Thread by @DGlaucomflecken

So it appears my health insurance saga has come to a somewhat dissatisfying ending. There’s a lot to unpack. I’ll do my best...

As many of you know, I received multiple surprise medical bills associated with my emergency hospitalization for a cardiac arrest. Several doctors (who I never met btw due to my lack of consciousness) were out of network and therefore, not covered by Cigna

I began fighting these bills, first with phone calls to reps and supervisors and whoever else was willing to talk to me. At times there was yelling and pleading and attempts to rationalize with a system that is wholly irrational.

The “best they could do” was reclassify the out of network charges as “in network” which knocked a few hundred dollars off the bill, but they “could not send payment” to those out of network doctors because Cigna did not have a contract with those doctors

Now, if you are already confused about this, join the club. I’m still not sure what that all means. Seemed like a lot of hand waving to me. I had several people and multiple levels of people all say the same thing, all waving their hands at me.

So after several months and multiple appeals filed and denied, I was still on the hook for many thousands of dollars even though I had already reached my out of pocket max for the year

Next, I called the state govt, because I thought what Cigna was doing was illegal. Surprise billing is unlawful in some states, including mine. However, because my insurance was on a corporate account (as opposed to Medicare/Medicaid) the state could not advocate on my behalf

So I went to my HR department, explained the situation, they got in touch with the Cigna rep associated with our account and 3 weeks later...sorry, no luck. The exact phrase from HR was, “we’re not getting anywhere with them.”

At that point, I went to twitter. I was out of options. I made sure Cigna received thousands of notifications and, well...guess what, I got an email & a personal contact with a private number. She was perfectly nice & helpful and 2 weeks later my balance with the hospital was $0

Great, right? Well, I logged into my Cigna account because I wanted the satisfaction of seeing the corrected statement from Cigna, but it wasn’t changed. It still showed those fucking out of network charges. But my balance with the hospital was $0. I didn’t pay it, so who did?

I called the hospital billing dept and found out that THE HOSPITAL (and doctors) covered the balance. They dropped it. So when I say the outcome was dissatisfying, it’s because Cigna didn’t do anything but pressure the hospital to eat the cost, which they did.

This lasted 6 months. Look at all steps I went through to get to this point. Can you imagine your 80 year old patients navigating all this? How about a single parent with 2 jobs and no medical background? No. They are either paying the bills or going bankrupt.

If I had paid every medical bill that came my way without question, I would have paid $10,000 more than I ended up paying. That is what our patients are dealing with daily, and it’s sickening.

So what can we do as physicians to help advocate for our patients: First, find out what the balance/surprise billing laws are in your state, check with your state medical society to see if work is being done to enact legislation. Write to your representatives.

The ultimate goal is to enact federal law to ban this harmful practice. The AHA has been involved in advocacy work in Washington @AmHeartAdvocacy #iwasbilled

Don’t be afraid to talk to your patients about medical costs. Give them resources. Your state health department may be able to help. Organizations like @HealthWellOrg, @PAN_Foundation, and @LLSAdvocacy provide assistance to underinsured patients.

Finally, I appreciate the support I’ve received during all this. I am incredibly fortunate to have this support network, but it’s not about me. It’s about our patients who recover from devastating illness only to face the prospect of financial ruin. We have to do better for them.