“What the hell is a medical billing advocate?” Brian had asked. “I’ve never heard of such a person.”
“Apparently they help people with hospital bills,” Aimée had responded. “I hadn’t heard of them, either, but a friend of mine had a problem with an MMH Inwood bill and told me a billing advocate had helped her. The advocate’s name is Megan Doyle, and she has an office here. You should let her help you.”
Following that relatively pleasant morning and with Aimée entertaining Juliette, and Hannah expected to join them, Brian had gone to Hudson Valley Rehabilitation Hospital with the intent of spending the day with Emma. His plan was to get a true idea of how much rehabilitation she was actually receiving. But similar to what had happened at MMH Inwood on Thursday, as soon as he had entered HVR, he was told he needed to see Antonia Fluentes in the business office immediately.
With some trepidation Brian complied, but the moment he entered the woman’s office, he knew from her body language that trouble was afoot, and she confirmed it immediately.
“It’s been brought to our attention that your MMH Inwood bill is outstanding with no payment plan arranged,” Antonia said. She stared at him expectantly with dark, piercing eyes framed with equally dark glasses.
“It’s only been a few days since my wife’s discharge,” Brian said evasively.
“But we also have learned that your account has been turned over to collections. As you can imagine, that is not encouraging for us.”
“It’s not great for me, either,” he responded.
“We’ve also not had a good experience with your insurance carrier, Peerless Health.”
“That doesn’t surprise me,” Brian added.
“I’m sure you can see our dilemma. Due to the pandemic, Hudson Valley Rehabilitation Hospital has been struggling financially, like most healthcare facilities. To be perfectly honest, we are going to need upfront coverage for your wife if we are to continue with her rehabilitation.”
“I see,” Brian said, feeling like he was taking yet another low blow. “Exactly what kind of figure do you have in mind?”
“Minimally we are looking for two thousand dollars a day for the first ten days. At that point we can reassess the situation and her progress.”
“I’m afraid we don’t have a spare twenty thousand lying around.” He could hardly keep the sarcasm out of his voice.
“I figured that might be the case, so I spoke with our chief medical officer, Dr. Harold Spenser,” Antonia continued. “Medically he doesn’t see any reason your wife cannot be discharged and have her rehabilitation carried out at home by local physical therapists who will be up to you to retain.”
“What about somewhat of a lower advance, say, in the five-thousand-dollar range?” Brian said. “This would be a gesture of good faith to keep my wife here as an inpatient.”
“I’m afraid not. Your wife’s current bill is already almost five thousand dollars.”
At that point the conversation went downhill as he became incensed that Emma’s charges could already be at the five-thousand-dollar mark, considering she’d only been there two full days, the shabby state of the facility, what seemed like a lack of staff, and that she’d essentially received no treatment. In the end, it was decided that Emma had to be discharged, and to avoid another thousand-dollar ambulance bill, Brian had to drive her home himself.
Although getting Emma into the car had been a struggle, once they’d gotten underway, she perked up. “Being discharged was unexpected, but I’m looking forward to getting home,” she’d said. She was out of breath from the effort of climbing into the car’s front seat. There was no doubt her spasticity was worse.
“I can well imagine. We are all going to be thrilled to have you, especially Juliette, who’s really missed you.”
“I’ve missed her, too,” Emma confessed. “And how about the business? I’ve been afraid to ask.”
“Not good,” he told her regretfully. “There was a possibility of a wedding in October out in the Hamptons, but just yesterday it was canceled. Camila is constantly trying to scare up some business with social media.”
“How are our finances?” Emma asked.
“Also not good, I’m afraid,” Brian said with a wince. He’d not mentioned anything to Emma about the problems with Peerless or the hospital bill and didn’t intend to until she was fully recovered, seeing no reason to stress her out.
At first Emma’s homecoming had been well received, especially since both Aimée and Hannah were there to greet her with Juliette and Camila. Juliette was obviously thrilled, at least initially. But the bonhomie didn’t last, as Emma’s physical limitations and precarious emotional state put the festivities to a quick end. She quickly tired, had no patience with Juliette, who needed constant attention and reassurance, and soon just wanted to go to bed and sleep. Getting her up the stairs to the master bedroom became an exhausting ordeal for everyone; although she could walk on the flat with some difficulty, the stairs were almost impossible.
For him it had been the night that was by far the most difficult part, when he was left alone with his ailing wife. Although Emma had slept most of Saturday afternoon and evening, at night she was mostly awake, emotionally unstable, and rather restless, putting Brian’s patience to a true stress test. She even managed to fall out of bed around four a.m. On top of that was the difficulty of getting her from the bed to the toilet on multiple occasions. He’d barely slept a wink, and it also made him understand why it had been far better that he’d become a policeman rather than a medic, a notion he had entertained for a short time as a teenager.
Sunday had been spent trying to make the home situation tolerable for everyone. Luckily Hannah had an acquaintance with a late husband who’d been chronically sick and had required a hospital bed with guardrails for the last years of his life. Since she no longer needed the bed, she’d graciously offered it to Brian to install in the second-floor guest room, across from Camila’s room. To his great relief, Hannah had insisted she’d spend the night with her daughter to give him a break and a good night’s sleep.
The sound of the front door chimes ringing shocked Brian from his recollections of the past few difficult days, and he leaped out of bed, grabbing his robe in the process. As he headed for the stairs, he wondered who in God’s name could be ringing his doorbell before eight on a Monday morning.
Grabbing a mask off the console table in the front foyer and looping its strings around his ears, he pulled open the door. His wild rush had been hopefully to prevent whoever was there from impatiently ringing the doorbell yet again. About eight feet away, standing on the top step of a mini flight of stairs in the middle of Brian’s front yard, was a white-haired, moderately well-dressed gentleman in a white shirt, poorly knotted tie, and sports jacket. Despite only seeing the man’s forehead and his blue eyes through rimless eyeglasses above his face mask, Brian sensed that he vaguely knew the person. The man was holding an envelope in his right hand, although his arms were limp along his sides.
“Can I help you?” Brian asked, trying not to be irritated. It wasn’t a convenient time to be bothered, especially with the possibility of rousing Emma and Juliette. Thanks to phones and email, house visits of all sorts were rare these days, especially with the pandemic.
“I apologize,” the man said with a mild Irish accent. “Really I do.”
The combination of the sound of the man’s voice and the other visual cues brought some memories back. “Grady?” Brian questioned, tilting his head to the side to get a slightly different view. “Grady Quillen?”