In Ann Arbor, there are two major healthcare providers – Michigan Medical and IHA/St. Joe’s. Michigan Medical is good, unless you’re a little squeamish about being the practice body for doctoral students in the University of Michigan medical school. IHA used to also be good, until the provider switched it’s third-party billing service, and is now punishment to all who require billing, regardless of whether they have been good or bad boys and girls.

Dealing with IHA billing is the 8th level of hell that Dante was too frustrated to write about. The third-party billing service IHA has switched to is Trinity Health Professional Billing Services, but don’t let that name fool you – unless the representatives you will be speaking with are training to deal out torture and frustration, there is nothing professional about the service you will receive. I have a family member who is literally abstaining from seeking professional treatment for an ear infection that has bothered him for approximately 1 week because Michigan medical cannot get him in to see a doctor and does not currently have an urgent care, which leaves him with… you guessed it, IHA. Just the thought of dealing with the billing errors that will inevitably result is more torturous than the pain he experiences from a burst eardrum and noticeable hearing loss. But having dealt with Trinity Health multiple times myself, I am unable to tell him that he is wrong, because, to be frank, this organization is the most inept business that I have ever encountered.

That’s right, folks. This medical billing service is worse than GameStop, which has a business model nearly as archaic as Blockbuster and people need to stop investing in it because it’s a shitty business model that preys on the stupid (sorry if you use Gamestop, but, like… you should stop). This medical billing service is worse than the Little Caesars I went to on a regular basis when I lived in the Bay Area, which had Yelp reviews along the lines of “This store gets a 1-star rating in comparison to other Little Caesars,” and which was often managed by a woman obviously strung out on crack who sometimes made people wait for hours at the counter. This medical billing service is worse than my brain was previously capable of even imagining. I think of myself as having a fairly active imagination, but I would never, in my wildest fantasies, have imagined that this degree of ineptitude would be tolerated by a medical organization that, as far as I know, does not want to go out of business (though you have to wonder…).

Now, if you have not been to IHA since this medical practice group switched billing service providers in early 2020, let’s walk through a hypothetical situation:\

You take your toddler to the IHA Arbor Park Pediatrics center on Clark Road in February 2020. While you walk up to the familiar door, you notice an 8 x 11 paper taped to it that states that IHA is in process of switching medical billing services. You open the door, espy the colorful handprints painted in the doorway, and walk through the second door to enter the waiting lobby. You check-in, including stating that there are no changes to insurance from what was provided when you first began bringing your child to IHA shortly after birth. Insurance for the family is through your work, and you are responsible for any charges exceeding what insurance will cover.
The check-up is normal; your child is fucking healthy as a horse.
You receive a bill in the mail, but it looks like the visit was not processed through insurance first. Since this check-up was a normal, required examination for a child in the first two years of life, you expect that insurance will cover most, if not all, of the cost. You look up IHA billing provider information on-line, and see that for visits made on or after January 24, 2020, you need to contact Trinity Health:

You call the number for Trinity Health Professional Billing Services, explain that you have a question about a bill you recently received, you have the date of the visit, the invoice number, etc., immediately in front of you, but the representative on the phone informs you that this bill does not appear to be in their system yet, and that you should call again in a month or so.
You move to a new residence, lose the bill you have questions about in the fracas, and are generally trying very hard to complete a move in the middle of COVID restrictions.
You call Trinity again a month or so later. They are still unable to locate your bill in their system, but update your address.
You receive a bill a month or so later, forwarded from your old address with the notice that the bill is overdue. The bill is exactly the same; i.e., there is no indication that this visit was sent to insurance. It is summer. You call Trinity, which requests the address on file, since the bill was processed in your spouse’s name and not yours. The address Trinity has on file is your old address. The representative states that the bill needs to be sent to your insurance to be processed, that she has written a note on the account to that effect, and that you should wait for the new bill that will come once insurance has processed the bill.
A month or two later, your spouse receives a notice from a collections agency that this bill has been sent to collections. Enraged, your spouse calls Trinity and berates them for not doing their job and sending the bill to collections when our understanding was that the bill was going to be processed by insurance, and the bill should be in your name, anyway, since insurance is through you. Trinity agrees to rescind the bill from your spouse’s collections. You call your insurance, which calls Trinity and does a 3-way call with you so that Trinity gets all of the information needed to process the claim with insurance.
A month or two later, you receive a notice from a collections agency that this bill has been sent to collections. The next day, you receive a bill, forwarded from your old address with the notice that the bill is overdue. The bill is exactly the same; i.e., there is no indication that this visit was sent to insurance. You call Trinity, upset that the business is not performing the duties promised to you verbally over a call. The representative you speak with claims there is nothing she can do to take it out of collections, that there is nothing documented on the account to show any previous calls over the bill. You get very angry, and the representative hangs up on you.
You call IHA to let them know you are having difficulty and that the customer service representative, whose entire job is to handle people who are probably not in the best mood, hung up on you. IHA says there is nothing they can do.
You call Trinity again, speak with a different representative, ask if you need to get your insurance to call them again to get resolved, and the representative assists.
Fall of 2020, you receive an updated bill that shows the majority of the visit has been paid by insurance, and there is a small amount remaining you need to pay. You promptly pay your bill.
Oh, also – all of this happened to me. In fact, what is stated above is a small portion of what I went through to try to pay for my children’s health and wellness visits.

So what do y’all think? Am I just exaggerating? Or does IHA seem to have made some weird Faustian deal, and been forced to use Trinity for billing as a result? Keep in mind that a casual perusal of Facebook will easily show a slew of other Ann Arborites who have suffered similar fates. It’s like IHA billing is a migraine in a bottle, and the bored “customer service” representatives at Trinity Health “professional” billing services are constantly rubbing your bottle, without your consent and against your predisposition. I can safely say that, if I have any say in the matter whatsoever, I will never use IHA personally again. I could be hit by a car right in front of St. Joe’s hospital, with a terrifying numbness where the feeling in my legs used to be, but if I have an ounce of strength left in my arms, will drag myself as far away from the inhospitable billing situation that will result as I am able.