Change
17/09/14 04:36
Got a bill from the doctor’s office a while back. It was for some routine preventive care. There was an explanation that the claim had been denied by our insurance company and so we were responsible for the entire $670 bill. After a little checking, it was pretty clear why the insurance company had denied the claim - the clinic had summated the bill to the wrong insurance company. The people who denied the claim don’t insure us. Makes sense. After we got the clinic to bill the correct insurance company and they paid the claim they sent us a new bill. Our insurance company paid $460.46. We owed $17.80. We have good insurance - and the clinic couldn’t send the new bill without noting that the bill was “past due” even though the reason for the delay was a clinic mistake and not something we did.
Did you do the math? That’s right. If you have an insurance company that pays, the actual amount collected by the clinic is $191.74. It is about a 30% discount for having insurance.
To be clear: people without insurance have to pay more. Those who are least able to pay get charged the most.
There is something wrong with that system. But I don’t even know where to begin making changes. To start, no one, not the doctor, not the nurses, not the billing department, not the insurance, and certainly not the patients, know why things cost the amount that they cost. Why does it cost $58 to administer an injection? That’s not the cost of the medicine, just the cost of giving the shot. The clinic seems to charge more to administer more expensive medicines than it charges for less expensive ones. Like I said, no one can explain why the charges are what they are. The numbers seem to be random. One explanation I got a few year ago is that prices are based on what the insurance company will pay. Do you suppose they add 30% to every charge in order to be able to give the insurance company a 30% discount?
I’m sure it isn’t that simple. Nothing about medical billing is simple.
Again, I don’t even know where to begin to make changes in the system.
Change is a difficult proposition even in a small arena like the church. Even if we were to get common agreement that we need to make a change, which is unlikely, we wouldn’t all agree on what change would be best. We have different visions of how things should go.
Many of the people in the church seem to think that I have more power than I think I have. I get blamed for things that I don’t have the power to do and most of the folks who want to give me their opinion don’t want me to have more power. They want someone to blame, but they don’t want someone to really have that much authority.
As a result, change in the church is often a process of going back and forth. We make changes and then we reconsider the changes, but we don’t really go back to exactly the way it was before. In fact, we can’t go back. Funerals are permanent, we can’t undo the deaths that occur in the church. Change is built into our very existence.
But sometimes people come into our community and decide that we need a lot of changes and they start making changes like a bull in a china shop. I wouldn’t make the decisions they make and I wouldn’t do things with that particular style, but it is an organization where the person who is willing to do the work has a lot to say about how the work is done.
The result is often less than graceful.
Which is part of the reason that we are so in need of God’s grace. We make mistakes. We need to apologize. We need to head in new directions. We need to ask for forgiveness. Of course asking for forgiveness is a difficult proposition - almost as difficult as forgiving those who make mistakes that we can see.
But that is who we are.
One of my teachers once said, “I believe in original sin, but our sin isn’t very original.” We all sin, but our sins tend to be mistakes that we could have seen coming - we make the mistakes of previous generations. How many times did God have to remind the people of Israel about the basics like : you shall have no other gods?
I think that part of the role of the pastor is to sometimes take the blame for things that I didn’t cause to happen. Sometimes I need to apologize even when I didn’t create the mess. That is part of being the person who is seen to be in charge. I have broad shoulders. I can take it. More important, however, is the ability to listen - carefully and accurately - to what is being said. It is often too easy to dismiss a complaint as someone who is resistant to change when that isn’t what is going on at all. It is too easy to categorize people rather than accept them for who they really are.
And then we move onward. It would be good if we were always moving forward, but our history doesn’t follow a straight line. We move onward, realizing that sometimes we will need to adjust our direction. Sometimes we will need to back track a little. Sometimes we have to face in one direction to go in another direction. Maybe two steps ahead and one back is the normal pace for the institutional church.
It can be frustrating if you can only see one point of view, or if you take things personally. I’ve seen people quit the church over issues that to me seem so trivial as to be inconsequential - except for the fact that someone lost their church in the deal.
Hopefully we can make changes together and move onward.
After all, God creates a fresh day every day.
Onward!
Did you do the math? That’s right. If you have an insurance company that pays, the actual amount collected by the clinic is $191.74. It is about a 30% discount for having insurance.
To be clear: people without insurance have to pay more. Those who are least able to pay get charged the most.
There is something wrong with that system. But I don’t even know where to begin making changes. To start, no one, not the doctor, not the nurses, not the billing department, not the insurance, and certainly not the patients, know why things cost the amount that they cost. Why does it cost $58 to administer an injection? That’s not the cost of the medicine, just the cost of giving the shot. The clinic seems to charge more to administer more expensive medicines than it charges for less expensive ones. Like I said, no one can explain why the charges are what they are. The numbers seem to be random. One explanation I got a few year ago is that prices are based on what the insurance company will pay. Do you suppose they add 30% to every charge in order to be able to give the insurance company a 30% discount?
I’m sure it isn’t that simple. Nothing about medical billing is simple.
Again, I don’t even know where to begin to make changes in the system.
Change is a difficult proposition even in a small arena like the church. Even if we were to get common agreement that we need to make a change, which is unlikely, we wouldn’t all agree on what change would be best. We have different visions of how things should go.
Many of the people in the church seem to think that I have more power than I think I have. I get blamed for things that I don’t have the power to do and most of the folks who want to give me their opinion don’t want me to have more power. They want someone to blame, but they don’t want someone to really have that much authority.
As a result, change in the church is often a process of going back and forth. We make changes and then we reconsider the changes, but we don’t really go back to exactly the way it was before. In fact, we can’t go back. Funerals are permanent, we can’t undo the deaths that occur in the church. Change is built into our very existence.
But sometimes people come into our community and decide that we need a lot of changes and they start making changes like a bull in a china shop. I wouldn’t make the decisions they make and I wouldn’t do things with that particular style, but it is an organization where the person who is willing to do the work has a lot to say about how the work is done.
The result is often less than graceful.
Which is part of the reason that we are so in need of God’s grace. We make mistakes. We need to apologize. We need to head in new directions. We need to ask for forgiveness. Of course asking for forgiveness is a difficult proposition - almost as difficult as forgiving those who make mistakes that we can see.
But that is who we are.
One of my teachers once said, “I believe in original sin, but our sin isn’t very original.” We all sin, but our sins tend to be mistakes that we could have seen coming - we make the mistakes of previous generations. How many times did God have to remind the people of Israel about the basics like : you shall have no other gods?
I think that part of the role of the pastor is to sometimes take the blame for things that I didn’t cause to happen. Sometimes I need to apologize even when I didn’t create the mess. That is part of being the person who is seen to be in charge. I have broad shoulders. I can take it. More important, however, is the ability to listen - carefully and accurately - to what is being said. It is often too easy to dismiss a complaint as someone who is resistant to change when that isn’t what is going on at all. It is too easy to categorize people rather than accept them for who they really are.
And then we move onward. It would be good if we were always moving forward, but our history doesn’t follow a straight line. We move onward, realizing that sometimes we will need to adjust our direction. Sometimes we will need to back track a little. Sometimes we have to face in one direction to go in another direction. Maybe two steps ahead and one back is the normal pace for the institutional church.
It can be frustrating if you can only see one point of view, or if you take things personally. I’ve seen people quit the church over issues that to me seem so trivial as to be inconsequential - except for the fact that someone lost their church in the deal.
Hopefully we can make changes together and move onward.
After all, God creates a fresh day every day.
Onward!