It’s been quite a day.
We flew up to Boston this morning—really early!—because I had the heart catheterization scheduled for tomorrow at 9:30 am.
I spoke with Dr. Desai after we arrived. He explained that they would be doing both the left and right sides of the heart; normally this procedure is one or the other, but he needs the information from both (described in fairly easy-to-understand detail here) to make the best choices about the next steps in my treatment. He explained clearly both the medical logic in doing both and the urgency in having it done.
Last week, I spoke with the financial folks at the hospital, and after first saying that I would need to pay for the circa $15,000 procedure up-front, they said I would be billed for it. It was an enormous expense, but given that it would be crucial in treating me effectively, it was clearly necessary.
A couple of hours after I spoke with Dr. Desai—about 2:30 pm—I got a call from Edith (she didn’t tell me this, but she’s the Director of Patient Financial Services) who informed me that I would need to pay $31,000 before having the procedure, the total cost of which would probably be closer to $40,000.
Hold the freaking phone.
Dollar value aside, we’re in Boston. Our credit union is in St. Petersburg. We don’t have plastic that has a $31,000 limit, and we don’t travel with checks. Wire transfers take days to clear. And we don’t travel with a suitcase of cash. So paying this amount tomorrow morning was logistically impossible.
I explained all this to Edith, and she said to leave it with her. I let Dr. Desai know, because, frankly, at this point, I was panicking. (Side note: Yeah, I really need this kind of stress right now.)
Edith called back a bit later and said they would accept $10,000 tomorrow morning if I signed a promissory note for the remainder. I was fine with that, because it only occurred to me later that I had no idea what the terms of this note would be. And this is all leaving aside the fact that they had given me a quote of approximately $15,000, and this had now more than doubled. But I still had the logistical problem of getting them $10,000 by 9:30 in the morning. She also described the procedure as “elective,” which seemed odd to me given that Dr. Desai had described it as medically necessary…and Edith isn’t a doctor.
Dr. Desai phoned after a bit. He was as helpful as he could possibly be, and apologized profusely for my having been given such grossly erroneous information. (Side note: Edith freely acknowledged from the get-go that I was, in fact, told that it would be about $15k and I would be billed.) We talked about different options, and he emphasized that it really is medically necessary for me to have the procedure. He said he would speak with Edith.
Next call was from Edith. She said they would take $5,000 up front (which we could do with plastic). But the cost would still be at least $40k.
So I went back to Dr. Desai and explained that while the up-front demand was now logistically feasible, I’m left in a situation where I have no idea what the actual bill I get might be. It’s already more than doubled, so should I figure on getting bills for $60,000? $80,000? $100,000? Edith was clear that the $40k was just an estimate, so really, the sky’s the limit.
And I don’t care to spend whatever time I have left on Earth arguing with Edith.
But at the same time, I don’t want to die because she decided the hospital should behave like a gouging gas station when there’s a hurricane coming.
So where does this leave us? With Dr. Desai’s help, I think we’ve found a reasonable way forward.
I’m not having the heart cath at Brigham and Women’s tomorrow. I am going to make some phone calls in the morning and find out the feasibility of having it done in either Tampa or Dublin. And Dr. Desai is going to speak with a cardiologist in Tampa about the procedure, and having it done so that he gets the results basically in real time, so that he gets the information he needs to continue to treat me. We’re going in to see Dr. Desai at noon so he can listen to my heart and possibly do some non-invasive tests that will allow him to refine my medications and dosages.
Just for the record, the self-pay cost of this procedure in London is somewhere around $12,000. Exactly the same procedure.
Thank you for all of your support today. I might well have lost whatever marbles I have without it. And thank you for reading.