The Vacation That Just Keeps Giving – I Mean Taking

We all remember the hilarity that was the incident I affectionately refer to as Face Smash 2011.  Well, today I got a lovely surprise in the mail.  It was an envelope from Hawaii Emergency Physicians Associated, Inc., or HEPA for short.

My first thoughts on receiving the envelope consisted of a collection of What the what?, and This must be a receipt of payment, or Maybe they sent me a survey (is it surprising that a Statistician would think this?). And, if I am to be perfectly honest, I have to admit that there was even a small part of me that thought Maybe they realized they overcharged me and have sent me a refund.  Ya, I can be that stupid.  Well, that’s probably not true.  I know I can be far more stupid than that.  Although I prefer to think of it as being not so much stupid, as optimistic.  Okay fine, let’s just say I’m optimistically stupid, or stupidly optimistic; whatever.  As Rick would say in a most dramatic way “I’m done with this”.  Either way, and moral of this paragraph, I’m an asshat for being so stupid.

My Physician, Dr. Coker - who was awesome - was also worth $619.75 apparently. Should I take comfort in knowing that his skills are worth more than the cost of the stitches?

Anyway, upon opening said envelope I was presented with an almost illegible invoice.  Yes folks, that’s right; an invoice.  It’s not a receipt of payment already received, it’s an invoice.

Now, you might be asking yourself, Didn’t Dan already pay something like $550 when he got his stitches? And you know, that is exactly what I asked myself.  Well, not exactly.  I may or may not have thrown some expletives into the mix, and I may have opted to refer to myself in the first-person.  Regardless, I was ever so slightly confused.  Maybe I had smashed my face so hard, that I imagined the entire paying-the-hospital-a-ridiculous-sum-of-money-that-could-have-been-better-spent-on-pina-coladas scenario.

Nope.  I double checked my bank account.  I did indeed already pay about $550 for wound cleaning, wound numbing, and wound stitching.  Five hundred and fifty dollars on 5 stitches.  That’s $110 per stitch.  Clearly, this invoice must be a mistake.

Desperately hoping a mistake had been made, I started sleuthing, as one is inclined to do in a situation such as this.  I managed to find the HEPA website, and it was quite informative.  Apparently HEPA is a group of emergency response physicians that work in the hospitals of Hawaii.  Let me restate that; they are a group of doctors that work in the hospital, they do not work for the hospital.  Which means they need to be paid too, because clearly the hospital bill is a completely different animal than the doctor’s bill.  And clearly $550 can’t be expected to cover the costs of cleaning, numbing, and stitching a wound, plus the 15-30 minutes that it took the Dr. Coker to perform the required stitching (especially since I could have just bought some crazy glue and had a glorious DIY party on/in my face).  GAH!

Don’t get me wrong.  I fully believe that Dr. Coker’s work deserves payment.  I mean, he did stitch up my beautiful face and leave me with a rather sporty Harry Potter scar.  He was professional.  He was entertaining.  He allowed us to document the procedure.  And he also assured me that the scar would be minimized because of his stitch-work.  So I’m not upset with him.  How could I be?  Plain and simple, he was awesome, and is very much deserving of being paid.  I would recommend his work, and if I were in the state of Hawaii again finding myself in need of medical care, I would absolutely, 100%, and without-a-doubt seek out his expertise.  Ultimately I am annoyed with the stupid American medical system.  Let me write that again, because it feels good to do so:



I guess what bothers me the most is that no one at the hospital informed me that this would be the situation; that is, that I would receive 2 separate bills, the last more expensive than the first.  This despite the fact that I kept asking How much will this cost? and I can’t afford this, so let’s replace stitches and needles with some old chewing gum, and elbow grease if that keeps this cheap.  Of course, according to the HEPA website:

When someone comes to the Emergency Room, it is implied that they have a medical emergency. Specific regulations require that Emergency Room Clinicians first see the patient before we can discuss any financial questions.  We understand that this restriction can be frustrating.  However, the regulations are there to ensure everyone who comes to an Emergency Room will be seen regardless of their ability to pay.

While I support the idea that everyone should be seen regardless of their ability to pay, I have to wonder what happens to those patients who, after having seen a doctor, must choose between paying for food/shelter, or paying a doctor’s bill.  The poorer families in the USA; what do they do?  How do they survive in a system like this?  Perhaps they don’t.  Anyway, I digress.  Bottom line: I wish I was made aware that 2 payments would have to be made.  It certainly would have prevented the annoyance that I am currently experiencing.  Once more for good measure:


It still feels good to write 🙂

Thankfully, while the bill is $619.75, it’s not the end of my financial world.  Given the state of the American medical system, the bill could have been for so much more, and that is the silver lining that I will cling to.  So despite being a glorious pain in the ass and wallet, I will pay my HEPA bill like a good little patient.  And I will submit the expense to the health coverage I have through the school in the hope of getting a refund.  And I will move on from this and focus only on the awesome that was Hawaii, because that is what awesome people do.

Unless the nurses of Hawaii also have an incorporated association that requires some form of payment.  Good gravy, let’s hope not.


4 Comments Add yours

  1. lara says:

    Dude, I thought you totally scored on your hospital bill when you told me it only cost 550 bucks to get stitches so I can’t say that i’m surprised about the second asshole bill. I was in San Fran a couple years ago and it cost me 1200 bucks to see a doc for a simple prescription. Well, I didn’t pay it, CAA did. Moral of the story: with the amount of travelling you do, you really should get travel medical insurance……or just stop smacking your head into things. Just sayin’.

    1. dangillis says:

      I’ve been told that I do in fact have travel insurance through the school, but due to some rather annoying issues with my contract, I don’t have all the details on it as of yet (i.e., who the hell to send the bill to). I will be submitting the expenses for reimbursement once all of that is figured out. w00t!

      Speaking as a stat nerd, given all the travel I’ve done, sans insurance, I’m still ahead.

  2. Beth says:

    Doctors in Canada (well, in BC at least, not 100% sure about the financial aspects of the health systems other provinces) also don’t work for the hospital, they just have privileges to work in the hospital. The difference, of course, is that they send their fee-for-service bill to the government, who then pays it for you. And the hospital is run by the health authority, which also gets its funding from the government. FSM bless our socialized medicine! w00t!

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