Friday, December 30, 2005

With apologies to the professional staff of the J. Blog Medical Center

One of the unanticipated consequences of becoming a member of the Jewish blogosphere is that, surrounded as I am by three bloggin’ docs and a nurse, I’m beginning to feel guilty about paying my medical bills late.

Well, it’s like this: First, we pay the bills that keep a roof over our heads, our utilities working, our son in college, and our various insurance policies still valid. Then, we pay the bills that have late fees. Medical bills, I’m sorry to say, run a distant third.

The problem is that health care professionals and lawyers aren’t the only professionals who often provide services to individuals and/or groups who sometimes have difficulty paying for them.

Magnetized to our apartment entrance door as I type are two checks, both from the same non-profit foundation and both made payable to Punster Husband, CPA. The total is enough to pay not only our medical bills, but also our son’s college tuition for January.

There’s only one catch: Both checks are postdated January 9.

And the less said about the major client who took over four months to pay my husband, the better. !#$%^&*!!!!!!!!!!!!!!!!!!

To all of our assorted health care professionals and labs: Sorry, but you’ll get paid when he gets paid.

Update: As promised, I wrote checks for *all* our medical bills today. It helped considerably that my husband *finally* got paid on December 29 for a fee that had been due since July.


Blogger Doctor Bean said...

Your post is an eloquent testimony of the reason my patients pay at the time they are seen. You would never expect to be able to treat your supermarket or shoe store or plumber the way you treat your doctor. Partially I blame doctors for putting up with this for so long, but that doesn't get you off the ethical hook.

Fri Dec 30, 10:45:00 AM 2005  
Blogger Shira Salamone said...

Sign--Remind me never again to post on a winter Thursday evening. Since I blog *about* the office, I don't dare blog *from* the office. And with Shabbat starting so soon after I get home at this time of year, I don't have time on Friday to respond to any comments.

The consequence, in this particular case, is that I felt like a heel all Shabbos, which isn't exactly conducive to "calling Shabbat a delight."

So allow me to clarify. I would *never* walk into a doctor's office unprepared to pay my out-of-pocket fee, or, in the case of doctors or dentists whom our insurance doesn't cover, the entire bill. What's at issue are the bills that come *later,* by mail, the ones that *aren't* charged on the spot. The ambulance bill for when the Punster had his kidney-stone attacks. The surgeon's and anesthesiologist's bills from his surgery. The half-dozen lab bills that we seem to get every month. The portions of doctor bills that are sent to us long after the appointment, treatment, and/or test because our insurance didn't cover 100%. *Those* are the bills that get paid late.

Does that "get me off the ethical hook?" No. But I don't want to leave the impression that we're *completely* irresponsible.

The good news is that, now that the Punster finally received that fee that's been due for over four months, I expect to spend a good part of this Monday paying bills. And *all* of our medical bills will be among them. We know that doctors and lab technicians have to eat.

Sat Dec 31, 06:59:00 PM 2005  
Blogger PsychoToddler said...

Shira, I have to agree with Doctor Bean on this one. If you don't pay your electric bills, they turn off your power. If you don't pay your gas bills, they turn off the heat. If you don't pay your doctor bills, what happens? To you, probably nothing. Your doctor will probably (if he's anything like me) still return your phone calls and still dispense medical advice.

But your doctor still has to pay his rent, utilities, his malpractice insurance, his employee salaries, and if he's a little younger than me, his medical school loan payments. So in effect, if you don't pay him, you are "stealing" medical care from him. And that's not fair.

Remember, your husband is a professional who gets paid for his services (or at least he should be), and so is the doctor who spent years learning his trade at great financial and personal expense.

Sat Dec 31, 10:03:00 PM 2005  
Blogger Doctor Bean said...

Ms. Salamone: I assumed that you pay copays immediately and that the bills you were referring to were those in which your deductable had not yet been met or your coverage was less than you expected. Many patients are similarly slow in paying their bill after they're feeling well and the memory of the satisfactory service they received is fading.

I simply meant in my comment that this behavior is why I charge for the entire service at the time patients are seen. I wish more doctors did the same. That we don't demeans us beneath supermarkets and shoe stores.

I wish you good health and few medical bills in 2006.

Sat Dec 31, 10:33:00 PM 2005  
Blogger Shira Salamone said...

Remind me never to post a guilt trip on my blog again. Now, if you'll excuse me, I have some medical bills to pay. I mean, it's not as if I actually have an argument to make here. Oy. I'm not only *throwing in* the towel, I'm *getting out* the towel--I've got some well-deserved rotten eggs and tomatoes to wipe off my face.

Sun Jan 01, 01:09:00 AM 2006  
Blogger Ezzie said...

It's also somewhat circular, as Shira noted in the post: Because others aren't paying her husband, she can't pay her bills. I know the feeling all too well.

Sun Jan 01, 02:39:00 AM 2006  
Blogger Shira Salamone said...

Thanks for tossing me a life-preserver, Ezzie. I never said that delaying my payments was right, I just said that there was an explanation for the delay. Still, I will try to do better in the future. The whole point of this post is that I feel bad about not paying on time.

Sun Jan 01, 03:05:00 AM 2006  
Blogger Shira Salamone said...

Update: As promised, I wrote checks for *all* our medical bills today. It helped considerably that my husband *finally* got paid on December 29 for a fee that had been due since July.

Mon Jan 02, 07:55:00 PM 2006  
Blogger Noam S said...

As a general response, I would agree with PT and doctor bean. while the average salary of doctors is still usually pretty good, it isn't what it used to be, and physicians, like any other working people, rely on the public paying their bills. Sometimes people think that the insurance pays enough, but I think Mrs. Balabusta showed how one of her care givers was paid a miniscule amount of the overall bill. As a sub-specialist with a different billing and fee structure than DB and PT, I have a bit more flexibility in collections, since patient payments are usually a small percentage of the overall bill. Still, every month I get on my desk a list of patients who have not paid, despite multiple attempts to collect. I then have to decide whether to sign off on sending the account to the collection agency. I try to figure out what the circumstances are, if the bill isn't being paid because of real poverty, or if it is just because the patient thinks that they can get away with not paying it. It is never easy to figure out and decide what the best approach is.

Wed Jan 04, 05:10:00 PM 2006  
Blogger PsychoToddler said...

I almost never send anyone to collections. I don't have the heart for it. Maybe that's why Mrs. B. can't afford a cleaning lady.

BTW I've been sent to collections by an electrician who tried to charge me for work he never did.

Wed Jan 04, 10:31:00 PM 2006  
Blogger Shira Salamone said...

Good heavens, Dilbert, I've never gotten *that* far behind in my payments that my bill got sent to a collection agency.

Mark/PT, the Punster rarely goes after *his* clients, either, which is probably why *I* can't afford a cleaning lady. Sigh--I suppose that what goes around comes around.

Wed Jan 04, 10:58:00 PM 2006  

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