Viral

by Robin Cook

  “It’s going to go up,” he warned. “There will be an additional charge for an ED visit yesterday.” Brian then gave her a quick history of Emma’s illness and her death the day before.

  “I’m so sorry to hear you have lost your wife,” Megan said with genuine empathy. Her shoulders visibly sagged.

  “It’s the worst part,” Brian said. “But the financial impact is a real issue I still have to deal with. Do you think you can help me?”

  “Absolutely, without a shred of doubt,” Megan said, regaining her fervor. “I’ve yet to have a client whose bill I haven’t significantly reduced. I can assure you that MMH Inwood pads their bills and makes billing errors with as much or more regularity than the other hospitals in the city, especially for the uninsured or poorly insured. By poorly insured I mean those people whose health insurance companies haven’t negotiated significant deductions in the hospital’s charge master price.”

  “I apologize, but what is the hospital’s ‘charge master’? Is it like a list of prices for their services? I’ve never seen that.”

  “Nor will you see it, even if you ask,” Megan said. “It’s not meant for the public to see. It’s a list of artificially high prices for goods and services that merely serves as a starting point for negotiating deductions for the more powerful, meaning large, health insurance companies. These prices have nothing to do with cost plus profit, which is how prices are usually determined in a real market and how Medicare tries to determine how much it will pay. And to make matters worse, hospitals keep raising their charge master prices, particularly when a hospital chain buys a failing community hospital. It’s all a big game as hospitals and health insurance both benefit the more money is thrown at healthcare. Unfortunately, it is people like you who suffer the most because of this stupid and enormously expensive game. You end up being charged the artificially high charge master price, which is much more than everyone else pays.”

  “Good grief. I knew none of this. I feel like a babe in the woods, for Christ’s sake.”

  “Don’t be hard on yourself. Most people have no idea of any of this unfortunate reality, and most people still labor under the delusion that all hospitals and health insurance companies exist to help them in their time of need.”

  “I’m afraid I fell into that group for sure.”

  “All right, enough of this grim reality,” Megan said, regaining her enthusiasm. “As soon as you sign this patient privacy authorization form, I will start the uphill climb of getting a complete, fully itemized bill, which is never easy because they will try hard to keep it from me. But don’t worry. I know all their tricks and all their delay tactics. Have you been dealing with anyone in particular in the hospital’s billing office?”

  “Yes,” Brian said. “A Roger Dalton.”

  “Good. He’s almost human.” She laughed at her own joke. “And I assume you are working with Patrick McCarthy as well since he called me?”

  “Yes, starting just today,” Brian confirmed.

  “Perfect!” Megan said. “We have a good working relationship. Do you have any questions for me?”

  “I don’t know enough to have any questions at the moment.” He knew he’d probably have a dozen as soon as he walked out of the office.

  “Let me give you a quick thumbnail sketch of what will most likely happen,” she added. “Although I can’t promise you anything, but by my past experience with MMH billing, I should be able to reduce your bill anywhere between twenty-five to ninety percent. I know that is an awfully large range, but that’s been my experience. As soon as I get your completely itemized bill, I’ll start to work. After this in-person meeting, we can work remotely for the most part. I assume you have a computer and internet.”

  “Yes, of course,” he said. “Actually, I have thought of a question. You seem to be busy. Are there a lot of Inwood people in need of your services?”

  “Too many. And the pandemic has made it worse with people losing their employment-based healthcare and either going it alone or resorting to short-term health policies like you did. It’s another developing part of the Covid-19 American tragedy.”

  “What about your fees? How will I be paying you?”

  “You can either pay by the hour or as a percentage of what I save you,” Megan said. “It will be your choice, and you can decide at some later point. After I get a look at your hospital bill, I’ll be able to give you a better idea of what my fees might be.”

  “Patrick offered to put off payment until after the pandemic eases up and my business picks up. Are you willing to offer that as well?”

