The Case of The Mystery Invoice

I am posting this because I want everyone involved in caring for someone with any kind of disability or health condition to be empowered and knowledgeable.

So, what was the deal with that $700 bill we received yesterday?

Well, my husband made some phone calls in addition to me.  I don’t know who he called, but whatever he said motivated the physician behind the bill to call us this morning.

Enter Dr. Berry.  The phone rang before 9 AM, and my husband looked at the Caller ID.  A local hospital? Dr. Berry himself was on the line.  My husband was civil but direct: “Who are you? Why are you billing us? Did you treat my daughter when she was in the hospital? Why were we not notified of this when she was in the hospital since you were not a part of her care team? Did you produce a report? Where is that report? Why are you billing the wrong insurance company, and where did you get that information in the first place?”  It’s a good thing my husband has training in HIPAA.  He had his Data Security and Privacy Policy guns locked and loaded.

Dr. Berry was very…compliant and willing to be cross-examined.  He explained that Dr. Whiskey called him in as a consultant.  Is that right? Dr. Whiskey! He never told me that.  Shame on you, Dr. Whiskey.  You were supposed to keep me in the loop.  He also explained that he got whatever insurance information that he had off Grace’s chart.  Is that right? Poaching our insurance information off her chart? Did I sign a release for this? If there’s a report, I would like to see it.  He also explained that we should not have received a bill.  I should never have seen that $700 invoice.  Well, that’s all well and good, but I’m sort of glad I did.

What exactly goes on in these facilities?

I’m annoyed because the staff and psychiatrist that took care of Grace during her stay at the last inpatient facility claimed transparency.  I was never told of an outside consultant coming in and evaluating Grace.  I am not daft.  I understand that when a person is in the hospital all sorts of specialists have access to patients, but a specialty inpatient hospital such as the one where Grace stayed is not the same as a hospital.  What’s more, she’s a minor.  When she has labs scheduled, I have to sign off on them.  I have to sign off on practically everything that she does there.  So, if a doctor is brought in from the outside to evaluate her, then why wasn’t I told? And, if he generated a report, then why don’t I have a copy?

I understand that doctors are going to seek each other out concerning Grace.  She’s a zebra in a herd full of horses.  They want to talk to other clinicians who might have seen or even treated another zebra, but she’s also 12 years-old.  She is not a lab rat.  Just because she’s in the hospital doesn’t mean she can be subjected to evaluation upon evaluation to satisfy their curiosity or quash their insecurity.  They need to talk to me first or, at least, keep me in the loop.  Dr. Whiskey should have called me: “Hey, I’d like to get another opinion.”  I could have asked some questions like Why? From whom? What is their specialty? Her current psychiatrist is the department head of the only program in the state for children with psychotic disorders.  What exactly do you need a second opinion for? Her diagnosis or treating that diagnosis?

This is why many parents get nervous about leaving their children in an inpatient setting.  No matter how great the reputation is, there are always antics.  I’m not happy about this.  I’m also not happy about the billing runaround we’ve endured and the lack of follow-up.  Welcome to mental healthcare in America.

So, what can you do? Ask questions.  When you are sitting down for that intake, ask these questions:

  • Will you be bringing in an outside consultant to evaluate my child?
  • Is it your policy to notify the parent when you bring in an outside consultant to evaluate a minor patient?
  • What if the outside consultant that you choose is not in-network under my current insurance policy? 
  • How do you bill insurance for consultants?
  • If a consultant generates a report, will I receive a copy?

Once these questions are answered, then you can proceed whether it’s being clear that you want to be notified when a consultant is brought in and given a copy of the generated report or even speak to the consulting clinician on the phone.  It’s imperative, however, that you know what is going on in the inpatient setting so that you are 1) not surprised by expensive invoices after the fact and 2) kept up to date on exactly who is interacting with your child.  This requires being assertive, but it’s a necessary part of advocacy.

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10 thoughts on “The Case of The Mystery Invoice

  1. When my daughter was a minor she went to a doctor and was treated without my knowledge or consent. I received an enormous bill for “her treatment.” They demanded that I pay the bill while refusing to tell me what they treated her for. She said she had tonsillitis. That “tonsil” turned out to be my now 25 year old grandson. feel your pain and frustration with being left out of the loop with your daughter’s care.

    • That tonsil turned out to be your grandson….I nearly fell out of my chair reading that! OMG…I…UGH!!!! Trinity! I understand that people require privacy, but not 12 year-olds with psychotic disorders. At this point, they need protection! So do pregnant minors! Their brains aren’t even cooked yet! They need help from the people in their lives!

      • This happened in Massachusetts back in the time when a they were prevented by law from informing the parents of pregnant teen, but were still allowed to bill them. The laws have since changed, thank God.

      • I’m so glad the laws have changed. That’s ludicrous. It leaves teens in a very precarious position as well as parents.

  2. Go you and your husband for staying on top of it!
    My girl and I are bringing a relative from hospital to rehab today and will have to keep doing this through his stay there.

  3. I’m a little surprised that Dr. Berry called you himself. Usually doctors have nurses or their bililng department ro someone else make the call. Good for him. And a little shocking that he was called into consult but no one told you. That he evaluated Grace and you have not been privy to his report/test/whatever. I’m glad your husband took the call. Can’t wait to hear about what happens next. 🙂

      • Some people obviously don’t think that way. While I’m sure Dr. Whiskey thought he was doing a good thing consulting with Dr. Berry, things like consent and billing and insurance need to have a place at the table. And it should all be as transparent as possible. How can you go about planning Grace’s care otherwise?

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