Patient's issue with bill for medications


The Atlanta Journal-Constitution
Published on: 05/11/08

She was at the hospital to stay by her sick son's side, but Louise Beers was pretty sick herself.

She'd been battling a lingering viral bronchial infection for a week or so.

"I thought my chest would explode," the 67-year-old Duluth woman told me. "I had to wear a mask to sit by my son's bed."

Beers' primary doctor had been treating her with meds, but she was slow to improve. He suggested that Beers have a chest X-ray while at Piedmont Hospital to visit her son. The results were alarming.

She was admitted into Piedmont on Feb. 26 for an overnight stay. She received breathing treatments and insulin.

When Beers learned that she'd be staying, she had her daughter go home and get four other medications that she takes daily. But she wasn't allowed to take her personal stash of pills. Instead, the nurses ordered the same medicines from the hospital pharmacy.

Beers didn't have too much of a problem with that —- till she got the bill.

"I have to pay $175.48 for what Medicare would have paid no more than 10 or 15 dollars for!" she wrote in an e-mail. "Were you aware that this is going on?

Well, no, but Piedmont spokeswoman Diana Lewis explained why she couldn't take the medicine brought from home. It's a safety issue. Any reputable hospital, she said, would never let a patient ingest meds that came from home.

"It puts the patient at risk," Lewis said. "There's no way for the nurse to be sure about the dosages. She's not a pharmacist."

I explained Beers' unhappiness with her prescription bill. She, in return, turned to Joseph Ware, who handles patient financial services for Piedmont. My phone rang 30 minutes later.

"Medicare has a list of drugs that they consider 'self-administrable' that they will not pay for if administered to an outpatient [covered by Medicare]," Lewis said. "[Beers] was an outpatient."

Beers, who spent 30 years training insurance agents, has no issue with the hospital. Her son, who'd already had two heart operations, fought for his life in the cardiac ICU at Piedmont Hospital. He suffered from a torn aorta, the same condition that killed actor John Ritter.

"My son is alive because of Piedmont," Beers told me. "A number of times, we almost lost him. He's doing much better. And I was very sick. Piedmont is a wonderful place."

When the bill for the medicine arrived in the mail, she contacted Medicare. A customer service rep told her what Lewis had explained to me —- that the provider doesn't pay for certain drugs when administered to outpatients. Lewis of Piedmont told me to have Beers contact the hospital. Ware, of the patient finances department, can help her file an appeal.

Beers plans to.

"I am caught between the proverbial rock and a hard place," she said. "I have no complaints about my treatment at Piedmont, but this just needles me. If I am having to pay this horrendous amount, everybody else must have to pay, too. I wonder how many people get caught up in this."

Me, too.

Rick Badie's column appears on Sundays, Tuesdays and Thursdays. Contact him at 770-263-3875 or e-mail: rbadie@ajc.com.

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