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According to a CNN report, 49.9 million Americans were without medical insurance in 2010. To seal the gap between those insured and uninsured the government signed the Affordable Care Act that requires every American to be covered by medical insurance or Medicaid. Unfortunately the complexity of the Act has many scratching their heads about coverage options, services, and bill payment processes.
I learned firsthand how difficult the system could be after my fiftieth birthday. Yes, it was time for my first colonoscopy. But before making my appointment, I practiced due diligence by reviewing my insurance policy and calling my health care provider to ensure I used an approved doctor and facility for the procedure. I arrived at the doctor’s office, the doctor did his thing, and I was out ready to enjoy the rest of my Golden Years. A few weeks later, however, I found a $450 bill from the doctor’s office on my dining room table. Immediately, I was on the phone with my insurance company to dispute the bill. They explained that because the exam took place at an out-patient facility, rather than at a hospital, I was being charged a service fee. After six months of wrangling with the insurance company the insurance company finally paid the bill.
Then, at my last yearly visit, the doctor put me through the typical rigmarole of medical history questions. I answered “yes” to question 8. After poking and prodding the issue for thirty minutes, the doctor gave me a negative diagnosis. A month later I received a $170 bill from my doctor’s office. When I called to question the bill, the billings officer explained that I was being charged for the diagnosis I had requested. Excuse me? After a heated debate, the doctor’s office eventually cried “Uncle” and removed the fee.
I wish I could tell you that my medical billing woes ended there but I’m still dancing in the ring with another doctor’s office. The circumstances surrounding this dispute are so complicated that I had to get lawyers involved. I’m sure many of you have your own horror stories related to today’s medical system. So, what is causing the increased confusion?
The ideology of the Affordable Care Act is commendable. Unfortunately the system is too convoluted, complex, and new for anyone to understand. In some cases, insurance companies have to cancel plans because they don’t meet the coverage requirements set forth in the Act. The required benefits have raised the cost of healthcare due to the increase in preventive screenings and exams. Consumers are paying more for insurance that contain benefits they don’t need and on top of that the medical professionals and insurance companies can’t figure out who’s responsible for the bills.
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