by Robin Cook
“Fine, give her a try,” Brian said.
Using the speaker on his phone, Patrick made the call. In contrast to him, Megan Doyle had a secretary who put Patrick through directly to her. The call was friendly, curt, and decisive. Megan would squeeze him in between appointments, and told him he should come down directly after seeing Patrick.
After a short conversation involving another shared client, Patrick disconnected the call, then looked over at Brian. “You’ll like her,” he said. “She’s very personable but very professional, and she’s good at what she does.”
“Even if my bill is reduced to half, I’m going to be hard put to pay it off,” Brian said warily. “But let me ask you something else. What about going after my supposed health insurance company called Peerless? They’ve turned down my claims, denying any fiscal responsibility despite all the premiums I paid. To me it’s a fraud.”
“I’ll be happy to look into it, if you insist, but I can tell you up front that the chances it would be successful are minuscule. Short-term health insurance is a tolerated scam in my experience. They have spent millions in legal fees to protect themselves with their contracts. Did you read your policy?”
“No, I didn’t,” he admitted.
“That’s what they count on,” Patrick said. “They advertise themselves as being inexpensive, and they are. They love to take your premiums but are loath to pay out anything at all, and when they do, it is never even close to being adequate.”
“Why is it tolerated?” Brian asked, genuinely confused.
“That’s a question I can’t answer,” Patrick said with a shake of his head.
“I have one other issue that should be looked into. I think there’s a chance my wife was discharged before it was safe and possibly because I wasn’t paying the bill. I think that Charles Kelley, the hospital CEO, has created a very strongly profit-driven culture that’s willing to put patients in danger.”
Patrick’s eyebrows raised. “Let me understand what you are implying. Do you think there might be negligence involved?”
“I do,” Brian said. “If she had still been in the hospital under a seizure watch, she’d probably be alive today.”
“Hmm. That could possibly put a different spin on the situation down the road,” Patrick pondered. “At the same time, I wouldn’t count on it influencing this current case. What I can do is run it by a malpractice attorney friend of mine, provided you give me the okay.”
“Sure, if you think it is appropriate.”
“I’ll give it more thought,” Patrick said. “Meanwhile, I’ll start the process of getting you a court date.” He stood up, and Brian did the same, interested to meet his very first medical billing advocate.
CHAPTER 18
September 1
Conveniently it took Brian mere minutes to go from Patrick McCarthy’s office down to Megan Doyle’s on the ground floor. But the change was substantial. In contrast to Patrick’s space, there was a generous-sized waiting room and a receptionist, suggesting that Megan was doing significantly better financially than Patrick. Business for Megan was apparently brisk in spite of the pandemic, or maybe because of it.
To Brian, the elderly receptionist looked strikingly similar to the librarian of his middle school, and he was tempted to ask if she was related but couldn’t remember the librarian’s name. In keeping with the needs of the pandemic, a plexiglass shield had been added to the woman’s desk. Combining that barrier with his mask, he had to speak up when he gave his name.
“Miss Doyle will see you as soon as she can between patients,” the receptionist responded equally loudly. “Meanwhile, please fill out this form so we have all your contact information.”
Armed with the form on a clipboard, Brian turned to look for the most appropriate spot to sit in the waiting area. Despite it being as early as it was, there were two people waiting who had chosen opposite corners of the room beneath the windows that looked out on Broadway. In keeping with social distancing requirements, Brian went to the other end of the room.
As he was filling out the form, he thought about the receptionist calling Megan’s clients “patients.” It struck him as mildly bizarre that Megan was considered an integral part of the medical community, suggesting that dealing with a ridiculous hospital bill was somehow akin to setting a broken bone.
As he finished with the form, a fourth person came into the waiting area. What caught Brian’s attention was the woman’s age. Although the man and the woman under the windows were somewhere near his mother’s age of seventy, this newly arrived individual was closer to Brian’s thirty-six. She was dressed in biking shorts and a bright pink jersey with white stripes. And similar to Brian, when she gave her name to the receptionist behind the plexiglass, she spoke up to make sure she was heard. Her name was Jeanne Juliette-Shaw. Then the receptionist told her the same thing she’d said to him, indicating she, too, was being squeezed in. The only difference was that she was not given a form to fill out, implying that she was an existing client.
Despite the circumstance of being in a medical billing advocate’s office, his life in total disarray, and it being in the middle of a pandemic, Brian couldn’t help but be intrigued with this stranger on three accounts. The first was the woman’s youth, which suggested that similar to Brian, she shouldn’t be struggling with a difficult hospital bill. Second was her obvious French accent. When she pronounced her given name, it was “jhân,” not “jēēn,” suggesting that she had grown up in France just like Aimée. And third was her family name: Juliette-Shaw, calling to mind his daughter’s given name.
Jeanne retreated to the remaining corner of the room, relatively close to him although certainly more than the required six feet away. As she sat down, she nodded a greeting to Brian, who couldn’t help but closely watch her despite recognizing he might be acting mildly impolite. She then took out her phone from a pocket on the back of her bike jersey and became engrossed.
