When Did the Billing Agent become a Nurse?

Emergency room visits are typically not a pleasant experience. I think those that design emergency waiting areas want to extend in some form that very unpleasant experience. Today I had an embarrassing visit. My hemorrhoids flared causing me three days of anguish. So I made my journey to the emergency room. Let me interject by saying that emergency room furniture is designed by someone clearly depressed and uninspired. The artwork is replaced with bright health related meticulously placed framed posters. There are plenty of AARP and random golf magazines lying about. Nurse staff calls out names similar to a basic training induction. There are little humanity and comfort in a place where it seems to be needed the most.

Once you are finally called to the triage area you are not greeted by a nurse or doctor. Your first visit is someone from the billing department. Seems very insensitive in my opinion.  Somewhat providing an argument that billing is more important than overall health. Again, a missed opportunity of compassion, comfort and putting patients first.


After about an hour of waiting and lots of forms, I was cleared to be seen. I thought it was easier to buy a new car than go to the hospital. I signed HIPAA documents, and I asked an important question. “By signing this form does the mean my insurance company and doctors will be speaking to one another?”  I was told that doesn’t happen. So basically we are the only advocate for our insurance program policies to continually fight for what insurance won’t pay but physicians order. Again compassion, comfort and putting people first are not what health insurance and doctors seem to advocate for. Instead, they argue against one another putting patients in the middle. No wonder people won’t see a doctor or seek preventive medicine in America.

Not only do we design our hospitals sterile but we also develop healthcare in the same fashion. I am not demanding plush exuberant conditions. Rather I am asking that health care and its agents become a bit more aware of how it represents its industry. The first people to greet patients should be medical staff, not billing personnel. I am concerned that we are turning an institution that was once filled with compassion, dedication, and ethical standards into another sterile facility where bedside manners and caring for our neighbor must regulate itself past a billing agent.


I am mindful that there are plenty of doctors, nurses and other practitioners that take immense pride in what they do. However, the overall hospital experience from my observation didn’t seem very courteous, inviting or reflective of the hospitals I once knew from decades past.  Ironic how a regular doctor’s visit would have only cost about $125 with insurance, medication and a referral update in an office that was warm, inviting, and seemed to care about my medical needs. That same emergency room visit with all its sterility and no tests or medical procedures cost over $7000. We wonder what is wrong with our medical institutions in the United States? I think I just found one of the answers why.