BUREAUCRATIC NIGHTMARE DEPARTMENT

Dear George, 

All this medical stuff puts us at the mercy of huge impersonal bureaucracies, and it’s starting to drive me crazy. A few months ago Katja was diagnosed with a cracked wisdom tooth under her gum that needed to be extracted. While this sounded unpleasant, we were pleased that the operation would be performed by the head of the oral surgery department. He apparently was on vacation though, and the surgery was actually done by a resident. A month or two later Katja started having severe pain in the location of the surgery. An X-ray revealed a bunch of small bone fragments scattered around the now-healed area of her gum. The new doctor said he’d never seen anything like it, seeming to imply that the original operation had been badly botched. In any case, Katja needed to have another operation, more intrusive and difficult than the first. The hospital double-checked with our insurance company to make sure that the operation would be covered by insurance, and, after receiving an affirmative response, Katja underwent a second procedure. Six weeks later we got an e-mailed bill from the hospital for $13,000. Katja called the hospital, and they advised us to call our insurance company since the latter hadn’t paid the bill. When Katja called, the insurance person said they hadn’t paid the bill because the hospital had used the wrong code in sending the bill, classifying the operation as medical rather than dental. They told Katja to contact the hospital and ask them to change the code from medical to dental and resubmit the bill. Then they would pay it. Katja called, but the hospital said they were not able to change the code from medical to dental because that would involve breaking the law. (What law remains obscure.) The insurance company then said that nothing could be done and that we would need to pay the bill out of pocket. The situation, of course, seemed totally ridiculous. Katja called the hospital back, and, after some haggling, they agreed to reduce the bill if we would pay the full sum immediately. It was still many thousands of dollars, but there seemed to be no other choice. I brought up the idea of hiring a lawyer, but Katja gritted her teeth and gave the hospital our credit card number. The most positive thing I can say is that I’ve stopped losing sleep (though I have been having bad dreams). 

Love, 

Dave