Troubleshooters: Resolving Medical Billing Issues
PLYMOUTH MEETING, Pa. (WPVI) -- Mounting medical bills can sink anyone into a deep well of debt. In fact, some studies show medical bills are the single biggest cause of consumer debt across the country. Sometimes those bills come as a surprise and sometimes they're incorrect.
The Action News Troubleshooters have helped a number of consumers with surprise bills and we'll continue to help. But we were surprised and happy to learn there are other ways you and your family can get free healthcare help, too.
"I've played softball my whole life so I ended up tearing my labrum and a partially torn rotator cuff," said Lizzy Odren.
Odren got preauthorization from her insurance company for an MRI.
"I had cataract surgery on both eyes," said Peggy Kampf.
Afterward, Kampf was entitled to free eyeglasses, a $258 savings.
Peggy Kampf and her husband filed for reimbursement from their insurance company but got denied. Even after they appealed, they still never received a check.
"We waited, we waited. We called. It's tough we're old people. It's hard on us,' said Kampf's husband, William.
Odren says 9 months after her MRI, she received surprise medical bills totaling more than $3,000.
"My heart just dropped. I was like I don't know how we're going to pay for this and I don't know what we're going to do," said Odren. "Just having that in the back of your mind is terrifying."
"One-third of consumers report receiving a surprise medical bill in the last two years," said Chuck Bell of Consumer Reports.
Bell said it's a significant and growing problem often pushing consumers into financial ruin.
"So what typically happens is the bill will get sent to a collection agency. It could damage your credit or force you into bankruptcy," he explained.
After months of fighting with the hospital and their insurance companies, both Odren and the Kampfs contacted the Action News Troubleshooters through Call for Action.
"It was unbelievable. It was such a weight off my shoulders," Odren said.
William Kamps choked back tears as he told us, "A check was sent overnight and the money was in our hands and that's the truth. Thank you, thank you ever so much."
Call for Action and the Action News Troubleshooters are always happy to help our viewers but there are other resources for healthcare help. The Patient Advocate Foundation is one of them and it's free. It mediates and negotiates on behalf of patients with debilitating, chronic, or life threatening disease.
Suzanne Slattery of Radnor said, "I had a double knee replacement about a year and a half ago."
Slattery said when she got an unexpected $900 hospital bill six months later, she turned to a paid professional at a company called HealthAdvocate.
"She had actually figured out that I didn't owe the hospital any money and they actually owed me money," she said.
"We've had situations in which we've literally helped people with bills over $100,000," said Dr. Abbie Leibowitz, Co-President of HealthAdvocate.
"And to have a service like HealthAdvocate really is incredible," said Slattery.
HealthAdvocate is a local company based in Plymouth Meeting and it does a lot more than help with billing problems. You can click this link to check if you're already subscribed to the service through your employer or your insurance company.
If a medical billing advocate isn't part of your work benefits, HealthAdvocate has a sister program, HealthProponent, for individual consumers to become members of directly. For more information on HealthAdvocate and HealthProponent, click here.
Additional Resources:
Patient Advocate Foundation: Free help for patients with chronic, debilitating, or terminal illnesses.
More info on surprise bills:
http://consumersunion.org/topic/health-care/surprise-medical-bills/
http://consumersunion.org/wp-content/uploads/2015/11/SurprisebillsAdvocatesGuide.pdf
How to haggle with your doctor
That CT Scan costs how much? How to avoid surprise medical bills
Consumers Union Insurance Complaint Tool
Websites where you can look up billing codes and prices:
http://fairhealthconsumer.org/
https://healthcarebluebook.com/
You should try to contact your insurance company, hospital, or doctor's office for help with a bill first. Many state insurance departments can also help. Here are links:
http://www.insurance.pa.gov/Consumers/File%20a%20Complaint/Pages/default.aspx#.VrkXffkrK71
http://www.state.nj.us/dobi/consumer.htm
http://www.delawareinsurance.gov/services/filecomplaint.shtml
To find other advocates in your area, you can try these links:
Claims.org
AdvoConnection directory
Medical Billing Advocates of America
When it might be time to hire a medical billing advocate
