Monox Blog

Anesthesia Billing Services helping the patient

This morning I had a very rewarding experience that left me feeling proud of the Anesthesia Billing work I was doing here at Monox. A few weeks ago I received a phone call from a patient's husband regarding emergency medical services for his wife. After verifying who I was speaking with, I asked the patients spouse how I could help him. The patient's spouse stated he received a Final Notice that this account would be sent to agency if immediate action is not taken. I explained to the spouse that medicare has denied this claim multiple times and have also denied our appeal and he would be responsible for the balance. What happened next was something I had not experienced before as the husband broke down emotionally and begin to sob uncontrollably. I knew this wasn't a typical reaction to a medicare denial so I asked the husband if there was anything I could do for him. The husband took a few moments to respond and then began to relive the evening that his wife was taken in for emergency medical service. I listened while the husband told me, in detail, the events leading up to that emergency room visit. I remember the husband saying that he and his wife spent the whole day together and it was a wonderful day, but towards the end of the day his wife said she felt like something was very wrong with her so they called 911. As soon as they arrived to the hospital the husband was told his wife needed to undergo emergency surgery but the outcome of the surgery was very favorable.

 

I remember the husband repeating, almost as if he was in a trance, "everything was happening so fast." The husband stated he gave his wife a kiss and told her he loved her and they wheeled her back to the operating room. That night, during surgery, there were complications and his wife died. I listened while this gentleman struggled to regain control and when he spoke his next few words, I could feel his sadness and hopelessness. I told this gentleman he was a great husband and his wife was lucky to have him for as long as she did and the husband spoke a very soft "thank you" before hanging up the phone.

After hanging up the phone, a feeling of sadness coursed through my body. This feeling I had inside me was so strong it was hard for me to focus on my work so I went to my supervisor for counsel. I told my supervisor about the phone call and how I felt bad for this gentleman and that I wish I could do something to help him. My supervisor quickly responded saying that if I wanted to help this gentleman out then to get medicare to pay his bill. I explained that I have tried many different ways to get this paid, but medicare continues to deny this claim and now the account is very delinquent. My supervisor suggested I try one last time to get this claim paid but to remind myself of the importance of this particular claim. After numerous phone calls to medicare the claim finally got paid. After applying the payment, I called the husband and left a voicemail informing him that we were able to get medicare to pay and his small coinsurance responsibility was written off by the doctor so that account was now at a 0 balance. The next morning, the first call I received was from the husband, who sounded happy and calm, and all he said was, "Michael, thank you for everything you have done for me and my wife, you will be in my prayers."  

 

By Michael Polese