I hurt my knee. It hurts like hell in certain positions, like a scalpel being inserted point-first into the patella. If I sit too long and try to stand, or even just straighten my leg, scalpel into patella time. I am trying a knee brace, not bending the leg when I sit, but it’s not always possible to avoid the searing pain of trying to straighten my once sturdy leg.
Finally went to the doctor, who sat on my foot and pushed and pulled my knee from different angles. The only thing that hurt was the direct pressure on the patella when I tried to straighten the leg. The doctor told me to go have an x-ray, which would then allow my insurance to pay for an MRI if the sports medicine practitioner needed to do an MRI.
I called my current insurance company, Healthfirst. I declined the robot’s kind offer to take their customer satisfaction survey for the “service you are about to receive” by pressing two. It was only a few moments before Jackie was on the line, very pleasant, bright, sympathetic. She tried to walk me through the website, which was buggy today on my end. It displayed completely differently for her than it did for me. The search function did not seem to be working correctly on my end.
She found me a nearby x-ray place, then a sports medicine doctor, both of whom took my specific Healthfirst insurance plan. Then an opthamologist, so I can get a prescription for new glasses, then a gastroenterologist for my overdue colonoscopy. We truly had a great chat while all this was going on. At the end of ninety minutes of customer service I thanked her, we had a last laugh and parted as great friends. I began to make the calls.
The nearby x-ray place does not have an x-ray machine, it turns out. They do several other forms of diagnostics, have a lot of sophisticated equipment, but no x-ray. The receptionist there gave me the name of another nearby x-ray place, and the phone number. It was a fax line, I learned when that eerie squawking began.
I called the sports medicine doctor, figuring they might have an x-ray machine on site, save me a few steps. The doctor, it turns out, does not accept my particular Healthfirst plan. A first time visit would cost between $320 and $640, if insurance paid nothing. I asked the receptionist what determined whether the visit was $320, $435, $508 or $639.99. She had no idea.
You walk into a restaurant. There are no prices on the menu. When you ask the waiter how much the BLT is he tells you not to worry about it, the sandwich is delicious. In three months you’ll get the bill in the mail. The EOB from the third party that deals with the restaurant informs you that the BLT is billed at $640, but since you have insurance the negotiated price is only $120. Your copay is $50. You made out like a fucking bandit.
We can’t tell you what it will cost until the provider sends us the bill and the billing codes. That is the standard line and it is perfectly legal under the Patient Protection and Affordable Care Act. You see, until the provider tells us the exact price, nobody can predict anything. That’s clear, easy to understand. How is anybody to possibly know that this hospital charges $44,000 for a bag of chemicals they will infuse into your body? No possible way anybody could possibly know that, prior to the procedure, the submission of the billing codes, and the calculation of the EOB. Jackie confirmed as much when I asked if the $44,000 bag of Rituxan that may be in my immediate future is covered under my current plan. There is simply no way to know in advance.
The first appointment with this sports medicine doctor who will charge between $320 and $640 is a month from now. Your aching knee is nobody’s fucking problem but your own. You should have made this appointment weeks ago, you’d be almost in line to see the doctor by now.
I struck out with the other doctors’ answering machines. Call during business hours, the first one advised me, between 9 a.m. and 5 p.m. I noted to myself, with familiar bitterness, that it was 4:30. Same deal with the next doctor’s machine, only by then it was 4:35. Well, it was 75 degrees out, Sekhnet reminded me.
Soon she was done trying to cheer me up. As I laid the merciless details on she was finally struck dumb, began crying because this shit is so frustrating when it happens to somebody you love. It is worth noting, of course, that if the law allows an insurance company to list a thousand doctors as participating, and only a handful actually are, there is no harm and no foul. The piece of shit, er, customer, merely has to keep making calls to different offices further and further from their home. Eventually they will find a doctor somewhere who accepts their insurance. No fraud where the law says there’s no fraud. Patient Protection Act and shit. Hey Barack, Arbeit Macht Frei.
I asked Jackie about getting evidence from Healthfirst that my recent invoice had been returned to Healthfirst by my local post office as undeliverable. I told her the story, another short chapter in the million chapter book they are constantly updating. That book is called How We Fuck You To Death You Fucking Piece of Shit. The main device is never allowing the true facts to interrupt the dominant narrative. If you can’t produce irrefutable proof, and you are not incredibly dogged, we can fuck you with impunity, fuckface.
Jackie wished she could help, by giving me the evidence that the local post office is now returning rent checks to me and insurance invoices to my health insurance company. That could only be done by Finance. There was no way for her to directly contact Finance. Nobody was allowed to know who Finance is or what they do, but she dutifully made a complaint to them, asked them to send me some proof that they had received the last bill sent to me back marked “undeliverable”. She gave me the complaint number, said I can follow up in a few days if Finance doesn’t contact me. Finance unfortunately has no direct extension, so I’d have to get lucky when I try to follow up.
“This is exactly how they kill us, Jackie, those powerfully legally created psychopaths who make all the rules to best serve themselves. You have to admire the seamless perfection of it.” I then described my request to see a mental health professional, as I imagined it would go. It did not go well. Jackie found it hilarious. When I hung up the phone I noticed I was foaming at the mouth.
I was seated on my aching hind legs, head thrown back, howling as loud and plaintively as I can. I am doing that right now, as I type. Easier than you’d imagine, really.