By Consumers For Quality Care, on March 25, 2019
When David Sprecher’s wife, Tyna, was having issues breathing following pneumonia treatment, he brought her to a local emergency room. He believed did everything right, choosing an in-network hospital, Deaconness, according to The Spokesman-Review.
Sprecher says that at every turn of Tyna’s care they asked the physicians and nurses if insurance would cover the expenses. The providers were not always able to confirm that it would. Tyna needed care so they continued on despite not knowing for certain.
When the first bills arrived, the Sprechers were hopeful. Through negotiations and their insurance, they were only responsible for around $1,000 of a hospital bill that had originally totaled $50,000. They spoke with the hospital to resolve some other bills for laboratory work.
The physicians’ bills came next. That was a different story.
“They submitted to our insurance, and our insurance said no,” Sprecher said. “The hospital’s in our network, but these doctors are not, so, denied.”
The Sprechers found themselves in debt with thousands of dollars in medical bills. Sprecher told The Spokesman-Review that he compared the charges on Healthcare Bluebook, an online price comparison tool. He says that when he totaled the care using the tool, the cost amounted to around $750. The couple was charged nearly $4,600 by the out-of-network providers.
According to a 2017 study published in Health Affairs, twenty percent of consumers who visit the emergency room receive a surprise bill.
“I would have been willing to pay [$750], but the billing company insisted on the total $4,590,” Sprecher said in an email. “They also started threatening me with collection letters while we were trying to work it out. Every time I called they just tried to get me to make a payment with a credit card.”
Sprecher tried to negotiate the rates but was unable to. He said that before the incident, he believed he and his wife would be covered and that they “had one of the better insurance plans” on the ACA exchange. The experience has fundamentally changed the couple’s view of health insurance.
“I felt like they wanted to get out of it, in any way they possibly could. They really didn’t care about me or my wife, they just didn’t want to have to pay the bill themselves.”
Washington, like other states around the country, is working to pass legislation to end the practice of surprise billing for consumers.