Surprise medical bills can take years to resolve

Mediation, advocates can help clear up confusion, mistakes

By Marilyn Moritz - Reporter

SAN ANTONIO - When Kate Linden was rushed into an emergency C-section, her husband, Bill, was thinking about one thing.

“It’s a life or death situation,” he said. “Baby has to come out now. Period. End of story.”

He was not thinking about the anesthesiologist that was brought in or whether insurance would cover it.

“I was not really thinking about paperwork at that point in time,” he said.

But paperwork was about all he could think about when the bills began to arrive. They showed he owed roughly $2,500. Many phone calls later, Linden found out the anesthesiologist was being considered out-of-network, even though the hospital was in-network. It took 14 months to determine the Lindens did not owe the money.

Their situation is not uncommon.

“There’s a very good chance that your billing problem will drag on for weeks, months or even years and it may never be resolved correctly,” said Penelope Wang, Consumer Reports' money editor.

A Consumer Reports survey found two out of three people who had a major medical expense within the past two years had an issue with their bill. More than one-third said they had paid bills they weren’t even sure they owed.

“They felt it was too much trouble or too much effort to fight,” Wang said.

So what can you do to ease the pain?

Linden ultimately worked with a nonprofit patient advocacy group, which laid out the steps he should take.

Another option is to hire a medical billing advocate for a fee.

Texas law allows many consumers, depending on their insurance provider, to seek mediation for balanced bills that exceed $500. The program is run by the Texas Department of Insurance. http://www.tdi.texas.gov/consumer/cpmmediation.html

If you do actually owe the bill, you can also try to negotiate with the provider yourself.  They may offer a payment plan or discount if you agree to pay in cash immediately.

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