Security!

I'm sure you've seen her. The crazy lady that is just fed up with being taken advantage of and who is stubbornly refusing to comply to "their" rules? You know, the one they call security on to have escorted out?

I never thought I would invite someone to call the police on me, but that's exactly what I did in the doctor's office a week ago! I was the "crazy lady" on purpose!

Dawson had just not been himself for about three weeks or so. He wasn't running a fever or anything, he was just REALLY cranky. I decided, after waiting it out for three weeks, I should take him to the doctor to at least rule out the possibility of something physical causing the crankiness.

We got to the pediatric clinic, checked in and waited as patiently as a mom with four kids closed up in a small exam room can wait. The doctor came in for a WHOLE of three minutes and I left even more confused than I was when I arrived. He gave a guess diagnosis of a really strange ailment and send me out the door and on my way with a referral to another doctor. I may not be a doctor, and I'm certainly not going to let my kid suffer, but I honestly think someone was getting some kickbacks from referrals, if you know what I mean.

Dumfounded from the weird appointment and swift "in and out" treatment, I walked up to the front desk to check out.

Some quick history on my previous visits and financial dealings with this office. My insurance is not like the traditional "co-pay" type insurance. I don't have a copay, and I have ALWAYS been billed by the doctor's office after they have billed insurance. We are blessed to have insurance that writes off quite a bit and we normally owe less than $15 per visit. The ladies in the office either just couldn't grasp this whole concept or refused to look into the particulars of my insurance. The first severa times my children were seen there I paid the bill in full before leaving for two reasons. One, I was a new patient and had no financial credibility with the clinic. I totally respect that because, unfortunately, some people never pay. Two, they just didn't understand what I was trying to tell them and I didn't want the hassle of arguing with them. So, what happened is I paid them up $250 up front over the first four appointments. Insurance quickly wrote off and paid for most of the $250 I was billed for those appointments. The clinic owed me $180. I asked for a check to be returned to me for the surplus they had held in the beginning of July. I called again at the beginning of September because the check had never been issued. They profusely apologized and sent me a check the same week in September.

Back to the clinic visit. "What is your copay?" the clerk asked me when I handed her my check-out sheet.

"I don't have a copay," I politely responded. "My insurance is billed. They do write-offs and pay their portion, then I pay the remainder.

"Well, we'll have to have you pay the full $85 for the visit since you dont' have a copay," the lady responded.

"I'm not going to pay for the entire amount," I said.

Confused, the clerk referred me to a woman who was apparently the head clerk.

"Are you responsible for 20%?" She asked.

"It's never the full 20% of what is billed," I responded patiently, "because of the write-offs. It also depends on what portion of the deductible is met. Sometimes I owe nothing."

"I'll have to have you pay $85 today, since we don't know how your insurance works."

I stood and tried to remain composed. I thought, "Are you kidding me, after four visits they can't look at our past records and see how the insurance works?" I was beginning to get aggrivated. I could pay the $85, but when would I see the $60 or so the clinic would owe me after the claim was filed with insurance?

Still composed, I said, "I will write you a check for $10, so I don't end up overpaying again. Then you can bill me for the small remainder (which would be less than $5, if any)."

She said, "You'll have to pay this in full today."

My patience was wearing off. In a firmer, but still respectful manner, I said, "I paid over $250 during my first four visits here. After everything was filed I only owed about $60 of that. Your clinic then owed me $180 and I didn't see that money for three months after the bills had been finalized. I'm not paying the full amount. You can bill me." I said, "Let's go kids," and started to walk off.

"Ma'am you'll have to sit down while I call your insurance," The lady rudely said as she pointed a strong finger to the waiting room.

I still wonder why I felt obligated to immediately obey her orders and have a seat while she called my isurance. I should have left then. Nevertheless, I went and the kids watched Dumbo while we waited on the woman to come back.

She called me back up. "Okay, she said. Your insurance said you owe 20% percent of the remainder of the bill after write-offs. So, you owe $57."

I'm no math genius, but $57 is neither 20% or 80% of $85!

"I'm sorry," I said, I would not owe $57 even if I paid a full 20% of the bill, never mind the write-offs. This is why insurance needs to be billed and then you can bill me."

"Ma'am, you can't just leave without paying," the lady said again. "See, the sign even says that you must pay at the time of the appointment."

I said, "I respect the fact that you want to make sure you're not stiffed, but I have insurance, and the whole point of insurance is to ensure I do not pay more than have to for health care. You don't have to worry about me not paying. I'm going to pay you when I receive a bill AFTER you've billed my insurance company."

She threatened, "Well, Ma'am, if you walk out without paying, we'll have to ask you to pay in full before your children are seen when you visit us again."

I pondered, but I only had to think for a nonosecond. The service I had received that day was humorous, at best, and it would be no loss to me to take my business and kids across the street to the clinic that knows how to manage insurance and billing.

I said, "Look. You can call the police to come and get me if you want. I am not paying today. You can bill me. If you need a loan you are not going to take a loan out on my money. That's what the bank is for!"

The woman, face red and flustered, and in a last-ditch effort to collect my money before I walked out the door, said, "Well. Like I said before. You'll have to pay up front from now on."

I responded, "I'm finding another place that understands how my insurance works and take my kids there." I turned and walked out the door.

I got outside and took a few moments before I went to the car. I thought, "Wow, that lady was just trying to do her job."

I asked the kids to follow me back inside. I asked for the same lady I had spoken to. I aplogized to her and told her I didn't want her to take my not paying personally. I told her I understood she was doing her job, but reiterated I was not going to loan my money out for three or four months at a time wondering when I would see it again. I reaffirmed her she was doing a good job and that I'd pay when my bill arrived. She smiled. I smiled. I left with my $85.

I trust I will be getting a bill soon!