I’ve been sitting here for the last hour trying to figure out a title that best represents how I feel about what I’m about to write, and when I stumbled upon the recent Starbucks arrest of two black men, and how people express experiencing  the discrimination they call, “shopping while black”, I knew I had found a winner.

I don’t write much, anymore. In fact, I don’t officially write anything substantial unless I’m emotionally thrown into doing so. My best work comes from being deeply sad, angry, or hurt in general, and most of it I’m able to vent out on my Instagram page in the 2,200 character limit under each post.

This time won’t be the case.

In addition to feeling like I have more than just a little to say, I think the topic of being sick in the workplace is something that deserves more attention than a drive-by mention. I find this incredibly difficult to articulate most of the time, because I think every person’s situation is dramatically different, and when it comes to health, almost nothing is predictable. And even when it is, how people handle it varies, drastically.

I am someone who grew up looking at my illness as another appendage. I’ve never wanted to stand out because of it; I’ve never wanted pity or special treatment. All I ever wanted, really, was to be given the same opportunities as the person or people next to me who apply the amount of effort that I do.

Which happens to be a lot.

I’m not even talking about the extra effort it takes to be sick AND be a respected employee. I’m not counting the energy it takes me to shower, the money I spend on cabs, or the emotional stress that comes with not ever being able to turn my illness off. I am simply comparing oranges to oranges – which, in the most basic sense, to me, means: does the work get done?

Unfortunately, I can safely say in the adult season of having my career, which is nearly rounding 11 years, my productivity, quality of work, or commitment to my employer have never been what has been the focus of evalution. You can be smarter, faster, more resourceful, personable, and take initiative, but if you have to also juggle regular medical appointments, can’t physically be present for an exact schedule, or are limited to wearing flats instead of “power heels” because sneakers are the only shoes you are actually able to walk in, you will start to notice the trend of training others to move on while you stay exactly where you are.

At this point, I feel it’s necessary to reiterate and mention a few things to provide clarity on what I do not expect from an employer. As mentioned above: I don’t expect special treatment. I don’t expect to be handed an easier path. And I don’t expect it to be acceptable if I can’t complete the tasks surrounding the role I’m hired to do.

With that said, making reasonable accommodations for physically disabled employees is not special treatment. It’s treatment, period. I have as much control over my handicap as someone has over his or her natural hair color.

Next, making reasonable accommodations for physically disabled employees is not an “easier path.” It’s a path. Would an accommodation I receive be “easier” for those without my physical disability? Sure. But it would also be “easier” if I didn’t need to get chemo infusions once a month to do what other people can do just by waking up and wanting to.

Which brings me to the last point. Being chronically ill has never been a choice for me. Has it made me way more badass? Yes. But it wasn’t something I decided to try out for fun. One of the largest problems I face in the workplace is that being physically limited is often translated as “less motivated.” Working in healthcare operations means that you have to be “on” during specific hours, and prepared for when the shit hits the fan. I care more about my career than I do most things, so I have prided myself in learning the intricacies of my profession, mostly thanks to being a patient, so I can plan and coordinate my medical care around making sure my job gets done.

And my job gets DONE.

It shouldn’t matter if I’m creative about how it gets done; the focus should be on the fact that it does. And well. Every time. I empower staff to be strong and independent, so I can trust them to make important decisions, if necessary, in my absence. I build solid relationships with every walk of life in the workplace, so I can expedite issues quickly and without hassle. I make sure that my work is thoughtful and complete, and I do whatever I need to do to make that happen, so the final product is valuable and respected, to a fault. I function through pain meds; I check technology issues in the middle of the night; I have taken work calls while Remicade pumps through my veins on Saturday mornings.

But regardless of all of this, we live in a society that dehumanizes the process of making a living. Don’t get me wrong – I am someone who relies heavily on routine and structure. However, why the hell does it matter if I get to work at 9 or 9:20 or even 11:20, if I am responsive when emails come my way, if I am savvy enough to do my job from a cab (or my bed, for that matter), or if I am blowing past deadlines and submitting content that exemplifies my competence? Why don’t we understand, sick or not, that these are the reasons Americans are so miserable? Life doesn’t happen when we want it to – it just happens. So how can we expect anyone, especially sick people, to be able to work with that?

