The Unexpected Medical Bill

SEP. 09, 2019

By Peggy Crandell



If you or someone you know is experiencing a mental health, suicide or substance use crisis or emotional distress, reach out 24/7 to the 988 Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) by dialing or texting 988 or using chat services at suicidepreventionlifeline.org to connect to a trained crisis counselor. You can also get crisis text support via the Crisis Text Line by texting NAMI to 741741.



I recently received an invoice from a clinician for psychiatric services my son received two and a half years ago. At the time, I encouraged him to see a psychiatrist to treat his attention deficit disorder. He saw this doctor only once. He made a subsequent appointment, but didn’t go to it. So the clinic billed him a no-show fee. I know this because he was on our family’s health insurance plan, for which I pay the bills.
 
I know I paid that particular office visit bill two and a half years ago. It’s even in my health savings account billing history.
 
So I called the clinic’s billing department. I explained I was inquiring about the bill for my deceased child. She asked for his birthday and address. My voice quivered as I answered. She then followed up with, “What can I do for you?”
 
I composed myself, no longer crying. I said with anger, “Why are you billing me for services from two years ago, which I paid for, for a person who is no longer alive, as he died by suicide?”
 
Her immediate replies were not adequate. She blamed the insurance company and directed me to inquire with them.
 
I deepened my voice, in a shortened tone, and replied, “You are a behavioral health clinic, you should be prepared to deal with people like me. You are requesting payment for services that did not prevent his suicide. Your clinic is asking for payment, not the insurance company. That is why I am calling your clinic, the billing party.”
 
I firmly requested she find a supervisor who was capable of dealing with my inquiry. When she asked me to wait on hold, I could hear in her voice that she was crying.After a long wait, another person took the call, apologized, said she was sorry for my loss, told me to disregard the invoice. I thanked her, ended the phone call, and immediately shredded the bill.
 

My Anger is a Symptom of My Grief 

A couple of days later, I shared this story with my suicide loss survivor group. I started my account with, “I have an anger problem.” The group confirmed my story of angry behavior is not unique. Anger is really grief, and it comes out in uncharacteristic ways.
 
Generally, because of my anger,I have a low tolerance for those who make “foot-in-mouth” mistakes or don’t know how to talk to me anymore. These mistakes are not intentional, some realize once it is out there, others have no idea that what they did or said, which did not sit well with me. Things like:

  • Implying that I should stop feeling the way I am feeling
  • Not acknowledging the debilitating cognitive and physical effects of grief
  • Wanting me to be back to the way I was before my son died
  • ​Avoiding me because they do not know what to say

All of these things are a more significant problem in our culture where we do not talk about grief. How will anyone really understand grief when no one talks about the reality of it? 
 
If you read anything about grief and grief symptoms, the list will include anger. I have learned from others who have written about suicide grief that anger can become a default comfort. It is easier to fall back on anger than to feel guilt, shame, blame, depression, despair, anxiety, immense sadness, loneliness, etc. There are at least 10 other emotional effects. If you are a suicide loss survivor, you likely know the others.

Turning Anger into Something Productive

I am sorry to the person at the behavioral health clinic who answered my phone call. She was not responsible for making me a victim of their accounting incompetence. She was not responsible for why I am so angry. A therapist would probably tell me I need to turn my anger into something productive. Right now, two years since my son’s death, I am too tired to be productive. The fog has partially lifted and replaced with the black reality that my son is not coming back.
 
The reality is, year one sucked, and year two sucks too. I will never get over this. There is no cure for grief. But I have learned from others further along in their grief, that with time, you learn to deal with it better. They have learned to change the pain from reactive to proactive, doing something positive for themselves, to advocate, or honor their loved one publicly. I have read stories of loss survivors who go on to do inspirational things like public speaking, starting a nonprofit, writing a book, hosting a podcast or running a marathon for a cause.
 
Personally, I am proud of my accomplishment of making new friends who are fellow survivors. They do amazing things every day, like celebrating the life events of their child’s friends, writing inspirational stories for publication, leading large organizations, teaching our children about mental health, giving back to the community and finding happiness in the small things.
 
I may not be ready for that, but I try to be positive by recognizing my accomplishments—big and small—to channel my anger. Things like doing any form of exercise, passing on the weeknight glass of wine, not hibernating in my room all evening, eating a healthy meal, calling a friend back, and writing my story. 
 
I share my personal struggle and journey after my son’s death so that perhaps I will make a connection with other suicide loss survivors. By sharing, I hope others will understand what the loss of my child means to me, and the extraordinary devastation his death by suicide has brought.
 
 
Peggy has been married for thirty years, has two adult children, a meaningful job, comfortable living, good friends, and close family. On March 9, 2018, Peggy lost her son to suicide, shattering her world. She writes to share her personal struggles and journey after her son’s death.
 
 
If you are or someone you know are a suicide loss survivor, you can find helpful resources at Refuge In Grief and Suicide Loss Survivor
 



We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices

Check out our Submission Guidelines for more information.

Submit to the NAMI Blog

We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.

Check out our Submission Guidelines for more information.