Thirty-Three

Today, I am thirty-three completed weeks pregnant. I'm astonished, actually, that we've made it this far, considering our rough start. As far as actual pregnancy complaints, I'm pretty sure this has been my very, very easiest pregnancy thus far; which is information that I don't quite know what to do with, honestly. I have not had any swollen ankles so far, no heartburn to speak of (oh noes! Am I going to have a bald baby?!), no sciatic/back/leg/round ligament pain, no discomfort of any kind. The only thing I've really had to deal with is exhaustion, which is complicated by the fact that I'm also suffering from pregnancy insomnia. But, really, of all the things that could be going on right now, as a pregnant mom with three young kids, I'll totally take the exhaustion/insomnia. I mean, I'm a bit crabby, and it's hard to get much done during the day, but I can function if I have to. I'll take that.

Maybe 2013 Isn't Completely Unsalvageable

I would be remiss to not post this update, after all the whining and carrying on I've been doing lately. So I got a call from Behemoth Hospital yesterday, telling me they had received my nasty letter, and were willing to negotiate payments with me. Unfortunately, the lowest they could go was about $20 above my current budget. The (very, very nice) lady on the phone also informed me that she had plugged the information I'd provided into her system, and was pretty sure that we are poor enough to qualify for a bill reduction, or, possibly a total bill cancellation. Which, you know, would have been nice. But the thing is that we used the services. And we can pay the bill. If we can make monthly payments for, oh, a year, or so. But we can pay, so, of course, we should pay.

So we told her this. So we negotiated up and down a little, and she said she would recall any portion of the debt sent to collections, and, it'll hurt for a few months, but I think we can make the payments, and then, when our tax return comes in March (I hope it comes!), we can pay it off and be done with it. The lady told me to make sure to call them if we can pay it off then, and they will give us a Paid-In-Full Discount. Which, of course, I won't turn down.

So I don't know if my nasty letter worked, or what, but I didn't have to give ridiculously private information to them, and I was able to negotiate workable payments, and, I hope now this issue is in the past, and I can move on. I hope.

Choice

Choice. Everybody talks about it like it's something we're entitled to, but the minute you try to actually choose something, everyone gets all up in your business and tells you that You can't do that! For instance, with all this bruhaha going on with the hospital goliath in our city, I am looking for a non-affiliated FP who can provide care for me for my pre-existing condition. I called a few places today (after having been sent to collections again, you could say that I am highly motivated). I spoke to one nurse who was supposed to take my medical history, and then give the info to the doctors in the practice, who would then decide if they can take on a new patient. So I gave her my information: my pre-existing condition, the fact that I'm currently pregnant (I made it very clear that I am not looking for prenatal care, or any pregnancy-related care), how I heard about their practice, when I'm due, and who my pregnancy care provider is. I told her that I was receiving care from a midwife and that we were planning a home birth.

I got a call later that afternoon telling me that because I have this condition and am choosing to home birth, they cannot provide any sort of medical care for me ("But best of luck with all of your future endeavors, etc., etc.,"). Seriously? Because they don't agree with my choice to home birth, they are not going to help me. Now, obviously, I know that choice goes both ways, and they're free to choose not to help me if they don't want to, but it's just a little aggravating that I'm never the one that gets to make any choices here. And it's not just with this. I mean, the whole reason we started home birthing in the first place was because I was given no choices my first pregnancy (there are standard-of-care protocols for people with my condition, and regardless of a person's individual situation, these protocols must never be deviated from, even if it puts the individual in danger, or causes poorer outcomes). I ended up with a c-section because the OB who insisted on inducing me at 37.5 weeks had the nurses turn the pitocin up so high that it sent my baby into fetal distress (more on that another time). Then, when I became pregnant with my second baby, none of the doctors in my area were willing to support my choice for a vbac. So I found a home birth midwife who would, and did it myself, thankyouverymuch. Which ended up being the awesomest thing ever.

During my third pregnancy, people pretty much left me alone, which was actually refreshing, and I was feeling pretty good about this whole choice thing.

