EOB's and the Golden Gate Bridge

For those of you who are not from my lovely country of unregulated medicine and private practices and medical groups and conglomerates and insurance companies…you can just skip this post…unless of course you want to scratch your head and wonder why we’re called the “Land of the Free”.

A quick lesson.

We go to the doctor…any doctor we choose,….whenever we are sick, depressed or bored (JK), and then these doctors, who belong to medical groups or medical conglomerates of doctors (that’s when they all have partners of their own specialty (so they can take some weekends off and there’s someone to pat the hand of their patients who are in the hospitals) and they also (in conglomerates) have other groups of doctors of other specialties …all under one roof. THAT is so when you need a test, or an xray, or to see a doctor for some other malady….they can point to a door down the hall and say…”Go to this guy here, he’ll take care of you” and then you will get billed by 1) the doctor 2) the group and 3) the conglomerate. NOW, you don’t have to PAY all three, but somehow you are supposed to figure out WHICH of the three to pay and what amount. BECAUSE….

EOBs.

Explanation of Benefits.

These are the papers the insurance companies send you (and the insurance companies are the one who usually pay the majority of the bills….AFTER you pay , copay, deductible and coinsurance….ARE YOU WITH ME HERE???? The EOBs explain to you – usually Doctor by doctor….how much the insurance company pays…how much YOU pay….and how much the doctor swings for…..(basically…).

Now the problem I”m having….the one that wakes me up in the morning like morning sickness and keeps me up at night like caffeine….is when the EOB tells you how much to pay a DOCTOR…and you get bills from groups and conglomerates….HOW THE FREAK am I supposed to know how much to pay whom????

Because the groups and conglomerates also include the amounts owed to other doctors.

Now, you are probably thinking: Just pay anyone who sends you an itemized bill.

Ahhh yes.

I would, were it not for the fact that I’ve met my maximum out of pocket expenditure for the year…and beyond that I owe A BIG FAT NOTHING!!!

And doctor’s offices are sneaky. They send you bills before the situation is fully paid by the insurance company and they send you bills with errors…and they send you bills every month, despite the fact that you have already received 25 copies of that bill before. And I am completely swamped, overwhelmed, confused and SUICIDAL over this.

And that. is. just. what. they. want.

BECAUSE: If I panic as I did last week and say “Screw, it, I can’t figure this out, I’m just gonna pay these damn bills and hope it’s right.” And if you messed up and paid too much or you paid someone that you weren’t SUPPOSED to pay…then you are out of luck buddy…and then they get paid twice. Once by you and once by the insurance company. AND the to make matters worse, the doctor you were SUPPOSED to pay instead has every right to take your butt to court if you don’t pay him every penny you owe him….

My brain was fried numerous times by ECT.

I can’t remember anything from one minute to the next….due to whatever. Illness, meds,…age,….Alzheimer’s, ….ECT, ….Schizophrenia…..or all of the above.

And my husband has handed me this stack of papers two inches thick. And a stack of bills five inches thick. And said, “Here. You are paying these with YOUR disability money….YOU FIGURE IT ALL OUT and pay the doctors.”

which leads me to the second part of my blog title……(and if that is over your head also because you are not a local…then Google it.)