Hospitalization Results In $2K Surprise Bill For TX Man

By Consumers For Quality Care, on September 25, 2019

Last December, Darrel Riley went to the emergency room at Texas’ North Central Baptist Hospital when he was having trouble breathing, News 4 San Antonio reports.

After a few days at North Central Baptist, Riley was well enough to go home. In all, the bill for his hospitalization came out to $122,000. The contract between the hospital and Riley’s insurer, Oscar, reduced the charge to $11,500. Because Riley had already met his deductible for the year, he did not owe anything out-of-pocket. He thought that was the end of the ordeal when he suddenly received a new medical bill.

“Five months after the incident, I get a bill from Sound Physicians saying that I owe $2,000. Where’s this coming from?” said Riley.

It turned out that the bill was for two physicians who were out-of-network, despite the fact that Riley was treated by them at an in-network facility.

A new Texas law, which goes into effect January 1^st, outlaws this kind of surprise bill. Unfortunately for consumers, the ban only applies to the care received after that date. Until then, consumers are still vulnerable.

Luckily for Riley, after News 4 San Antonio got involved in his case, Oscar agreed to cover the entire bill he had received.