Andy Whalen

Review of Rex Healthcare

We needed to take our child to the ER for ingestin...

We needed to take our child to the ER for ingesting something that poison control wasn't sure either way it would effect him. After waiting 3 and a half hours in the waiting room, we were shown to a room in which we were told by the doctor, we're not sure either way, but we can't take you in because we don't have a pediatric ward. We'll transfer you to Wake Med.

For this pleasure, we received a bill from Rex for over $1600, with one line: "ER level 4". I looked this up and this level of treatment bears no resemblance to what was done. I asked for a detailed invoice and was told, that IS the detailed invoice. I objected several times over the phone and UNC Billing messages and was ignored when I challenged the medical coding for this visit. We received L1 or at most - stretch of the imagination - L2 treatment. I simply refused to pay until I got more clear answers, but after perhaps 15 to 20 rounds of email messages and phone calls, I simply got nowhere, questions were ignored, and we kept receiving bills, eventually (obviously) threatening collections. That was the brilliant conclusion to the process - expect the customer to blindly, cowishly accept whatever we say they owe, ignore the customer's reasonable, well-articulated questions, until we can threaten them with collections.

The entire attitude both during the visit and afterwards with billing was arrogant and incompetent. When I asked very simple, basic diagnostic questions about what we were paying for and why, I was met with silence. This hubris will come back around to the organization; an organization THIS poorly managed and operated can't compete. I'd put it back on the physicians and administrators who let this type of service and billing occur: Would you build a house and accept an invoice from your general contractor saying: "House, $500,000, please pay immediately". Would you ask questions? Would you want a bit more detail about the subcontracting and inspections completed? If your contractor said "4000 sq ft house, $500,000" but you walk around, measure a bit, and it's clearly a 2000 sq ft house, would you expect to just pay blindly because the invoice says it was 4000 sq ft?

I don't see why this is any different. Medical care is a service. The customer deserves (and is, as far as I understand, holds a legal right to) absolute transparency no differently than any other product or service. I should understand precisely what I'm being billed for, not just "1 house" or "ER Visit". Intake? Medical supplies? Facility charges? Consultation? I also should have every right to object, that the services billed differ from the services received. The service delivery and billing system simply is blind, deaf and dumb to any such possibility. This almost certainly runs afoul of legal obligations on the part of Rex, but the billings are just not large enough to justify engaging legal counsel, nor even taking it to small claims court. But in 2016, I should not need to rely on either extreme option to ask some questions about the detailed billings, challenge what was recorded, and at least ask the service provider to justify in detail what they perceive was provided - what we were billed for - and why - and expect a reasonable, clear answer. There should be a well-defined escalation path for these types of issues.

I've learned a valuable lesson: We will not be going back to Rex. We will advise family, neighbors and coworkers against it.

Rex: you need to fix your business. It's broken. Find competent management and move forward.