Dear ABC News Fixer: New Mom Fights $27K Filing Error
May 9, 2013 — -- Dear ABC News Fixer: Surprisingly, I am more frustrated with my doctors than my insurance company. Last year, I had an emergency C-section due to my health being in danger.
I do not have maternity benefits, so I had made arrangements to pay out-of-pocket. However, I do have pregnancy-with-complications insurance, which my situation fell under, according to my insurance provider.
As long as the medical providers filed the claims properly, I should have been covered after I met my deductible.
I am pulling my hair out trying to get these medical providers to file the claim properly. I have called the insurance company and gotten exactly what they need, and I have called the providers myself to tell them what to do.
For some reason, they keep filing it under the wrong codes, which brings my bills to about $30,000 instead of $7,000 (my deductible). I am at a loss as to how to handle this. Please help!
- Terri Toozoff, San Antonio, Texas
Dear Terri: First, congratulations on your new baby girl, Averie!
We're quite certain you'd rather be spending time with her than dealing with the insanely large medical bills that your insurance company said they'd be happy to pay.
You told the ABC News Fixer you experienced preeclampsia, a condition including elevated blood pressure that can lead to serious problems. This necessitated the emergency C-section, which somehow led to this billing snafu.
You were having a hard time getting it fixed, but we had a little better luck. We went to Baptist Health System, which runs five acute-care hospitals in San Antonio and South Texas, including the one you went to. They got on this immediately.
They connected you with the regional accounting chief, who was able to straighten this out. Now your account is back where it is supposed to be – and you are not on the hook for the extra $27,955.19.
Your problem brings up a larger issue for consumers: incorrect medical debt.
A recent Federal Trade Commission study found that one in four consumers had an error on their credit report. When the error concerns medical debt, it can be especially irritating. Given all the intricacies involved with medical billing and claims processing, many consumers don't even realize there's a problem until after the debt has gone into collections. Even if they paid off the debt or otherwise settle it, the negative information can stay on their report for seven years.
You were lucky because your bills never went into collections. Imagine a consumer trying to purchase a car or a house and finding out that an old, incorrect bill was deep-sixing their loan.
Some consumers decide to pay the bills first and fight over it later, to prevent any future problems with their credit. The hopeful news for them is there's proposed legislation in Congress – the Medical Debt Responsibility Act – that would require credit reporting bureaus to remove fully paid or settled medical debt from credit reports within 45 days. Stay tuned.
- The ABC News Fixer
Got a consumer problem? The ABC News Fixer may be able to help. Click here to submit your problem online. Letters are edited for length and clarity.
