How will you pay, sickling?

February 15, 2007

At the hospital, where should the talk about payment of medical bills begin? At emergency intake, of course, the patient is asked about medical insurance. If the patient is not bounced to another hospital (I wasn’t), hopefully the subject of payment won’t come up again until the emergency is stabilized. If you’re admitted to the hospital, and if you don’t have insurance, don’t presume the subject of payment won’t come up very soon. An intensive care nurse told me that financial counseling was available, but her telling me that did not come across as anything more than an effort to ease my mind. I was still in intensive care when a member of the financial services staff came by with a form to be completed. I told her my situation, and she put me in as a candidate for a charitable reduction of the hospital bill total. I still haven’t received a decision on the application for charity, although it was submitted over six months ago.

The distinction between emergency services and elective services can get blurred. Seeing that the patient’s medical situation has improved enough to responsibly declare further medical care elective can require outpatient lab testing, radiology, or other diagnostic procedures, as well as office visits to a physician. There’s a quandry for the hospital and its medical decision makers, I’ve figured out. If a we’re-through-with-you position is taken too soon, questions of medical ethics and potential liability arise. In my case, bacteria had produced abdominal abcesses after perforation of a peptic ulcer had occurred. If the eradication of the bacteria had not been assessed by scanning my abdomen, there would have been little assurance that a medical emergency resulting from infection would not have occurred in the near future. Nonetheless, the question of how I intended to pay was put to me before administration of a CT scan asked for by the physician in charge, the hospital chief of staff. By stating that I had already disclosed all financial details, and further stating that if we couldn’t go ahead with the test we wouldn’t, I found out whether the outpatient procedure fell into the emergency category or the purely elective category.

To see whether my changes to the blog account went through, I’m stopping now.

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