At my previous job, I was the Medical Billing Specialist/Insurance Liaison. We had a patient who was scheduled for an EGD/Colonoscopy due to a serious medical diagnosis (other procedures were going to be scheduled for her as well). I reviewed her policy before she was escorted to my office. I noticed she had a $10,000.00 deductible/aggregate policy (i.e, her insurance carrier capped the amount it would pay out for her insurance claims for the year. I think the number was like $1,000,000.00, odd for someone with a $10,000.00 deductible, right?) I sat at my computer, mouth agape, and shook my head. Self-Funded. She was purchasing her own insurance as she was the business owner.
Then came the moment for me to discuss this with her. My palms were sweaty. At that time, I had never seen a $10,000.00 deductible policy. I informed her what her estimated out of pocket costs would be for each procedure she was going to have and she nearly fainted. It was like she did not know. She purchased the policy herself, she was paying the premiums for it. However, she did not fully understand what “deductible” meant. That day, I knew I could not do what I was doing anymore. She had gotten so distressed, she did not want to schedule procedures that would possibly save her life. She was assured and reassured that she could pay monthly towards each bill, whatever she could afford, but she just did not want to have so many bills hovering over her like that.
Long story short; I met with the Gastroenterologist, explained her situation, and informed him that she had enough on her plate and anything we could do to assist her would help greatly. He rendered every service for free and did so at the hospital, so that their bill (s)would be drastically reduced based on her “situation.” Shortly after she had her follow up visit, I left. I put in my notice. I’d rather fight medical insurance carriers.