Our hospital’s financial assistance policy was clear. I know because I was among the dozen or so attorneys who had reviewed it prior to its publication.
Given its significance, we even kicked it to our outside counsel for a round of reviews as well to ensure we were not missing anything.
And for eight months, our hospital operationalized the policy according to plan and our patients complied with its terms as we had anticipated.
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That is until a patient I will call Jane came along and questioned our application requirements.
Our policy clearly required a patient submit their previous year’s W-2 statement and a copy of their most recent pay stub for review by our financial assistance team. However, Jane was certain she need only submit one, not both.
When the question originally made it my way, I typed up a quick, but polite reply for our team to use more or less restating what I thought was an obvious policy declaration. The “and” in the policy required her to submit both and choosing one over the other was not an option.
Less than 24 hours later, our financial assistance team was back in my office with Jane’s latest reply demanding a meeting with someone in legal to discuss our “incorrect interpretation” of the policy.
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Questioning my “interpretation” of pretty much anything when I know I’m correct is a surefire way to get me stirred up, and this was no different. I let our team know to inform Jane that I was happy to meet and that I would bring along several other attorneys who uniformly agreed with my interpretation.
Given Jane’s persistence we were incorrect, in addition to inviting two of my more well-credentialed colleagues to attend with me (one a former AUSA and another with an Ivy League pedigree), I posed Jane’s question to at least 10 other attorneys to ensure I was somehow not missing something obvious. As I suspected, all were in uniform agreement. The clear and unambiguous “and” provision required Jane to provide both sets of documents.
As the day of our meeting arrived, I was ready for battle. I had prepped my colleagues with a motivational speech befitting of a locker room during the Final Four and we piled into a conference room to await Jane’s arrival.
When Jane arrived, she appeared much less hostile than I had envisioned and wore the look of a tired patient who clearly wanted to get past whatever medical condition had ailed her and move on with her life.
Recognizing I had misjudged my opponent, I shifted tactics and declined to walk her through my colleagues and my credentials while we explained why she was wrong, and instead invited her share with us why she felt we were misguided in our interpretation.
Her explanation was both simple and staggering. You see, although last year her and her husband enjoyed a great deal of financial security which would be reflected on their W-2, their recent car accident which left her husband unable to work had shattered the security they once held. As such, her most recent pay stubs were a more accurate representation of their financial situation. And since our hospital proudly held itself out as a non-profit institution which helped the community, surely our financial assistance policy was not as stringent as she had been led to believe.
To say her words hit me like a bolt of lightning would be an understatement. We were clearly legally correct in both or application and our interpretation, but her story prevailed.
When she had concluded her story, I thanked her, assured her she was correct and that her application would be processed with haste. After the meeting concluded, my colleagues did not question my new interpretation and were in agreement our new course of action was proper.
As in-house, I am always primed and ready for the next battle be it with opposing counsel or with a regulator, but for future inquiries by well-meaning patients, Jane may have just taught me the political victory is almost more important than the legal one.
Stephen R. Williams is in-house counsel with a multi-facility hospital network in the Midwest. His column focuses on a little talked about area of the in-house life, management. You can reach Stephen at [email protected].