Fast-forward to this pregnancy: the care provider that provided early prenatal care to me in my last pregnancy informed me that she was no longer able to provide prenatal care because I birth at home. "Take your business elsewhere, fool!" So then I called around to other care providers at the other goliath hospital system in town, and was told that I could only be seen by actual OBs; no NPs, no CNMs, no FPs. When I went into be seen for my first visit (which, ironically was with an NP, because everyone sees the NP first at this system), I was criticized for choosing home birth. Which, you know—I can handle criticism.

So, now, it's this. I can't choose my care provider. I can't choose home birth. I'm supposed to bow down and let everyone take care of me. Because, last I checked, people taking responsibility for their health is the best way to, you know, be healthy. But apparently, it's frowned upon in the medical community, and all doctors are spoiled brats who take their toys and go home unless you play their way.

At least, that's the way I choose to see it. Because, darn it, that's one choice they're making it easy for me to make.

Well, I Guess I Know Where I Stand, Now, Anyway

I got sent to collections. Again. For $10. A scant three weeks after I was sent to collections the last time. Like, somewhere in there I was supposed to make a third payment to them (during a one-month period)? Like, apparently they didn't like my nasty letter, and just sent me to collections without calling or notifying me in any way so we could discuss things further? Like, even though I technically fulfilled all the requirements that I was supposed to fulfill for their little pay-your-bill-in-smaller-increments thingy (they demanded all kinds of info from me, and told me to send a letter of explanation for any information I did not provide. Which, I most certainly did), and even though they technically are not supposed to send me to collections when I'm working out a payment plan with them (or so I'm told by the billing CSRs), apparently, we're both playing passive aggressive, and I'm the one getting screwed over by it.

It really is frustrating, actually. I mean, I feel totally powerless, because I'm sure that technically they have every legal right in this situation, and I have none (and, if I do have any legal rights here, it's not like I can afford a lawyer to find out that I do), so they're bullying me into doing something that I really can't do. Note to Sanford Health System: just because you have a legal leg to stand on, doesn't mean you ought to go around standing on it. Stop being a bloated, bureaucratic, feelingless automaton, and recognize that, you know, you're dealing with individuals here, with individual situations. We are not patient numbers.

So, anyway, I'm going to fight this the best way I can (and they darn well better take that $10 bill back from collections!), and I am going to take my business elsewhere, because I refuse to pay for crap service, and I absolutely, positively refuse to be bullied.

And now, I am angry.

Thanks for Nothing, Folks!

The third trimester exhaustion has hit me. Hard. My husband keeps subtly suggesting that maybe a little exercise would boost my energy levels a bit. I disagree. Plus, it's hard to muster up the energy to exercise, when I can barely muster up the energy to go pee. Again. Which is—serious—to say the least. Other than the exhaustion, though, I've not really had any third trimester symptoms; no swelling, no difficulty breathing (well, except for when I'm trying to chase the toddler up the stairs), no real discomfort. Well, maybe insomnia, but, since I'm exhausted, anyway, who really cares. Right?

Other than that, I'm embroiled in a battle with the billing department of the hospital from which I receive all my medical care for my pre-existing condition. As in, I have, like a $500 bill running with them right now, and they sent me to collections over $45. Which I was totally incensed about, because I'd been making monthly payments to them, like, every single month this year, and a couple of months I actually made two payments to them. So I called them to square all of that up, and I was told that the remainder of my bill would be sent to collections if I didn't set up a payment plan. But when I tried to set that up, they wanted waaaaaay more money per month than I can afford. I mean, we keep it cheap at our house. As in, we don't do cable or Netflix, my husband's cell is paid for by his employer, and I have a cheap no-contract phone so that I have a way of keeping in touch with civilization in case I'm stranded out in the middle of nowhere with three kids while making the 30-60 mile drive that I have to make whenever I need things like groceries, gas, and medication. As in, if I wanted to make these obnoxious monthly payments, I'd have to take them out of my grocery budget. Which, I ain't doing.

Now, let me explain: I've been receiving services from this hospital for the past seven years. In seven years, I've never, ever, ever not paid my bill. Ever. But, apparently, they've totally redone their billing system, and the new one has no long-term memory. Or something. So the CSR said that if I wanted to negotiate lower payments, I would have to fill out an application. Fill out an application, folks. Like, regardless of whether I fill out an application, I can't pay more than what I've offered to pay. But I said, fine, so she mailed it out to me.

