In 2017, a 44-year-old high school teacher from Austin, Texas was at home in his bedroom when he started to feel intense pain in his chest. He was having a heart attack.
Drew Carver was rushed to St. Davis Medical Center, where he had two stents placed. The insurance he had through his union paid the hospital around $56,000. But the hospital, which was not in-network with Carver's insurance, wasn’t satisfied with that amount and sent the teacher a bill for $108,000.
This story published by Kaiser Health News reported that after much back and forth, with consumer advocates intervening and the story circulating on the news and social media, the hospital decided to reduce the bill to... $332!
How can a bill be reduced by over $107,000? What was being charged in the first place? Clearly, price markups are part of the problem...
The influx of “surprise bills” is affecting millions of people in the United States each day. One third of adults receive this type of bill. Because we don’t read the fine print, don’t have time, or don’t know to ask questions, Latinos in particular are one of the groups most affected by bills that can quite literally ruin your family’s finances.
What’s more, we tend to pay without asking questions so as “not to cause any problems.” Of course, Carver’s bill was unpayable. It forced the poor man to use energy he didn’t have (remember, he’d just had heart surgery) to fight the system.
Stress can kill heart patients... and anyone, for that matter! But as they say, what doesn’t kill you makes you stronger.
Here’s what you can do if one of these bills falls in your lap:
- First things first: Do NOT pay the bill. Don’t even agree to a payment plan with the hospital, because in doing so, you’re agreeing that this is, in fact, a reasonable price. While you’re disputing it, the bill should not be paid.
- Make your problem public: tell your friends and colleagues. There’s always someone who might have a solution on hand or who “knows someone” who can help you. And saying it out loud can help you see that you’re not alone.
- Go to your state’s Consumer Protection Agency to check if they can help you. Some states have laws that protect consumers from surprise bills. Click here to find your state’s agency.
- Talk to your insurer. With any of these companies, you can always appeal to reason by arguing that you didn’t have any options, you were dying, or in the middle of an emergency and couldn’t know that you were going to an out-of-network hospital. Tell them that you think that the insurer and hospital should reach an agreement on the payment and not charge you a bill that could ruin you financially.
- Review the bill and underline any charges that appear excessive. Remember that while many people can help you, you need to be the detective in your own case. Gather all the information on the procedures you had and compare prices.
- If you don’t have health insurance, visit your neighborhood community clinic. Even if you’ve never been treated there, they can help you navigate the bureaucracy surrounding these bills. You can also consult a pro bono attorney (one completing their community hours and who won’t charge you), if you require legal assistance.
This will involve extra work and time, and you will need to take deep breaths and be patient. But if your bill is substantially cut, maybe even down to zero, you will be ecstatic... and have much more money in your wallet.