Wednesday, May 21, 2008

Children's Mercy Hospital should be ashamed: An open letter

Children's Mercy holds this spot of endearment in the hearts of Kansas Citians and for many reasons it is certainly justified but they aren't all that AND a bag of chips in my experience.

If you have ever had the misfortune of dealing with them because you have a child who needs their services you can have a love-hate relationship with them not only in your heart but your pocketbook.

On one hand you love the quality of service, the caring doctors and staff, and the access to some of the best specialized care you can get for a child. On the other, once you get to billing your life can become a nightmare. So, I'll ask this question and hope someone at Children's Mercy will see it as a challenge to improve. Why can't you pursue the same level of excellence, empathy, and goodwill that you show in patient care to billing and insurance issues?

In our situation, we are educated professionals with good (major company) insurance and good jobs and we have put up with a ridiculous amount of problems with claims, billing, and threats to be sent to collections over relatively small amounts of money. First, they claim to deal with all insurance but they don't. They will take any insurance money but in some cases you have to handle filing the claims for companies they won't bill directly. In other cases you will have to fight with them over what part your insurance company pays and what you are suppose to pay and lots of incorrect bills coming your way that perhaps someone less savy will just pay never to know that it was something not your responsibility. Then they get angry for asking good consumer questions when you go back is this covered by MY insurance? How dare we treat health care like a good consumer. So, you have a bill for say $1000. Insurance says the usual and customary or approved rate for the procedure is $600. This is assuming that they actually billed it in way the insurance company approves of the procedure. You are suppose to pay 20% and the insurance company is suppose to pay 80%. So they pay $480 and I am suppose to pay $120. Except CMH wants you to pay the $120 PLUS the difference they didn't get from insurance of $400 so they want $620 from you. So they take the insurance but they don't accept the insurance company's standard negotiated rates or usual and customary and further you don't know who is being the biggest bastard the insurance company or the hospital because they have the knowledge of volume and we are newbies to the process.

In a real world example of how ridiculous this can child had tubes put in the ears at CMH. Again the doctor was wonderful but the billing? CMH billed us for ear wax removal as a separate line item in the procedure and insurance rejected it saying that is part of the procedure. the difference or else you go to collections.

So, we fight on dealing first with a child who needs care and second with the hospital who has an endowment that is huge and still threatens to send us to collections over a disputed $30 remaining balance here and there.

Children's Mercy.....shame on you. Then, finally they have the audacity to call me and solicit a donation? I'd like to see you take pride in having the best billing and claims department for customer satisfaction in the country in addition to all the other things.

Note: Generally, I take pride in a well organized and thoughtful blog but on this one.....I'll just rant. Sorry about that but the anger and disappointment flows. I've raised tens of thousands of dollars for them and it leaves a bad taste in my mouth to be treated in such a way......


Jay said...

I have heard this about CMH. Shawnee Mission Medical Center is not much different when it come to that either.

Chris Langston said...

I can only account for my experience and those I know in similar situations, but it was completely opposite of yours. Of all the hospitals, clinics, nursing companies, or home health companies we deal with (and there is a lot), Children's Mercy has been the VERY BEST of them all to deal with.

We have easily had over $1 million in billed services from Children's Mercy, including a five-month stint in the NICU from our son's birth. Those five months alone generated more than one three-ring binder of line-item services.

If you want to blame anyone, take a closer look at your insurance company. If we have ever had trouble, it has been because of the bureaucracy and red tape that insurance companies demand of the hospital (and policy holders). Because of their ignorance, we spent an additional two weeks in the hospital for no reason.... and they had to pay for it. Not once have we been billed or asked to pay ANYTHING before they worked their butts off trying to get the insurance company to step up.

I apologize if this seems, too, like a rant. But they saved my son's life. And I'd let them do it again, no matter the cost or hassle. I'd chalk your experience up as the exception, not the rule. Of all the visits, surgeries, and hospital stays we have had, you'd think I'd have encountered at least one similar experience. Truth is, I haven't.

JOCOeveryman said...

Chris, I certainly appreciate that you've had a good experience and I'm glad it has been satisfying.

I have a kid with special needs and it continues to be a nightmare and opposite of yours. We know several people who have echoed our complaints. Our son did 4 weeks in the NICU so I think you appreciate that I speak with credibility and experience as well.

I don't like how they treat us when we call to discuss claims and they certainly don't go out of their way to work with our major insurance company.

After my son was born I held a fundraiser on their behalf...not my son's... that raised over $40,000 and they threatened to send me to collections over less than $50. We are well educated in dealing with these issues as I'm confident you are too. The insurance company certainly bears some blame some of the time but to put it all on them is too convienent. We've let them have it on occasion as well. I seem to have less problems dealing with our insurance when we've been other is just that simple.

What you say is correct and they know it that if your kid needs help it is the place you will go because of the quality. We continue to go back. It just pains me that they are so great on the front end and so different on the back end. I disagree that my experience is NOT the exception. When they are saving your kid you don't generally sit around the waiting room bitching about claims. At least I don't. I'm glad they were able to save your son's life and of course anything is worth that. I guess I'm grateful your experience has been great but we talk to many others who share our concerns.

I'll never raise another nickel for them and I'll never give them a personal donation.

Then to make matters worse....they recently hired (well after I wrote this post) a man to work in their marketing department who I know to have serious ethical issues. I can't believe they hired him. Unbelievable.