  “I am,” Megan said. “I’m sorry to have to cut this short, but I need to get back to seeing my scheduled clients. But first, let’s have you sign this patient privacy authorization form to get the ball rolling.”

  “Of course.” He got to his feet and approached the corner of the desk where she had slid the papers that needed his signature.

  With the papers signed and in hand, he followed Megan out into the waiting room. While she called one of the elderly clients, Brian went to the receptionist as he’d been instructed and handed over the signed form. As he was doing it and listening to her saying she would be in touch if anything more would be needed on his part, he was trying to work up the courage to re-engage Jeanne Juliette-Shaw. Luckily, he didn’t have to improvise. To his relief, as soon as he was finished with the receptionist, Jeanne stood up and approached him. In her hand she was holding a business card.

  “Excuse me, Brian,” she began. “I am truly sorry about your wife, and I have been thinking more about your daughter. The experience I had as a school psychologist suggests it is not going to be easy for you or her. If I can be of help in some way, particularly if there are problems, I’d be happy to do so. I’m not working presently for a number of reasons, which I won’t bore you with, so I would be available if you were so inclined. Of course, it would be entirely pro bono.”

  Brian was immediately overwhelmed by Jeanne’s generosity and impressed with the force of her character. “That’s incredibly kind of you,” he stammered.

  “I wanted to give you my number if you are interested,” Jeanne said, extending the business card.

  He took the card and tried to read it but with difficulty. His eyes had teared up at Jeanne’s offer and her altruism threatened to dissolve the veil of denial he’d erected to keep his emotions in check. “I might very well call you,” he stammered.

  “I’m sorry if I’m upsetting you,” Jeanne said. “But I would like to help if you think I could.”

  “You are not upsetting me,” Brian struggled to say, even though he was lying. He focused on the business card to get himself under control. In bold letters it said: shaw alarms followed by a Washington Heights address. Her title was vice president. There was an office telephone number, but it was crossed out, and below that was a mobile number.

  “Whoa,” Brian said, taking a deep breath to pull himself together. “All this time I didn’t know I was speaking with a vice president!”

  “Vice president of a bankrupt alarm company,” Jeanne corrected with a laugh of dismissal. “Shaw Alarms was forced into bankruptcy after I tried to pay MMH Inwood what I owed, which was impossible, and then was sued by them.”

  “My God,” he remarked as rising anger saved him from his mournful emotions. Jeanne’s story was a stark reminder of how predatory MMH Inwood was and how perverse Peerless was to more people than just him. “MMH’s suit caused your company to go under?”

  “Yes, with a little help from the pandemic.”

  “Sounds like a perfect storm,” Brian said. “A storm I’m caught in as well. My wife and I started a personal security company just as the pandemic was starting in Wuhan, China. There’s been almost no work for us since it arrived here in the US.”

  “You’ll notice on the card that the office landline phone number is crossed out,”
Jeanne remarked. “But the mobile number is still operative. So please call if you decide you’d like to get ahold of me for some professional advice regarding your daughter. Or yourself, for that matter. Having recently lost my spouse, I can imagine what you are going through.”

  “Do you live in Inwood?”

  “I do. On Seaman Avenue. My unit overlooks Emerson Playground.”

  “That’s one of my daughter’s favorite spots,” Brian said, managing a smile.

  “I can understand why,” Jeanne responded. “Where do you live?”

  “West 217th Street.”

  “Nice! I’m familiar with the neighborhood. Do you by any chance live in one of those darling single-family homes?”

  “I do, and I’d like to keep it from MMH Inwood’s predatory hands,” he said, his mood going dark and anxious again.

  “Amen,” Jeanne responded, giving him a sympathetic look.

  CHAPTER 20

  September 1

  As Brian came in through the front door of his house, he had no idea what to expect. No one had texted him for the two-plus hours he’d been away. The first thing he noticed was the soundtrack from a PBS cartoon coming from the kitchen; it sounded like Curious George. Thankfully there was no arguing or crying. The second thing he heard was Aimée and Hannah talking in the living room. Aimée waved and beckoned him to come in.

