Once upon a time, people in hospital beds fresh out of surgery were off limits for bill collectors. That, apparently, is no longer the case. I spent all last week sitting at St. Mark’s Hospital in Salt Lake City with my dad, who had knee replacement surgery last Tuesday morning. St. Mark’s used to be a nonprofit hospital, run by the Episcopal Church. Today, though, the hospital is owned by HCA, the Nashville-based hospital chain founded by the family of former Senate majority leader Bill Frist. Frist’s brother and nephew are still on the HCA board of directors. Given my dad’s experience with HCA, I am greatly relieved that Frist is no longer making health care policy in this country.
Among the many hospital personnel who stopped in to see my father after surgery was a “financial counselor” from the billing office, who basically started stalking him from the minute he left the intensive care unit. After making several unsuccessful visits to his room on Tuesday and Wednesday, she slipped her card under the door asking my dad to call her. A little busy recovering from major surgery, my dad didn’t get around to it. So on Thursday, the woman called him on the phone in his room, waking him from a much needed painkiller-induced nap to demand a $1500 down payment on his surgery.
Still connected to IVs, a morphine pump and creepy-looking blood drains, my dad had enough to worry about without getting hassled by the billing office, like dying from a blood clot, or acquiring a drug-resistant infection from the guy in the next room. (Family and hospital staff alike were visiting the guy barehanded despite a big sign on his door warning people not to come within three feet of him without gowns, gloves and masks.) So I went down to the billing office to complain. A supervisor informed me that the counselor was making a “courtesy call” to inform my dad of the limits of his insurance policiy, but she acknowledged that it was hospital policy to wrest as much cash as humanly possible out of patients before they leave the building.
I told the supervisor that hassling post-op patients was incredibly inappropriate, especially given that most of them were too doped up on painkillers to even sign a consent form, much less negotiate billing options. If the hospital had wanted to discuss payment issues, it could have done so when my dad pre-registered with the hospital two weeks earlier. After some perfunctory apologies and some lame excuses, the woman thanked me for the feedback and I left. Later a nurse told us another patient had also complained of a similar shakedown, and she said the nurses were horrified but powerless to do anything about it.
What was particularly insidious about all this was that the hospital was trying to wring cash out of vulnerable patients before the bills even went to their insurance companies. My dad had already paid his deductibles and he didn’t have a co-payment for hospital charges. The hospital simply wanted to get paid before the surgeon and other folks also owned money for the procedure, and was claiming the entire out-of-pocket max of his insurance plan, money it might not even be entitled to at the end of the day. Fortunately, my dad understood all this immediately, despite the painkillers, and declared that he would not be paying the hospital a dime until his insurance company processed the claims. The only thing the hospital would get from him in the meantime was a heap of ill will.