for this.  It does not include the charges from the anaesthesiologist or neuromonitoring doctor or the assisting doctor, just his own charges.  It also does not include the hospital charges.  I have not yet been able to get those charges.  However, we can begin with this.

I will list the codes for each proceedure and the prices he charges.

63081     $13,000
22551       $19,000
22554     $12,500
22846     $ 7,900
22585     $ 3,500
20931     $ 1,300
Total       $57,200


63081     $13,000
22554     $12,500
22846     $ 7,900
22585 x 2  $3,500 each
63082     $ 4,500
20931     $ 1,300
Total $46,200

Please send me the list of reimbursement rates from ALLWRONG Insurance on both of these sets, and the total reimbursement for each one.

Thanks for your help and fine coverage.
I am going to get a LOT of Blogging material out of this!  :icon_sunny:

From RE:

OK, just fired off another email to try and get a Price Quote on the REST of the charges for this operation.

Doing this is not easy, because just FINDING an email address to send this mail to was difficult, but I did find one that was semi-appropriate in a pdf on the Providence Hospital website.

None of the Pros From Dover provide email addys, and everybody has their own Billing department.  If you have dealt with just ONE of these billing departments on the phone, you know you can't get jack shit in information this way.

Anyhow, here is my first attempt at trying to get the FULL LIST of charges for the operation by the Pros From Dover:

I have been Diagnosed with a neck injury I suffered at work, and will need Spinal Surgery to repair it.

The Surgeon at Providence I visited with is Dr. X.  He has provided me with his list of charges for the operation, but not the rest of the charges such an operation at Providence Hospital will accrue.

I need the list of charges from the following Doctors and Providence:

1-Anaesthesiologist charges (No Doctor Named)

2-Neuromonitoring Doctor (Dr. Q named)

3-Assisting Doctor to Dr. X (No Doctor Named)

4-Providence Hospital Charges for the Operating Room and Recovery stay at Providence

Estimated time in Surgery is 3 hours

This is the only email address I could find to try and get this information.  Please forward to the appropriate billing departments and have them reply to me if you cannot provide this information yourself at this address.

Thanks for your help.

OK, that is IT for today in trying to swim through this clusterfuck.

Now I am going back to DOOM!

From GO:

Realize it's easy to say but throw it out of your mind, it will add to your illness if you dwell too much on it.

There is no swimming through it, it's an endless river of pure evil extortion. Get the operation as soon as possible to get yourself well and deal with it later. The whole fucking country is in unpayable debt and bankrupt anyway, from students to senior citizens to the government. Something will have to be done to help out people in such an untenable situation sooner rather than later.

From RE:

Nope, will not do this operation until I get it all spelled out.

It's really a very good Test Case of many aspects of the system, besides the Medical Industry bullshit & Insurance Industry bullshit, you also have Unemployment Insurance (Epic Fail already), Workman's Comp (still under litigation) and  SSDI (still in bureaucratic paper shuffling).

I'm not going to get bullied into an operation that will bankrupt me before I am otherwise bankrupt anyhow.  Right now I can still write and I have a roof over my I head I can do it in and plenty of food to eat too.  When I have used up the last of my savings, THEN I will go in for the operation, if I'm still alive anyhow.


From GO:
Well, you certainly are the best judge of your own situation RE.

I was merely coming from the usual assumption that a medical condition untreated become worse and harder to deal with later on. But I'm no Doctor, that's for sure.

It's such an evil racket that it turns the stomach of honest normal people.  :'(

From RE:

Everyone "assumes" that "your health is the most important thing".  So no matter WHAT it costs, you're supposed to do it.

Really though, your Health is subsidiary to your Economic Well-Being.  If getting fixed up means GOING BANKRUPT, HTF am I better off?  I have a fixed neck but I am HOMELESS? This is an IMPROVEMENT?

The Med industry trades on the fact that sick & injured people will spend whatever it takes to get fixed up, rather than die or live as a cripple.  I WON'T pay whatever it takes, if whatever it takes will BANKRUPT me.  It's not worth it.

From JDW:

You know, RE, you may have trouble with your spine, but you definitely have BACKBONE.

Most people (myself included) would not do what you're doing, and that's why these businesses are able to get away with it.

From GO:

I hear you and think the same way RE. My idea is they know they can't get blood from a stone so it may be possible to work out a long term payment plan without ending up on a park bench.

Of course if you had a paid for home or they smelled assets they would bleed you dry. But a school teacher, on a modest salary, living in a rental and driving what they consider to be a shitbox is another matter. They surmise you are not rolling in dough They might want to grab every dime the could get from insurance and all the avenues you listed and then, after they maxed out all they could get there, saddle you with some leftovers and work out a monthly pay plan which allows you to continue without bankruptcy. A lot of legal firms offer an initial free consultation, perhaps you could get an idea with an inquiry.

Another idea is a legal aid society. a lot of colleges and schools offer free advice to people in financial trouble, the law students usually give ideas from that source and not actual lawyers.

I certainly understand what you are saying though, would do the same thing if in your shoes, just trying to offer some ideas. 

From RE:

Thanks for that JDW, but it's really not "Backbone" or "Courage" at work here, it's my LOGIC and CFS at work.

I just did a COST-BENEFIT analysis on the situation.

1- The operation is unlikely to restore my former spry and athletic self.  Damage done already is too great for that.  All it does is stabilize the situation some.

2- I am not likely to be fit for any type of work that I have experience with even after a successful operation which stabilizes it.

3- Being BANKRUPT and unfit for any type of work I have experience with leads to HOMELESSNESS if I cannot get my Bennies or a Settlement on the Workman's Comp Claim.

4- Finishing off my life as a Homeless Cripple is not how I would like to go to the Great Beyond.

So in this Game Theory exercise, I have only one valid option, which is to fight the system and hope I hold up long enough to make it through to the Other Side of it.

I'm not being "Brave".  I am just doing what makes CFS to me.

I will WIN!  I will make it through the Clusterfuck!  I have HOPIUM.  :icon_sunny:

I never QUIT!  I never GIVE UP!

It ain't OVAH till the Fat Lady Sings for RE, and she's not sung the final Aria yet!

From Monsta:

Logical it maybe but it still involves courage. The thing is we like to think of ourselves as rational human beings that apply logic whenever possible but the thing is when logic meets our primal desires it often fails. Our will to live is strong and quite often those logic decisions we make get overruled. It is partly this reason why we have the clusterfuck we see today. So in the end while your decision maybe CFS it still requires courage on the fact it takes balls to overrule your desire to live (you're primitive brain often does not make the distinction between good life and bad life). Also another desire that stops people is quite often people want to fit and not rock the boat and be a troublesome person. This is a fact that many companies play on when giving poor customer service; the lack of courage some customers have in speaking out.

And that is probable MORE than enough for Episode 2 of Days of Doomer LivesTM here on the Doomstead Diner. More coming down the pipe, to be sure.



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