when you go to a doctors office their favorite thing to do is tell you "okay check out at the front desk" when you're done. and the front desk tells you ummm you can just go! and you're like don't I have a copay? and they're like we don't know, we have to ask your insurance company first. and you're like well my insurance card says the copay is $30, can I just pay it right now while I'm standing in front of you? there's a card reader right there on the desk. and they're like nooo we have to send a representative on horseback during the next waning moon to meet with their claims adjusting associate director of benefits management and client services in the secret glade to negotiate. and you're like oh okay and go home. and you get twelve emails asking you to take a survey about your experience
AND THEN in eight months you start getting phone calls from unknown numbers and when you finally check your voicemail they're like Your Balance Is Past Due We're Going To Kill You (even though by this point you have forgotten that you ever went to the doctor). and so you go to your MyChart account and log in with your username and password and you have to reset your password for security reasons. and you get two emails that say Your Password Has Been Reset. Was This You? and you have to go find your phone and enter your two factor authentication code and then you have to select which location you visited and then you have to click through all the Reminder: Complete Your Health History Profile where they ask if you've had any new surgeries even though you definitely told the nurse about this at your visit and then you have to find the Pay Bills tab and your balance is $179.23 and you're like why is it so expensive I thought the copay was $30? and you download a PDF of the charges and find out that they charged a late fee of $15 a month even though that doesn't add up to $179.23 and you don't even remember being told you had any balance at any point and you could call a representative and ask about it but that would probably take at least half an hour and there's no way it would actually get rid of the charges. so you go pay it anyway and you have to go find a paper check to look up your bank account routing number because they'll charge you an extra 3% if you pay with a credit card and there's a fee of $2.75 for convenience also. and then you get three emails that say We've Received Your Payment! Thank You For Your Payment!
And next time you're there in person you're like please. Please. I'm begging you. can I just put a credit card on file. Can I just give it to you now and you just charge me whenever you want. It's actually kind of ruining my life how you do this to me. And they're like no we could never take responsibility for keeping track of your financial information that's too private
And then you schedule your follow up visit anyway
Of course i have to follow every step in this nightmarish process to interact with the labyrinthine bureaucracies of medicine and insurance. I have to do this every three months. I do this because I have ADHD, a condition which makes it hard for me to interact with labyrinthine bureaucracies unless I take Vyvanse. And if I do it wrong they'll stop letting me have Vyvanse, the medication which makes me capable of interacting with labyrinthine bureaucracies
I relate to this viscerally but also
I am currently taking several prescription medications every day and other prescription medications as needed and I'm somewhere between chronically ill and disabled at any given time and I have reasons to see my primary care physician (or the other v. capable folks at her clinic) at least once every 60 days and usually a specialist at about the same frequency although not usually the same ones in a single season and I am finally a) enough of a power user of the one central app for all my non TCM healthcare needs that I know when the practitioner is about to tell me to pick up the printout and make a new appointment and I can say, wait, stop, please don't print anything, will this be in the app? Will my next appointment notifications be in there? Perfect, thanks and b) capable of calling up the whatever org is telling me I owe money or my provider is not getting paid or whatever the notifications are telling me (oh and I have learned how to extract meaning from the notifications, a not insignificant subset of skills in this scheme) and patiently talking to the person or people or robots or both for as long as needed or as many times as needed to get to the point where they will concede that I don't owe anything and that the provider will get paid
Someone recently suggested a line of work to me in which I could actually actively apply my lived experience (not necessarily the medical billing from the patient's perspective parts) to help other people with their similar or parallel experiences and I can once again imagine doing meaningful work in my lifetime
Like no the key is not to replicate my systems in other people's lives but it is to demonstrate that a person can devise systems and use them to make a life less bad
