Tuesday, November 25, 2008

Monopoly and medical billing

So have you seen the new Monopoly game? I know, there are scores of them, but I'm talking about the new cashless version. Evidently you use a credit card-like thing to keep track of your money electronically. You know, I have never enjoyed playing Monopoly (I do enjoy the junior version that we have), but to me it's worth playing to get some practice adding and subtracting and handling and investing money. It is beyond me why anyone would want to play the game for any other reason, such as, it's fun. But the new cashless version takes that away. I see it as both the death of a fine tradition and as a sign of the times...I am just a dab horrified (horrified is too strong a word, but the children have stolen my brain cells, so I can't come up with anything better right now), but mostly just feel sad and compelled to shake my head.
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I have been unemployed for over 9 years now, and as you can imagine, I've spent some time thinking about how to make my re-entry into the working world. I have already determined that I don't ever want to work full time again. I actually had that figured out while I was still working. I've determined that whatever I do, it'll either have to be tied to the school year, or it'll have to be something that I can do from home and that I can do as much or as little of as I wish, depending on how much is going on with kids. That is, at least until 2026.

So at times I've thought that I might enjoy being a medical biller. I'm told (by the scores of advertisements that I've gotten through the years) that I can make up to $40,000 a year at home (right). I enjoy working with numbers, computers don't intimidate me, and I actually find filling out paperwork to be calming, plus it's definitely a growth industry. What better job could there be for me?

About 6 weeks ago, during the course of a doctor's visit, my middle son was required to pee in a cup (don't worry, everything's fine). Let me just say that this is one more reason I'm glad we have boys instead of girls. So a couple of weeks ago, we got the Explanation of Benefits back from the insurance company, and found that there was a charge for the office visit, and two separate charges for the lab. Now, I can understand a collection charge and a separate analysis charge when the lab workers actually do something to collect the sample, for instance, when they draw blood, but come on, people! I was the one holding the cup for the kid. The really silly part is the fees were the same for each charge: $15, but the allowable amount for the collection fee was $10.50, while the allowable amount for processing the sample was $3.50! You'll notice that the two together just about equal one $15 charge, which it should have been in the first place. I complain about how expensive our medical coverage is, but I am so thankful that we have medical insurance, or we'd be paying double.

We had similar issues with all of the late term ultrasounds we had for Caleb: separate (huge) charges for procedures that had a marginal cost of zero. They also charge an administration fee for immunizations in addition to the charge for the immunization itself, and it's not just an administration fee, it's an administration fee for each separate shot, regardless of how many they're giving the poor kid (we've had combined administration charges of over $100 in one office visit--makes me wonder if the nurses are paid by the shot).

So this all has me thinking that medical billing may not be the best career choice for me. I think I would object to the ridiculousness of the charges, and I find it difficult to keep that kind of thing to myself. My sense of justice and fairness would always be filling me with disquiet, and who wants to live that way? So, I guess I'll have to come up with something else...good thing I have a little time to decide, eh? Any suggestions?

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