Father finds $9,000 worth of errors in hospital bill

DENVER - It wasn’t that Will Schafer didn’t feel grateful for the care his son received during a short stay in The Children’s Hospital. Yet looking at the bill, Schafer recalls, he felt sick.

Then he says he felt angry.

"I get a bill and it’s $21,000," said the 46-year-old sales manager for Transwest Trucks in Commerce City, whose medical insurance required he pay 20 percent, or $4,000. "There was no surgery. There were no broken bones. … So I’m going, ‘How can this be?’"

It took weeks for the Schafers to sort through the bills from their son, Michael’s, hospital stay, but in the end, they found $9,000 worth of accounting errors. Their bill was adjusted, but it’s a cautionary tale that health care consumer advocates say others should heed.

"It shouldn’t be a full-time job to really have to review pages and pages and pages of medical bills," said Denise de Percin, executive director for the Colorado Consumer Health Initiative in Denver. "Hospitals need to have clearer, more concise billing, so that the people who look at it can say, ‘Yeah that makes sense,’ or, ‘No, I think there’s some charges here that don’t make sense.’"

Officials from Children’s Hospital declined to talk to 9NEWS for this story, but did issue the following statement:

"Hospital patient charges reflect indirect costs associated with overall hospital operations including, but not limited to pharmacy, nursing and technology. In the rare instance of documented patient billing error, The Children’s Hospital works to rectify that error in as timely a manner as possible."

For his part, Schafer says the experience left him frustrated with the healthcare system.

"There’s got to be some accountability" on both the part of hospitals and insurance providers, he said. "What is allowable, and what’s reasonable to charge?"

It all started, Schafer said, toward the end of last June, when then 10-year-old Michael came down with a fever that wouldn’t break.

"We took him to his primary care physician and he said, ‘Well, you need to take him to Children’s,’" Schafer recalled.

He and his wife, Lori, complied.

"So they did the blood work and the spinal tap and then it’s a 48-hour waiting period to see if anything shows up. … So he was on IV antibiotics and observation for two and a half days," said Schafer.

By July 2, Michael was found to be better, so the Schafers brought him home.

At the end of August, the Schafers received their first bill. It was $21,000. Under their medical insurance, Great West Healthcare, they have a co-pay of 20 percent. In this case, their co-pay amounted to $3,988.80.

The first bill was not itemized, Schafer said, and lumped most of the costs into a category called "Hospital extras."

After asking for a detailed statement, he says he noticed that $10,500 worth of the bill was for pharmacy charges. There were eight items distributed from the pharmacy, he noticed.

"Now, that’s some pretty expensive medicine," Schafer said.

After contacting representatives at The Children’s Hospital, Schafer says he was told that an "accounting error" caused a $9,000 overcharge for three injections.

The new pharmacy bill became $1,600.

Yet even the small items, he says, were overpriced.

"They charged $5.69 for one ibuprofen," he said, "and you can buy a bottle of almost 100 for that."

At Children’s, one capsule of the antibiotic Clindamycin was more than $23.59, Schafer noted, while a prescription he filled for the same drug that same day at King Soopers cost less than $2 per pill.

"You wonder why healthcare is so outrageous," said Schafer, who wonders if Children’s would have caught the accounting error on its own.

He is also frustrated that his insurance company paid their part of the bill without question.

"Everybody’s entitled to a markup, to cover their costs and provide the best care they can – but in this case, 10 times?" he said. "They are responsible for what they charge."

The consumer health advocate, de Percin, says not all consumers have the capacity, time or patience to sort through a complicated healthcare bill like Schafer did, but it’s what she recommends.

"We need to be able to understand healthcare the way we understand other things that we purchase and buy and use," she said. "The most important thing is for consumers to be really good consumers – to be informed, to be vigilant, to be careful."

"Look over every bill," de Percin said, "to make sure it’s in line with the services they received."

Click here to contact the Colorado Consumer Health Initiative or call 303-839-1261.

For Families USA, a national, non-profit consumer healthcare advocacy organization, call 202-628-3030, or send an e-mail to info@familiesusa.org. Click here to visit their Web site.

For the National Coalition of Mental Health Consumer/Survivor Organizations, call 978-590-2014, or send an e-mail to info@ncmhcso.org. Click here to visit their Web site.

(Copyright KUSA*TV. All rights reserved.) [Link] [Link to 9News video]

Leave a Reply

You must be logged in to post a comment.