June 5, 2008
Shady St. Luke's?
(By Anonymous) [No, not them, but a well-respected writer who choose SFist in which to rant about their woeful experience at St. Luke's, using a veil of anonymity. -- SFist]
The billing department at St. Luke's Hospital in San Francisco is a shady operation. Last month we received two bills for about 250 bucks each. Our primary doctor is based out of St. Luke's, so most medical needs are taken care of there. One of the bills was for services this year, and since $250 is my insurance's yearly deductible, we paid it, no questions asked. But the second bill, you see, was for services from 2007. When we called St. Luke's to ask about it, they said that Aetna had paid for the services in 2007, but then "took the money back."
WTF?
So. We called my insurance, and asked them about it and they had no idea what St. Luke's was talking about, and told us to check our records and see if we had indeed paid them last year around the time the services were done. Alas, we checked our records, and could find nothing indicating that we had paid St. Luke's at that time, so: we went ahead and forked over the money.
Yesterday, though, we get another bill from St. Luke's, for $285, for services done in 2006. 2006?! Once again, we called them and said, "um, wtf?" And again they told us that Aetna had "taken the money back." They said Aetna must be doing some kind of audit and found out they had overpaid a bunch of stuff, or some such bullshit. Then the lady on the line, who was looking up my account, got kind of quiet, said something like "Shoot...uh, can you hold on a sec?," put us on hold, and then came back and asked if she could call mus back. She needed to "email a colleague" about my balance. OK. Fine.
So, about 30 minutes later she calls back and tells us that the bill was a mistake. And my balance? Is zero.
Shady. Shit.
We were in the middle of work, so we couldn't get into asking what the hell the mistake was about, and whether the previous $250 we had mailed them was ALSO a mistake, which sucks. But nonetheless we're glad we called and complained.
But! What about people who don't know to question these things? How much shadiness is St. Luke's getting away with here? Any similar experiences? Do tell.
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That can go with any hospital as I know from experience. Whatever you experience shouldnt represent the hospital as a whole, but those billing people are sometimes missing some screws in their heads. Its a must to confirm the charges on your account with a rep before paying anything.
Rant #2
AETNA Insurance will rip you and the hospital off any way they can. In my experience at another fine San Francisco hospital, my Aetna HMO doctor recommended I head to said hospital's emergency room.
7 months later, I get a bill from that hospital because AETNA kept refusing to pay the bill. 7 months for crying out loud (another calendar year, if you care)!
Anyway, I ended up having to get the California Department of Health Care (http://www.hmohelp.ca.gov/default.aspx) involved ... the state order AETNA to pay the bill, and AETNA obeyed. After that experience, I have only one thing to say to anyone who tells me a government run health single-payer health insurance plan would be less efficient than one run by a private company - bull pies!
That's how insurance companies operate. They stall and stall, figuring eventually you'll get sick of sitting on hold for hours at a time and let it go and pay it instead. Of every legitimate lawsuit brought against an insurance company, there are ten more that could have been brought, but weren't. I read that insurance companies are willing to take the gamble that you will be in one of the other 9.
And the next time anyone compares our healthcare to France and says "but they pay more taxes" I'm kicking them in the balls as hard as I can. Fair warning.
I have had a similar issue with St. Luke's charging me for services rendered two years earlier. They told me that I had a outstanding balance but I never received a bill that I owed them. Once I was able to reconcile the bill back to the services I was able to place a claim with my insurance and most of the $750 bill was covered.
It would seem that St Luke's will have an audit and find uncollected money and figure the easiest way to get it is to go after a patient and hope questions are not asked.
I just want to say that I experienced a serious injury this Spring and found my dealings with St. Luke's...from the emergency room care to the eventual physical therapy to be fantastic. Billing issues have been swift and without error.
St. Luke is the patron saint of physicians, surgeons, butchers and billing departments*. He's not the patron saint of patients so it's no wonder people have gotten screwed.
*Ok, so I made the last one up.