Healthcare According To Ernie – The Final Chapter

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It’s been many months since I’ve written about my ordeal with Bayfront Medical and BCBS MA.  During this time I’ve continued to receive a monthly invoice from Bayfront and each month I call and I get a really nice young person on the other end that tells me that they know that the claim has not been reviewed or paid by the insurer yet so I should just ignore the bill for $10K+ that is stamped PAST DUE.  Every other month or so I would call the insurer and inquire on the status and they would assure me that once the hospital files the claim correctly they will pay the claim but to not pay anything until that time…so I just waited patiently.

At last – the time has come!  Two weeks ago I received the first EOB indicating that portions of the hospitals claim are being adjudicated!

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I haven’t received all of them but I have received two of them related to outside physician services.  That’s promising.  At this pace I expect to receive everything and finally be able to pay my medical bills by the end of May – a scant 11 months after my discharge.  Look at it this way, at least it’s take a long time, like a WHOLE YEAR.

It is no wonder that providers worry about cashflow and consumers are concerned about credit ratings and being able to pay their bills.  Imagine if I was not the savvy healthcare consumer you see before you but rather the average Joe.  And as Joe I had a FSA and I was told not to pay my bills until now but oh no!  I lost all but $500 of my money because it’s now May 2015 and not the year I actually incurred the services.

The good news is that the industry is in a state of flux and I see many positive moves on the part of all parties.  Have I been critical of Bayfront Medical and BCBS of MA – sure I have.  I must say though that the PEOPLE in the equation were very helpful and that the two organizations are certainly trying within the framework available to them to do a good job. It will take a concerted effort to move past the days of yesteryear, throwing off the shackles of batch processing and the arcane language known only by medical transcriptionists and billing specialists to get to a consumer centric, near real-time healthcare marketplace.  I for one look forward to being a part of that transformation!