I’m in Hospital Billing Hell at the moment, a dreaded space familiar to anyone with health insurance and a shockingly high and inaccurate medical bill. I’m in an odd position; I’m very fond of my hospital and the doctor whose office sent me a $670 statement for two orthotic inserts for my shoes that generally cost under $200, which my insurance has always paid for.

I’ve been in Billing Hell before and learned a lot about it. I’m happy to share what I’ve learned. If you are over 65, have health insurance, and go to the doctor, this is a place you know and can relate to. If you are younger, as many of my blog readers are, you might wish to be prepared when your time comes.

The bottom line; be like a sheep and also a pacifist. No violence, verbal or otherwise.

Take deep breaths. Be prepared to call often. Do not ever complain or feel sorry for yourself. Everyone in the world has it worse than you and me. When your head stops spinning, and you want to give up, take a walk, do some breathing, and cuddle your dog. If you never quit, you have a fighting chance. And remember, the odds and the gods are never really with you.

As a diabetic, inserts are essential for the health of my feet, they are serious. My insurance has always covered them without a problem. So it was a shock to get a $670 bill for a may visit to get one orthotic checked and one ordered. It is off.

The first thing I do when I get a bill like this is a pause, meditate for 10 minutes and get a pen and a notebook out and ready. Hospitals are smart and under tremendous pressure these days.

They can’t get enough nurses, the pandemic cost them a fortune in surgeries and treatments, and the inflation drives more potential customers away, even the very ill. Nobody wants to get a $670 bill out of the blue for something they know costs a fraction of that.

So their answer is to turn billing over to computers, which only speak to one another, and not really. Humans are mostly there to buffer frightened and outraged people trying to figure out their hospital bills that absolutely no one seems to understand or complain. They are the corporate punching bags, paid poorly to be abused all day while their CEOs are cashing their bonus checks. Whenever I hear a poor working person denounce socialism as a great evil, I shake my head. If only they knew.

There is no point in being angry. There is no point in huffing and puffing and bitching. I make sure I am calm and patient. Most doctors and many hospitals farm out their billing. They don’t want to deal with it and know that many people will pay it rather than go through Billing Hell. I am one of those usually, but not for $670. My new budget is much tighter than that.

My hospital, the Saratoga Hospital, is not affiliated with a bigger hospital, the Albany Medical Center; all of its billing is done through Albany Med, as locals call it. Albany Med has all those codes that hospitals and insurance companies use these days so that no human will ever converse directly with another human. They are the ones to call if there’s a problem.

So they say.

I am odd in other ways. Not only do I like my hospital and doctors, but I also have no complaints about my insurance company, United Health Care. Health care is too expensive, but mine is a responsive, open, and courteous insurance company.

They get on the phone, seem eager to help, and often do. When I was in New Mexico and realized one of my insulin pens was damaged, they replaced it for a nominal fee at a local pharmacy.

This time I knew I was in trouble. But I’m anything but a quitter. The billing department at Albany Med could only tell me that the insurance company had rejected the $670 bill. They didn’t know why. They said I had to call the insurance company. I called the insurance company, and they said they didn’t understand why it was rejected, it might be the codes, or it might be that the computer thought it wasn’t something they usually paid for (they do, especially with diabetes.) They suggested I call the billing department again, which I did. They told me to call the insurance company in a week to see if anything changed, which I did, and they told me to call the doctor’s office and ask for a note saying I was a diabetic and needed the orthotics; they were necessary for my health. Nobody had an opinion about why two small orthotics would suddenly cost $670 and result in a bill to me. When I called the doctor’s office, they said they don’t do the billing any longer; they had nothing to do with it (? I sympathized, but how could this be possible?) I had to call Albany Med again, and they told me I had to check in with the insurance company, which they did, to see if anything might have changed. I asked them to appeal the bill. They did. When I called the insurance company back, they said there was good news, the account was being reviewed, but that didn’t mean it would be paid,  the codes might be off, or the hospital billing company might have neglected to mention my diabetes, which happens often, said the lovely insurance person. The bill said nothing other than that I owed $670, and there was some medical numerical jibberish I couldn’t understand and which no one could explain. I have a few months to pay (before they file suit to take my car away). She suggested I call back in a week to see what had happened. After several calls, the doctor’s office called and told me to call the insurance company and find out  (again) exactly why the payment was rejected, which I did, and they said they had no way in knowing, try the hospital billing department; I’ll have to talk to the billing department and let them know what they said. More good news, the insurance company said (more good news? Was there really any?: the bill is on hold until the final acceptance or rejection is received. That’s something, the insurance company said, although it might be bad news. Here’s my faith. Somewhere along this tangled line, a good person will get up from their desk, take off their earphones and walk over to another human. Then we’ll know.

You get the idea, I’m sure. Everyone seems responsible, and no one is responsible for the perfect corporate solution.

I might be crazy, but through this maze, I feel I might just be getting somewhere. It’s probably a delusion, but it keeps recurring. Maybe my angel is watching. Maybe God is just having a little fun. Maybe the devil is laughing his ass off.

When I got off the phone, what I was thinking was this. How could an 85-year-old widow, living alone in her house or an apartment, possibly deal with this problem for which no one is responsible or understands what anyone in the process has done? We know the answer. She couldn’t. Neither could an immigrant or a poor person with literacy problems.

In a sense, this is computer hell, not billing hell. No one I’ve talked to was willing to pick up a phone, talk to any other human,n and get a quick and straightforward answer. But I have hope. I was told my doctor has no part in any of this.

If I owe the money, I’ll pay the bill; I can do it on installment plans if I want. I am courteous and patient. I don’t blame the people on the phone; I never take it out on them. I find that the better I treat them, the better they will work for me, and someone somewhere will take an extra step and help me resolve it.

Everyone has been friendly to me; everyone has been patient with me, and everyone is being monitored and taped by the people they work for.

We dehumanize our lives at our peril. I add this to my spiritual list of challenges. I will be patient. I will keep notes. I will call every week and make the rounds until this is resolved, which it must be, one way or the other. I will not succumb to anger, whining, or grieving. It accomplishes nothing. I always keep in the forefront of my mind that these are people all along the line just like me.

They are just trying to make a living, do good when they can pay their bills, and struggle with their reality, which is that people are calling them in rage and panic all day, yelling at them and blaming them for things they have no control over. They are taking the bullet for the cowards that run giant corporations where no one is responsible for anything without filing a lawsuit.

I asked Lila, the insurance woman, “does this go on all day? Are people yelling at you all day?” She paused, being recorded, I’m sure. “Well, yes,” she said, “but don’t apologize, you have every right to call, and I will try to help you.” Was it my imagination, or did she take a deep breath?

I will not be one of those people yelling, complaining, and making other people’s lives miserable. Like a sheep, I will be still and wait and accept what life has given me.

When it’s done, I want to look back and be proud to say I handled this patiently and courteously and was cruel and rude to no one.  I didn’t give up, and I didn’t lose control. The trolls online are making me better, training me well.

I feel that it might work this time, and if it doesn’t, I will find a way to pay my bill and move forward. I remember all the time that I am so much luckier than a poor or extremely old or fright mother of a sick child would be in these circumstances.

I have some time, skills, knowledge, and privilege that will help me. A lot of people are not so lucky.

Like everything in life, this is a gift I can use to improve and strengthen. And healthier.