Once in the house, Brian went to the office. He knew he had to contact his mother, but he hesitated. It was now 12:20 p.m., and he imagined the interment was in progress, meaning even if he tried to rush out to Woodlawn Cemetery, he had probably missed the ceremony. He felt fairly guilty and worried that he’d let Hannah down, yet Juliette’s well-being was far more important to him than his sense of responsibility to his in-laws. Besides, he had to admit that he felt relieved not to have witnessed the stark reality of putting Emma’s body in the ground.
Instead of making a mad dash to the cemetery or even calling Aimée, he sat down at his desk and used a letter opener to get at the contents of the manila folder Grady had brought over. After he and Jeanne had seen on the internet the huge number of people the Manhattan Memorial Hospital had sued or was suing in the metropolitan area, he wasn’t totally surprised the list comprised hundreds of Inwood residents whom Grady had served. Having spent his entire life in the neighborhood, Brian fully expected there would be a number of people he knew personally. Sure enough, just with a random glance, he found Donavan Bligh’s name with an address on Indian Road, a ten-minute walk from where Brian was sitting. He knew the family because they had a son who’d been in his sister Erin’s class at P.S. 98 like Patrick McCarthy.
Although Brian was now more interested to help Jeanne learn the gory details of a number of the cases to hopefully motivate the media and maybe even the local politicians to do something, he slipped Grady’s list back into its envelope, and put it aside. He then got his phone out with the intention of calling Aimée, but still he hesitated. Instead of initiating the call, he put the phone down on the desk and stared at it. Not only did he feel guilty about missing the burial, but he also now worried about the possibility of his call coming at just the wrong time if the interment was still in progress. If that happened, he’d only be adding insult to injury. With that concern in mind, he wondered if he should wait just a little longer, or send her a text instead. He knew Aimée was expecting him to be in contact.
While Brian sat paralyzed by indecision, the phone suddenly rang with its raucous “old phone” ringtone, making him jump. In a kind of panic, he snapped it up to see who was calling. To his great irritation it was Roger Dalton. Recalling the anger the man’s phone call had incited the previous day, he debated whether to answer. He was already in a foul mood, and Roger Dalton, as the embodiment of MMH Inwood’s business tactics as well as Kelley’s sidekick, was fast becoming for him a persona non grata. Yet rationality intervened, making Brian again question whether he might be calling concerning Megan Doyle’s or Patrick McCarthy’s need to get a complete printout of Emma’s hospital bill. With that possibility in mind, he answered but quickly wished he hadn’t.
“This is rapidly becoming a farce,” Roger said without even identifying himself. “I don’t know why I’m making the effort to call you other than feeling some sympathy for what’s happening to your life. Another charge for which you are responsible was brought to my attention. Of course, I immediately sent it to Peerless Health, and in their usual rapid but disappointing way, they have refused any coverage. Ergo, if you don’t get them to reverse yet another denial, it will be added to your growing delinquency. Can I expect you to look into this quickly and get back to me?”
For a moment Brian struggled to control an almost overwhelming vexation and didn’t answer immediately, partially because Roger Dalton had at least expressed an ounce of empathy. “Is this new charge for my daughter’s Emergency Department visit?”
“It is indeed,” Roger said.
“You are not talking about today, are you?”
“No, yesterday,” Roger said. “Did you return to the ED today?”
“Yes, I just got home. I was there all morning.”
“Oh, dear,” Roger said. “Well, that makes it more important to get in touch with your insurance company. Because your account is flagged, I’ll be hearing about a new charge probably this afternoon. Both these charges will be added to your default unless you would like to take care of these ED bills yourself. Is that a possibility?”
“How much is the charge?” he asked hesitantly. Since nothing had been done in the way of laboratory tests or imaging, he thought there was a possibility he could show some good faith, but it depended on the amount.
“Yesterday’s charge is $1,776.55,” Roger said. “We’d be happy to accept a check or credit card.”
“Wait a second!” Brian blurted. “That’s almost two thousand dollars! There must be some mistake. We had to wait for so long that my daughter’s symptoms disappeared, so nothing was done: no tests, no nothing. That’s impossible.”
“Quite the contrary,” Roger said. “The facility was used and the facility charge is a good portion of the bill. On top of that, your daughter was seen by a doctor, so there was a charge for that.”
“I have never even heard of a facility charge,” Brian said. “What the hell does that mean?”
“It means that everyone who is seen in the ED has to pay some costs involved in constructing and maintaining the whole facility and all its necessary equipment, including all the X-ray machines, MRIs, you name it.”
“How much was the facility fee?” he asked.
“Let me check,” Roger said. There was a brief pause before he added: “Eleven hundred dollars.”
“Good God! I’m being charged eleven hundred dollars for merely walking into the ED.”
“No, you are being charged eleven hundred dollars for your daughter to be seen, examined, and treated in a Trauma 1 facility.”
Brian tried to rein in his outrage. Instead he harkened back to the lecture Megan had given him about hospital-inflated charge master prices used to negotiate with the larger health insurance companies, but which Medicare didn’t pay. “If my daughter was on Medicare, how much would the facility fee be then?”
“That’s proprietary information,” Roger answered.
“Oh, come on, Roger,” Brian said. “I’m sure I could call Medicare and they would tell me. You expressed some sympathy for what I’m going through. Help me out here, so I can begin to understand what I’m up against. How much would Medicare pay? I won’t tell anyone you told me.” Brian rolled his eyes at his own falsity.
“It is true Medicare could tell you,” Roger admitted.
“There you go,” he said. “Save me the effort.”
“Somewhere in the three- to four-hundred-dollar range,” Roger said. “It depends on what part of the ED was actually used.”
“That’s quite a difference,” Brian responded, keeping his real thoughts to himself. “When we first met, you gave a lot of credit to Charles Kelley. Has he been involved with this facility charge situation?”
“Of course,” Roger said. “It’s a key element in his turning the hospital around financially.”
“Interesting,” Brian managed. Struggling to contain himself, he changed the subject. He knew it was a hopeless cause arguing about prices with the likes of Roger Dalton or finding fault with his CEO and hero. “Did Peerless give you any reason for denying the claim for my daughter’s ED visit?”
“No,” Roger said. “They rarely do. That’s for you to find out and try to rectify. What about this most recent ED bill? Do you want to use a credit card? I could take direct payment over the phone. It’s your choice.”
“I’ll call Peerless,” Brian said.
“Fine,” Roger said with irritation. “You do that.”
Without another word being spoken, he found that the call had been disconnected. Yesterday he’d hung up on Roger Dalton; today Roger Dalton had hung up on him.
With his own anger and resentment mounting, Brian subjected himself once again to the frustration of calling Ebony Wilson. As he waited through the required hold music, he tried to imagine what reason Peerless was going to give for denying Juliette’s ED visit. He also marveled at what a nightmare American healthcare had become for himself, his family, and apparently for too many of his neighbors and friends. After this whole ordeal, he’d be happy to never have to speak with another healthcare representative again.