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Medical Debt- Medical Billing- Financial Toxicity

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Sick and struggling to pay, 100 million people in the U.S. live with medical debt

Medical Billing is a key component of a diagnosis of cancer. Most cancer patients don’t think about financial toxicity when they’re diagnosed simply because they are consumed with basic life and death issues. After several years pass by, the patient and caregiver can become overwhelmed with the bills adding up day after day, month after month, year after year.

I crashed headlong into medical debt after several years of struggling with “explanation of benefits” (E.O.B.) that I received following surgery, chemotherapy and radiation for cancer therapies. Ironically,  my aggressive, toxic cancer treatments didn’t extend my life but caused a host of short, long-term and late stage side effects.

I’ve written about the cost of chemotherapy, the cost of everything hospital-related and then most importantly, the final result- medical debt. Financial toxicity can be as devastating to the cancer patient as any chemotherapy, radiation or surgery can be.

Please, please, please don’t think that you have to blithely agree to every therapy suggested by your oncologist. There are always choices to be made. An excellent example is the use of a class of drugs called bisphosphonates.

  • Number of monthly doses-
  • Zometa vs. Denosumab-

You could undergo acedia therapy for only 6 months or for 12 months. You could undergo zometa which is a fraction of the cost of Denosumab.

The challenge with a trip to the hospital or a diagnosis of cancer, is that the patient focuses on his/her healthcare, not the charges resulting from that healthcare aka medical debt. Buyer Beware!

The solution? The No Surprises Act, linked and explained below, is a giant step in the right direction.

Have you been diagnosed with cancer? To learn more about financial toxicity read the blog posts linked above or scroll down the page, post a question or comment and I will reply to you ASAP.

Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Here’s what the new ban on surprise medical billing means for you

“The new year brings new protections for patients with private health insurance who will no longer be blindsided by “surprise” medical bills when they unknowingly receive out-of-network care…

The No Surprises Act, passed by Congress in 2020 as part of the coronavirus relief package, takes effect Jan. 1.

It generally forbids insurers from passing along bills from doctors and hospitals that are not covered under a patient’s plan — such bills have often left patients to pay hundreds to tens of thousands of dollars in outstanding fees. Instead, the new law requires health care providers and insurers to work out a deal between themselves…

Once the law takes effect, “it’s completely irrelevant whether an emergency room doctor is in network or not,” he said. “For all intents and purposes, that doctor is in network. The patient will pay the in-network cost sharing and there is a price the provider has to accept, and the insurer has to pay.”

“Much of what we accept as legal in medical billing would be regarded as fraud in any other sector…

Now, after a summer of firsthand experience — my husband was in a bike crash in July — it’s time to call out this fact head-on. Many of the Democratic candidates are talking about practical fixes for our high-priced health care system, and some legislated or regulated solutions to the maddening world of medical billing would be welcome…

My husband, Andrej, flew over his bicycle’s handlebars when he hit a pothole at high speed on a Sunday ride in Washington. He was unconscious and lying on the pavement when I caught up with him minutes later. The result: six broken ribs, a collapsed lung, a broken finger, a broken collarbone and a broken shoulder blade.

The treatment he got via paramedics and in the emergency room and intensive care unit were great. The troubles began, as I knew they would, when the bills started arriving…

What I’m talking about here were the bills for things that simply didn’t happen, or only kind-of, sort-of happened, or were mislabeled as things they were not, or were so nebulously defined that I couldn’t figure out what we might be paying for.

To be clear, many of the charges that I would call fraudulent — maybe all of them — are technically legal (thanks sometimes to lobbying by providers), but that doesn’t make them right. And no one would accept them if they appeared on bills delivered by a contractor, or a lawyer or an auto mechanic…

Why do insurers pay? Partly because insurers have no way to know whether you got a particular item or service. But also because it’s not worth their time to investigate the millions of medical interactions they write checks for each day. Despite the advertised concern about your well-being, as one benefits manager enlightened me: They’re “too big to care about you.” Electronic records, which auto-fill billing boxes, have probably made things worse. For example, the birth of a baby boy may automatically prompt a bill for a circumcision; having day surgery may prompt a check for sedation…

So what is the appropriate payment for swag I didn’t ask for,

  • outrageous cover charges,
  • stand-in doctors,
  • drive-by visits and
  • faux surgery?

In some cases, zero; in others, far less than was paid. And yet, these are all everyday, normal experiences in today’s health care system, and they may be perfectly legal. If we want to tame the costs in our $3 trillion health system, we’ve got to rein in this behavior, which is fraud by any other name…”



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