Healthcare companies suck. Pretty much all of them.

For the third time this year, I’ve received a huge, largely unexpected bill for some health care issue that I thought was paid for already. Today’s contender is Gabe’s speech therapist. The insurance coverage for speech therapy was maxed out, so we pulled him out for the year, because we can’t really afford to pay them $500 or so per month out of pocket. We knew that there were a couple sessions that weren’t covered by insurance, and we were expecting a bill for a few hundred. Instead, they sent us a bill for $2,300, including unpaid items going all the way back to last September that they just found, along with a pile of questionable bills from earlier in 2004.

Considering that we’ve been paying them the whole time, every time they bill us, I’m unclear on why there’d be unpaid visits from last fall. That’s just the beginning, though. They haven’t actually bothered to send us a bill since February. Since then, they’ve started adding all sorts of fun items to the bill. Things like billing us for the insurance company’s write-off amount, which is against their contract with the insurance company. Things like billing us for 5 services in a week when we only visited once. Fun stuff like that.

The thing is, I don’t think they’re being fraudulent or anything–I think they’re just completely incapable of billing us right. The bill itself obviously came out of some medical accounting software package, but the actual amounts due are written in in blue ink next to the computer-generated itemized total that they billed the insurance company. There’s no real indication why one line item is going to cost us $40.99 while the next, identical item is $105 or $31 or $75.

Even the doctors that I like keep doing this to me–they’ll outsource their billing and insurance administration, and then wait six months before sending us a bill for $500 worth of accumulated services. The smaller companies keep billing us for the insurance write-off amount, even though they have a contract with the insurance company that says that they can’t do that.

Even big hospitals, where you’d expect to find competent accounting and IT groups aren’t immune–Evergreen sent us a bill for $600 for labor and delivery charges, 14 months after our daughter was born.

I swear, from now on, I’m not going to bother doing meet-and-greets with the doctors that will be providing services–I’m going to skip straight past the docs and talk to the bookkeeping staff. They’re the ones that are going to screw me up, every time.

The weird thing about all of this is that it makes the (stereotypically) insurance company look like the good guys. They’ve been responsive to our calls and have provided piles of documentation when we’ve needed it. From watching our Explanation of Benefits notices go by, they even seem to be fairly quick at paying bills. Of course, it’s probably all an evil plot on their part.