Jewish Hospital: Profits over Patients
I want to share with you a recent unfortunate experience with the Jewish Hospital & St. Mary's Healthcare network of healthcare facilities in the greater Louisville area. To understand why this experience was so ridiculous, you need to understand how PIP (Personal Injury Protection) or No-Fault insurance coverage works in Kentucky. For an explanation of how PIP works, see our post here. What is important about PIP for purposes of this post is that the client, though his or her attorney, has the right to "direct benefits." That means that the client and their attorney can tell the PIP carrier which healthcare facility to pay, when to pay them, how much to pay them, or even to not pay them at all and to reserve the benefits for lost wages or some other more pressing matter.
Why is this direction of benefits so important? Because, often people have no other insurance (health insurance for example) to help pay for these medical bills. Or, they have little or no savings and have been involved in an auto accident that is so serious that they can't work for some significant period of time. If all of their PIP money was used to pay medical bills and could not help pay the client's lost wages, they would very quickly be put in a position where they were not able to pay bills, buy food, or provide for their families.
So, what do Jewish do? Well, after a bad accident in which a client of ours was forced off of the road by a large delivery truck and into a ditch, they needed to find treatment out in the state in a fairly rural area. A Jewish clinic is one of the only medical facilities with the ability to see this client for his injuries. However, they refused to even set up an appointment for him or see him on an emergency basis as a patient until his auto insurance company promised to pay the bill.
Well, what's so bad about that? First, it shows an absolute disregard for the health and well being of this man who had been seriously injured in an accident and had few if any other options for treatment. But Jewish should be entitled to be paid for their services, you might argue. Well, no one, including me, is saying that they shouldn't be. And this client was more than happy to pay. However, he has no control over what his PIP insurance is willing to pay or not pay. That is, he can AND HE DID, tell his PIP carrier to pay any bills that it got from this Jewish facility. However, the PIP carrier has a right to get the bill, get the medical records, review all of that, and decide whether it is something that is related to the accident and that they are obligated to pay. There is nothing this client could do to force them to agree to pay prior to even knowing what the treatment was or what the bill was for. Remember, Jewish would not even set up an appointment for him without the promise to make the PIP carrier pay the bill; a promise that the client had no control over – despite his instruction to the company to not put any hold on the bill.
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