Yeah. I got the "application" in the mail a few days later, and, let me tell you: my mortgage application didn't even require as much information as this "application" required. Plus, they wanted the last two pay stubs of every adult member of the household, and permission to check our credit. Um—let me think—NO. So I was totally insulted, because the little letter that they sent with the application was totally demanding and demeaning ("We don't trust you or believe you, so prove that you're too poor to pay the monthly amount of money that we think you should pay."), and the application was ridiculous. As I said, I've been making payments on my bills for the past seven years, and I've always paid them off. Dude, I'm not "applying" for financial aid or bill reduction. I'm simply telling them that I can't pay the monthly amount that they're demanding; here's what I will pay.

So, instead of enabling this pettiness, I sent them their empty application back, along with a nasty letter (they said that if I didn't send the requisite information, it had better be accompanied by a letter of explanation—well, they asked for it!) explaining just what I thought of their system and their demands and their overall suckiness. Or something. This is what I said:

To whom it may concern:

Last week, I received a very unexpected letter from [collection agency name], informing me that [hospital name] had turned my account over to them for collections because of a $45.77 outstanding balance. I immediately called [hospital name]'s billing department regarding the letter because not only had I been making monthly payments on my [hospital name] bills for the entire year (I have enclosed bank records that indicate this), but I had received no phone calls or any indication that [hospital name] was somehow not satisfied with my payments. When I spoke to the CSR in billing, I was informed that [hospital name] has been implementing a new billing/patient records system, and that my account had not had any payments made on it for several months and was past due. The CSR also informed me that the new system automatically sends all past-due accounts to collections. Apparently, because I had been paying off a bill (that I had received prior to the bill sent to collections) from the old system, the monthly payments that I had been making were completely irrelevant. I paid the balance that had been sent to collections over the phone, but I was absolutely insulted that my bill was sent to collections at all, despite my best efforts to make payments, and I was beyond frustrated that your system, apparently, has no actual person reviewing whether an account really needs to be sent to collections.

I called your billing department again, later that day, and spoke to a different CSR about setting up a payment plan so that the remainder of my bill would not be sent to collections, but the CSR informed me that I would have to make the first payment immediately, and, furthermore, the minimum payment that your system would have allowed me to make was much, much more than I can afford. I told the CSR that I could pay a lower amount, and she said that I would have to fill out a form, provide copies of my last two pay stubs, and would probably want to provide information regarding my monthly expenses. I agreed to do this, so she mailed the form to me.

I received the form in the mail on Friday, 12/21, and as I looked over it, I was again completely insulted. The letter accompanying the form was extremely demeaning and petty, and the information that your form is demanding I supply is completely irrelevant to the situation. My mortgage company didn't even require all of the information that your form requires, when my husband and I were applying for a home loan. I can possibly understand asking for every minute detail of my financial situation if I were applying for financial aid or a bill reduction, but that's not the case. I am simply trying to pay my bill—in its entirety—in increments that are affordable to my family's budget. You do not need to know who the lien-holders are on my mortgage and car loans; you don't need to make inquiries into my credit. None of this information will get my bill paid any faster than I am able to pay it, and it is a gross invasion of my privacy.

If you review my payment records, you will see that in the seven years that I have been receiving healthcare services from [hospital name], I have never once failed to pay my bills. And let me be very clear: I will be paying this bill—all of it. I will pay it as quickly as I can, in increments that are amenable to my family's budget. You can take my word for that, you can let my seven-year bill-payment record speak for itself, or you can take this letter as a written contract. But I will not be providing the very personal financial details that your insulting form is demanding. I have enclosed my family's monthly budget for 2012, and while I object strongly to providing this information to you, I have also enclosed copies of my husband's last two pay stubs. If your billing system can't work with this, then perhaps it's time to reintroduce a little human reason, understanding, and compassion to your new system.

If you would like to discuss my account further, you are welcome to contact me.

I may have just totally ruined my really, really good credit. But, dude, it felt so good to mail that letter.