Lori Jane Gliha, Fox 31 Denver
LONE TREE, Colo. (KDVR) — Suzi Doerhoff made it 63 years without breaking a bone, but when she slipped on some stairs and heard a snapping sound a few months ago, she immediately knew her safe streak had come to an end.
“It literally sounded like a branch breaking,” she told the Problem Solvers.
Doerhoff, who didn’t realize her medical insurance at the time wasn’t valid, said she was referred to HealthONE’s Sky Ridge Medical Center emergency room for treatment.
“We were there all day, but most of it was just waiting,” she said, explaining that she received X-rays and a referral to see an orthopedic surgeon prior to leaving the facility.
Two women also helped her into a splint.
“They pulled down really hard to try to straighten out the bone, and they got it as straight as they felt that they could, and then they wrapped it with a piece of material that was like a U shape, and then they wrapped around that like an Ace bandage,” she said.
Then she got the bill.
“I literally felt ill,” Doerhoff said.
It was $18,350.50.
Doerhoff said she also received a separate bill from the radiologist.
“I thought, ‘How could this be? How could that event of the service that I actually received in the emergency room – how could that be $18,000?’” she said.
The former police detective said she reached out to the billing department on several occasions for an itemized bill, but “to date, I’ve never seen an itemization,” she said.
So, she turned to the Problem Solvers for help.
“It was very scary,” she said. “If your credit rating gets destroyed, life for you becomes very, very difficult, and that was my concern.”
Within days of the Problem Solvers asking for more clarity about Doerhoff’s bill, Doerhoff said the bill was dramatically reduced.
“I received a phone call from a gentleman,” Doerhoff said. “He said, ‘I’m very interested in why a reporter is calling about your bill,’” Doerhoff said.
She told the Problem Solvers he asked her whether she would consider paying $1,500 for the treatment that she received, and Doerhoff agreed that it would be a fairer amount. She paid the lower amount, but she said she never received an exact accounting showing for what services that money paid.
“I don’t believe that there is another service that has such a lack of transparency for their charges and their billing as what I’ve experienced with this event,” Doerhoff said. “Transparency is what keeps things true and honest and something that we can understand.”
Repeated collections calls for paid bills
“I could have screamed some nights,” said Jessica Seib, a surrogate mother who said she endured repeated phone calls from bill collectors even though her bill had already been paid.
Seib said she received months of calls and voicemails from the business office of HealthONE’s Rose Medical Center, trying to collect $5,620.80 for a pregnancy-related bill that Seib said her surrogacy agency had already paid.
“I got the CFO (of the surrogacy agency) involved. He had emailed all of Rose (Medical Center) basically saying, ‘Stop the billing. Stop contacting her,’” Seib said. She said she believed the bill had an incorrect code on it.
When the calls wouldn’t stop, she called the Problem Solvers.
“It wasn’t until the media steps in that all of a sudden answers come,” said Seib, who explained that her problem was fixed within a week of the Problem Solvers inquiring about it.
“It shouldn’t take the media getting involved,” she said. “I understand everybody in the medical field – especially in billing – is overwhelmed. Especially with the coronavirus. I get that. And I get working in medical billing is a very difficult job, but when somebody is coming to you one, two, three, four or more times saying, ‘This bill is incorrect,’ or, ‘We’ve paid this bill,’ and it’s the same person on the same bill, same billing date, same account, and everything is matching up, something is wrong.”
HealthONE responds
Stephanie Sullivan, a spokesperson for HealthONE, declined to participate in an interview with the Problem Solvers but provided a written statement.
“HealthONE is honored to provide care through more than 1 million patient encounters annually across our system. We aim to deliver exceptional care pre-, during, and post-visit to each and every patient. This care includes not just care at the bedside but the education necessary to ensure our patients feel informed and engaged in their own healthcare. If any issues related to a patient experience occur, we utilize patient advocates within each hospital who can assist in answering questions or addressing billing issues,” it said.
New law will provide patient protections
“It really does feel, oftentimes, like the Wild West, like people don’t know what to expect in the mail after they go to the hospital,” said Allison Neswood, the deputy director of strategic priorities for the Colorado Center for Law and Policy.
“They think they’re going to get one bill that tells them what their costs are, what they were billed for, but they don’t. They get a multi-page, confusing document that doesn’t explain the services they received and how much they cost,” she said.
Neswood said it is “troubling” to know some people have had to rely on a news organization to get answers about their billing concerns.
“These critical systems need to work for everybody, and the news is not going to work for everybody,” she said.
The Colorado Center on Law and Policy successfully pushed for medical billing reform during the legislative session in 2021, and parts of the law will take effect next year.
“The inability to get an itemized bill is something that was addressed in the legislation,” said Neswood. “As a result of the legislation, there are several steps that the hospital will have to take before they send somebody to collections, and one of those is provide a list of charges, in plain language.”
The law also includes enhanced accountability measures for hospital systems by requiring a more robust complaint process and a requirement for the hospital to inform patients of their rights.
Medical facilities will also have to screen patients for eligibility for possible medical discounts and limit bills for low-income patients.
Neswood said a new federal law also requires hospitals to post clear, accessible pricing information online.
“I really encourage people…to keep looking at those bills, to keep calling the hospital and insisting that they can get information and have a payment plan that works for them. Right now, it really is down to what the person can push for themselves. Under the new law, there are going to be new protections,” she said.
Resources for patients
Neswood recommended a slew of resources that might help patients better understand or manage their bills.
Medicaid eligibility
“There are many people that are eligible for but not enrolled in Medicaid. If someone facing a hospital bill thinks they might be eligible for Medicaid, they should apply,” Neswood said. “People determined eligible for Medicaid can have healthcare services received up to 90 days before they submitted their Medicaid application covered. So, people can get their hospital bills covered even if they don’t apply for Medicaid until after they leave the hospital.”
Charity and financial assistance
Neswood said many hospitals have financial assistance programs to help patients manage their bills. Patients should inquire about the application process.
Colorado Consumer Health Initiative
While the Colorado Consumer Health Initiative recently has been inundated with requests for assistance, they do offer help to people who are struggling to resolve their bill.
Patients are also able to file complaints with the Division of Insurance, according to Neswood, if they receive a surprise bill.