HENRICO COUNTY, Va. — Priscilla Owens did not spend as much time gardening this year as she would have liked. Instead, she spent more hours than she could count making phone calls to her health insurance company and chasing down medical records from an urgent care clinic.
“I feel like saying, ‘okay this is my hourly salary rate. I’d like to send you both a bill for the stuff I’ve taken care of for you,” Owens said. “I don’t think they’d like the bill.”
In January, Priscilla and her husband came down with a nasty virus and went to Patient First on Woodman Road to get checked out. Patricia paid her copay, just as she’s done during the multiple visits she’s made to the clinic in the past.
Two months later, Priscilla received a bill for over $1,200, more than she would have owed if she had no health insurance at all. Patient First sets a cap on how much a self-pay visit will cost that is well below the bill Patricia received.
“I was stunned because my understanding was they [Patient First] accepted United Healthcare and once I paid my copay, I was done with it. Apparently not,” Owens told the CBS 6 Problem Solvers.
After sorting through Priscilla’s pages of notes, made during phone calls and follow-up visits to the clinic, we went to work, asking both the healthcare provider and insurance company to explain the charges and why it was taking so long to settle the account.
Within 24 hours of our inquiry, Patient First reached out to Priscilla to say her account had been reviewed and settled.
A Patient First spokesperson sent the following is a statement to CBS 6:
“This is an unfortunate and frustrating situation, and we are sorry that Ms. Owens experienced it. An unusual set of circumstances created a complicated billing process, requiring multiple back-and-forth communications with the insurance company. Moreover, it is extremely rare for a bill to be as high as the one initially received by Ms. Owens.
As indicated in the message sent to Ms. Owens, after working with the insurance company and reviewing her records, Ms. Owen’s claim has been paid in full and her balance brought to zero dollars.”
United Healthcare told the CBS 6 Problem Solvers that while they did initially request additional records regarding her visit, from their end, Owens account was cleared in June, despite the bills she received from Patient First well into August. United Healthcare released the following statement.
“We’re sorry for the difficulty Ms. Owens experienced and are glad that Patient First has resolved its outstanding issue regarding her claims. Ms. Owens will owe nothing more than she has already paid under her plan.”
It took months of frustration, but Owens is pleased to finally have the bill settled.
“My biggest issue is, if this is supposed to be between you and the insurance company, why do you keep billing me? I think the answer is because there are people who won’t understand their rights and will just pay it,” said Owens.
Just last week, a state regulatory board held a public hearing about a proposal requiring healthcare providers to inform patients if they might be treated by an out-of-network doctor.
At the hearing, groups representing hospitals and doctors didn’t agree with other groups representing insurance companies about how to best regulate surprise medical billing. Yet both sides acknowledge that it is often the patient caught in the middle of provider and insurer disputes.
If you have received a surprise medical bill, we want to hear from you. Let us know about your situation here and we will be in touch if we think we can help.