Don’t Take Your Emergency to the ER

I always thought the point of a hospital, its emergency room and those who work in it were there to help people. However, after a recent trip to the ER, I believe I was seriously misinformed.

At 8 p.m. on a Tuesday night, my husband was rushed to the emergency room with a dislocated shoulder. Running to be by his side, I was not greeted by the security guard, as he was too busy joking around with his colleague about the drunken woman babbling on about her shopping cart.  When he finally did help me, he failed to tell me where I could find my husband.

I walked through the halls and found my injured partner. He was propped up in a bed with a sling, and in a lot of pain. He had a nice nurse helping him who seemed to be giving him the attention he needed in a timely manner. She even had a back-up nurse who introduced himself should my husband need additional services.

Before I even sat down in curtain 16, an administrator came with her computer-on-a-cart to get our insurance information. That’s fine, I knew I wasn’t going anywhere anytime soon, but seriously, let me sit for a minute and see how my husband is feeling before you’re up my ass to see if and how I can pay for this shit.

Shortly thereafter, two doctors came around and explained the procedure they’d be taking – some pain meds, X-rays and a pop back into the socket.  Wow, maybe this wouldn’t be as long as we anticipated. Everyone was so helpful and attentive to my husband’s condition. It was really very refreshing. And then the shit hit the fan.

The second nurse came back and told us someone would be down “in a second” to take my husband to X-ray. In the meantime, he was given some pain medication to hold him over before the morphine started. A half hour later, after we had to have our original nurse paged, someone finally came.

I sat and read my magazine, catching up on the latest developments in the Natalee Holloway/Stephany Flores/Joran van der Sloot case, and before I knew it, an hour had gone by. Where was injured shoulder boy? I peered around the curtains, walked around the ER, he was nowhere to be found. I figured the doctors decided to go over his scans with him right there. Wrong!

Finally, as they rolled him back, he tells me how he waited in the X-ray hallway for like 45 minutes. His pain medicine had worn off and they shifted him in ways that put him in more pain than he originally was. No one looked at his X-rays, no one was waiting to give him the morphine, he was just left in a hallway while X-ray techs took personal phone calls.

Another hour or so went by and no one came back to curtain 16. Not the nice nurse, not her back-up guy, not the doctor, no one. The pain was getting worse and I was getting pissed. I saw all these doctors and nurses just sitting in this admin area talking, eating, playing on their phones, so I asked for help.

I was blatantly ignored. Someone picked up a phone, someone else walked away, another was ferociously typing away on their Blackberry. Seriously, come on dude, help a girl out here. Finally, after the finger tapping irritated them as much as it did me, and a woman asked what I needed. Well, geez, let’s see….

I didn’t need anything, but my husband, he needs some pain maintenance. We need a doctor. Oh, and the 90-year-old woman screaming, “Help me, can someone help me?” in curtain 14, she obviously needs something too. Can you help her out?

Apparently they couldn’t….and they wouldn’t. We were on the “Green Team” and these blokes were on the “Red Team.”  Translation: they couldn’t do a damn thing because they each work on different patients. I understood that, but if you have seven people who have the ability to help patients and zero who are actually around to do anything, isn’t there something wrong with your strategy?

All the Red Team did was page someone, but no one came, as they were attending to a critical patient. That was completely understandable – my husband was not an emergent patient, but did need care. Someone could have readjusted his arm, provided him a pillow, done something to show bedside manner still existed.

Finally, the original nurse showed up. She was kind and apologetic, yet baffled that no one else, like the floater nurse, had assisted, much less returned during that time. We told her our plight and she looked at us, sympathetically, like she’d heard this before.

Six hours later, armed with a sling and a prescription, we were on our way home. Of course, the hospital made sure we paid our co-pay upon our departure and surely, had provided enough staff to help us in this effort.

I’ve never had a great experience in an emergency room. I don’t know many people who have. I expect to wait, I expect to be ignored, and I expect to be asked for money and proof of insurance as soon as I set foot in the door. What is unacceptable to me is dozens of workers sitting on their asses while people cry out in pain or request help. There’s gotta be a better, more efficient process, even if you just  hide these people from the patients!

Does Your Doc Owe You Money? I’d Bet My Co-Pay On It…

How many of you actually know what your explanation of benefits are? Sounds boring, I know. Until recently, I never really knew myself, primarily because I didn’t bother to pay attention to them. If something came in the mail that said I was not responsible for any payments and/or it was covered by my benefits, that was all I needed to know.

Now that I am paying my own health insurance out-of-pocket (with some government aid thanks to Obama’s American Recovery and Reinvestment Act of 2009, which reduces the cost of COBRA for the unemployed), I look at everything related to my health bills a little more closely, including my EOBs.

It has come to my attention in recent months, that I sometimes pay a co-pay at a doctor’s office when I actually don’t need to. I’m usually only shelling out about $10 to $20 a visit, depending on the type of doctor I am seeing and I’m ok with that, because when I receive my EOB, it tells me if I actually needed to pay a co-pay or any other charges. The EOB is a complete breakdown of what my doctor charges for the visit, what my insurance company pays the doctor, what I am responsible for, and what costs were not covered, if any. It is, as it states, an explanation of your benefits.

As these annoying pieces of paper kept arriving in my mailbox, I started realizing that I was paying doctors when I didn’t need to. Since there were lots of lines and numbers and insurance jargon I didn’t quite understand, I called my carrier to make sure I was understanding this correctly.

What I heard on the other end shocked me. My doctor(s) receives these same EOBs. They see that I am indeed, not responsible for these co-pays and by law, are supposed to refund me my co-pay upon receipt of this document. Let me just tell you, checks are not miraculously showing up in my mail. Are they showing up in yours?

So I have to call my doctor(s) and explain which isn’t a big deal; well, most of the time. Sometimes they want a copy of the EOB (which I can easily obtain through my online account), sometimes they already have it on file. However, there are times when I get the run around for a measly $10. One doctor made me wait four months for a refund. I was told my doctor was too busy with patients to approve this. My insurance company finally called and just like that, the check was in the mail the next day. I’ve already been refunded nearly $100 in the last 2 months in overpaid co-pays! As I mentioned, it is against the law for physicians to not refund you your money (if you are owed money) when they receive this document, because they are receiving an overpayment; they have already been paid by your carrier. That is what you pay for by having benefits (whether you are like me and pay for them out-of-pocket or you are on a company plan).

I urge you to take a few minutes out of your hectic day to go over your explanation of benefits. While it may seem like only a few dollars, it all adds up in the end. If 4,000 people aren’t refunded their $10 co-pay, that’s $40,000 lost to working Americans. And we all could use an extra few buck in our pockets, couldn’t we?