"Eastern MI" Receivables, Ltd.
Att'n: Ms. Lynn "East"
Re:
"EMI"-Dept. of Psychiatry
Account No. 17###########
Reference No. 53
Dear Ms. "East":
Enclosed please find a check in the amount of $230.00 made payable to "Eastern MI" Receivables under the above-referenced account. Payment is being made pursuant to my letters of June 8th, June 29th and their enclosures. This shall be my last payment on my account unless and until I hear from you with convincing argument to the contrary.
I have been reticent about approaching the issues hereinbelow for fear of breach of my own patient confidentiality: however, at this point, I am also fully aware that "Eastern" over the years has accumulated a massive amount of patient records under the about account number. At each admission, these records are made freely available not only to my insurance companies but others, as yet unknown (some, like Medicare, irrelevant). At the inpatient level (to say the least), I have seen them to be available for light reading and/or study to any manner of staff and student. I have no doubt I have been the topic of many teaching conferences, and having worked at the Johns Hopkins complex over so many years, I know how easy it is to access these records for research purposes alone.
At this time, I would like to note that funds have been transferred to your firm only as a good will measure, under a certain amount of misconception and under protest. It is my judgment that the contract establishing any right, title and interest in obtaining and/or recovering these monies was signed under conditions of false statements and duress over and above physical and mental condition (if any) at time of admission, and by the nature of the emergency room at Johns Hopkins Hospital and its procedures in general.
The only document I signed and in existence regarding your present billing is the "Business Office Authorization Notice" dated August 2, 1989 by and between myself and John R. "Intake Man", M.D. Though Dr. "Intake Man" is not, to my knowledge, an employee of the Hospital, he was acting as its agent in inducing me to sign said contract. In his capacity with the Department of Psychiatry (primary responsibility for admissions), with regard to the instant billing (with the University Department), Dr. "Intake Man" can be said to be solely responsible for any agreement(s) reached with patients at the time of admission, at the least with regard to the physician component of the total bill.
I therefore refer you to the "Business Office Authorization Notice" by and between myself and John R. "Intake Man", M.D. (of the "Eastern" University Department of Psychiatry). (Fortunately, I managed not to misplace it during my stay at the "Eastern" Hospital facility under the care of "Eastern" University physicians. Further, some time after discharge, I mistakenly filed it under "Hospital" rather than "University" though the contract covers both entities. Besides, the Hospital bill was in excess of $18,000, while the "doctor" bill was only about $5,000.)
The following statements checked off by Dr. "Intake Man" are false and were false at the time the contract was signed: "You or your representative must be seen by the discharge coordinator in the inpatient business office", "Hill-Burton Notice of Availability Given", and "Semi-Private rate 334/day plus Professional Fees". (Apparently [see preprinted part of the form], the Head Nurse was by this form instructed to have declined discharge ("release") pending validation by the "Insurance Section". If "Eastern MI" has any evidence of such an occurrence, please furnish me a copy at your earliest convenience.)
Please note that the contract was marked at the time twice by me that it was signed under duress, the first time next to the paragraph under "Assignment of Benefits", the second time by the legally-valid abbreviation "UD" to the right of my signature.
Rather than go through a lengthy description of all the facts and circumstances which led me to be in the "Eastern" Hospital Emergency Room as of the date of this contract, suffice it to say that "duress" included, but was not limited to, several hours of waiting in the presence of young men and of the kind I have come to known in my ten years of experience in the Maryland prison system and Baltimore City Jail (one of whom had obviously been raped but the young resident didn't realize this even when I tried to tell her); being restricted to a small area consisting of no more than a handful of hard chairs and a pair of concrete "quiet" rooms, only one of which was supplied with a mattress (a bare one), watched over by two security guards (and no "medical" professionals); having my "medical" history, including questions on food, bathroom, menstrual, and sexual habits, taken by the young resident in full view and hearing of the many and several young men, security guards, and an assortment of miscellaneous hospital staff present; growing hungry after a while, but prevented by the guards from trading cigarettes with the other patients (except for a small cup of ice cream) as trays came up for them but not for me (they sat along the corridor with the bulky food trays in their laps); having to trade cigarettes with one of the young men to vacate the "quiet" room with the bare mattress and to turn over possession of the one blanket available for all of us; having a blood test drawn not in the usual place (in the crook of the elbow) but about an inch an a half toward the wrist causing a certain amount of pain at the time and resulting in severe bruising about two inches wide and four inches in length which did not subside for several weeks [I was questioned about it later - perhaps a notation about its existence may appear in the chart for this admission]. (In my perhaps "disturbed" state of mind, it occurred to me then - and the thought lingers - that I had received a subcutaneous injection of the HIV virus. After all, certain of the young men were almost certainly infected as their behavior seemed to indicate a familiarity with the non-prescription drug trade.)
Particularly disturbing was that the young resident seemed intent on finding space for me at the "Eastern Detritus" Medical Center, a "lesser" ("farm team") component of the "Eastern" Medical System, with which I had prior experience. I kept having to yell out the name of my Johns Hopkins University Department of Psychiatry outpatient doctor, along with his two telephone extensions, inside address and Division locations (I was going to the bathroom while the resident was asking these questions. The bathroom was bare concrete except for fixtures. The sound echoed throughout the wing.)
I was well aware that "Eastern Detritus" is characterized by shoddy maintenance, rude housekeeping personnel, rotten and abusive nursing, second rate food, invasion of privacy during rounds and by ill-trained and insensitive nurses, skimping on amenities such as sheets, pillows (a nurse got me one by taking it out from under another patient), blankets, soap, and soap powder, theft of personal belongings, and having to contend with male patients from the state hospitals during acute phases of their illnesses.
Finally, at the point when I signed the "Business Office Authorization Notice", I was not able to access my personal belongings as they were locked in the resident's office. Among the items I had packed were foodstuffs: after a seven-hour wait in the emergency room at "Eastern Detritus" (supposedly suffering from the same psychiatric symptoms), the only food on the ward was a can of Sustacal ordered for an anorexic.
So thus, I believe one might safely conclude that the "duress" under which the "Business Office Authorization Notice" dated August 2, 1989 by and between myself and John R. "Intake Man", M.D. is well-founded and not due to any pre-existing psychiatric and/or mental condition on my part. The contract can then be said to be invalid and unenforceable. "Eastern MI" cannot lay claim to a "just debt", nor can the "Eastern" University Department of Psychiatry, its successors or assigns.
By copy of this letter, I shall be providing the contents of this letter to my private insurer and outpatient physician at "Eastern" University School of Medicine. I trust you will be forwarding a copy to the inpatient people. I reserve the right to distribute other copies to other payors in the future.
If you and/or "Eastern" University inpatient choose to respond to this letter, please do so in writing. Be aware that other than myself, two insurance companies have already paid out on this claim and they and others continue to do so on behalf of other patients.
Sincerely,
Nancy Moran
nm
cc:
Referring physician
Primary insurance companies (2)
And others ...