Letter: Health care billing practice was ‘egregious’

To the editors:

I would like to tell you of a situation in which I found myself in the hope that I may win some support and, also, that I may apprise others who find themselves faced with the same dilemma and may be able to avoid what I went through.

I was in such severe pain from a herniated disc that I had to go to a neighboring hospital. There I received beautiful care from the hospital staff. I was dismissed from the hospital after two days of being “under observation.” I was told by a staff member that I was to go to a nursing home for rehabilitation. I was still in severe pain and heavily sedated.

I was taken to a neighboring nursing home, still in pain. There I was informed that because the hospital had let me go after two days with the description “under observation,” my insurance Medicare and United Health (secondary) were not required to pay the nursing home facility. Therefore I had to pay all the costs myself. I thought this seemed wrong, but if I had to pay, Medicare and United Health will surely pay my claims later on.

Soon after I arrived I was asked to make out two checks equaling more than $10,000. I was still in pain and sedated and did as I was directed. In retrospect I should not have agreed to these  demands. Every sick and vulnerable person should be kept in a hospital bed to meet the three-day requirement for hospital stays and also to have a good lawyer at hand for extra protection.

After I returned home, I received from the nursing home a bill for $24,000. I called the office to ask about this huge bill. Had he submitted claims to Medicare and United Health? “No,” he said.

All in all, I was charged a total of $34,000.

I consulted my lawyer and he got the nursing home to reduce the fee of $24,000 to $4,000, for a total of $14,000. The nursing home was asking for a total of $14,000, still a large sum to have to pay.

I called both Medicare and United Health Care insurance and the people I spoke to said: “You were screwed by the system.” What was more evidence than that? Do I need to claim I was truly victimized by both the hospital and the nursing home?

I contacted the office of Jim Himes and found that Congressman Larson last spring introduced a bill co-sponsored by most of Connecticut’s delegation to forbid this particular treatment of patients. I will provide a copy of this bill to anyone who would like it.

I am a senior citizen, have paid my premiums for both Medicare and United Health Care Faithfully and I believe I should have been treated more fairly.

I must say I am grateful to the nursing home staff for their responsible and kind treatment and I am extremely grateful to the physical and occupational therapists who helped me to walk again.

As for the financial practices of the nursing home and the hospital, I would say they are egregious. I do hope that this reconstruction of my experience may help other people who find themselves, or who might find themselves, in a similar situation.
Florence K. Romanov
Deforest Road, June 7