“It’s going to go up,” he warned. “There will be an additional charge for an ED visit yesterday.” Brian then gave her a quick history of Emma’s illness and her death the day before.
“I’m so sorry to hear you have lost your wife,” Megan said with genuine empathy. Her shoulders visibly sagged.
“It’s the worst part,” Brian said. “But the financial impact is a real issue I still have to deal with. Do you think you can help me?”
“Absolutely, without a shred of doubt,” Megan said, regaining her fervor. “I’ve yet to have a client whose bill I haven’t significantly reduced. I can assure you that MMH Inwood pads their bills and makes billing errors with as much or more regularity than the other hospitals in the city, especially for the uninsured or poorly insured. By poorly insured I mean those people whose health insurance companies haven’t negotiated significant deductions in the hospital’s charge master price.”
“I apologize, but what is the hospital’s ‘charge master’? Is it like a list of prices for their services? I’ve never seen that.”
“Nor will you see it, even if you ask,” Megan said. “It’s not meant for the public to see. It’s a list of artificially high prices for goods and services that merely serves as a starting point for negotiating deductions for the more powerful, meaning large, health insurance companies. These prices have nothing to do with cost plus profit, which is how prices are usually determined in a real market and how Medicare tries to determine how much it will pay. And to make matters worse, hospitals keep raising their charge master prices, particularly when a hospital chain buys a failing community hospital. It’s all a big game as hospitals and health insurance both benefit the more money is thrown at healthcare. Unfortunately, it is people like you who suffer the most because of this stupid and enormously expensive game. You end up being charged the artificially high charge master price, which is much more than everyone else pays.”
“Good grief. I knew none of this. I feel like a babe in the woods, for Christ’s sake.”
“Don’t be hard on yourself. Most people have no idea of any of this unfortunate reality, and most people still labor under the delusion that all hospitals and health insurance companies exist to help them in their time of need.”
“I’m afraid I fell into that group for sure.”
“All right, enough of this grim reality,” Megan said, regaining her enthusiasm. “As soon as you sign this patient privacy authorization form, I will start the uphill climb of getting a complete, fully itemized bill, which is never easy because they will try hard to keep it from me. But don’t worry. I know all their tricks and all their delay tactics. Have you been dealing with anyone in particular in the hospital’s billing office?”
“Yes,” Brian said. “A Roger Dalton.”
“Good. He’s almost human.” She laughed at her own joke. “And I assume you are working with Patrick McCarthy as well since he called me?”
“Yes, starting just today,” Brian confirmed.
“Perfect!” Megan said. “We have a good working relationship. Do you have any questions for me?”
“I don’t know enough to have any questions at the moment.” He knew he’d probably have a dozen as soon as he walked out of the office.
“Let me give you a quick thumbnail sketch of what will most likely happen,” she added. “Although I can’t promise you anything, but by my past experience with MMH billing, I should be able to reduce your bill anywhere between twenty-five to ninety percent. I know that is an awfully large range, but that’s been my experience. As soon as I get your completely itemized bill, I’ll start to work. After this in-person meeting, we can work remotely for the most part. I assume you have a computer and internet.”
“Yes, of course,” he said. “Actually, I have thought of a question. You seem to be busy. Are there a lot of Inwood people in need of your services?”
“Too many. And the pandemic has made it worse with people losing their employment-based healthcare and either going it alone or resorting to short-term health policies like you did. It’s another developing part of the Covid-19 American tragedy.”
“What about your fees? How will I be paying you?”
“You can either pay by the hour or as a percentage of what I save you,” Megan said. “It will be your choice, and you can decide at some later point. After I get a look at your hospital bill, I’ll be able to give you a better idea of what my fees might be.”
“Patrick offered to put off payment until after the pandemic eases up and my business picks up. Are you willing to offer that as well?”
“I am,” Megan said. “I’m sorry to have to cut this short, but I need to get back to seeing my scheduled clients. But first, let’s have you sign this patient privacy authorization form to get the ball rolling.”
“Of course.” He got to his feet and approached the corner of the desk where she had slid the papers that needed his signature.
With the papers signed and in hand, he followed Megan out into the waiting room. While she called one of the elderly clients, Brian went to the receptionist as he’d been instructed and handed over the signed form. As he was doing it and listening to her saying she would be in touch if anything more would be needed on his part, he was trying to work up the courage to re-engage Jeanne Juliette-Shaw. Luckily, he didn’t have to improvise. To his relief, as soon as he was finished with the receptionist, Jeanne stood up and approached him. In her hand she was holding a business card.
“Excuse me, Brian,” she began. “I am truly sorry about your wife, and I have been thinking more about your daughter. The experience I had as a school psychologist suggests it is not going to be easy for you or her. If I can be of help in some way, particularly if there are problems, I’d be happy to do so. I’m not working presently for a number of reasons, which I won’t bore you with, so I would be available if you were so inclined. Of course, it would be entirely pro bono.”
Brian was immediately overwhelmed by Jeanne’s generosity and impressed with the force of her character. “That’s incredibly kind of you,” he stammered.
“I wanted to give you my number if you are interested,” Jeanne said, extending the business card.
He took the card and tried to read it but with difficulty. His eyes had teared up at Jeanne’s offer and her altruism threatened to dissolve the veil of denial he’d erected to keep his emotions in check. “I might very well call you,” he stammered.
“I’m sorry if I’m upsetting you,” Jeanne said. “But I would like to help if you think I could.”
“You are not upsetting me,” Brian struggled to say, even though he was lying. He focused on the business card to get himself under control. In bold letters it said: shaw alarms followed by a Washington Heights address. Her title was vice president. There was an office telephone number, but it was crossed out, and below that was a mobile number.
“Whoa,” Brian said, taking a deep breath to pull himself together. “All this time I didn’t know I was speaking with a vice president!”
“Vice president of a bankrupt alarm company,” Jeanne corrected with a laugh of dismissal. “Shaw Alarms was forced into bankruptcy after I tried to pay MMH Inwood what I owed, which was impossible, and then was sued by them.”
“My God,” he remarked as rising anger saved him from his mournful emotions. Jeanne’s story was a stark reminder of how predatory MMH Inwood was and how perverse Peerless was to more people than just him. “MMH’s suit caused your company to go under?”