Two Steps Forward, Two Steps Back

Yesterday, I decided to find out exactly what kind of financial headache I was in for with my upcoming radiation treatment.   I have contact information for a very friendly, helpful guy in the financial services area at Mayo Clinic, so I gave him a call.  I explained the situation with my insurance company, and I told him that I need to know as accurately as possible what my charges would be for each phase of the radiation treatment, so I could figure out what the insurance would pay and what my responsibilities would be.  I told him that I want to make sure I can pay my bills in full when they start coming.  I told him about the mess from my first time at Mayo and explained that I wanted to make sure neither of us went through that again.

As usual, this dude was very helpful, but he wasn't able to give me all the numbers right away.  He told me that I need to get a detailed treatment plan, which I should receive at my consultation on Wednesday.  When I have that he will be able to give me an itemized list of the expected charges.  Then he gave me the best news I've had all week: as of November 1, Mayo Clinic will be an in-network provider for my insurance group.  That change will come about a week later that ideal, but I'm willing to wait it out.  It's only a week.  We made an appointment to reconnect by phone on Monday, when we'll call the insurance company together to see if there is anything we can do to bridge that gap in coverage. Things were definitely looking up.

Today, however, I got a call from the business office at Mayo.  They initially called to update my insurance information, but then, they dropped the biggest financial bomb yet in this nightmare: oh by the way, because I took financial assistance on that one previous occasion, I am now required to prepay any and all charges that the insurance isn't likely to cover.  That includes the deductible, copay, non-covered charges, and any amounts above the "reasonable and customary" amounts allowed by my insurance.  Of course, they don't have any idea how much that will be, but I have to provide full payment before I receive each phase of treatment.

What the hell? 

Over the years I've had clinic and hospital bills that I've paid in full right away, and some that  I paid over a period of months.  It's never been a problem.  I've never had delinquent credit cards, never been late on a mortgage payment, never had any sort of credit problem.  I took the financial assistance from Mayo only because they decided, a few months in, that the payment agreement I made (and was current on) wasn't good enough.  They started calling and harassing me for more money, threatened to report me to collections, all kinds of unpleasantness.  Considering that we had a written agreement that I was keeping my end of, I probably could have fought back, but I was overwhelmed by the idea of hiring an attorney, and of course I didn't have the financial resources for that.  When Mayo offered me an out, I took it.  I guess that was a mistake.

Then again, maybe not.  Had I not taken the financial assistance I would still be paying on that bill.  I would probably be in the same boat, or worse, if that were the case. It's possible that I would have turned down the mammogram that detected this cancer, for fear of running up yet another clinic bill. 

I'm not sure where I go from here.  I'm planning share this news with the helpful guy I'm scheduled to call on Monday, to see if he has any ideas.  At my consult on Wednesday, I'm going to tell them that I absolutely can't have any further appointments scheduled before November 1, when in-network benefits will apply.  I'm still waiting to see if I need chemo.  If I don't, prepayment may be a non issue as I'll be able to finish my radiation therapy in 2010.  I've already met my out of pocket maximum for this year, so there should be no additional charges after November 1st.  I did call Dr N to see of the results of the 21 point test are back, but they are not.  Until I get those results, and learn whether or not I'll be taking chemo, I'm stuck in limbo.