Granduncle Mark's Genealogy Parlor
Cancer Debt
These pages are not intended to substitute for expert medical evaluation or treatment.
Instead, I am sharing with you what I learned as a cancer patient, about how to advocate for the best possible
treatment of not only my cancer, but of all of the conditions, questions, and decisions associated with my cancer.
Many people may not realize that soon after a person is
hit with a cancer diagnosis, the person is also hit with horrendous financial impacts.
My bottle of 30 pills to control nausea during radiation was priced at $954.00. And that was one of the minor
interventions.
While it is wonderful that there are now
excellent cancer detection and treatment technologies, they cost huge amounts. And, in today's healthcare market, even
some of the better insurance plans will only absorb part of this huge impact.
During cancer-related depression, the person with cancer may try to put the bills out of mind.
But, the bills don't go away.
It is best to
go ahead and make plans for payments, but do so politely, cautiously and assertively.
Don't let the first hospital talk you into $200.00 monthly
payments when you still haven't seen the bills from the surgeon, anesthesiologist, x-ray / CT-scan / MRI radiology
company, laboratories, urologist, oncologist, endocrinologist, pharmacy, other hospitals, your primary care physician, etc.
The billing department staff in each of these areas is trained to push for certain commitments, but they are also human
beings, so be polite, but also honest, with them. Tell them that you will, of course, pay your bills, but that you still don't know how
much you owe the many groups that will be sending you bills, and that you have to make a master plan so that you don't
make promises that you can't keep.
As human beings, most billing technicians will appreciate your honesty and this
real dilemma. The fact is, most of them are paid limited wages and have the same shrinking insurance coverage that is
happening all over America. If a major illness should hit the billing technician's family, he or she will be in the same
rocky boat that you're in. So, these billing technicians are usually people who can empathize with your situation,
provided they can tell that you are being honest with them and making an effort to pay your bill.
Even more specifically, billing technicians are trained to tell you that they can make plans only within certain strict
limits. For example, they may say that they can't make plans for repayment that endure
longer than six months or twelve months. The truth is, they do have more flexibility than that, or at least their
supervisors have such authority. If it takes you three
years of regular payments to repay, it's still better for them than those accounts that default on repaying or
those accounts for which they must hire a collection agency.
Knowing these things can empower you to assertively, and of course politely, postpone a written repayment agreement until you
know what is truly possible.
Certainly don't sign specific repayment agreements with any one provider, until you know what your overall debt and
repayment plan will be with all of the various medical providers.
Of course, you'll feel pressure when they talk with you, as they recite the lines that have been assigned to them. For
example, one billing clerk explained to me that "we'll need to sign a payment agreement to prevent the entire bill
becoming due today."
While that line was designed to intimidate me into signing a repayment agreement on the spot, it
wasn't the billing technician's evil plan. She was just doing as she was instructed to do.
I found the real human being on the other end of the phone when I chuckled and said, "Well, if you make me commit to a
payment before I know how much all of my other medical bills are going to be, we'll have to set a very tiny payment to be
sure that I can keep my promise to you. I was going to pay your $100.00 today, but let's make it $20.00 instead, since
that's as much as I dare say that I can pay you each month without knowing my other medical debts."
This doesn't mean you shouldn't start making payments. Of course you should start payments promptly.
Starting payments promptly demonstrates your commitment to repay, even though you can't commit to a certain monthly
amount yet.
I'm just saying don't let yourself be pressured into signing an agreement to repay say $100.00 a month until you
have seen all of the medical bills, and know that there will be that much in your
budget for that particular provider.
For example, you may be able to pay the hospital $100.00 both this month and next,
but what about the following month when you receive a bill for your radiation treatment showing that after insurance
you still owe the radiological group $1,700.00? I'll tell you what about.... You're in trouble if you've already
committed every available dime in your budget to the first few medical groups that billed you.
Despite the initial rehearsed speech that the billing technician must make because of those irresponsible people who
don't even try to pay their bills, the fact is they know that it's not in their best interest to drive you into
bankruptcy, because then they wouldn't get paid at all.
