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Rising Health Care Cost Inefficiency Example, my experience

A recent encounter with a Geisinger billing problem could certainly add to healthcare costs.  Is this a "How To", sure How To cut some healthcare costs!  What follows is a simple example of situation where health care costs could be reduced significantly.  If this financial organization is consistently pursuing the billing process that it applied to my case, this organization is doing twice as much work as it needs to, to achieve the simple goal of collecting a bill efficiently and in a reasonably timely manner.

Recently, now being an uninsured person, I received my first medical billing from Geisinger's finance department.  The subsequent follow-up that I was forced to pursue is documented below.  This is an example of an over zealous accounts receivable department in the health care industry.  I have no problem with the test that was administered the staff that administered the test, the testing facility which I assume was Geisinger Hospital itself.  But I do have a problem with this billing process.  Here is a link to Geisinger's mission statement and they did address Fiscal Responsibility. I wonder about the not for profit? Seems like hospitals close and research centers open. Plus there seems to be an vague internal insurance system.  I have to look further.

The Quality Process

I have learned in the past that the most important step in improving quality is analyzing the process.  Improving quality usually leads to a more satisfied customer, which leads to reduced costs to the customer, and to the organization as well, which therefore results in a more profitable organization.  Everybody wins when quality is improved through process analysis and improvement.  Responsible for the process is the management of the organization, reaching right to the directorship.  Staff plays an important role and as far as I can tell in this case, the staff has already tried numerous times to improve the process and has failed.

The tests went fine!

I had my test on 11/13/03 everything went well and the results were returned in a reasonable time.  My doctor's office called and said everything is fine, so all that is left is to pay the bill.  That is where the fun begins.  This was not a difficult problem for me to handle but it must be costing a lot of money because it probably is occurring for most customers who interact with this financial department.

The first bill arrives ( a little late? )

My first statement from Geisinger Wyoming ValleyThe bill for my test arrived on 12/03/2003.  The bill states "Please pay the balance immediately".  The statement date was 11/25/03, took a long time to get here?  The payment due date was 12/7/03.  I immediately noticed the bill did not itemize what it was for, it was just a bill for $56.  I could send out bills for $56 with nothing itemized I wonder if anyone would pay them?  I could be rich!  So I tried to call the phone number on the bill 1-800-380-7716 and I got a menu system and no staff was available at this time and if I waited ten minutes they would take my phone number and get back to me.  I did not wait ten minutes.  I have done this before with other organizations, given my number after waiting on the phone a period time, and found I was rarely called back.  This implies the staff is probably overloaded and in this case it is a problem that is organizationally self induced!

My payment will probably be late

So now it is 12/4/03 and the bill is due 12/7/03.  I called 1-800-380-7716 the next day waited for two minutes and was connected to a very nice person.  I do know this person's name but I am not going to reveal it.  I told this person I would like to know exactly what the bill is for, nothing is itemized and I have other open billings from different parts of the Geisinger organization, and I want to be sure what this bill is for.  She said "Is your bill green?".  I said Yes.  She says: They always do this, send out bills without itemizing what it was for!  She says: We have complained about this repeatedly and they continue to do it.  She then checked what the bill was for and it was for the test I had taken.  I asked the support person is there anyone I can follow up with for a complaint regarding the billing and she said; "Sir the customers have complained, we have complained, and nothing gets done, there is no more I can offer".

Support Person Very Good, bill paid with credit card

As I said this support person was very nice and then offered to have me pay the bill on the phone.  Bob says: "Wow I can do that?".  She says yes sir!  So on 12/4/2003 I paid the $56 bill with my Discover Card, finally done, and I even managed to beat the ridiculous 12/7/03 due date.

Surprise, my second bill

My second uncalled for bill from Geisinger, this is already paidWell not quite:  I receive another bill on 12/17/03.  "Your account is past due,  Please remit payment immediately".  This statement was dated 12/11/03; again, took a long time to get here, post office must be slow!  This statement is due by 12/23/03.  Well now wait a second I cannot blame the postman the post mark is dated 12/15/03 and it is from nearby, about 100 miles from me.

Check out the post mark
The December 15th post mark date indicating when Geisinger actually mailed the bill

So it took Geisinger Financial, which is actually in Philadelphia at PO Box 827702, 19182-7702, 5 days to mail the bill!  It only took the post office 2 days, really less, to get it to me from Danville.  This was a bulk rate mailing at $0.27 cents; lets save some money and make sure the customer cannot pay the bill on time!  I wish I would kept the envelope from the first billing.

So on 12/17/03 I place another call to 1-800-380-7716 and wait about 3 minutes and hang up.  Sure glad this is not a toll call, but somebody's paying for all that telephone connect time (rising health care costs?) !

When did my credit card company pay?

I decided I better do some research and look up my credit card statement.  Surprisingly the credit card statement shows a payment to Geisinger on 12/09/03.  But wait I made the call and payment on 12/4/03.  I guess Geisinger waits till the actual transfer is received from the credit card company, man, I am glad I did not use a check, I would really be in trouble.

So going back to the first bill I see that if Geisinger only credited me with a payment of $56 on 12/9/03, that payment was 2 days late!  I cannot win here!  But now I can see why the computer has issued me a second bill.  By Geisinger's date standards I could not possibly pay this bill with a check and be on time.  For now I am going to ignore this second bill.  I should call again and confirm but frankly I do not want to waste my time anymore.  My time is much better spent documenting the inefficiency, thereby contributing to the analysis of Geisinger's financial department's process.  And now I also am going to follow up with the Better Business Bureau regarding Geisinger's billing practices.  A much more productive way to spend my time, trying to cut rising health care costs!

So just think of the waste, all of this was needless:

  • Customer is irritated, bill does not itemize procedure or test

  • Customer must call 1-800-380-7717 and wait!

  • Customer must call 1-800-380-7717 again and wait.

  • Customer must speak with representative.

  • Customer pays bill with credit card instead of check, great for customer bad for business (maybe).

  • Geisinger needlessly issues another bill.

  • Geisinger pays postage on another bill using a slower delivery method, not first class, a savings?  I think not!

  • Customer gets another late and blank bill for $56.

  • Customer calls 1-800-380-7717 and waits again.

  • Customer contacts Discover to research payments.

  • Customer decides at this time no further action should be taken.  This is risky for the customers credit record.

  • Customer is disgruntled and will probably contact Better Business Bureau!

This has nothing to do with health care, but it sure increases health care costs!  I will have to take more tests in the future, it will be interesting to see if I get more bills without itemized procedures.

Pertinent Government Agencies:

Agency for Healthcare Research and Quality  http://www.ahrq.gov part of the:
Department of Health and Human Services  http://www.hhs.gov/

I have decided not to file a complaint with Better Business Bureau.  I am sure this is an excellent hospital and they have had no complaints in three years filed with the BBB: Geisinger's BBB report http://www.scranton.bbb.org/common.html  If the next bill is dated the same way?????  In talking to the support person it seemed like there were a lot of problems with this particular billing department.  Perhaps next time I will first talk to Conrad Schintz 570-826-7300 their BBB contact and go from there.

Bob,   12/19/03








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