February 15, 2010

Wheaton acknowledges billing, ER problems; Working with doctors behind the scene

If you've been reading RacinePost the last few days, hopefully you've taken a few minutes to read through our coverage of a major rift between local doctors and Wheaton-Franciscan Health Care.

It's a remarkable story because of the near unanimous outcry in the comments against Wheaton. Dozens of readers have written in with story after story of billing problems, long waiting times in the ER and general dissatisfaction with care.

While most of the comments are anonymous, it's clear reading them that health care is a huge problem in Racine.

For its part, Wheaton acknowledged Monday it's working with doctors to resolve differences that surfaced last week

"Right now it's mostly behind the scenes work with physicians," said Anne Ballentine, Wheaton spokeswoman. "We're here to work collaboratively with them. We have a common purpose of serving our patients."

"We take any concern from our associates, patients and community very seriously," Ballentine said in response to the public outcry.

She said Wheaton was aware of problems with its billing system and is working to fix them. Jennifer Garbo Shawhan, also a Wheaton spokeswoman, said changes have already been made so ER patients see doctors faster.

"We've made some pretty significant improvements," Garbo Shawhan said.

Even with improvements, Wheaton is facing a PR disaster. They'll have to overcome stories like this one from a trusted reader:
I saw your article today about the near riot by the doctors at All Saints and I thought you might appreciate a story from the patient's point of view.

My (family member) visited in December. He is paralyzed, wasn't feeling great and thought he might have a urinary tract infection so we took him to Prompt Care.

(The family member) has no health insurance, so before we took him, we asked what the cost of Prompt Care would be - and were told $105 for the visit, and perhaps we could work out a payment plan. This sounded okay so we proceeded and on December 28, we went to Prompt Care when they opened.

We spent two hours waiting, and then we finally saw a doctor (Dr. Foley), he looked at my (family member) in his wheel chair and told us to go to the emergency room since they'd be better able to handle someone in a wheelchair. I said we had been there for hours so certainly it was no surprise that the patient is in a wheelchair, that there was no way we were going to head over to ER and start waiting and that my husband and I would lift him up onto the table ourselves, which we did.

I left the room so the doctor could examine him. The nurse took a urine sample from the urine bag, and the nurse and doctor looked at my (family member's) bedsore, and then the doctor prescribed Cipro and left. It took about 5-10 minutes total.

Within days, we started getting phone calls asking for payment - the amount? The first bill came for $930.00, with no explanation. I called a nurse I know who asked if they ran a CT Scan, as did several other medical professionals. Apparently there are reasonable and customary rates for procedures - so I requested a detailed breakdown. The Urinalysis was $33.00, the urine culture $59.00, and the rest is hundreds of dollars in procedures that only a medical professional would understand and we've never, ever gotten the test results. Only bills.

The most recent bill is laughable. Again, I'll send it to you if you'd like. The balance due at the top says "$930.00" but the total amount due on the bottom reads "$7,733.46." We're in the process of disputing this, but surely, we're not the only ones having such bizarre events at All Saints.

By the way, (our family member) traveled to Philadelphia after Racine and the doctors there said Cipro was the wrong medication ...

48 comments:

  1. I repeat my comments from an earlier post. Who is representing the patient in all this? The hospital obviously has the doctors in an employee relationship. Do I trust a Wheaton spokesperson who merely says they are working behind the scenes with the docs? Emphatically no. Let's see some community involvement. Then, maybe then, we will see some real trust built.

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  2. How can they make improvements in less than 72 hours? That was fast. Please, be more specific as to what has really changed. Don't forget it's just not a billing issue, it's the employee's that are unsatisfied too. Thanks letting us post these anonymously because if they found out who was really posting some of us wouldn't have a job tomorrow.

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  3. Wheaton, just don't work on the quality of care and not the cost of care. It's all tied together. Don't forget if you slap lipstick on a pig, it's still a pig.

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  4. How the hell is a management change supposed to fix the Cipro example above? This issue is about the providers as much as management.

    And now I'm pissed because prompt care cost me $150. Somebody explain that crap to me. I'm fuming. We need a God damn consumer protection around here.

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  5. The prices are never consistent for anything.

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  6. Where is our mayor in all of this? This is not just about private business, it has to do with the personal welfare of every citizen in Racine. He should step in and try to solve these issues with every resource available to him.

