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Butting heads with bureaucracy

I’ve been battling the local hospital lately. It’s a long and boring story, but suffice it to say I was enrolled in a low-income assistance program and was removed from the program without my knowledge, meaning that I owe $1500 of a $1500 bill instead of the $300 I paid.

Trying to navigate the bureaucracy of the hospital is no small feat. My man Jim has been quite proactive in working with them to make sure his own bills are paid off, yet he constantly gets threatening “LAST NOTICE” letters despite his having arranged to pay his bills on a monthly payment plan. In any given conversation, the person he speaks with seems to know nothing of the arrangements he made previously with other workers, and he’s given yet another lengthy list of instructions to follow.

I like to think I’m pretty good at staying on top of my bills, too. When paying for the August 2010 migraine ER visit that put me in this situation, I included a cover letter citing my low income assistance status, explaining why I was only paying 20% of the total bill. Many moons and many frustrating phone calls, letters, and emails later, I ended up crying in defeat while at the billing office—this seemed to be the straw that broke the camel’s back and convinced the bills representative to reclaim my account after having referred it to a collections agency (which still another rep said would NOT happen to me).

This particular situation has now taken up hours of my life as well as valuable brain space. I worry about it relatively often, and I make sure to stay on top of any developments as I continually make my case. I am a lower middle-class, well-educated 30-something. What do really young or really old patients do when faced with these hurdles? What do people with limited English and/or limited literacy skills do in similar situations?

As someone who has periodic bouts of severe migraine, it’s hard to know what battles to pick. As I walked away from the hospital billing office, tears in my eyes and $1200 less rich, I thought about how much of my free time I’ve spent dealing with this. Think of all the healthy, non-migraine hours I could have spent on things more fulfilling than butting heads with bureaucracy!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Dexter Englebert
    8 years ago

    I suffered from migraines for many years. I think it was sudden onset since I remember the first time I drove to the Dr. with squinted eyes, barely seeing the road. That was 35 years ago. I had triggers of chocolate, red wine, alcohol, cheese, environmental (the detergent isle of the grocery store, perfume departments), stress and unknown. About five or so years I began seeing a neurologist who special.

  • Val Milo
    8 years ago

    Migraines have been around for a very long time. They used to drill a hole in the sufferer’s head to let the evil spirits out. Hippocrates disagreed with that (yes, THE hippocrates). He thought drilling the hole in the head was A-OK, however it was poison gases that needed to come out.

    God help us all dealing with mentally deficient medical office workers and phone reps.

  • Denise R. Noland Cadle
    8 years ago

    I’ve been suffering them for over 30 years. Some culprits are this Georgia heat and humidity combined with barometric pressure rising, sinus/strong scents, some I believe are neurological. I once got one after bringing the horse I was on into a canter, in which my neck got jarred.

    I quit work because of the bad conditions-frequent strong scents from co-workers, then found out if I’d missed one more day-they would have fired me anyway! I had followed their rules and got a doctor excuse so it would not affect my using sick leave, but it still counted against me.

    I don’t know if they provide disability for migraine sufferers, but it would be helpful since we could use that lost income. I doubt I could hold a job because I can’t come to work and function with a migraine.

  • Denise Stevens
    8 years ago

    Thanks for helping to “wake up” the Sheeples of America and the world.

  • Cindy Dalton
    8 years ago

    Suzanne has a great point about healthy organic foods. I found out that the fewer food additives I eat the less frequent and severe are my migraine attacks. The only hurdle for many senior citizens like me is the high cost of healthy food versus cheap junk foods. It’s a problem we struggle with daily, along with not being able to afford our medication. We need some serious health and social service reforms in America and people need to boycott stuff that makes them sick until the manufacturers get the point.

  • Laura Bagley Asher
    8 years ago

    If it was a public hospital you may have recourse. If it was private probably not. I’ve worked in medical bookkeeping offices for over 20 years and most places are willing to take payments. A public hospital will usually reduce your bill if you can show that you are low income. They’ll want pay stubs and tax records. I see over and over again that people go to the hospital for treatment which is sooo expensive. It’s so much cheaper and less wait at a walk-in clinic. They usually have the medications there to treat, but call ahead to make sure. My family doctor keeps quick emergency appointments open during the day for such things and I don’t have to explain my medical history. I’ve had to wait far longer in the ER then in the clinic. Besides the ER is noisier and brighter and takes forever to check me in and ask annoying questions I’ve suddenly forgotten the answers to.

    And to Suzanne,
    Not everyone has migraines for that reason. There’s no reason to yell.

  • Nancy Orlando-Bell
    8 years ago

    I have been there too! Ours will not give you a payment plan past 3 months! LOL! So I paid it with a credit card. I am going in for major surgery next week. I called the hopital and told them why I have chosen to take my business elsewhere.:)
    I did not go in for a Migraine at that time. Try some generic stadol and use it only when you get a severe Migraine Only. It is a narc. and could be addictive if over used. But, it works very well. But, like my Neurologist said use in emergency situations only. I hope this helps you. I read all your blogs as you are all personality! You be Blessed!

  • FlutePlayer
    8 years ago

    Yes, that’s such a common issue, and the lack of or miscommunication among departments is apalling. Even more so are the intimidation tactics used against the disadvantaged you mention, and the uninsured. Many places, but not all, have cycling bill systems that even if you pay $5.00/month on your bill, it will just stay under the radar and keep cycling through no problem, despite what they say, like “You must make 9 payments of $98.47 within the next 7 months in order not to be turned over to the credit bureau,” or something of that nature.

    But keep on them; reapply, find other community action or government agencies, talk to a local DHS office to see if they can give leads, or even whatever billing agency the hospital uses (they might be owned by a larger entity).

    It’s true; that precious little migraine-free time we have could be so well put to better use. And then these greedy people take advantage of the least able to give them what they want. Frustrating. Great post, thanks.

  • Carrie Coulter Nelson
    8 years ago

    What about dealing with this same thing but within your work situation? Also, how would one go about appearing before state legislation?

  • Carrie Coulter Nelson
    8 years ago

    Definitely discrimination but they won’t say that! Some principals I’ve found are very understanding. My first boss could look at me and tell I was having a migraine and just send me home, no problem! Others, especially females (and you think they’d be more understanding) could care less; tell you to suck it up and move forward. I take either Relpax or Treximet, but both make me so sleepy I have to stay on my feet and keep moving. I’ve done a lot of research and wrote a paper that I’m hoping to publish. I may move next to state legislature! Good luck with your situation.

  • Susan Imboden Vrablic
    8 years ago

    What do you do for migraines at work? I can’t take triptans, no pharmacy carries Midrin anymore and I was sent home for being “impaired” during an attack. Work productivity is down with chronic daily headaches and being written on my work evaluations. Any recourse? Currently back in analgesic rebound b/c I can’t be at work and in pain so I take what relief I can so I can keep my job, but as you all know, every day is different. Discrimination?

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