“Excuse me,” Brian said, unable to restrain himself. “I couldn’t help but hear the first part of your hyphenated family name, Juliette. It’s quite . . .” For a brief moment he didn’t know what to say, as he had spoken impulsively and hadn’t planned ahead. Finally, after an awkward pause, he added: “It’s quite beautiful.”
“Thank you,” she said, but quickly reverted her attention back to her phone.
“It caught my attention because it’s my four-year-old daughter’s name,” Brian added, in an attempt to initiate a conversation.
Jeanne looked up again. Because of her face mask, he couldn’t be sure of her reaction, but there was a faint crinkle of the corners of her eyes at least suggesting a smile, but to his dismay she didn’t speak, forcing Brian to stumble ahead: “The reason we chose the name is that it was my mother’s maiden name. My mother grew up in France. She didn’t come here to the United States until college age, actually to go to Barnard College, where she met my father, who was going to Columbia on a hockey scholarship and then had us kids.”
Brian felt distinctly uncomfortable, which was why he’d carried on so long. Although social to a fault, he’d never been particularly comfortable talking with women he didn’t know.
“Juliette is not that common as a surname,” Jeanne said. “Even in France. Where in France did your mother come from?”
“Normandy,” Brian said, relieved to be asked a question. “Near Bayeux.”
“That’s a very interesting part of France.”
“Have you been there?”
“Of course. Everyone visits Bayeux because of the tapestries.”
“I suppose you are right,” he said. “Even I have seen the tapestries: several times, in fact. My mother took me and my brothers and sister to France every year to visit our French grandparents. To make it easier, she even got us all French passports so we could zip through immigration. My middle name is Yves, after my mother’s dad.” Brian didn’t kn
ow why he felt pressured to keep speaking. Being a private person normally, it was unlike him to be so revealing about himself.
“You and your siblings were very lucky,” Jeanne said.
“We were,” Brian agreed. Then, in hopes of turning the conversation away from himself, he said: “You have a distinctive and charming accent. Are you French?”
“Yes and no,” she said. “Like your mother, I grew up in France. I, too, came here to the USA to attend college but ended up staying and becoming a citizen. I consider myself American as well as French.”
“As you should. Could you be related to my mother’s family since, as you say, Juliette is not a common family name?”
“I doubt it,” Jeanne said. “I grew up in a totally different area of France that’s not that well known outside of the country. It’s called the Camargue. It’s way in the south, and all my relatives have lived there forever.”
“You are right, I’ve never heard of the Camargue, but I’ll ask my mother.”
“She’ll know of it; it’s the Rhône River delta,” Jeanne explained. “It’s marshy and agricultural with more birds, cattle, and horses than people.”
“I’ll check it out with Google,” he said. “I should introduce myself. My name is Brian Murphy.”
“Nice to meet you, Brian,” she said. “I’m Jeanne Juliette-Shaw.”
“It’s a pleasure to meet you, too. If you don’t mind, let me ask you a question about Megan Doyle. Is this your first visit, like it is mine?”
“No, she’s been working with me for a number of months. I’m just here to sign some final paperwork.”
“Has she been helpful?”
“She’s been most definitely helpful,” Jeanne confirmed. “I just wish I had come to her sooner. I wasn’t even aware such people existed.”
“Nor was I, not until a few days ago.”
“One of the main things I miss about France is the healthcare system,” she said. “It is so, so much better. Here it can be a disaster, and I am living proof.”
“So, I assume you had a large hospital bill, too?”
“Énorme,” Jeanne said. “Huge.”
“Were you sued as well?”
“Oh, yeah! Yes, I was sued.”
“A local hospital?” Brian asked.
“Yes again. MMH Inwood.”
“Did you not have insurance?” Brian asked.
“We had insurance, but it was a short-term policy and ultimately worthless,” Jeanne said. “They didn’t pay anything.”
“Could it have been Peerless Health Insurance, by any chance?”
“How did you guess?” she said, eyebrows raised.
“Merely by your saying they didn’t pay anything,” he said with a scoff. “We had the same insurance, and they haven’t paid a dime. I’ve learned it’s their modus operandi, thanks to their CEO, Heather Williams.”
“I’ve heard of her,” Jeanne said. “She’s popular with Wall Street.”
“What excuse did Peerless give for not paying any of your bill, if you don’t mind me asking?”
“They claimed my husband’s heart attack was due to a preexisting condition,” Jeanne began. “Somehow they found out he had gone to a doctor several years ago with chest pain. Even though the doctor at the time found nothing except mildly elevated cholesterol and blood pressure, the insurance company claimed his heart attack was due to a preexisting condition. Unfortunately, it held up in court. We were duped. We didn’t know that short-term health insurance could do such a thing.”
“That is criminal. I mean, almost everything can to some extent be considered a preexisting condition.”
“I couldn’t agree more,” she said. “It is criminal.”
“Did your husband at least do okay medically?”
