Consumer Assistance Program Saves Coloradans Over $10 Million in Unjust Healthcare Charges in First 6 Years
“I cannot imagine what my life would be like without the help and support of CCHI’s program”
DENVER – Today the Colorado Consumer Health Initiative (CCHI) announced that its Consumer Assistance Program has saved 3,881 Coloradans over $10 million with their medical and prescription drug bills since 2018. The Consumer Assistance Program (CAP) advocates on behalf of consumers to reduce overbilling or fix coverage, at no expense to patients.
Individual consumers can turn to CAP for assistance on billing issues with insurers and healthcare providers such as hospitals and clinics. CAP staff and volunteers help patients navigate hospital financial assistance programs, overbilling, surprise medical bills, health care denials, and claims issues, and also negotiate payment plans with doctors, clinics, hospitals, and collections agencies. They also help with referrals to health coverage enrollment assistance and other basic needs programs like food and energy assistance. CAP was created in June 2018 after hearing a desperate need for help from consumers for medical billing navigation.
“CAP isn’t just about assistance, it’s about empowerment,” said Stephanie Arenales, Director of CCHI’s Consumer Assistance Program. “We work with consumers to push back against an overly complicated healthcare system that charges too much, denies coverage too often, and that is really hard to navigate. After working with us, we hope that consumers have gained the tools and confidence to be their own advocate the next time they face a high medical bill.”
“The success of this program is remarkable,” said Mannat Singh, Executive Director of the Colorado Consumer Health Initiative which oversees CAP. “But it also underscores the financial toxicity of the healthcare industry, when so many Colorado families are consistently being taken advantage of by a deliberately complex and opaque system that is riddled with overcharges, billing and coding mistakes, compliance issues around coverage, and soaring costs. $10 million in medical bill savings is huge, but makes us wonder about patients who were not able to reach us, who may have simply paid the bill to avoid being sent to collections. Patients already have to advocate for themselves so much, they shouldn’t be responsible for making sure a hospital is billing correctly, or have to seek out more information on discounts. The onus should not be on them to check and correct unjust medical bills.”
In the past few weeks, CAP has seen a surge in inquiries for medical billing navigation support. With an increased caseload and limited staff capacity, they would like to grow their services to meet the need.
The average number of new cases per month in 2024 is 81, which is 24% greater than in 2023. CAP has served more people thus far in 2024 than in all of 2023 and is on track to reach 1,000 Coloradans served this year. CAP is the only program operating statewide that provides these kinds of services at no cost to patients.
Glenn Hayes, a Palmer Lake (El Paso County) resident, lost his marketplace coverage at the end of 2022, unbeknownst to him. He had a medical emergency in which, because of his lack of coverage, was billed an incredible $550,000. After over four months of trying to resolve the bill himself, Glenn reached out to CAP for help. A CAP volunteer helped Glenn appeal his Medicaid determination and backdated it to the time of the emergency, the entire bill was resolved and the portion of the bill he had already paid was returned.
“I have been able to continue to see my doctor as I recover from the emergency I had earlier this year and I was refunded the money I had already paid towards the bill,” said Glenn. “I cannot imagine what my life would be like without the help and support of the Consumer Assistance Program. God bless ‘em.”
Bibian Reyes, an Aurora resident, recently reached out to the Consumer Assistance Program because a family member received 3 separate medical bills that totaled over $11,000. She had applied for discounted care but had not heard whether the bill was resolved, and if they owed any remaining balance. Melissa, the CAP Manager, walked through the application process for hospital discounted care and helped contact the billing department to ensure that the bills were covered and that they owed nothing.
“Melissa made sure we heard back from the billing department and that my family member’s bills were resolved. When we got the final approval, she helped us understand the difference between the financial assistance options we received,” said Bibian. “She made the whole process less stressful and complicated for my family when we were worried about having to pay $11,000 in medical bills.”
CAP also informs CCHI’s policy and regulatory advocacy by identifying emerging concerns that consumers face on a daily basis and the need for changes in the law and implementation, monitoring, and enforcement.
This year, CAP has been able to handle an increased caseload due to an increase in staffing, with 4 full-time employees, 2 part-time, and a volunteer. CAP is looking to grow its free, public services to help more Coloradans with their medical billing issues, but it is also mindful of its caseload capacity. Consider supporting our CO GIVES CAMPAIGN today here.