A 53 year old woman is involved in a motor vehicle accident. No fault of her own. She is taken via ambulance to Munroe Regional Medical Center in Ocala, Florida. While there she fills out her patient information and lists her health insurance information including all billing information needed to process the health insurance which is Aetna PPO. She is told they will bill her insurance. Without telling the patient the hospital then refuses to bill her health insurance and bills her directly. Why? The hospital bill collector stated, without apparent shame, that the hospital can attach a lien against her property and can make her pay personally and pay more money than they could charge her under her health insurance. At least they are not bashful about using the power they have. They brazenly state that they can charge her personally and charge her more and so they do. To make matters worse they charge these higher rates even though they did not even diagnose the fracture in her lumbar vertebrae that was found later at another hospital. She did not sue the hospital, she even agrees to pay a fair bill to escape from the lien on her property but the hospital is demanding payment for charges far in excess of the reasonable and customary rate her insurance would pay if they had billed her insurance.
The charges the hospital is demanding from the patient are in excess of the reasonable and customary rates that her health insurance would pay. For example, later she had to go to another hospital in the area, Ocala Regional Medical Center. That hospital did bill health insurance. It listed a charge of $2,396.00 for a CT scan but made a contractual allowance and decreased the bill pursuant to the contract with the health insurance. The health insurance paid to the Osceola Regional Medical Center $420.00 for the CT scan charge of $2396.00. Therefore, the original CT scan charge was over 5 times the reduced charge to the health insurance.
Munroe Regional Medical Center is charging $2517.51 for CAT scan charges. If the reduced rate is similar at both hospitals then the insurance rate would be closer to $500.00, certainly less than $2517.51. The patient has agreed to pay all charges at the health insurance rate including all copay and deductible charges. The hospital refuses to take that and refuses to bill the health insurance.
After treatment the hospital refused to bill the health insurance and filed a lien. The lien letter sent to the patient states that: “[a]ny balance on the patient’s account after insurances have been exhausted become the responsibility of the patient, and his/her guarantor. The lien lists the name and address of the Executive officer of the Hospital as “Steve Purves, 1500 SW 1st Avenue, Ocala Florida 34471-6504”. Despite this statement the hospital still demands full payment of the bill without discount for the reasonable and customary rates her insurance would pay.
As a result of the crash and related injuries she loses her job and her health insurance. She cannot find another job due to her disability. Her insurance has run out. She is not a welfare queen, she was a hard working manager at a Pizza Hut. She will pay a fair charge for the hospital bill but why should she be forced to pay the hospital bill personally when she had insurance? Further, why should they lien her property for a bill more than the hospital would take under her health insurance? Is it just because they can?
Ask yourself, if you or your children were hurt, you had health insurance and gave it to the hospital on admission, would you want a hospital to reject it and attach a lien to your property and make you personally pay it and pay it for much more than the insurance would pay, just because they can? Please help us do something, together we can take action to stop these practices. Call the Hospital, call the Press, let them know that this is unfair and that the golden rule applies to all of us, including self proclaimed “not for profit” health care machines. There is a debate about national health insurance, in this case she had private insurance. Both sides of the debate must agree that greedy behavior is wrecking our health care system and that it must stop.