Baldies' Blog began originally in the UK by a 26 year old journalist with a blood cancer on a mission to inform the world about bone marrow donation.

He has since died, and I took on the cause of making cancer care more transparent for everybody.

Cancer is a disease that will touch everybody through diagnosis or affiliation: 1 in 2 men will be diagnosed and 1 in 3 woman will hear those words, "You Have Cancer."

I invite you to read how I feel along my journey and
how I am continuing to live a full life alongside my Hodgkin's lymphoma, with me controlling my cancer, not my cancer controlling me.

I hope that "Baldies' Blog" will prepare you to handle whatever life sends you, but especially if it's the message, "You Have Cancer."

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Saturday, January 24, 2009

$COST$ to fight insurance

I have many wonderful aunts and a great family who has been supportive of me through my entire struggle. I’m very lucky to come from where I do. I don’t think my life would be as joyful as it is without them.
Today, I’m going to highlight one, though so many others need to be given special credit at some point too. I’m going to talk about Aunt B, the aunt that gets the special luxury of fighting my medical bills. She works as a liaison between BC/BS, medicare, and all the facilities where I have ever been treated. Here is a sample: Dana Farber, Brigham & Womens, Dartmouth Hitchcock, Valley Regional, Memorial Sloan and Kettering. This list could go on and on and on.
She has taken on the role of communicating with all these treatment centers to ensure I pay NO MORE than I absolutely have to.
As you can imagine, this is no small feat.
We recently discovered that two of the previously named hospitals have not even been submitting their billing queries to either of my insurances, Highmark BC/BS or Medicare. The hospitals decided to cut out the hassle of submitting to the insurance, which likely wouldn’t pay what it is contractually obligated to, and send the full bill straight to me.
Imagine my shock when I start opening bills for $250, $1200, or $1400 when I KNOW I’ve met my maximum out of pocket deductable.
I usually meet the maximum out of pocket deductable (which is $4000 for the family) by the end of January. There is no way this was not met in Sept or October of 2008.
But the bills keep rolling in.
With this discovery, I began to wonder exactly how much work it takes my Aunt B to arrange appropriate payment of my medical bills.
When I asked her, she estimated she spent 3-4 hours a week making phone calls. She said she generally does this early in the week, on Monday, this way she can receive call backs between Thurs. & Friday.
The 3-4 hours does not include any of the time she spends after Monday actually speaking to people.
So I thought, maybe I should do some math and figure out how much it would cost these hospitals to fight on behalf of me if I didn’t have superwoman Aunt B at my command.
I’m estimating Aunt B gets paid about $32 per hour, or whatever a top pay LPN or relatively new RN would be paid.
At $32/per hour, for 3 hours, every week of the year (that’s 52), she would cost an astounding $4992.00 yearly.
But that’s the low end of the estimation, because she also said it is three to four hours generally. How much would four hours cost? Four hours x $32/hr= $128 weekly x 52 weeks = $6656.
WHOA! That is a huge cost to hospitals to fight on behalf of patients for insurance to pay for services patients are contractually allowed.
Furthermore, could you imagine ME spending 3-4 hours a week (not including call backs) fighting with my insurance company for paybacks.
It just wouldn’t happen.
I can’t fight CANCER and the INSURANCE company at the same time. I just don’t have that much energy, and I think the stress would cause the tic, toc of my all ready shortened lifespan to tick even faster.
With all this, no wonder people are dropping like flies and health care is unaffordable.
Hospitals do have to employ many people like Aunt be to fight insurance companies for what they rightfully owe.
If the going rate is $28 an hour for this job and the average week is 40 hours, then hospitals are putting $1120 out the door each week to fight insurance. That’s $58,240.00 yearly!!! This number does not include benefits either.
That number is also for ONE PERSON to fight with insurance companies. Let’s guesstimate that Dartmouth Hitchcock employs 6 of these personnel, with ranging salaries, but we’ll stick with the $58,240 yearly salary.
$58,240 x 6 people = $349,440.00, which is the ultimate cost to a hospital to fight with insurance companies.
Where is the non-profit going to make up for this hole? Well, costs have got to go up, and the problem just gets worse and worse, the hole just gets dug deeper and deeper.
Ouch. I have to go. I hear my wallet crying and my bank account screaming for its life.
If I hadn't just regrown my hair, I think I'd be pulling it out right about now.

6 comments:

Paul Levy said...

Hi,

Good stuff. I linked to you.

Anonymous said...

Way to go Aunt B ... like Hillary, YOU ROCK!!

And Hillary ... to you I say look around ... there are a lot of folks who are committed to you & who are willing to help you fight this battle because you are worth it.

So stay strong & focused ... & thank you for being willing to share yourself with so many. The only way things will be any better is via education.

So you GO GIRL!!

F

Anonymous said...

Hillary, you are so lucky to have Aunt B not only in your corner, but fighting for you. As you've said many times, you need all of your energy to fight off this dreadful disease.

Keep it up! You have no idea how many people's lives you have impacted with this blog, to say nothing of all of the people in the WORLD that are praying for you.

Eileen

Kelly Kane said...

Hi Hillary, sounds like you have an awesome Aunt B! I'm so glad someone is helping you fight this battle.

I know times are tough, and I'm thinking of you!

XO
Kelly

Chris said...

Hey Hillary,

I was just made aware of the crappy news from Bekah on the Hodgkins forum. Just wanted to throw my support your way and let you know I'm sending good vibes.

Take care of yourself,

Chris

Anonymous said...

How lucky you are to have an Aunt B to take care of the insurance battles so you can focus on fighting the cancer battles! Keep up the strength and will to fight - you've developed quite a cheering squad!
Dianne