The phone rang. A reporter wanted to interview the Coalition about a problem that’s been vexing medical patients with growing frequency: surprise jack-in-the-box bills for urine drug testing that patients assume their health policy covers.
The investigative story by the respected Kaiser Health News posted a couple of weeks later. A fine reporting job that featured Elizabeth Moreno. The Texas woman was handed a whopping $17,850 lab bill for a routine urine drug test her health insurer refused to pay because the lab was out of her health plan’s network.
In the story, experts described the lab’s bill as “real fishy,” “outrageous” and a “misplaced decimal point.”
The story took off. CNN posted it. So did the Washington Post, NPR and Money Magazine. Soon an avalanche of news outlets re-posted it — more than 420 at last count.
Longtime reporter Fred Schulte had struck a journalistic and human nerve.
Stunned patients with growing frequency are stuck with ruinously large bills when they’re shuttled to medical providers outside their own health- insurance networks.
Their health policy thus won’t pay up, so the patients have to drain their bank accounts or face collections, suits and wrecked credit ratings.
Surprise out-of-network bills are bedeviling patients around the U.S. Moreno’s lab bill is just one signpost of a larger billing problem that can invade almost any medical procedure.
The bills often straddle a fine line from large to abusively large to criminally inflated.
News outlets everywhere wanted to report on a spreading abuse that could land hard on any of their readers’ doorsteps — and bank accounts. Fred Schulte gave them another chance to alert readers.
The Kaiser story isn’t the first, and likely many more news outlets will pull the lid off unexpected and onerous medical charges until reforms lay this problem to rest.
A bill in Congress would prevent surprise bills for patients treated in a hospital.
As for consumer action:
• Check with your insurer, doctor and hospital before getting treatment if possible. Ask for projected range of costs for planned medical procedures;
• Ask what provider and work your health plan will cover, and what’s out of network. Anesthesiologists, radiologists and pathologists are common examples of out-of-network providers who may be called into your case without your knowing.; and
• Afterward, get an itemized bill. Read it carefully, and check for procedures you didn’t receive. Your insurer also may help if you see surprise bills, so contact your insurer before writing any checks. Also see if the hospital has a patient advocate who can help.
There’s no bullet-proof answer, especially if you need fast emergency treatment. Still, any preventive steps might save thousands.
And as for Elizabeth Moreno, her father settled the lab’s bill for $5,000, which he now regrets.
Jim Quiggle is director of communications for the Coalition Against Insurance Fraud.