Tuesday, April 15, 2014

Mothering through medical bills

I've been avoiding it for over a week now.  Zachary's radiology bills are overdue.  There was a snail mail malfunction and they never received two of the previous payments I made.  Although I have followed up and corrected those, there are more charges that have come due, or that insurance isn't paying, and the responsibility falls on me to figure it all out and make the payments.  There have already been a couple of pained phone conversations in the last several weeks, with the billing department of the radiologist.  The on-hold wait times and the abrupt tone they use for debtors like myself is not eased or softened at all by the fact that the patient, my infant son, has died.    

I sit down to log on to the health insurance site, to compare the bills I have received with the explanation of benefits and insurance payments online.  I filter by Zachary's doctors and providers.  There are 21 distinct billing entries, just for his x-rays and echo exams.  It stings all over again when I see "Newborn" as the family member who has incurred those charges.  Even after my husband spent part of an afternoon on the phone with the insurance company, imploring them to correct the error (they have had his full name since the day after his birth), many of the records still show "Newborn".  When you're expected to pay large sums of money for health care, that didn't save your son's life, you assume that all interested parties would at least acknowledge he has a name. 


I was with Zachary for his first chest echo exam.  I was warned it would be exhausting for him because it typically takes a full hour to get all of the images of the heart and arteries.  He held my finger and I laid my hand on his head as the tech squeezed the warm jelly on his chest and neck.  He squirmed and fussed a little bit at first, but ultimately fell asleep for most of the exam.  The technician was visibly pregnant and struggled to situate her body so that her arms would be at the right angles to use the probe through the portholes.  We worked together to shift and position Zachary so that she could get the hard-to-reach images near his neck.  I knew he felt comfortable because his mommy was there with him.  Throughout Zachary's life, I physically ached for any comfort or relief I could provide him, since it was my body that had put him at risk for prematurity complications. 

I was also with Zachary for his first head ultrasound.  Although he showed no signs of neurological problems or brain hemorrhage, I was on edge with anticipation about this exam and its results. The man performing the exam was so wonderful.  He put me at ease immediately with his calm and serious demeanor, and after hearing about my involvement in the chest echo exam, acted as if I were an integral part of getting the images of Zachary's brain.  Throughout the exam, while holding Zachary's hand and moving my other hand around to accommodate the probe moving around on his head, a few tears slipped out and down my face.  After the exam was over, as we attempted to wipe up all the jelly on Zach's head, the tech gently touched my shoulder and actually asked me how I was doing.  He noted how good Zachary looked.  The fact that he took just a couple of minutes to acknowledge my fear and exhaustion, recognize that this was damn hard and see the love I had for my son, meant a lot to me.  That head ultrasound, performed on Day 7 of his life, was clear.  Crisis (officially) avoided.  Or so we thought. 

A few days later, after Zachary had developed sepsis, I saw the nice tech gentleman again in the hospital cafeteria, from afar.  Zachary was finally stable enough that B and I hurried to the cafeteria to stuff our faces with some much-needed food.  I remember looking over at the tech and thinking I would never interrupt his meal, and honestly didn't have the emotional energy to speak to him in our crisis (even if it looked as if Zach might be through the worst of it).  But, I prayed for him silently, on the spot.   

One day later, at a time during which Zachary was showing true signs of recovery, that same tech would perform the follow-up head ultrasound, which is routine in cases of sepsis. It revealed the massive grade 4 brain hemorrhage, with midline shift (of the contents of Zach's brain).  Although Zachary's body began to recover from the sepsis, his brain had been all but destroyed as a result.  We weren't with Zachary for that head scan.  We hadn't been alerted of when it would happen and had stepped away from his bedside to grab a bite in the cafeteria.   

I think I would dissolve into a sobbing heap on the floor, at his feet, if I ever got the chance to come face to face with that ultrasound tech.  I'm not sure why it matters to me, but I'm glad he was the one.  The one who was with my Zachary, the one who gently scanned his brain and saw the damage first.  And I don't even know his name. 


After I finish my due diligence on the health insurance website, I swallow hard and pick up the phone to dial the radiologist billing office.  I am going to tackle this one today.  I get a recording that thanks me for my patience and asks that I continue to hold, that my call will be answered in the order in which it was received.  I wait for 20 minutes or so and then I think maybe someone is finally answering.  No.  It has put me through to voicemail where I can leave the details of my inquiry and expect a call back within 24 hours.  I hang up.  I don't know if I'll be ready, like I was today, when they call back. 

1 comment:

  1. I always 'liked' the head and chest ultrasounds, the doctors that did them were so gentle and thorough and I felt pleased with the way that they inspected every aspect of my tiny girls so scrupulously. And I will also never know the names of people whose faces and hands I will never, ever forget. Some people I immediately wanted to care for them again.
    I'm so sorry that the sepsis had such absolutely devastating consequences for your Zachary. The NICU is such a cruel, cruel place where conditions like sepsis and NEC snatch way even those babies who looks so healthy and likely to survive. I hate it.
    Navigating this minefield of medical billing must be horrendous. You need to do this on your terms, not waiting on a call back. I'm sorry that the powers that be don't appreciate this.