An $80,000 surprise bill points to a loophole in a new law to protect patients

[Nelson Vergel]

I think we should all read this, specially now with the new law.

An $80,000 surprise bill points to a loophole in a new law to protect patients

An insurer refused to pay bills related to the premature birth of the Bull family's twins because it said their delivery wasn't an emergency and their stays in the NICU weren't medically necessary.

www.npr.org

 

[Vince]

I also had a $19,000 medical bill that my insurance refused to pay. I appealed it with the help of a health advocate. It took me 16 months but I finally won. What a pain in the butt. It was worth it because I knew I was right.

 

[Nelson Vergel]

What a pain in the butt. It was worth it because I knew I was right.

Good for you. What most hospitals do is to send you to collection and try to ruin your credit.

What advocate did you use?

 

[Vince]

Good for you. What most hospitals do is to send you to collection and try to ruin your credit.

What advocate did you use?

I had to call the hospital every month, when I would get the bill and tell them that I'm appealing the insurance. And not to put me in collections.

It was a health advocate through work. SPX health advocate.

 

[WestB87]

My wife and I just went through something similar with our insurance after her bilateral salpingectomy in the same year as the birth of our fourth son. Got hit with a surprise bill for over $2500 after having already met our $3000 deductible. Took us arguing with insurance several times over and using the very paperwork defining our policy FROM THEIR OWN WEBSITE stating that sterilizations are a one time covered procedure with zero copay or deductible, yet they argued that “wasn’t what our policy covered”. Hospital never seemed to put the note in our file stating we were debating the charge with insurance. They had “borderline” sent it to collections offering a third party medical financing organization to pay for the bill before making a final send to collections. Has been an absolute debacle. I feel for anyone who ever has to play this stupid game.