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  7. See Here we go again and the management issues are going to be forgotten and here we go again with OUR issues unaddressed!

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  8. If they made improvements in the ER, they must have been done in the last day or so. My next door neighbor was there last week for sever lacerations to the scalp and had to wait three hours. Not much improvement there!

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  9. If they are billing for procedures never performed that is FRAUD and should be reported to the proper authorities! In addition, it sounds as though the original post is describing "bait and switch" which is also against the law. Not only is the Wheaton administration using fear and intimidation with their doctors and staff, but with the patients they claim to care SO MUCH about!

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  10. All of a sudden Wheaton seems to care about it's doctors, staff and patients. How ironic! DON'T BE FOOLED! Make no mistake, Wheaton is waiting for this to "blow over" and go back to it's fear and intimidation ways. We are a society of news bites, floating from one controversy to another. Corporations like Wheaton bank on the thinking that this will soon be forgotten. Let everybody you know , know about this problem. WE WILL NOT FORGET!!!!!!

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  11. 2/16 12:15 a.m,

    Our useless excuse for a Mayor will not step in, think about it he has invited them to a campaign fundraiser! "Johnnie Boy Dickerthead" full time campaigner, full time idiot and part time want- to-be Mayor!

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  12. I have worked All Saints for several years and know for a fact that there is a significant issue with significantly decreased employee moral, patient satisfaction and physician satisfaction. The system has always had problems but they were dramatically compounded with the Wheaton Merger. What they don't mention is the hiring of a consulting firm Well Spring to finds ways to save money at the cost of patient safety. New unsafe nursing models are put into place and employees are silently let go without warning or reason. Ask lab management how many they silently let go. Ask Cardiovascular how many management and staffing changes have been made... This problem is bigger than a 72 hour fix!

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  13. Today is Tuesday, and I have to go to work. I wonder what kind of verbal blow job we will get today from management regarding this issue? Oh yeah, just like we did yesterday....nothing.

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  14. Fook WF, they are way to late to make things better overnight. Aurora needs to build or find a facility to open a hospital How in this day and age with the population we have we only have 1 hospital. Their drug and alcohol counseling are horrid and they don't help the people there. Maybe its just time to move out of this hell hole.

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  15. Can someone at Whwaton explain to me why the cost for an identical procedure or visit changes from patient to patient?

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  16. When you have doctors arguing in the halls with each other in front of patients and complaining to staff members how much their pay is getting cut, just shows you how broken the system is at the momment. Would you want to see a disgruntled doctor when you need one the most? Things are in discord, I would look for healthcare somewhere else.

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  17. Psst. You left (the family member)'s relationship showing in paragraph four.

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  18. Journalism at it's finest -- Keep these stories coming and your following will grow. It seems you folks know what the public needs.

    Important Stories that were buried in the back pages of our local newspaper have now found there way to the front page.

    I find many of the comments humorous, weird or distracting. But there is a need for people to voice their opinion.

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  19. Ken Buser states this current situation is out of (the employees) direct control, each of us should focus on the quality of care. He is working with the physicians proactively to address the concerns that have been identified. (what concerns? what's the big secret?) Don't forget the underdogs that support the physicians! LISTEN!!!! It's just not them who are upset most of ground floor employees too!

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  20. The local medical / hospital / clinic environment has been rapidly deteriorating for some years now. I have attempted to cope with the medical care issues and NO CUSTOMER SERVICE, but as time has progressed, I have sought service in Milwaukee with Aurora. Aurora has a much friendlier approach to patient (customer) service, particularly billing. It was much easier to move services to a friendly accounting group than continue to deal with the incompetent receivables department. I listened much too long at a long line of excuses, new computer programs, etc. That excuse has lingered for at least five years and I cannot believe that WF has installed multiple systems. I have to admit that driving to the south-side of Milwaukee is inconvenient but I have not had to deal with the billing issues. I miss the local physicians, whose community support is applauded, but the Milwaukee groups are pretty nice people as well.

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  21. The billing issue has been around for years. So I guess Wheaton has also admitted management problems too. We all knew it but it was nice to see they know it.

    Now, whatever ivory tower that runs this operation needs to come in and fire the whole management team and start over. The local management here isn't who is really running the show. The mystery management team needs to step in and clean house before there is no house to clean.