But don’t forget – if sick people don’t work and submit to the “benefit” (heavily quoted, by the way…) of being on disability, it means they are lazy and not contributing to society, right?

…Right?

So how do we win? I put myself through undergrad with a dual major and minor, and immediately moved out on my own, started working full-time a week later, and began grad school right after that. I completed my 3-year master’s program in 2 years, while working full time, which frankly, is a feat before even considering the fact that I have a debilitating, degenerative, aggressive joint disease. I’m not asking for a hand-out because I had to bust my ass to do it as a sick person; I’m asking to be seen for my professional qualifications – many and most of which my peers do not possess.

And this is where I get really, really, frustrated. I have never been promoted. I have been reprimanded and disciplined for lateness and attendance “issues”, which is really interesting since my work has never suffered. Also, I haven’t taken a vacation in four years. Yes, you read that correctly. I have used all of my sick and vacation time for one thing, and one thing alone: to manage my health. And I’m not talking about unexcused absences, even. It has been years since I’ve called out of work for any kind of illness, which is absurd, since I wake up sick every. single. day. But since I don’t spend my vacation days at the beach, the perception is that I am worth less to the overall organization.

I’m not naive. I understand that people abuse sick and FMLA benefits all day every day. But as a manager of staff, those people are easily spotted from miles away. They call out every time it snows, or rains, or has either of the two in the forecast. Or better yet, they call out every time it’s sunny also, and come in with a nice tan when they come back to work. These are also people who simply say, “I can’t” instead of “I’ll figure it out.” Don’t you think it would be more beneficial for me to get my infusion treatments on a weekday, so I can be better by the weekend? The only reason I do them on Saturdays is to preserve my time at work.

In the four years I’ve been at my current job, I’ve had different managers and have been handled differently between the two. I’m very grateful, because the role I currently have is much more removed from the operation than it had previously been. I have also had the flexibility to work my medical appointments into my day and work from home when exceptions in my health arise. However, I can’t help but feel that the perception from my employer is that these accommodations that I need to function, no, SURVIVE, are acceptable substitutions for being promoted and considered for growth opportunities.

A year ago, I was asked to move into my current role, and I declined. A few months later, I was told I no longer had a choice. I was told it wasn’t punitive.

It felt punitive.

As I do with everything else I have to deal with in my life, I took this opportunity as a challenge. I stepped up. My entire day-to-day changed, along with the expectations of how I would function as an employee. I had never done project work before, and it’s not the job I was hired for. Not even close. But I did it, and with the same enthusiasm I’ve done jobs I’ve actually wanted.

However, all of my peers have moved on (read: “up”) within a year or two of their hire. When discussing it with my manager (who I greatly respect and value, and has worked with me more than any other manager before him has), he reiterated something he says to me often, which is that the “right” opportunity hasn’t presented itself to me yet. I find that really hard to accept, when my feeling is that the opportunity DID present itself, about a year ago, when the hospital I work for needed a project manager. They didn’t recruit for it; they didn’t create a new position and use it as a growth opportunity for someone who had worked hard for it; they laterally moved me and told me I had to learn a whole new set of skills.

The thing that made me most emotional and discouraged about the dialogue surrounding my concern was that there was an expectation that I be grateful for my accommodations (and of course I am – I’ve had horrible managers who haven’t treated me half as well) – but more than that: that my employer’s extension of offering me the things I NEED should satiate my desire to be offered the things I’ve EARNED.

And this has been a recurring theme in my life in so many places. When you have a special need that “easier” people don’t require – whether it’s physical or emotional – we are led to believe that once that need is met, we shouldn’t ask for anything more.

I’ll admit, I’ve been content with this notion for a really long time, mostly because I know what it’s like to suffer. I know what it’s like to feel abandoned by a mentally ill parent; I know what it’s like to be in a marriage that didn’t have passion; I know what it’s like to feel like a slacker, sneaking in and out of work, hoping that I don’t get caught because my meds didn’t kick in fast enough to punch-in on time.

“Be grateful, Beck, that you had mother figures in your life that stepped up when your mom stepped out.” “Be grateful, Babe, that you have passion, even if it doesn’t come with love.” “Be grateful, Rebecca, that you haven’t gotten fired for the issues surrounding your health, even if you do everything in your power to maintain your job performance.”

But if being sick hasn’t stopped me from working towards the life I want, why should it stop me from thinking it’s the life I deserve?

I don’t want to be victimized, nor do I want to be seen as a martyr. I have always owned my health’s circumstance, far more than most people think is natural. But as I’ve gotten older and I’m spinning around the same hamster wheel, it’s becoming intolerable to exist while I watch my peers travel, pay off debts, buy homes, and prepare for a comfortable retirement.

Maybe we should work on the language in the workplace and the stigma surrounding that language, as it relates to people with certain God-given limitations. Why is what I require a “special” need? Why isn’t it just a need? Why is what I require a reasonable “accommodation” and not just REASONABLE? What if everyone who was hired was just looked at as people, and they had to list their needs on paper before starting on day 1, right before they get their ID photo and a locker assigment? A clinician’s list might include a lab coat, a mom’s list might include a shift that mirrored her kids’ school hours, and a physically disabled person’s list might include having a seat near the bathroom.

I’ve never been someone who is overly sensitive about semantics and being politically correct. I’ve always functioned off of the belief that I am a good person at my core, and that intention is everything. But I wonder if putting certain systems in place to “protect” people has actually hurt people worse. I’ve analogized this to not wanting certain medications or diagnoses in my chart, because I know patients are often judged based off of how their medical record reads. It shouldn’t be, but it is. Like anything, there are laws against this kind of discrimination, but it exists.

It sort of feels like a catch 22. Since I’ve always been insanely transparent about my disease and how it affects my day-to-day, it can be used as a weapon against me, intentionally or not. However, my feeling has always been that there is some human component to sharing something that personal, or rather, harder for an employer to be  jerks if they know what I”m going through.

We all have needs.

Being seen past an illness is mine.

 

 

 

 

 

 

 

For a little change in pace, I started writing this post from my infusion chair: my home-away-from-home, last Saturday morning. I’ve been doing this routine for 4-ish consecutive years, and it’s become such a part of my life that the first thing I did when I walked into “Bay 2” was rearrange the furniture. I know it sounds crazy, but when there are things in your life that are outside of your control (a chronic illness, for example…), it becomes easy to try to control everything else that isn’t.

For as long as I can remember, my lines have always been placed in this rock-star vein I have in my left arm, so when I saw the IV pole on the wrong side of the recliner, I had to immediately take action and swap it out with the vitals machine. I couldn’t let all of those wires cramp my style.

But the reason I lugged my laptop to my treatment, however, was not to get into “How to make your hospital room cute: 101”, it was because I have had a particularly nerve-wracking experience surrounding my regularly scheduled programming, and the part of it that really made me need to put hands to keys was an interaction I had with someone that left me questioning, “How do any of us do it?”

As most of you know, a good amount of the conditions that we suffer from in the chronically ill community cause our immune systems to become compromised. On top of that, the methods of treatment for those conditions tend to weaken them even more, which in a lot of cases, is intentional, but leaves us more susceptible to catching a whole slew of other shit we don’t need to be dealing with.

But what happens when the chronically ill become “healthy-people” ill? You know, the times that you wake up with something out of the blue, and there’s the strong likelihood that it’ll go actually go away? (A novel idea, I know).

Well, I was faced with this predicament this past weekend, and it caused me to have to make a serious judgment-call. “Should I postpone my Remicade infusion and wait out whatever is temporarily making me ill, or should I take a chance and have my treatment, making it harder for my immune system to fight off whatever is virally occurring?” Since my infusion center is booked-out for months, I was worried about causing a flare-up of my joint disease as a result of the delayed dose, so I decided to go with the latter. But as anyone can imagine, there was seemingly no right answer, and my anxiety about all of this went through the roof.

The thing is, I’m accustomed to having to make tough decisions on a daily basis, just usually to a much lesser degree. “Do I prep my meals for the week on Sunday night, stressing out my joints standing in the kitchen for a couple of hours, or do I push myself through the discomforts I experience in the morning before work to make my food for the day?” These decisions that we, as sick people, are faced with, seem light and airy at first glance, but the wrong choice could impact us greatly, and as I feel I’ve exemplified, both options are often detrimental in some way.

What I have yet to be able to deal with, however, after 32 years on this planet, is finding a balance between remaining tough while concurrently finding someone to lean on. It’s pretty natural to become more vulnerable when you’re not feeling well, so when you’re hit with a whole lot at once, I think it’s fair to say that you just want someone, anyone, to swoop in and say, “I got this.” I have never needed much from others in that way (although, I’ve certainly wanted it at times), and for some reason, I conditioned myself at a very young age to be exceptionally resilient when not getting that “want” met. I’m not sure where it stems from, because my parents were both very supportive and overprotective of their sick kid, but I’ve always handled my illness in a very black-and-white manner.

For example, last year, I somehow contracted e-coli for the second time in my life. When healthy people get this bacteria, they normally kick it within a few days, and most of the time they don’t even know they have it, because it just presents as a nasty stomach bug. I, on the other hand, develop debilitating abdominal cramping and a whole shitload (pun) of other gross symptoms that typically make me utter the words, “just end it all.” It’s easily my least favorite way to get sick, and I wouldn’t wish it on my worst enemy.

Obviously, when I’ve gotten that sick, I’ve taken a trip to the ER and was admitted, but I’ve been to the hospital on numerous occasions, many of which my family and friends don’t even know about, so that doesn’t automatically mean I’m panicking. The difference in this scenario was that I was sick to the point where fear crept in, and I ended up calling my parents because I was unsure of what the outcome would be. However, if for some reason I started to feel abandoned in the situation, I would have immediately rejected all offers for help and managed it on my own.

This is all a long way of getting to the reason I felt compelled to write. In my everyday life, with my everyday illness, I do it all. I manage my doctors’ appointments, make sure I take my medications, pick up my prescriptions from the pharmacy, and haul myself to and from medical facilities. And when I get sick after treatments, I take care of myself; I make sure I stock up on food, and I make sure I have natural and prescribed remedies on hand to deal with the side effects.

I walk my own damn dog.

And when my current dilemma came to be, where I started to feel the weight of everything that was happening to me physically, I expressed to a friend that it would be nice to have some company, mostly because I was afraid of having an allergic reaction as a result of my body being in a weakened state. I wasn’t necessarily asking for help, but I also wasn’t expecting the response to be that he wasn’t “comfortable” coming along.

Sitting and thinking about that response in this moment doesn’t have the same impact that it had when I was in distress, but it does leave me wondering. As I mentioned above, it takes a whole lot for me to feel the desire or warrant to even share that feeling with someone, but once I was rejected (again, for something I hadn’t even requested), I immediately shut down. Rather than allowing myself to feel disappointment, I iced that cake with a whole lot of “well, fuck you, then.”

It’s funny, because I know that’s probably not a healthy way of dealing with those types of situations, but I also know that it’s always worked for me, because I don’t waste time sitting around crying about selfish assholes when I need to be worrying about things that are more important. Also, that emotion almost always immediately repurposes itself into something better: fuel to fight. When I feel disenchanted by someone’s lack of integrity, I somehow become stronger and more determined to get through whatever I’m dealing with – but again, not from a healthy place – it happens out of spite.

A lot of us talk in my live chats and comment strings about how isolating it can be to be chronically ill, and for me, situations like this have been the main cause. Since I am dealing with something that controls everything I do, it’s hard for people to understand the emotional component that comes along with that. Being sick, for me, usually feels like a toss between convincing someone that I’m not a flake because my illness caused me to cancel plans at the last minute, and convincing someone that I don’t need help, because they weren’t going to help anyway. Maybe it’s a matter of pride, but no one wants to be labeled as incapable, especially when the cause, in this case, has nothing to do with my drive or determination otherwise.

As a result of these encounters, I have lost a lot of relationships in my life. Sometimes it’s a friend who decides they won’t make dinner plans with you ever again because they put on their “face” for nothing, or someone who uses your inability to be reliable as a scapegoat or justification for their own lack of consistency. Sometimes it’s someone who refuses to understand that you have physical limits, and makes plans that you can’t be a part of as a result of your incapacitation. Sometimes, you might be “blessed” by someone who decided that they need to start keeping score – you know, the ones who helped you hang curtains once or twice, and when you call them out for shitty behavior, they remind you of “that one thing” they did, “that one time”, 3 years ago. Worst of all, it can also be someone who comforts you in a way that makes you think it’ll all be OK, until they realize that providing any level of emotional support offers nothing tangible for them in return, and you’re left hanging out on a limb, with nothing but lost confidence in the human race.

For me, all of these interactions add scars, and sometimes I think it’s those scars that make me more resilient than anything you could see on my body. Because really, what is this life if you don’t have people to share it with? What exactly am I working towards, if I’m experiencing all of my successes alone? There are many people out there who say you shouldn’t expect anything from others, because then you won’t be disappointed, but I have always felt that this was just a bullshit way to rationalize away one’s ability to just be decent.

I’m not really sure what has made our society so cold. Over time, I’ve felt like we developed a general lack of commitment to anything, really, and that this character flaw has spiraled into this mess of everyone sort of being on their own, whether they know it or not. People get divorced after having a fight, and they cheat on their significant others rather than getting out of the relationship when the decision is made to not work on things. There also seems to be a ton of competition on social media to maintain some sort of semblance of a “cool” life, when no one appreciates how to create one that’s simply fulfilling.

What I’m trying to say is that I think if people took a step back, thought about their actions, and really understood how they affected others, perhaps we wouldn’t constantly be in this position of feeling entitled to act like animals. It’s interesting, because our society tells us that we SHOULD feel entitled to do/say whatever we want, because it’s our lives and to hell with anyone who gets in the way of that, but people forgot a long time ago that everything is cyclical. Putting bad energy out into the universe eventually comes back to us, and if you’re foolish enough to do that in your own immediate circle, you can be sure as shit that it’ll find it’s way back to you a whole hell of a lot faster.

When I lay down at night, I don’t just pray for loved ones on the surface and call it a day. I pray that those who lack compassion for others are able, at some point, to reboot their perspective and start viewing the interest in another’s well-being as an investment for their own. We need to stop cutting people out of our lives for things that deserve a slap on the wrist, or better yet… a conversation.

And finally, I feel that I’m living in a world where I am routinely punished for the hurt that those close to me have received from someone else. I am not perfect, and I’m sure this post probably gives the feeling that I think I am – but that’s not how I feel at all. I guess I just wish sometimes that rather than people relying on bitterness and questioning my genuineness (yes, it’s a word!) they would see “Becky” before anything else.

I’m not some opportunist who cancels plans with you for better plans with someone else – I’m Becky, and if I need to make a change at the last minute, it’s because my disease had other thoughts about how my night should go. I’m not some pathetic antisocial slug – I’m Becky, and if I say I can’t walk the mall with you, it’s because on most days I can barely walk to the bathroom. I’m not a charity case who expects people to do all the heavy lifting – I’m Becky, and if I ask you to help me with a repair in my apartment, you better believe I’ve already tried to do it myself.

I’m not the roommate who left you hanging with the other half of the rent in the middle of your lease. I’m not ungrateful or unappreciative of the little things in life. And finally, I’m not some girl who broke your heart. So before you see our relationship as “imbalanced” or taxing because I can’t commit to plans the same way, or because my memory was wiped out by meds, or because my gravitation towards you when I’m sick makes me look like a clingy girlfriend, please remember that you weren’t the only one inconvenienced, disappointed, or scared to be vulnerable. Before any of those thoughts creep into your mind, I beg you to remember one thing.

I’m Becky.

 

 

Hello from the land of Ramen and energy-saving light bulbs. Being sick is a lot of things, and being a total bank-account buzzkill is at the top of the list. As if it’s not bad enough to be schlepping around in a body that has a broken on/off switch, the healthcare industry (industry, business, corporate crapfest…) seems to have everything in mind BUT the actual well-being of the patient. Don’t get me wrong, I am the most fortunate and grateful person to be living and working in the world’s medical mecca (NY to the C!), but trying to navigate through the financial woes of chronic illness can be sickening all on its own.

I’ll start off by saying that I am writing this post due to the overwhelming feedback I got from people saying they could relate to the craziness that happens to me regarding my medical bills. I wish I was over-exaggerating when I say I have some sort of an administrative issue every 2 weeks on average, but it’s the truth. I’ve said it before and I’ll say it again – I am one of the “lucky” ones. I am educated. I have 31 years worth of experience as a sick person. And finally, healthcare: it’s what I do. And even with that armory of weapons in my corner, I still get hosed, screwed, and lost in the mix.

For the purposes of delivering what ya’ll are asking for, I’ll keep this post specific to the money stuff, even though it shares space with scheduling horrors, idiot office staff, clinical error and state prescription laws. I could (and will) write a book one day, but until that glorious light shines, we are here, and the bills are rolling in.

The first place I think we should go here is to talk about how many different avenues there are when it comes to the general payment of ones health. It’s funny, because reading that last statement back, it seems so inhumane for “payment” and “health” to even be in the same sentence. I wonder at what point in our history people changed from being good and kind to deciding that their life was only important if it was worth everything they own. It seems extreme, but I assure you that working with cancer patients for the last 10 years has made it very clear that when someone’s life is on the line, anything is on the table to be sold if there is a dollar sign attached to it.

So there are a few different things that can happen when you’re sick. You can ignore it (it’s free!) or you can seek medical attention. Whether it’s a walk-in clinic, the ER, or your family doctor, it’s gonna cost you some shells, and unfortunately, not literally. If you’re lucky enough to have health insurance, a good portion of the services might be covered, but even that has levels of security. And if you don’t have health insurance, you are still among a very large population, which in America, is around 15% or 30 million people.

Whether you have health insurance or not, it’s still insanely important to do your absolute best in trying to understand the billing process and the charges that will be coming your way.

For those who have health insurance:

1. Know WHAT’s covered. Do you have a deductible? Do you have to hit a certain maximum out-of-pocket payment before your insurance decides to join the party? Do you have co-insurance? Are you responsible for a certain percentage of certain services, even after the deductible is met, again, before the insurance company steps up to the plate? Do you have a co-pay? Do you know what it is for each type of service? Typically, your insurance card will usually tell you what the different amounts are (ie: $30 specialist, $20 PCP, $50 urgent care, $100 ER, etc.).
2. Know WHO’s covered. The worst thing a person with insurance can do is not pay attention to the doctors that are or aren’t within their network. So for example, let’s say you have to see a Rheumatologist. Your PCP says that Dr. Smith is a great guy, gives you the number, and so of course, you get the next available appointment because you trust your PCP. I don’t care how great this Dr. Smith is – if he does not participate with your insurance plan, do not go see Dr. Smith (unless you can afford it. And I mean REALLY afford it. Because it’s never just a fee for the MD. You’ll get zapped for the visit, the Medical Assistant taking vital signs, bloodwork, and god forbid you have to go to the bathroom, there’s another $100 for toilet paper. Some places also charge a “facility fee” but I’ll talk about that later.) The bottom line is that your PCP is not going to pay your medical bills, and Dr. Smith isn’t doling it out for free (or this post wouldn’t exist), so make smart decisions about the providers you choose. Typically, insurance companies have some sort of resource for letting their subscribers know who is/isn’t in-network, but the best way to confirm this information is to call a specific doctor’s office and ask them  if they accept your insurance before you make the appointment.
3. Know how to read your bills. You ever get a bill in the mail from a doctor pretty soon after the appointment, and it says you owe something crazy like $500 dollars for the office visit? “But wait, I paid my copay to the idiot who didn’t make eye-contact in the office, and I confirmed that the doctor accepts my insurance. What gives?” Well first of all, trust your gut. ALWAYS trust your gut. If you’ve done your due diligence and you know WHAT and WHO is covered, you absolutely, 100 percent, without-a-doubt should question why you have a monster bill. One tip that I can give you is that since so many medical facilities have become automated with their billing processes, sometimes the computer does a better job than it should, which ends up causing some problems. Basically, medical centers pay millions (sometimes more) to install computer programs into their process which automatically send out notices to patients when bills are outstanding on their account. But since the computer doesn’t have an actual brain, all it’s conditioned to “know” is that there is money unpaid, and a bill is printed and sent out to the patient. The real issue, however, is that insurance companies sometimes take a month or two (or more) to respond to a medical claim when it is submitted by the doctor’s office. So let’s say you saw a doctor on June 1st, and the claim was submitted to the insurance company on June 5th. On June 20th, there might not be a response from the insurance company yet, so rather than your balance being covered, the balance gets sent to you (which is no mistake, since you typically sign a waiver at the beginning of your visit, swearing to give limbs and children and vital organs if the insurance denies to cough up the dough.) BUT,  since you now know this information after reading this post, what you can do is call the number on the bill, and what you will usually find out is what I just mentioned. You will typically be able to discard the bill, or at least do nothing with it immediately, because until the insurance company has paid its portion, the balance is not yours. As I said earlier, the portion varies from coverage plan to coverage plan, but if you have insurance, SOMETHING should be covered. Once the insurance responds, you’ll usually get an updated balance from the doctor’s office, and at that point, it’s reasonable to panic. But not a second before.
4. If something doesn’t seem right, ASK QUESTIONS. Since I have had the unfortunate experience of taking many ambulance rides in my adult life, I am familiar with the fact that it is common for the EMS workers to not gather insurance information, because let’s face it – what patient is riding in the back of an ambulance just to give it a whirl? Most people in that situation are very sick, debilitated, traumatized and in some cases, unconscious. I don’t know about you, but I’m not usually very valuable when I’m not conscious. As a result, the ambulance company gets the basic demographics from the patient’s ID and sends them a “get well, soon” present, and in my case last week, it was in the form of a bill for $978. Since it took so long for them to find me, a collections agency was asked to step in and help, and when I spoke to the woman managing my case, she stated, and I quote, that “this was the bill after the insurance paid it’s portion.” Because I’m not an idiot, I asked her why the insurance denied my claim. She said she didn’t have access to that information. “Well, that’s interesting,” I thought, because how could she know that this was really the amount I owed if she had no access to the explanation of benefits? When I asked her the same questions, she said that I could call the insurance company myself and figure it out. Which I did. And do you know what I found out? I didn’t owe $978 or anything close to it, because my insurance company confirmed that they had no claim on file for the date of service in question, which means I was being billed for the entire, insurance-untouched amount. I avoided paying almost $1000 just because I knew enough to ask questions and trust my gut. How many people out there know enough to do the same?
5. Don’t be afraid to follow-up with your doctor’s office about charges. Regular office visits, for the most part, can be relatively straight-forward when billing is concerned. The problem sort of arises when you are having something out of the norm added to the mix, like an in-office procedure (ie: a scope at an ENT’s office) or a surgery you have to go to the OR for. One thing that I’ve seen happen many times (and have had happen to me, unfortunately) is when patients are scheduled for surgery and require an insurance prior-authorization (which is sort of a soft promise from the insurance company that they might, just might, pay for some or all of your surgical procedure)  and you either find out last minute that the office didn’t obtain the authorization so your surgery is cancelled (better case) or they didn’t obtain the authorization and you had your surgery and just like that, you owe a billion dollars to the hospital (worse case). The second scenario very rarely happens because most operating rooms will cancel a procedure if they have no evidence of ever getting paid, but you better believe that when it does happen, the only fingers that are pointing will be pointing in the direction of the patient. Because in general, the expectation is that the patient knows the process and knows when to speak up when it’s not adhered to. It’s unfortunate, but it’s the truth, and it’s why I always say you have to be your own patient advocate. So if you have anything coming up and you aren’t sure of what your financial responsibility is, ask questions, talk to your insurance company, and don’t be afraid to be the squeaky wheel, because it sure beats being in the car when the tires fall off.

For those who DON’T have insurance (and other tips):

1. Read the forms you are signing. This is a tip that I have as a result of working at my current job. As some of you might know, I have had a career in healthcare operations management for about 10 years. This means that while I have had the priceless opportunity of weighing-in on patient care matters and implementing ways to make things better, I have also had access to the ugly insides of this industry, and at times, have been expected to carry-out policies that I don’t necessarily agree with. I think I have done a good job fighting to keep my immediate situation honest and ethical, but there’s a bigger picture, and no matter which way you spin it, that picture is green. In my current role, I have worked closely with the patient relations department, and have learned a lot about how to handle patient complaints and grievances. One of the most common pieces of feedback that I’ve received in the last 3 years has been about getting billed for charges that patients didn’t know existed. Among these mystical bills is called a “facility fee,” where a specific type of facility (specifically, an Article 28 site) can charge extra, because the patient has certain conveniences in that type of site that a regular outpatient private practice medical office wouldn’t be able to provide, like everything being in one place (infusion floors, radiology, and social work all being in the same building as your doctor, for example). It’s sort of like the patient is going to a mini hospital, and this type of site has very specific guidelines that they need to follow according to the department of health, like being within a certain radius of a full-fledged hospital, or always having an ambulance parked out front in case of an emergency. Since this fee was relatively new in the beginning, leadership provided some leniency when patients would complain, and maybe a percentage of what they owed would have been reduced. But over time, as the complaints became more frequent, it caused the institution to be more creative in communicating this policy to patients, and one of the ways in which that happened was to create a form that patients sign when they arrive for their appointments. As time moved on, when patients would complain about the fee, if they had a signed form on file in their medical record, they had no leg to stand on. It didn’t matter if that patient didn’t speak English or if the importance of the form wasn’t communicated well-enough by the staff, let alone the patient being distracted by whatever illness they are battling. If the signature was on the page, the bill was theirs. So just keep in mind that you are asked to sign things for a reason, and usually that reason is so you have no defense.
2. Know who you’re speaking with. Whether it’s the person in the office  who answered the phone or the representative at the insurance company – get names. Get names, get names, get names. This has always been important, but I was on the phone with a collections agency the other day (with the same winner I mentioned above), and she used that age-old saying of, “it’ll be your word against theirs.” Think about this for a second. This is a person who makes her living harassing sick people for money they probably don’t have, and if that wasn’t bad enough, she had to throw in some aggressive zinger to make me feel shorter than I already am. My word against theirs? Last time I checked, I was the one who called them about the money I owed, and I was also the one who figured out that the information she was providing me was way off. I know I’m flaky and have a lot going on, but neither of those sentiments implies I’m some half-wit that doesn’t do my due diligence. Yet, because I didn’t have the name of someone (I should have just made it up, honestly…), none of my efforts would matter because when you owe money, your doctor might as well be in the mob.
3. Get health insurance. I’m not even trying to be funny with this one. There are so many options out there now for people who are unemployed or whose shitty employer doesn’t give a flying pig about their health. It doesn’t matter how healthy you are; everyone gets sick, and when it’s something bad, you never see it coming. Depending on your financial situation, you could be a candidate for Medicaid, or if not, the Affordable Care Act options have grown tremendously. Many big-name private insurance companies partner with the ACA and offer several options for those who need help. There are different levels of coverage based off of what you can afford, so at the very least, become educated on what’s out there before you just submit to a lifetime of debt or living in a bubble.

 

So that’s sort of a snapshot into the ins and outs of how to stay on top of your medical bills. There is so much more to deal with than these few paragraphs could even begin to cover, but hopefully this will be a good jumpstart into the basic knowledge you need to start feeling confident about speaking up when things aren’t right.

Our world is filled with human error, don’t let it cost you your health.

 

(And as always, if you have any questions or need some help, feel free to email me at BeckyMotivated@gmail.com)