Supervisor, Collections,
Professional Fees Office
Department of Psychiatry
"Eastern MI"
School of Medicine
Re: Account No. 81xxyyzz
Sir or Madam:
Your department (Ms. "M") sent me and I have received a "Final Notice" on the above referenced account. You say I have "made no effort to settle" the account.
However, my records indicate a payment of $453.00 was applied during the last billing cycle, and a payment of $1107.00 for the billing cycle before that. You've also received $415.00 from Blue Cross under this account number.
Now you are asking for $3,560.00 "within one week" or the "account will be sent to an outside collection agency".
Judging from the papers, notices and invoices I have received from you, that would probably be a good idea. I don't think your office is capable of following up on this kind of claim properly. It sounds to me that you don't understand an outside collection agency is going to charge you a percentage of whatever I send in.
Here's the situation that you or your collection agency have to know: $3,560.00 is a lot of money to someone who grosses (not nets) less than $10,000 per year. Imagine what is left over after taxes, rent, food and other expenses. Imagine after that that the hospital itself is still after me for their money, and I have to buy drugs and pay doctor bills other than for Dr. Lima (who I hardly even saw to begin with but started out charging $5,535.00 on this).
It is not that I can't pay this money, but you can't ask for $3,560 and expect it in one week (especially now since I just lost my job). It should occur to you that you've already gotten quite a bit of money on this and it looks like you could get more if you realized the situation. (It is pretty stupid to expect someone like me has a Master or Visa, by the way.)
I don't want irritating phone calls from belligerent people such as from your inpatient department, or people calling here using false names as if I don't know how the protections and rights of the credit or legal systems. I do not want any more of these filled-in xeroxes you pulled off the shelf because you didn't know what else to do. If I do have to deal with three Johns Hopkins departments and two collection agencies for one hospital stay, I would like to see some cooperation if not organization.
Looking generally at what I tend to make when I am working, I can pay you people around $200-$300 a month (without looking at personal bankruptcy where you would get close to nothing). Since your people fix prices within your institution so that the bill goes over $5,000 for one hospital stay, you should be prepared to deal with the "little people" who are not in on the salaries and benefits and profit sharing that are apparently customary over there.
When this goes to an outside collection agency (and I think it should because they tend to be more professional, let me know the name, address and phone number of the agency and the person I'm supposed to deal with. I do not want to have to call in there and have to go through three or four people before locating someone with knowledge of the account. I also don't want to talk to one person one day and find out another day that there is no record of any agreement reached. One last thing you should mention is that my "credit" is already messed up from screwed up JHU Physician billing foul ups dating back ten years when Medical Assistance credit was never applied for by your office. (In other words, I have had a lot of experience at this by this time, no credit, and precious few assets.)
If you decide not to use an outside collection agency (and save yourselves their fee), I could very easily pay you the same amount of money instead but I would expect not to get "Final Notices" or whatever other xerox form you may have on hand from time to time.
Sincerely,
Nancy Moran
nm
cc:
--- Chairman,
--- Department of Psychiatry
--- And others ...
"Chairman Man", M.D.
Chairman,
Department of Psychiatry
"Eastern MI"
School of Medicine
Re: Your billing systems
Dear Dr. "Chairman Man":
I have been a patient of your department for ten years (inpatient and outpatient). I have therefore been dealing with your billing systems for ten years.
My "primary" physician is Asst-Prof, but on the inpatient level I have dealt with a variety of professors and assistant professors and residents (mostly residents), the latest of which was Dr. HigherUp (who I found to be quite personable).
I don't think it is incumbent upon me, Dr. Asst-Prof, or any patient under the care of your department to spend a lot of time and effort not on medical care, therapy or whatever name you want to give it attempting to straighten out bills and billing systems.
For this reason, two recent letters I have written regarding the billing system now in place in your department. One is for inpatient care, the other, outpatient (currently using two systems, apparently neither of which is working properly). I also have a letter dating back to 1984 (on the outpatient clinic) which apparently resulted in administrative and pricing changes at that time. I am not forwarding an account of a telephone conversation I had with the hospital's billing office regarding my last hospitalization since I know that is not your department.
As a result of my first hospitalization, the bill was not submitted to Medical Assistance by a deadline and there was a shortfall of some $2000 or more similarly turned over to a "professional" credit agency. I have had bad credit since that time, but I have also been hospitalized enough since then to know how to deal with the aftereffects. (Your social workers are useless as to matters of this kind.)
It is only with the greatest deal of assistance of Dr. Asst-Prof that his outpatient billing stays "on track" and the situation is the topic of many of our conversations. Having been employed in clerical fields for a long time, I can only surmise that Dr. Asst-Prof himself would have to take over the billing operations himself to figure it all out. I suspect others in your department are having similar problems.
I am not asking that you straighten out my bill or give me any forgiveness on the monies outstanding (as for outpatient I've been waiting for a balance due for four months and will accept Dr. Asst-Prof's determination; as for inpatient I know that is the "going rate", Dr. HigherUp has nothing to do with it and your billing people don't know anything else they are supposed to do except go to a collections agency). I know that in time that the bills will eventually get worked out (average: 6 months outpatient, 3 years inpatient).
I am telling you that your department has a serious billing problem that requires attention from a higher level. Not only are patients being treated unfairly, bankrupted, credit ratings destroyed, etc., but you are (apparently) losing insurance payments among all the sloppiness, disorganization and ill-equipped people doing the paperwork. I don't understand how your department is letting all this continue as it has for so long, but I believe it is time you get a handle on it.
Sincerely,
Nancy Moran
nm