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  22. class action lawsuit? you know, for when there's a major problem with a vehicle, for example, and you get a letter, "you could be part of a class action lawsuit" - the people of this city need to demand better AND yes, i would think our city and county government should get involved and what about major employers? how attractive is it to get people to come and work for you in Racine when the schools suck, the health care sucks - utopia for sure

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  23. That's exactly it. Racine sucks. Reading this story gave more fuel to the resolve that our family wants to get out of here.

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  24. Yes, Wheaton has fixed everything overnight. No story here. Go back to your routine and relax knowing that the professional liars at W-F have made everything right.

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  25. In addition to frusterated physicians, the past few years have created significant changes for the medical group staff as well. Work loads have increased, staffing has been reduced. We work in an environment that does not allow for any dissent. Once there existed a climate that encouraged staff input, no more. We fear that any questions raised will place our job in jeopardy. Many of the changes have produced no improvement to the quality of patient care. They have resulted mainly in trying to do twice the work in the same 8 hour period. My hope is that the doctors continue to press for changes that will improve conditions for all.

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  26. There is NOTHING factual in your report. Just people complaining about long waits etc. How about some FACTS!?

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  27. Wheaton PR suffers from verbal flatulence.

    Don't worry, the Racine Post won't let this get heaved into the bed pan.

    Keep giving Dustin something to write about on this, factual things, your stories, your experiences as a professional and he will write it.

    Good job Dustin and Pete!

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  28. Dah, a fact is a piece of information about circumstances that exist or events that have occurred. How much more factual can you get by people telling their ACTUAL stories and experiences by the employees, patients and physicians of WFHC?

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  29. My wife had a miscarriage last year.
    For the first 6 hours of her hospital stay, up to when her water broke, I was sitting in jail after a Wheaton nurse had the Police haul me off to jail.

    My crime?
    Suffering from many different medical maladies, including a mental illness and diabetes, having been woken up at 2am after two potent doses of sleeping pills.

    After both my wife and I telling the ER admittance nurse that I suffered from many illnesses, and that she was bleeding, I was getting anxious. I kicked a wall in frustration.

    Rather than treating my wife, or addressing my needs, (low blood sugar amongst other things), the nurse sent me to jail.

    Must be nice when you know you are running a monopoly.

    The DA dropped the charges, but I still missed at least the water breaking.

    And the State refuses to have any follow-thru, and I've received no response from Wheaton.

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  30. Antiweasley, you are a nutcase!

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  31. My mother just told me she just received a $1500.00 bill for my grandmother.She pasted away a year ago.Oh well guess there out this time!

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  32. I have worked at All Saints for close to 20 years. There are more problems than the Doc's. But certainly they have brought things to light. We have lost numerous good nurses to other hospitals or systems because of the broken system. Nurses and nursing assistants are walking out the door so fast we don't have enough help to care for patients currently hospitalized. Well Spring has caused so many cuts in staffing that the patients are not getting quality care and the conditions are unsafe. Nurses cannot in good conscience continue working for a system which does not allow them to care properly for the patients. They are threatened with termination if they don't get out the door on time no matter what the situation. No excuses, death of patient, code blues, disgruntled family, no matter what the problems, just punch out and go. they have been given larger patient loads and can't care for all of them properly. The electronic health records take time away from the patient also and make it appear to the patient as though the computer is more important than they are. Patient safety is ! ignored because of lack of staff and restraints are being used instead.
    The clerical staff is overwhelmed with work and expected to get 3 times the work done in 8 hours with no overtime! Wheaton has always had some issues but this is huge!!

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  33. Wheaton has many issues. You think doctors are unhappy you should talk to employees!!! Wait , if you do that- they will get fired! a lot of issues derive from management. Middle management at Wheaton is so far up Wheaton behinds!! If an employee questions anything,they are out the door. I hope aurora and/or someother group comes in and breKs up the monopoly. On healthcare in Racine!!

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  34. I questioned management and wanted to know what was going on during our daily disconnection and I was told I should purchase the newspaper if I wanted to find out....nice real nice.

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  35. This whole thing has shaken me. I have had great care and attention from doctors, nurses, nurse practitioners, medical assistants and staff in general in my dealings with Wheaton Franciscan. A few weeks ago I spent time with 3 individuals who were firm that they would continue to travel to Froedtert in Milwaukee rather than trust WF. I said I respected their previous bad experiences but thought they must be isolated. Looks like I have either been very lucky or totally unaware. May I add that none of the staff I have spoken to over many visits have ever bad mouthed the hospital. They are a class crew all the way. It is hard to keep smiling when you are as unhappy as the current discussion indicates they are.

