Medical Bill Mayhem

Healthcare takes a page from Starbucks’ “experience economy”

Photo by Sripfoto/Fotolia

In the course of welcoming a tiny new person into my family, I accessed more health care in the past year than in my previous life. Being pricked, prodded, scanned, and asked to choke down a bottle of glucose syrup wasn’t exactly pleasant. On the plus side: I received knowledgeable, compassionate care from all my medical providers and was heartened to see that their employers have been adopting some of the “experience economy” ideals famously embodied by Starbucks. (Instead of simply selling a commodity beverage, the coffee chain offers the “experience” of a comfortable, social environment in which to luxuriate over a cup of fresh brew.)

A colonoscopy is never going to be a cappuccino, of course, but you get the idea. When medical groups view patients as customers who can choose to take their business elsewhere, they’re more inclined to care whether the entire healthcare experience—from setting up an appointment to departing the parking ramp—is a positive one. During my visits, I found signage in the lobby suggesting that if I’d been waiting for more than 15 minutes, I should let the receptionist know. Formerly cold, stark, inhospitable hospital rooms now resembled those of boutique hotels. Mailed surveys arrived after my visit, asking for feedback on how everything went.

Now if only the same effort being applied to the healthcare “experience” extended to paying for it.

In the months after my son’s birth, I spent far too many bleary-eyed hours sorting through claims and compiling spreadsheets. I had my medical providers and insurance company on speed-dial—though I often wished it were three-way when I’d get stuck in an infinite loop with each side telling me to call the other.

Billing offices told me my insurance was accepted, then later it wasn’t, then later it was. I was asked to pay different amounts for the same procedure. Just when I thought I’d mastered the language of deductibles and co-insurance, an alarming, five-figure whopper arrived with a letter stating that I had no insurance on file, even though a hospital billing representative had wheeled her computer into my room and, between coughing fits, interrupted bonding time with my newborn to collect the information.

Today, my son is crawling up stairs and opening cupboards, and I’m still trying to get one last bill sorted out from when he was a fetus. (Ironically, I’d had the exact same procedure, at the same location, billed with the same code a few weeks earlier, and it was processed in a timely manner.) Back to the Starbucks metaphor, the experience has felt rather like having a barista request, in Swahili, that I call someone in Russia and, after keying in my
ID number seven times and waiting on hold for hours, negotiate the price I will pay, in yen, for the latté I drank six months ago. Whoever can improve this part of the process, I will owe my future mental health.

Photo of Rachel Hutton by Erika Ludwig. Hair and makeup by Margo Gordon.