Medicine as a Business: Billing 2

In the prior post in this series, I presented a couple bills and dove into detail for one of them. Now it's time to see what pleasures there are in the second bill.

The doctor visit bill

Here’s the bill I got for a visit with the doctor who ordered the procedure:

This bill is a bit of a relief compared to the one for the MRI. While the return address (some PO Box in New York) and the address to which payment should be sent (NSLIJ at a PO Box in New York) are opaque and confusing, at least the box in the middle of the page names the doctor I saw and gives the date of the visit. I know what I'm being billed for: a visit with this doctor on that date. That's good!

Let's look a little more closely.

First, there's something interesting about the date. The visit with the doctor was Dec 11. Now look at the statement date: 3/13/18. Yes, that's right: the statement was dated a full 3 months after the visit! Wow. Northwell has clearly optimized their systems to march everything through so they can bill and receive payment promptly, right? Sadly, no.

Second, I'd like to point out an important issue: paper vs. electronic. With all the noise, billions of dollars of federal subsidies, and the obvious fact that electronic is better than paper, you would think that a major NYC hospital system would be entirely electronic. You would be wrong. Here is a post about this. But about this bill:

I got the paper bill in the mail. They could have gotten my email from me at any time, but didn't.

There is no opportunity to sign up for paperless billing, unlike even notoriously backwards bureaucracies like utility and phone companies, which constantly harass you to sign up.

Two things on the bill are highlighted to make them stand out: The amount to pay and the URL to pay it:

I think it's fair to say they're trying to get me to pay online. So I tried. But what a pain! Copying that looooooong URL without error isn't trivial. Then once I entered it correctly, here's where I landed:

They re-directed me: that long string I copied could have been tiny, because it wasn't actually the place they wanted me to go!

But the fun has just started. Now I have to fill out the form:

Once I filled it out, here is the result (with my DOB cut off for privacy):

Fail!

Dutiful person that I am, I got out my ancient check book, revved up my hand-printing skills, and ... yes, put the check in the mail.

There is more joy and fulfillment to be found in this simple-seeming one-page bill, but that's enough for now. For the next installment, we can look forward to some only-in-healthcare wonders of billing.

 

Comments

[C]

Thanks for blogging on this. I was especially interested to read your comment that

"there is good reason to believe that a software group that lets obvious flaws like these appear on patient bills has far deeper problems, and that the "underground" parts of their software are probably nightmares. Which all the evidence shows that they are."