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  36. So many of you bloggers state bring on Aurora. Well... I hope you have good paying insurance because if you don't they will not even let you in the door.
    All Saints is dedicated to see and treat ALL patients despite their ability to pay. Private local MD's and Aurora?? NOPE! That is why All Saints ER, Prompt Care and even your Physician offices get behind. Unfortunetly there are so many residents in Racine that do not have "good paying insurance" that would allow the Urgent Cares of Aurora to even know what backed up means.

    Do I feel that some things need to be fixed at Wheaton... Yes, but the Physicians, PA's and NP along with their support staff (Nursing and clerical staff) CARE! It hurts to hear these hateful words some of you are blogging. Don't give up on Wheaton/All Saints. We are a great organization but like any company may need to work on a few things. God Bless all of you in Racine! I am proud to be a memeber of this community. I have lived her all my life.

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  37. Terri P Said
    I agree that most or all if the problems stem from the upper management down.the moral of employees suck, I have seen it each time I have been in there weather to visit ,or be a patient myself. This has made the quality of care you receive is bad And you hear the whispers in the halls. We are not blind to a deaf ear. My mom passed away in that hospital in 2008 and while in hospice care we took care of her because the care she was getting was unexceptable letting her lay in her own fluids for hours... Not enough help on the floors. and just all around bad care, Not to mention the they gave her a medication when she was in ICU that she was allergic to and on top of that the bag didn't even have her name on it, it was the patients from a room over that had left that day,a man's name. now tell me what is there defiinition of safe care practices? I personally wish we still had 2 hospitals in Racine . As a former employee NOTE I was terninated while on medical leave, that is an upper managment issue, What they say goes.They say Jump you say how high. and if you don't go along, Well you risk your job.

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  38. It seems to me when this disruption started was when St. Mary's and St. Lukes joined the Milwaukee based corporation. I have many friends working there and this just didn't begin overnight...it's been slowly brewing for years and now it's finally coming to a head. Management isn't going to budge -- words are said, but all in all -- months will go by and they are banking on our town to forget! We need the community to get involved and WHERE IS OUR MAYOR WITH THIS DISRUPTION??? Why isn't there someone who is neutral negotiating each side's concerns? Can't anyone out there understand it's not only the doctors... it's nurses, surgery techs, CNAs,clerical, maintenance -- their morale is down too! They have concerns, but are afraid to speak up or they'll get fired. Where is their protection if they DO speak up? This seems to be out of control and I think the city should hire an outside group to get down to the bottom of all this, listening to ALL concerns from the hospital staff. I was told from a friend of mine when she called that the hospital management were conducting Town Hall meetings. Come on!!!At Inner town hall meetings the "little guys" are afraid to speak up;and when were they held??? During surgeries when everyone was busy.Talk about one-sided. Management is not considering patient care at all - it's how much money can they make, cutting corners, overloading staff responsibility, no pay raises, on-call bonuses taken away...what next? Other hospitals are trying to deal with this bad economy too, but patient care is first...sounds like there are a lot of frustrated people out there AND inside the hospital as well... just sign me off as a concerned citizen.

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  39. ER management and Directors are stuffing the CODES SO THEY CAN CHARGE THE INSURANCE COMPANIES A LOT MORE.
    Someone should notify Medicare and Insurance companies.

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  40. That is not true about Aurora and having to have good insurance, I know families that have Badgercare and also people on Medicare. I wouldn't consider that outstanding insurance. They see regulars doctors, they go to walk in care, etc. Walk in care at All saints won't take a self pay unless there is money down and neither would any other doctors office. The only place you can walk into flat broke and no insurance is the hospital is because BY LAW they have to treat and stablize a patient. All Saints doesn't have to keep them either, and I have seen my share thrown out and they should have stayed

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  41. I'll add to the laundry list of issues here....I too have had the same problems already discussed. Received a bill 18 months after the date of service. When I questioned them they told me that our insurance company "took payment back" and now we owe the balance. I called the insurance company to find out why they "took payment back". The only info they had was the original claim and payment, no recent activity or "taking payment back". They told me it was a Wheaton problem. Well, someone is lying here, so i called Wheaton back and explained what the insurance company told me. They then changed their story and said it was because of something else blah blah blah. What kind of a business bills their clients/patients a year and a half after the service. If the insurance companies can deny claims becuase it wasn't billed in the 90 days following the service, then why should the patient have to pay for something from a year and a half ago? Anyhow, I know at least 5 other people who have had similar experiences with receiving old bills along with everyone else on this blog too. Something stinks here..............

