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Back to reality

When the April 10 snowstorm blanketed Falcon a few weeks ago, I was on the last leg of a vacation along Florida’s Gulf Coast. We were supposed to fly out of Key West that Sunday. When we arrived at the airport counter, we soon discovered that we were going nowhere due to the storm. The Monday flights were booked, so we couldn’t get out of Key West until Tuesday. Of course, it’s not like we were stuck in an airport or the middle of Indiana (I can say that because it’s my home state); we were “stuck” for two days in the Keys, amid lots of sunshine and a vast, blue-green ocean.The extra time added to a great vacation, thanks in part to new friends in Tampa and my aunt and uncle in Naples, as well as my very cool traveling companion. However, as we all know, when you play, you pay.The vacation is a mere speck in the sand now. Once I returned, it didn’t take long for reality to hit – kind of like that snowstorm. Suddenly I was once again buried in drifts of chaos and confusion.Maybe life would be a little less complicated if we didn’t have to deal with problems like an inadequate health care system. Okay, I know, last month I lambasted the legal system and this month it’s health care. Well, write me if you think I am too far off the mark. But someone please tell me how a system can be so muddled.Here’s the deal. Through my day job, I have health insurance. I opted for the best plan the company offers. I rarely go to the doctor. However, a couple months ago, I visited an orthopedic surgeon because I was having debilitating back pain. The problem, it turned out, was caused by long days and nights on the computer. With a little physical therapy – thanks to Falcon Physical Therapy – and new ergonomic-friendly work stations, the pain has subsided considerably.Before I went to the orthopedic surgeon, I checked my insurance to make sure it covered x-rays, just in case. If the x-rays were done in a physician’s office, Blue Cross/Blue Shield covered the service 100 percent.When I strolled into the doctor’s office at Front Range Orthopedics, I figured I was in a physician’s office. There are only two hospitals in town, and they were miles away.The doc ordered x-rays immediately. I walked out of an office, down the hall into an x-ray room, where an attendant took about five pictures of my back.Long story short, I received a bill for a portion of those x-rays after I returned from my laid-back, lovely vacation. Why would I get a bill for something that was supposedly 100 percent covered? I called Blue Cross and was on hold for what felt like seven days. Is our technologically riddled life (humans do not answer phones anymore) and an obvious lack of respect for the customer the driving force that is pitting corporate America against individual Americans? Technology has definitely spawned a lack of manners in this country.When a real voice finally came to my rescue and I was able to explain that I had the Blue Cross Gold Plan – 100 percent of my x-rays should be covered – the woman responded, “Well, the problem lies with Memorial Hospital. They billed the x-ray charges under hospital x-ray services, and your plan only covers 90 percent of those services.” I responded, “But I wasn’t in the hospital.” The voice: “We can only do so much; it’s how they billed it.” The bill was from Memorial. Hmmm … I wasn’t anywhere near Memorial that day.I called Memorial. After a few calls – one demanding a supervisor – I learned that even though I was at the doctor’s office, Front Range Orthopedics contracts with Memorial for the x-ray services, so the x-rays are charged under hospital services. I was told that a nurse is supposed to inform all patients that they are entering Memorial Hospital territory when they walk a few steps to the x-ray room. Frankly, I don’t remember if the nurse said that, and I don’t care. How many people are thinking about their insurance coverage when they are walking down a hall with a little gown wrapped around their half-naked body? People are more likely thinking, “I hope I don’t have bone cancer,” or “what if they find a degenerated disc or something.” They are not thinking, “Oh yeah, the doctor contracts with Memorial so that means the x-rays are going to be billed under hospital charges rather than physicians services even though we are in a physician’s office.” Let’s be real.I spent 10 years in health care in public relations and customer service. Today we are talking about the same problems that existed 20, 30 years ago. Insurance costs have skyrocketed and continue to do so. We still have hidden charges; we still have trouble accessing the system. Technology has enhanced and advanced our lives, but there has been nothing done to advance the competence of the system. Most people don’t even see the hidden costs. Most people just give in and pay.I’ve heard health care horror stories that make me embarrassed to even mention this issue. But I believe it’s something that every reader of this column can relate to.The problem: The doctors blame the insurance companies; the insurance companies blame the doctors; the hospitals blame the uninsured; the uninsured blame the high costs of insurance and so on and so on.Something has to be done about health care in America. It’s not going to be easy, but some things are simple. When the supervisor of Memorial’s billing department asked me, “What would you do to change this situation?” I had an immediate answer: “Bill the x-ray charges under physician services to avoid confusion and include that in the hospital/physician contract.” A no-brainer: yes. A money-maker: no.If it continues to always be about the bottom line in this country, whether its corporate America or small business, when the customer is as far away from being No. 1 as the island to the shoreline, the bottom line will take us to rock bottom.Meanwhile, I’ll write the insurance commissioner and then dream of the day I’ll sail off once again into the Florida sunset.-

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