I've had so many issues with SMDC billing that it's not even funny. Well, it's kind of funny. For a while they thought that I was married to my mom and that my dad was our son. Weird, but funny.

It's not just SMDC. St. Luke's once billed my dad for a procedure I had had done. I was 29 years old and living at a different address and we have different names. Then of course they wanted me to pay a late fee, even though the bill went to the wrong person at the wrong house.

Speaking of medical billing, after the blowup about Dave Ross making 180K I looked up some other local non-profits, and found the St. Lukes 990.

Strange makes about 500k, reasonable for someone running a 300 million organization, but some guy named John Yoon is making 2.5 mil. Stefan Konasiewicz is making 1.6 mil. Am I reading this right?  Are these guys bringing people back from the dead or what?

Return of Organization Exempt From Income Tax:
St. Luke's Hospital of Duluth

I have taken a lot of my past clients to Yoon and he worked very well with those individuals.  2.5 mil?  If someone thinks you are that valuable I say go ahead.  Yoon actually helps people.  Our society generally just pays off the people that are good looking or are good with a ball.

In a recent bill we were charged nearly $400 for an office visit to a mid-level (nurse practitioner) at SMDC.  It was roughly  30-40min visit.  No labs, no tests, nothing special.  It included a brief description of my problem and about 3-4 drug recommendations.  When I got the bill I laughed, literally.  It was followed with a call to their business office saying the charge is excessive and out of line.  Believe it or not, they conducted an audit and agreed (holy crap!) it was coded incorrectly. An admitted mistake. So they reduced it about $45. Boy, do I feel special.  Too bad most people lack the knowledge, courage or have the access to do this.  Health care change will ultimately be driven by the consumer.  Go where they treat you well and can explain the darn bill!

I guess I should stop bitching and go get one o' them opthamologist licenses. They have that at LSC right?

I at one time had a problem with the Duluth Clinic and double billing.  I had all the insurance explanation of benefits, cancelled checks and prior statements.  Despite faxing all my information multiple times and speaking to multiple supervisors there was no resolution.  I then went on line and looked up the names of the CEO and Public Relations liason and used the generic Duluth Clinic email format to send them emails.  My emails were a respectful request for intervention along with a dated history of my contact with the billing department (dates of contact and names of representatives and supervisors I spoke with). I also sent electronic copies of my documents.  Within two hours I had a call from the head of billing assuring me my issue would be resolved and within two business days the charges were reversed along with a letter of confirmation the issue had been corrected.

I have worked in the customer service field for a long time and know mistakes happen and there are unhelpful frontline employees and supervisors.  There are steps everyone can take to make sure you are getting the assistance you need when a 'mistake' happens.

Always check your statements when you get them.  Catching problems early saves a world of hurt.

Save your all your documentation.  For medical billing that means all explanation of benefits from your insurer, statements from your medical provider and cashed checks or records of on line transactions

Order your documentation in chronological order so if you have to submit it to your provider #1 You know you truly have been overbilled  (it is amazing how many times people think they are over billed when they are not) #2 They can see you have your poop in a group......they are going to look at their own documentation but if you show you have yours they know they are dealing with an intelligent consumer

Write down the date, time and first name of the representatives you speak with.  I always start out my conversation by asking for the reps first name, if they won't give it to me, I ask for a supervisor.

If you have to escalate to a supervisor, manager, etc...... Do so respectfully.  Calling people names and making negative comments about the evil capitalist system or the corrupt health care syste doesn't advance your cause.  It sets off an emotional response in the representative that begins blocking communication.

When your call is escalated get the name of the supervisor.  If they can't help and won't refer you higher start looking on line for execs in the company and submit your issue and documentation to them.  Supervisors often say, 'there is no one higher who can help you' or 'even if I were to send you higher they will tell you the same thing'.  When you hear this they are probably telling you the truth, there is no one higher in the OFFICE with the power to resolve your issue.  Go higher in the ORGANIZATION versus higher in the office.

Company email addresses usually maintain a standard format for all employees.  If the supervisors email address is [email protected] then the CEO's email address is that way.  Get that information  if you can.

What happens to your issue when the CEO gets it?  Well, most likely it will get forwarded on to a mid-level manager with the command, 'fix it'.  Which to many mid-level managers is code for 'make it go away' which equals give the customer what they want.

Hope this helps

Good comments, Andy.  I agree.  Billing at any American health care provider is complex.  I don't work with billing and can't speak to the original situation.  

It should be simple.  Like you said, you want a cheeseburger so you go to MacDonald's and order a cheeseburger.  You pay the price on the screen, usually cash, eat and go home. A health care provider can't run that way.  Going with the MacDonald's comparison...

It often takes one or more trained clinical professionals to diagnose you need a cheeseburger.  Lab tests determine ketchup is needed.  Records are checked to see if you're allergic to onions.  

Let's say it's obvious that you need a cheeseburger.  A trained professional still makes your burger under sterile conditions with medical-grade equipment.  Every patty, pickle and tomato is itemized.  

We can't always tell you how much it'll cost.  It's frustrating.  We'll give you a real estimate whenever we can.  Sometimes we can't know.  Maybe your hunger doesn't respond to the mustard so the doctor has to order a different mustard before your hunger gets worse.  Your insurer pays for the bun, but NOT the sesame seeds on the bun unless we get prior approval.  (You wait for that approval, getting hungrier by the minute.)  That same insurer pays in full for the lettuce but only a percentage of the patty's cost.  Some insurers pay differently if you're served in a clinic than if you're served in a hospital.  Things like coding or in-network or out-of-network add to the complexity.

After you enjoy your burger (with or without sesame seeds), the physician has to dictate the meal prep, a transcriptionist enters the notes, Pharmacy verifies that 4 pickles were prescribed and dispensed, someone sends notes to the insurer and 30-90 days later we get paid...maybe.  

This is from my perspective in health care.  I work at SMDC but AM NOT SPEAKING ON BEHALF OF SMDC.  I'm sure someone at a health insurer has good perspective on this, too.

A mistake is a mistake no matter the cause.  We're sorry for those.  Health care and billing are heartbreakingly complex.  We wish it were as simple for you as a trip to MacDonald's. All I can say is we pay attention, keep it running smoothly for you and fix whatever needs fixing.

Wow.  All of a sudden, I want Subway.