insurance statements one realized that our obligation was for about sixty five percent of the charges. After much exasperating inquiry with the insurance company through telephone and written correspondence, it was discovered that the remedy organization was not billing the insurance company correctly. This was finally revealed about nine months after the family member began treatment. The insurance company then informed one that after a six month time period, the claim will no longer be paid by them thus leaving the patient possibly responsible for the bill (this may also depend upon who you are). I stated to spouse through this experience that patients were seemingly being held responsible for how a remedy organization processes the billing to the insurance company. In early 2013, another “explanation of benefits” was received by the insurance company that denied payment of a claim. I contacted the physician’s office immediately about this matter as the remedy organization through which one received the bill, was selected through the physician. The physician’s office worker instructed one to disregard this statement because there was a problem with the method on how the billing was processed by the recommended remedy organization. Based on the previous experience, I stated to the office worker that if the bill is not paid by the insurance company within six months, the patient could be held responsible for the charges so it is imperative that the charges be billed correctly to the insurance company. One also recognized at this time that medical insurance companies have contractual agreements with remedy organizations where less money is paid and accepted under a contact. For individuals paying their own medical costs their charges are substantially higher. As one can realize, this is a corrupt system.
While reviewing the costs of medication prescribed to a family member who is insured under an apparent greatly reduced price prescription drug group plan, one realized that privately purchasing these medications from a wholesale prescription drug outlet would cost one less money. One then telephoned the corporate administrator of the group plan with this information. After much discussion regarding comparisons of costs of various drugs, it was finally revealed to me that one was charged more because of the way the prescriptions were written. Through this conversation, one discovered that a ninety day supply of medications costs considerably less than a thirty day supply.
This year one discovered a booklet published in 2008 by a large and renowned charitable organization on the “proper” care of an infant. The booklet was printed to be freely distributed to new mothers who more than likely were low income because this booklet was free of charge and was printed by a charitable group. After reading through this booklet that was written in a condescending and abrasive way, one recognized that some instruction was detrimental to newborns and other imperative instruction was not included in the booklet. For examples, in a section on feeding the infant, no mention was written about heating the formula to body temperature prior to feeding the newborn. After feeding the infant, the recommendation was to wash the bottle with hot, soapy water. Newborns bottles should be sterilized to prevent illness. Other instruction stated to swab the umbilical area with rubbing alcohol to prevent infection. An antibiotic ointment applied to this area after cleaning the area with soap and water would likely be less painful than alcohol and serve the same purpose. The booklet stated that infants can be bathed in a bath after their umbilical cord dries and dislodges from the naval area. Realize that many infants become traumatized and anxious by bathing in a shallow tub of water. This trauma