That's why it's best to be polite and honest, do offer a prompt initial payment, but explain that you will not
be able to sign a repayment agreement until you see all of your many cancer treatment bills and can calculate how you
are going to repay all of them.
P.S. If it is possible for you to repay all of your cancer debts within one calendar year, you might be able to
recoup at least some of it if your medical costs qualify for deduction on the I.R.S. long form for income tax.
Beware also of medical facilities that generate a separate billing account each time you walk through their door,
as if you were 15 different patients.
I dealt with one hospital that has billing set up that way, obviously valuing convenience to themselves over
customer service. The unfortunate patients of that hospital have to sort through myriad bills, some of which are
duplicates, some not. The amazing amount of paperwork and mail that this generates is multiplied as separate radiation
and laboratory companies bill you based on the hospital's system, and then the insurance
carriers must also respond to you by mail in the case of each separate account at each of these places.
As you are starting to see, it is a
domino effect that surely kills hundreds of trees each year for every hospital that sets it's billing up in this way.
In a system like this, the patient may not even be able to deal with paying the bills until they have a four hour
block of time free to sort out the scores of pieces of mail pertaining to their services at this one hospital during
this one episode of illness.
Of course, the hospital doesn't have to keep track of your other accounts when it calls you about any one account.
It puts the burden for sorting all of this on the patient.
But, the major danger to the patient is that if you nobly put all of your available cash into paying off one of the
multiple accounts, you will get absolutely no credit for this on your other accounts, which may end up getting sent to
a collection agency, despite the fact that you just gave that hospital a significant chunk of money.
For example, if you go to such a hospital three days in a row for laboratory tests, you will generate three separate
billing accounts. When the bills arrive, say for $110.00, $45.00, and $65.00, and say you have only $110.00 available
this month and decide to use that to pay the first bill in full, the other two bills will become delinquent, even
though you promptly paid the hospital 50 percent of your total debt to them.
Outrageous, isn't it?
I wrote to the previous CEO of this hospital in recent years, explaining this impact on patients, but nothing changed.
Now, such unfair practices are not the fault of the billing technicians who call you. Be considerate and polite with
them. They want to do their jobs, and they have no interest in harming you.
I'm only suggesting that you should beware of the agency's multiple-account billing system,
and be sure that if you only have $110.00 that you send your $110.00 broken down into three separate
checks, paying some on each account, so that there is a record of you paying something on each account each month.
Similarly, if they have generated 28 accounts because of each time you've been in during the course of your illness, break
that $110.00 down into 28 small payments, one to each account, to have even their cumbersome system showing a record of
you paying regularly on each account.
I should mentioned that this same hospital also shows it's disregard for patient rights in how it handles the
HIPAA requirements about confidentiality.
The patient is presented with a form to sign, selecting either to release information to interested parties, or to not
release information to interested parties. It's all or nothing.
In other words, if I want my family to be able to receive information, I also have to agree for everyone from my worse
enemy to my co-workers having full access to my personal medical information.
No where on the form can one specify who can get personal medical information about me. Either it's releasable
to everyone, or it's a sealed case.
Obviously, this makes life easy for the hospital. They don't have to check to see who I want them to talk with.
Kind of helps you understand how this same hospital doesn't care about the impact of it's multiple-account billing
system on it's patients, doesn't it?
If you have a choice, find hospitals, laboratories, and clinics that have a culture of respect for patient rights.
Shop around for your medical care. You'll pay plenty for the services, so find places that will treat you well.
Remember -- you're hiring them!
Visit my main Testicular Cancer Web Page
at
http://grand_uncle_mark.home.insightbb.com/cancer.html
And, I'll be glad to communicate with anyone who has concerns about facing cancer fatigue,
testicular cancer, testicular implants and/or
testosterone level.
Just send me an e-mail.
Click
on small ribbon
to go to large purple cancer survivor ribbon
that you can print out for yourself!
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