Hospital Tells Family To Not Worry About $31,000 Medical Bill; Sends Bill Anyway

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With so many people being slammed with surprise medical bills following a medical emergency, it must be nice when your hospital and insurance company both tell you that your huge bill will be taken care of. Then all that goodwill goes out the window when you still end up with thousands of dollars in medical expenses.

CBS Sacramento’s Kurtis Ming reports on one California family that was left holding a $31,198 hospital bill after their daughter broke her leg in a car crash.

The hospital that treated the 17-year-old was not in-network with the family’s insurance, but the mom tells Ming that the insurer and the hospital both assured them that they would work together to make sure the teen’s care was covered.

And still they were balance-billed for the full difference between what the insurer paid and the hospital charged.

“We have medical coverage, I pay for medical coverage for a reason so that my family’s taken care of,” the woman says.

Our colleagues at Consumers Union tell CBS Sacramento that when an insurer and a hospital can’t agree on bills, it shouldn’t fall to the customer, especially when there is an emergency.

“These bills can be huge and have a devastating impact on a family,” Betsy Imholz, director of special projects for CU, said, noting that in the case of an emergency.

Under the Affordable Care Act, your insurance company can’t make you pay out-of-network rates for medical emergencies, nor can it require that you get prior approval. However, you still might end up getting balance-billed by the hospital (even an in-network one) for services provided by out-of-network physicians or specialists. This is why emergency rooms continue to be a source of expensive surprise medical bills.

In this case, Ming’s team contacted the hospital, which said it has a policy not to bill patients for charges when their out-of-network plans don’t cover the costs.

It’s unclear why the policy wasn’t followed from the beginning in the family’s situation, but the hospital says it has withdrawn the bill and apologized to the family.

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