Wednesday, January 10, 2018

You may balance-bill me at will: This hospital contract is literally bulletproof

I went to our local community hospital for some routine blood work today. The new wing is open! From the plain former reception desk, you're directed down a long space age-y corridor to the new reception office, a warren of glass cubicles that looks like a customs and immigration area in a shiny new airport. After presenting your insurance card and i.d., you're asked to wait until you're called into one of these cubicles for a one-on-one encounter in which you're compelled to sign your life away.

That is, you are presented with four (4) disclosures and contracts of adhesion to sign (contracts, that is, in which the terms are dictated entirely by one party). You sign under the gaze of the hospital employee across the desk, and you do not sign the paper. The contracts are encased in plexiglass, perhaps because I'm not the only smart-ass on the planet who sometimes alters them. You sign on an electronic pad like those that take your credit card in retail stores. The hard case enclosing the paper contracts makes them literally bulletproof.

And what you agree to, most notably, is to let any of the multitude of "independent contractors" who may breeze by your bed (if you're an inpatient) bill as much as they friggin' please, and send the bill to you. Here's the deal you can't refuse:

Being cut off  (or rather plexiglassed off) from the paper contract does leave a tiny window for input. Below that fat-finger kindergartner's signature is my little counter-claim:

That says "authorize in network only." Did the person across the desk invalidate this, and make me sign again, or deny service? No. Would this hold up in court? Probably not.

Note the pointlessness of the mandated disclosure referenced in the first paragraph of this deal-you-can't refuse. If you were to schedule a procedure in advance, and the hospital sent you a list of care providers who would be participating, and you at least had the opportunity to check with your insurer which were in-network, and to request replacements for those who weren't, and if you were held harmless if no replacement were available...that would be a ridiculously cumbersome system, but the disclosure would mean something.

This document merely discloses carte blanche: anyone working here may participate in your treatment, and they may or may not be in your insurer's network, and there's nothing you can do about it, so sign. It's witness to a sick predatory system.of healthcare delivery.


  1. There was a bill in the NJ legislature to protect against this outrage.

    I do not know if the bill passed. I think NJ already has some protection against balance billing in emergencies........

  2. Thanks, Bob. Yes, there's a very good bill pending, supported by the incoming governor.