In Yr 7, ‘Invoice of the Month’ Offers Sufferers a Voice

In 2024, our nationwide workforce of gumshoes got down to reply your most urgent questions on medical payments, comparable to: Can free preventive care actually include add-on payments for objects like surgical trays? Or, why does IT value a lot to deal with a rattlesnake chew? Or, if IT’s referred to as an pressing care emergency heart, which is IT?

Affording medical care continues to be among the many prime Health issues going through People at this time. Within the seventh yr of KFF Health Information’ “Invoice of the Month” sequence, readers shared their most perplexing, vexing, and downright costly medical payments and requested us to assist work out what occurred. Our reporters analyzed $800,000 in prices, together with greater than $370,000 owed by 12 sufferers and their households.

This yr, we met a number of sufferers who fought again.

Caitlyn Mai of Oklahoma Metropolis was preapproved for a listening to implant, but for months she was nonetheless hounded by notices saying she owed $139,000.

To resolve the issue, Mai estimated she spent at the least 12 hours on the cellphone doing duties that usually fall to somebody working in a hospital billing division. “I stated, ‘I’ve achieved your job for you — now are you able to please take IT from right here?’”

Jamie Holmes of Lynden, Washington, refused to buckle when a surgical procedure heart tried to make her pay for 2 operations after she underwent just one — even after a group company sued her.

She confirmed up at two court docket hearings and defined her aspect. “I simply obtained stonewalled so badly. They handled me like an fool,” she instructed “Invoice of the Month.” “In the event that they’re going to be petty to me, I’m prepared to be petty proper again.”

As at all times, we reached out to medical billing specialists for his or her takeaways and realized that these sufferers had the fitting concept.

“You recognize what? IT pays to be cussed in conditions like this,” stated Berneta Haynes, a senior lawyer for the Nationwide Shopper Regulation Heart who reviewed Holmes’ invoice for KFF Health Information.

From our curious, tireless “Invoice of the Month” workforce, joyful holidays — and, when unsure, don’t pay the invoice.

The Colonoscopies Had been Free. However the ‘Surgical Trays’ Got here With $600 Value Tags.

By Samantha Liss, 

January 25, 2024

Health suppliers could invoice nevertheless they select — together with in ways in which may go away sufferers with surprising payments for “free” care. Routine preventive care saddled an Illinois couple with his-and-her payments for “surgical trays.”

With out Medicare Half B’s Protect, Affected person’s Household Owes $81,000 for a Single Air-Ambulance Flight

By Tony Leys, 

February 27, 2024

Sky-high payments from air-ambulance suppliers have sparked complaints and federal motion lately. However a rural Tennessee resident fell via the cracks of billing protections — and a single helicopter journey may value a lot of her property’s worth.

A Mother’s $97,000 Query: How Was Her Child’s Air-Ambulance Trip Not Medically Crucial?

By Molly Citadel Work, 

March 25, 2024

There are authorized safeguards to guard sufferers from massive payments like out-of-network air-ambulance rides. However insurers could not pay in the event that they resolve the journey wasn’t medically mandatory.

Signal Right here? Monetary Agreements Might Depart Docs within the Driver’s Seat

By Katheryn Houghton, 

April 30, 2024

Agreeing to an out-of-network physician’s personal monetary coverage — which typically protects their capability to receives a commission and could also be suffering from complicated insurance coverage and authorized jargon — can create a binding contract that leaves a affected person owing.

He Fell In poor health on a Cruise. Earlier than He Boarded the Rescue Boat, They Handed Him the Invoice.

By Bram Sable-Smith, 

Might 22, 2024

A person from Michigan was evacuated from a cruise ship after having seizures. First, he drained his checking account to pay his medical payments.

IT’s Referred to as an Pressing Care Emergency Heart — However Which Is IT?

By Renuka Rayasam, 

June 24, 2024

Struggling abdomen ache, a Dallas man visited his native pressing care clinic — or so he thought, till he obtained a invoice 10 occasions what he’d anticipated.

Her Listening to Implant Was Preapproved. Nonetheless, She Received $139,000 Payments for Months.

By Elisabeth Rosenthal, 

July 17, 2024

Even when sufferers double-check that their care is roofed by insurance coverage, Health suppliers typically ship them payments as they haggle with insurers over reimbursement, which may final for months. IT’s aggravating and annoying — however authorized.

Affected person Underwent One Surgical procedure however Was Billed for Two. Even After Being Sued, She Refused To Pay.

By Tony Leys, 

August 21, 2024

A group company sought court docket authority to garnish a affected person’s wages to pay a disputed surgical procedure invoice. However after the affected person confirmed up in court docket to argue the invoice was bogus, the choose declined to let the invoice collector seize her cash.

In Power Ache, This Teenager ‘May Barely Do Something.’ Insurer Wouldn’t Cowl Surgical procedure.

By Lauren Sausser, 

September 25, 2024

An Alabama teen was instructed he wanted surgical procedure for debilitating hip ache. However his household’s insurer denied protection for the process, which lacked a medical billing code. Anticipated to pay greater than $7,000, his father charged IT to bank cards.

Toddler’s Yard Snakebite Payments Totaled Extra Than a Quarter Million {Dollars}

By Jackie Fortiér, 

October 30, 2024

For snakebite victims, antivenom is essential — and dear. IT took greater than $200,000 value of antivenom to avoid wasting one toddler’s life after he was bitten by a rattlesnake.

A Toddler Received a Nasal Swab Check however Left Earlier than Seeing a Physician. The Invoice Was $445.

By Bram Sable-Smith, 

November 27, 2024

A mother in Peoria, Illinois, took her 3-year-old to the ER one night final December. Whereas they have been ready to be seen, the toddler appeared higher, so that they left with out seeing a physician. Then the invoice got here.

He Went in for a Colonoscopy. The Hospital Charged $19,000 for Two.

By Harris Meyer, 

December 19, 2024

A person in Chicago with a troubling symptom underwent a standard process. Then he needed to know why the hospital charged practically 3 times its personal value estimate.

Invoice of the Month is a crowdsourced investigation by KFF Health Information and The Washington Post’s Well+Being that dissects and explains medical payments. