July 16th, 2013
I try to avoid making a habit of dissing things online, but when I’ve had a horribly, awful, no-good experience – repeatedly – with a business or service, I’m going to write about it because other people should know before a) they do business with the same and/or b) they need to validate their own sub-par experiences with said business.
That written, I’ve been so continuously frustrated with my health provider network’s billing system that I’m airing it because I seemingly can’t be heard by the business itself, who has not at all to my satisfaction explained nor reasoned my lackluster experience with its customer service and systems in general.
So here’s my situation with a large slice of this-is-my-personal-experience-and-maybe-the-below-has-only-happened-to-me,-but-I-doubt-it:
I’ve been seeing Scripps doctors since 1998 when I first moved to San Diego. Despite a primary care physician who stole away in the middle of the night to “pursue beauty school,” and astronomically crazy fees probably standard across all healthcare networks, I’ve been pretty happy with my providers.
Where the issue comes in, is the ridiculous-to-me and inefficient-in-my-experience Scripps billing system. Now, I’m not a rocket surgeon, but I do normally know how to look at numbers and say “WHAT?” Or at least keep track of what I owe and when I paid thanks to the grace of online billing and banking.
But things got confusing even taking into account my meager math skills. See, I receive bills from Scripps, separated by “bills from my doctor,” and “bills from the lab,” and “bills from radiology,” all of which apparently never the twain do meet, because for the same service, I receive a multitude of different bills with different account numbers and different billing systems for (I’ll say it again) THE SAME SERVICE. It was hard to decipher if the lab was charging me for something radiology might have charged me for and which my doctor may or may not have already billed. That’s mainly because Scripps doesn’t send itemized bills as far as I can tell, rather opting for a “HERE’S WHAT YOU OWE FOR DATE OF SERVICE XX-XX-XXX” overall bill. Except it’s not an overall bill because I receive something similar from the lab, from the clinic, and from the hospital with varying amounts.
So, a sane person may argue, call the billing reps and find out what’s going on with your bills. To which I answer, “I’m sorry but my line is temporarily busy/down/unavailable/will make you wait an hour to talk to someone,” a pretty standard message from Scripps’ automated lines. When I DO get through to a live and real person, I give my account number and am told, “Yes you owe $XXX,” after which I ask, “Is that for the whole service, i.e., is that my entire amount due?” and am answered with, “We don’t know. This is Scripps Financial Services, you need to call Scripps Memorial for its part of the bill,” an answer I love because then I have to call another number and wait again to speak to a real and live person who will tell me it can’t access all of Scripps’ systems, only its part and get in the 21st century Scripps and buy yourself some centralized systems so your reps can see AT A GLANCE the entire bill of each of your patients. (And it would be good if your patients could also see the ENTIRE bill for the ENTIRE service, even if broken down ON THE SAME BILL by “lab costs,” “radiology,” and “doctor visit.”)
The above has bothered me for a long time, I admit, but even worse is when Scripps tells me I’m paid up for all 2009-2012 outstanding accounts, and doesn’t send me communique for nearly a year, only to send a $172 bill in 2013 for a March 201o date of service many, many months after telling me I was up to date with payments.
Even better, no one can explain to me why I’m receiving an out-of-the-blue bill for 2010, when in 2012, I was told owed nothing further. I guess I need to call the Scripps GOD division for that explanation.
In the interest of full disclosure I’m going to tell you that I went on payment plans for several Scripps bills, because when one is paying $800 a month for insurance that reimburses you for nothing, $3,000 in additional medical bills is pretty daunting (at least I THINK it was $3,000). So I set up a payment plan with Scripps where I made monthly payments. And some months, I missed payments. I have to say that I was confused as to what I paid and to what it went for, since Scripps sent a monthly bill saying, you owe “$59.97 for XX-XX-XXXX date of service,” but there was no running total of what I’d paid and what the amount was now. I know that keeping an accounting is up to me, but it would be a nice value-add for a healthcare billing system to you know, show what you owe overall and what you paid.
Also, I had to set up payment plans for each division, for instance, I get a mammogram and I must arrange payment with the hospital, the doctor, and radiology (whose billing service for a time was located a convenient 200 miles away in Newbury Park, California). As a result, I DID get a little confused, I admit.
Which brings me to why I called Scripps last year and asked where I stood on my bills, and was subsequently told, “you’ve paid everything,” which is why I was so confused when eight months later I receive a bill for $172 dating back to 2010.
After trying in vain to understand what happened – did the system suppress the bill due to operator error? did Scripps have an incorrect mailing address it suddenly cleared up? was this all a dream? – I resigned myself to paying the damn thing, without even being sure I actually owed it.
And while I was on the phone, I asked about other bills I should be getting for doctor’s visits from the last six months because see, I HADN’T BEEN BILLED YET for a 2013 mammogram, a 2012 cardiologist appointment, and two ultrasounds from March and May of this year. I mean, I know there are amounts I owe, BUT WHAT ARE THEY, SCRIPPS? The doctors tell me to check with Scripps Billing, who tell me there’s nothing on record, OR that something is stuck in the system and they need to re-submit to insurance and OH MY GOD I’m just at the end of trying to demystify this inefficient and messy process.
I write an email. Sure I penned, “I’ve been a longtime patient of Scripps, but am slowly extricating myself from your network of doctors, because this will give me a heart attack and I don’t want to have to go through Scripps for treatment,” but I tried to as calmly as I could muster get to the bottom of this whole issue.
To Scripps’ credit, a patient advocate reached out to me and said she’d look into what I owe and when and what happened and what the hell, but some of my bills weren’t in her “purview,” which is a real problem Scripps, PLEASE CENTRALIZE YOUR BILLING FOR GOD’S SAKE.
I also received an emailed response from the manager of Scripps’ financial services, which was detached and homogenized and documented a gap in communication from 8/2/12 and 4/9/13, which to my thinking is the time period when I believed I was paid up for that 2010 bill. The letter also “assured” me that Scripps had sent monthly bills during this time (subtext: YOU ignored them).
When I point out the gap, the manager tells me “we sent five statements,” which again begs the question if Scripps claimed it sent monthly bills during that time (eight months) why did I get five statements (shouldn’t it be eight)?
I hate to tell you all, but we’ll never know.
I’ll get another “we-don’t-really-care-but-by-law-we-must-respond-to-all-complaints” letter and I’ll just continue to remove myself from this network and hope the next one will be more efficient.
Or, I’ll move to Tennessee for its Appalachian Hillbilly Emergency Room, because God knows, it’d be much more imaginative with its runarounds.