“I wish,” Jeanne said. “He died after multiple procedures, waiting for a heart transplant. It didn’t happen. With lousy health insurance, which wasn’t going to cover anything, and without adequate personal resources for the half-million-dollar procedure, the hospital dragged its feet. It became clear to us that the chances of him getting a heart were not good. He lived for a while with what’s called a ventricular assist device, but it wasn’t much of a life.”
“I’m so sorry to hear that,” Brian said, feeling self-conscious he’d asked. And then he surprised himself by saying with a catch in his voice: “I can certainly sympathize. I lost my wife, too, just yesterday.”
“Oh, no!” Jeanne exclaimed. “What happened?”
“It was a viral disease called eastern equine encephalitis, or EEE for short, that she got from a mosquito. I think she’d been bitten while we were having a beach barbecue a few weeks ago.”
“Good lord! So tragic. I’ve never heard of EEE.”
“I hadn’t, either,” Brian said. “But it’s a developing problem that I’m afraid we are all going to hear more and more about. The Asian tiger mosquitoes that carry it have spread all the way up to Canada from the tropics.”
“Between that and coronavirus, it seems that viral diseases are becoming an existential threat. And you say your wife died just yesterday?”
He nodded.
“You poor man. How can you be out and about? I couldn’t even leave home for weeks after my husband died.”
Brian took several deep breaths, started to speak, and then had to pause again. Finally, he managed: “I’m still in the denial and anger stage, I suppose. But I had to get out, especially with MMH Inwood suing me and threatening my house. That’s why I’m here to see Megan Doyle and a lawyer upstairs, hoping they can help.”
“I assume you mean Patrick McCarthy. Wow! You are on a similar trajectory as I. If it is any consolation, I can at least assure you that they work well together.”
“That’s good to hear. Thank you.”
“This kind of situation would never happen in France,” she said. “It’s enough to make me think seriously of moving back even though there is a lot to love about this country.” Then, wrinkling her forehead, she added: “You said you have a daughter. How is she taking this tragedy?”
“Not well, I’m afraid. She’s always been a mommy’s girl. She’s had a lot of trouble since my wife was hospitalized two weeks ago. Telling her yesterday that her mother died was possibly the most difficult thing I’ve done in my life.”
“It’s an awful experience for a child to lose a parent, particularly a mother, no offense to you as a father.”
“No offense taken. I get it.”
“Your biggest challenge will be to convince her you will be there for her, that she is safe. Fear of abandonment will be her biggest concern, which you’ll need to address head-on.”
“It sounds to me like you know more about this kind of situation than I. Have you had some professional mental health training? Or are you a parent yourself?”
“No, I’m not a parent,” Jeanne said. “But I did study psychology at Fordham University, where I met my husband, probably similar to the way your mother met your father. I also took a master’s degree in school psychology and was an elementary school psychologist for a few years. While in that position, I had to deal with several students who had lost parents.”
“Well, that explains it,” Brian said, impressed by her experience.
“You’ll have to be prepared for a potentially wide range of symptoms on your daughter’s behalf,” she explained. “She could get psychosomatic symptoms, like gastrointestinal complaints. In the mental arena, she could exhibit practically no change to outright regression.”
“What do you mean by ‘regression’?”
“Reverting to an earlier age. For instance, she could stop talking, forget her potty training, or demand a bottle and refuse to eat solid food. There’s no way to predict. You’ll have to be prepared for whatever comes.”
At that moment the door to the inner of
fice opened, and a white-haired man appeared on crutches. He was immediately followed by a woman Brian assumed was Megan Doyle. Despite the mask covering half her face, she looked younger than he expected, quite a bit younger than Patrick McCarthy, more like a college-aged woman than a professional with graduate training. She was dressed in a blue blazer over blue jeans with a white, open-necked blouse. Her medium-length light brown hair was a forest of curls. But what he liked immediately was that she projected a sense of assurance and almost cheerleader exuberance as she greeted the two older clients who were waiting by the windows, saying she’d be with them shortly.
After handing off some papers to the receptionist and taking the clipboard that contained the form Brian had filled out, she also greeted Jeanne before calling out his name and waving for him to follow her back into her office.
“Good luck,” Jeanne said as Brian got to his feet.
“Thanks,” he said, taking a deep breath. “I’m going to need it.”
CHAPTER 19
September 1
Like Megan’s outer office, the inner one was a polar opposite of Patrick McCarthy’s shabby domain. It was hardly posh, but the furniture was relatively new, indeterminately modern, and constructed of a blond wood with a Scandinavian simplicity. Besides the obligatory desk and chairs, there was a good-sized bookcase that Brian could see was nearly filled with myriad hospital billing manuals and coding texts, underlining his ignorance of the entire field, one he never even knew existed.
“Please,” Megan said, pointing to one of the chairs that was a bit more than six feet away from her desk. She sat behind her desk and quickly scanned the form that Brian had filled out.
“Okay,” she began cheerfully. “This preliminary meeting won’t take but a few minutes, and it is mainly to get you to sign a patient advocacy authorization form, so we can get the ball rolling to get a complete copy of your hospital bill. It will also give us an opportunity to talk about my fees. I see you are being sued by MMH Inwood for nearly one hundred and ninety thousand dollars.”