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  42. Heard awhile back that Wheaton could not give raises, but all the administrators went on a cruise? Who's money did they use for that?

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  43. They used the money they swindled from the patients for billing, rebilling and rebilling again!

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  44. Wellsprings really did a job on Wheaton but the alternative was not pleasant either. Perhaps some additional management overhauls would help. Accountability of the employees would help. Removing some key players that have crippled the ability of good leaders to do what it takes to make improvements would be a fantastic start. Start with the CEO and stuff will always roll downhill. It wouldn't take long for the new "guy" to figure out who needs to go. Small town, small pool to choose from. Too many "internal" people moving up the ladder with not a clue! Would love to see Wheaton stay and prosper, for the health of the community, for the health of my family.

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  45. As many before I have stated, it's not just the nursing staff and doctors. A loved one of mine works for Wheaton in environmental services. The management for that department is a complete joke. Everyone is pissed about favoritism, ineffectual and just plain ignorant managers and want things to change but there is always the fear of being let go. Of course this atmosphere only serves to bury the hard and industrious workers who take pride in what they do knee deep in the work that the supervisor butt-kissers get away with not doing. Also, if people REALLY KNEW how biomedical waste was just floating around all willy nilly unsecured in that place...there would be NO PATIENTS AT ALL. I find it hard to believe they would have passes state inspection! All thanks to lazy, butt kissing employees who pile they're work on others so they can sneakily take an hour and a half lunch while co-workers who fear being fired do the extra work. Why is there no union representation at Wheaton for non-medical positions?

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  46. Anne Ballentine admitted the problem without knowing it.

    She said, referring to the doctors, "we're working behind the scenes with them. We have a common goal of serving our patients". Excuse me Anne? Our "patients"? When did you or any other of your hospital administrator boss friends get to refer to your CUSTOMERS (because that's how you treat them) as your "patients"? What medical school did you go to?
    A doctor has a patient and a patient has a doctor, FYI. Pretty basic.
    Maybe that's the problem. Hospital administrators with junior college degrees or slightly better and with zero people or medical skills are running the show at Wheaton All Saints St. Mary's in Racine (Gee, you change your name so much I'm not sure what to call you).
    Anne and her cohorts apparently act as the real doctors there, and the real MD's are nothing more than very highly-paid employees who can be let go at a moment's notice.

    Because its all about the bottom line.

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  47. Most of you are bashing All Saints. From what I understand is that All Saints had some problems but was doing pretty well until Wheaton/Illinois took over. If you want to write a letter, send it to the Chiefs at the Wheaton Base in Illinois. They are the people who created this problem, not Ken Buser, CEO of All Saints. When Wheaton took All Saints money to float their other (troubled) hospitals, then All Saints didn't have the money to fix their problems. You better hope that Wheaton can fix this mess. There are 3600 local people who could lose their jobs if this system goes down. Those are 3600 jobs that your relatives and friends could lose. Another thing, if Wheaton had to take money away from All Saints to save their other hospitals, what did Wheaton do wrong that those hospitals got into trouble? Obviously, Wheaton is not a very good medical system manager. All Saints should pull out of and renounce Wheaton.

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  48. This is a true story regarding the utter lack of common-sense and compassion at All Saints Wheaton hospital in Racine.
    My mother recently passed away after a prolonged hospital stay. After she died, she continued to have bills sent to her home. I called the billing service to inform them of her demise, assuming this was a simple error.
    The billing person basically laughed at my story, and said she did not believe it to be factual. I stated: "Are you kidding me? Check your own records, her primary care doctor at All Saints signed the death certificate".

    Still this was not good enough. So I mailed a copy to the billing department. What happened next? She was sent to collections! I guess they had a hard time finding her in heaven, because they eventually gave up...but we continued to recieve bills for close to one year after her death.
    So even dying doesn't get you a break from paying the All Saints hospital group.

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