  “Did you have any luck?” she questioned.

  “It depends on what you mean by luck,” he said. “I did retain a lawyer. His name is Patrick McCarthy, he was in Erin’s class in elementary school, and he seems competent enough although he looks younger than I expected.”

  “I’m sure he’ll be good,” Aimée reassured him. “It’s a fine family. And his father is a lawyer, too.”

  “I also retained a medical billing advocate. It’s Megan Doyle, the one you mentioned helped a neighbor. I have to say she seems very professional although she looks even younger than the lawyer. The important thing is that she’s confident she can lower Emma’s hospital bill significantly. It crossed my mind that she might even be a bit overconfident, but we’ll see.”

  “I’m pleased to hear you’ve taken my advice. She certainly aided Alana Jenkins. But we want to warn you about Juliette. She’s not doing so well.”

  “What’s wrong?” After taking the sound of the cartoon coming from the kitchen as a modicum of promising news, this was not what he wanted to hear.

  “She refuses to talk to either one of us.”

  Brian nodded while replaying in his mind Jeanne’s warning about regression.

  “And she won’t eat,” Aimée continued. “Camila has really risen to the task and bent over backward, even making her favorite breakfast of eggs, bacon, and toast strips with sugar. To give Camila a break, I sat with Juliette for a time, trying to get her to interact with me, but I had no luck. It’s such a change from yesterday afternoon when we took her to the Church of the Good Shepherd, and she was acting herself. Now all she wants to do is watch cartoons, and she cries if anyone tries to interfere.”

  “That’s not good,” he said. “All right, I’ll go in and see if I can turn things around.”

  “Before you do, how are you doing?” Aimée asked, catching Brian off guard.

  As if his mindset were poised on a knife blade, as soon as Aimée asked her question, he felt a wave of emotion wash over him. She saw it and responded by standing up, coming over to him, and giving him a long hug. Brian didn’t resist. When she finally let go, he wiped the corners of his eyes with the back of his hand. “Sorry,” he managed.

  “Nothing to be sorry about,” Aimée insisted. She pulled him toward the couch where she’d been sitting. “Before you see to Juliette, join us for a moment. Hannah has some news she needs to share with you.”

  Lacking the strength to resist, Brian sat and sighed, sounding like a balloon losing its air. Hannah spoke up immediately. “I’m happy to say I’ve made a lot of progress,” she began. She moved forward where she was sitting on the opposing couch. “I’ve been in touch with Riverside Funeral Home, and they have been most helpful. As soon as Emma is prepared, which I’ve been told will be in a few hours, they will bring her to our home for a proper wake, which will start this afternoon and continue overnight. Some family members and even neighbors have offered to help with food, drink, and other preparations like candles and flowers and arranging the house. How does all this sound to you?”

  Hannah paused in her monologue and looked at him for some kind of response. Brian didn’t know how he felt about all this traditional rigmarole but was unwilling to openly object even if he did. It was so apparent to him that Hannah was trying to come to terms with her daughter’s death by attending to all the details. Once again, he wished he and Emma had discussed death in some form or fashion so he’d have some idea of what she would have wanted. If he had to guess, he thought she’d want her mother to decide if that could somehow be a help. With that in mind, all he did was nod.

  “Okay,” Hannah said, as if relieved by Brian’s tacit agreement. “For tomorrow, I have arranged a funeral mass at the Church of the Good Shepherd, followed by interment at Woodlawn Cemetery. I hope you don’t mind, but we have gone ahead and covered the expenses.”

  “That’s very generous of you,” he managed to say. He wasn’t one who expected or generally accepted handouts, but this was an exceptional time, and he was grateful, considering the state of his finances.

