Consumer Fights Bogus Hospital Charges and Wins

An Arizona woman has won a two-year battle against a hospital that charged her $900 for the birth of her newborn daughter.

The infant, Kaylee, died just moments afterward. She was 12 weeks premature. “She was born, and we just held her,” Melissa Sherman told ABC 15. “We just held her. That’s all we did.”

Although Kaylee received no treatment and spent no time in nursery care, the hospital billed Sherman $862 for “Nursery Level 1 Care” charges, she said. The bill was later raised to $896.

According to childbirth site Birth.com, this level of care not only includes routine check-ups every few hours but also clothing, feeding and observing the infant’s vital signs.

Since Kaylee was only wrapped in a blanket before she was handed over to her parents, Sherman said she didn’t understand what care she was being asked to pay for. When she reached out to the hospital and insurer to have the charges reconsidered, both parties stood firm.

“Despite the unfortunate outcome the hospital did incur expenses and those charges are accurate,” a Banner Good Samaritan Medical Center spokesperson told ABC 15 in a statement. “Hospitals have expenses whether a patient lives or dies.”

Sherman said she spent months trying to work out the charges but it wasn’t until she told the hospital she’d involved the local media that they decided to change their tune. Almost immediately, the charges were reversed.

In cases like Sherman’s, it’s routine for hospitals to bill patients even after they’ve collected payment from their insurer, according to Joshua Greenberg, CEO of health care advisory company HealthCPA,

“The way most insurance contracts are structured – with the insurance company paying a percentage of total charges – it is considered insurance fraud for a hospital to collect from the insurance company and not try to collect anything from the patient,” Greenberg told BI.

That’s not to say hospitals aren’t able to waive charges if patients prove they’re unable to pay, but it seems Sherman came out on top based on persistence alone (and the media attention probably didn’t hurt either).

Standing your ground could mean the difference between paying hundreds or thousands of dollars for treatment. Here’s how you can follow Sherman’s lead to save yourself time and money down the road:

Don’t pay upfront until you’re sure it’s correct.

Sherman was right not to pay the bill before she tried to get the charges reversed. If you make a payment to a provider and then find out later that you paid too much, it can be difficult to recoup that money. That being said, it’s not wise to ignore the bill altogether – hospitals are sending debt collectors after patients more than ever these days. If you show that you’re trying to take action, they’ll be less likely to take that route.

Ask for an itemized bill from your provider.

Request one if you have to, but you shouldn’t rely on whatever your doctor sends you, as it can sometimes be difficult to read and understand. In Sherman’s case, the hospital did not list exactly which services they were billing her for, which was a red flag right off the bat. Once you have your charges listed one-by-one, you’ll know exactly how things add up.

Be sure your insurance actually kicked in.

Even in-network providers can screw up and fail to apply your insurance to your bill. If your bill doesn’t show an insurance payment or an insurance discount, that’s a major red flag.

“Consumer Fights Medical Bill and Wins” was originally run as, “This Woman’s a Shining Example of Consumers Fighting Back Bogus Hospital Charges” and provided BusinessInsider.com.