About a year ago, a friend went through some complicated medical procedures. They took several months and a fair bit of travel. Ultimately the procedures were frustrating. The doctors finally told him, “We don’t know why it’s happening, and there’s no cure.”
“At least it’s not life-threatening,” my friend said with a wry smile.
Most of the billing and insurance went through without a hitch — a minor miracle, really. My friend has a national insurance company with a good reputation.
What he doesn’t have, however, is a local radiologist who can handle high-end scans. So when complex images needed to be read as part of his diagnosis, they had to be “farmed out.” That out-of-town radiologist used a third-party biller halfway across the country.
My friend got a bill from said radiologist saying that his insurance had rejected one of the claims. Strange, he thought: my insurance records show that they have no such claim. His insurance had paid for the scan itself no problem, as well as other reads from the same radiologist. (The scans and the readings of the scans are separate claims.)
Thus began the rigmarole that lasted nearly a year for my friend. He would call his insurance company first: we have never received that claim, they would say. Then he would call the third-party biller for the radiologist: your insurance rejected that claim, they would say.
He would go over all the details with them. His insurance information, the dates, the procedures, you name it. He even had to learn things he’s supposed to know nothing about, like ICD medical billing codes. Can you please resubmit it, he kept asking the billing company. What will it take for you to accept it, he kept asking his insurance.
Even after two resubmissions, the situation was the same. His insurance still said they hadn’t ever received it, despite the billing company’s detailed information on the denials. The billing company was threatening to put him in collections. He has a credit score in the 800s, by the way; I think he’s been late with a payment maybe once in the past six years.
He received good advice from knowledgeable friends. Medical bills don’t affect your credit score much, they said. If you’ve done your part in good conscience, simply don’t pay the bill, they advised.
But my friend was still perplexed. His insurance has paid all the other claims, including three others from this same third-party biller in the past six months. Something had got to have gone awry somewhere.
Again, he got on the phone. He prayed to be connected to someone who could actually help him. He went through all the information with the representative. She warned him that they were going to refer him to collections. I know, I know, he said…
Suddenly she said something that didn’t sound right. “What is the billing address where you’re sending these claims?” he asked.
She told him: Topeka, Kansas. He did a quick Internet search. “That’s the claims address for the Kansas City, Kansas branch. My insurance is the Kansas City, Missouri branch.” It was the same insurance he’d had for years.
The representative did a little checking. Indeed, she confirmed, we have sent all the bills for this particular claim to the wrong office. She apologized and promised to send the claim to the proper office.
Finally, two weeks later, he received word from his insurance. They had received the claim at last, and they were processing it. It would take 4-6 weeks from there.
Mistakes aren’t sins. We all make them, and even a disciplined person with exceptional habits will sometimes mess up. Especially when you’re dealing not only with complicated information, but a lot of that kind of information.
But when we don’t learn from our mistakes, we are at risk of the sin of negligence.
Not doing one’s duty with the proper attention is a sin against prudence, perseverance, and justice. When you’ve sent a patient’s bill to the wrong address three times in a row over the course of nine months, that’s no longer a simple mistake. Especially when all it would take is a moment’s checking to see that this same patient has had three other bills properly paid at the same time.
Yes, privacy laws can hamper the exchange of information in these cases. But let’s learn at least two important spiritual lessons here. .
First, negligence causes others to suffer.
While we must avoid perfectionism, we must do our duties with proper attention. Too many good people sacrifice the greater good of doing their jobs excellently for the lesser goods of pleasure, honor, power, and wealth. (Of course, mea culpa.)
Secondly, faith seeks understanding.
If something seems awry, we should seek out answers, even if it takes a while. A standard principle of the spiritual life is that God prefers to solve problems through secondary causes — i.e., through ordinary human interactions shot through with His extraordinary presence. While my friend was certainly weary, he kept seeking until he found the answer.
Let us be quick to overlook mistakes (Proverbs 19:11).
But let’s do our jobs with the freedom of excellence, the antidote to negligence.