  “We’re happy to help, knowing your security business is struggling,” Hannah said, offering him a sympathetic look. “The one thing I’d like to ask you to do is to alert some of Emma’s NYPD friends and colleagues about her passing even though attendance will be limited at both the wake and the funeral mass because of the pandemic.”

  “I can do that,” Brian said. It also occurred to him that at the same time it might be an opportunity to at least float the idea of his returning to the NYPD with the ESU commander, Deputy Chief Michael Comstock. With Emma gone, he truly had no idea how much enthusiasm he still had about Personal Protection LLC, especially with the ongoing pandemic.

  “Good!” Hannah voiced, slapping her knees with the palms of her hands before getting to her feet. “I’m sorry to have to leave you two to handle Juliette for the time being, but I have to get home to make sure everything goes smoothly. There’s so much to do.”

  “We understand,” Aimée said. “We’ll see to Juliette, and thank you for bearing the burden of the wake and the funeral.”

  “It’s the least I can do,” Hannah said with a wave of dismissal. She turned around, hurried into the foyer for her shoes, and disappeared out the front door.

  For a moment mother and son eyed each other.

  “She’s a whirlwind,” he offered at last.

  Aimée nodded. “She needs to be, and you are generous to allow it.”

  “I don’t have the energy to interfere. Besides, I don’t know what Emma would have wanted other than not wanting her mother to suffer.”

  “Je comprends,” Aimée said. “Besides, your worry at the moment really has to be Juliette. My mothering instinct tells me she is going to need a lot of your attention. I’m more than willing to help, but I’m afraid the major burden will fall on you.”

  “My fathering instinct is giving me the same message,” Brian agreed as he reached into his pants pocket and produced the card for the defunct business that Jeanne had given him. “To that end, I had an unexpected experience waiting to see Megan Doyle. Another of Ms. Doyle’s clients came in, and I heard her give her name: Jeanne Juliette-Shaw.” He handed the card to Aimée.

  “Really?” she questioned. She looked at the business card and raised her eyebrows. “That’s surprising. Juliette is not a common family name.”

  “That’s exactly why I had the nerve to strike up a conversation,” he said. “It turns out that she, like you, grew up in France and, also like y
ou, came to the United States for college, Fordham University to be exact, and met her husband-to-be.”

  “Une telle coïncidence,” Aimée said. She handed the business card back. “Mon Dieu! Did you ask where in France she’s from?”

  “I did. She’s from the Camargue.”

  “Fascinating, but I surely don’t know any Juliette families from the Camargue,” Aimée said. “I’ll have to ask my mother. It’s a unique part of France, rather sparsely populated. I’ve never visited myself. What I do remember about it is that they have a special breed of horse called the Camargue, which has a unique light gray, almost white coat.”

  Suddenly the sound of the cartoon emanating from the kitchen stopped, yet there was no further sound from Juliette. Brian tensed, and he and Aimée exchanged a questioning glance as they listened for a moment.

  “I wonder what that means?” he asked.

  “I wonder the same. At least there’s no complaint from Juliette, so it can’t be all that bad.”

  “I guess,” Brian said as he visibly relaxed. “Anyway, to get back to my story, I know it sounds odd under the circumstances for me to have had a conversation with a stranger while waiting to talk to a medical billing advocate, but our situations are surprisingly similar. Jeanne also recently lost a spouse and was sued by MMH Inwood. But most interesting of all is that we talked briefly about Juliette. She has a graduate degree in psychology, had been a school psychologist, and had experience with students who’d lost parents. She offered to give some advice, which is why she gave me the card with her mobile number. In fact, she even warned me that Juliette might regress and have psychosomatic symptoms.”

  “Sounds like she could really be useful,” Aimée said. “Considering how Juliette has behaved this morning, I think some professional advice might be wise. Perhaps you should call her. My sense is that Juliette is going to need help, and your presence and attention are going to be crucial but might not be enough.”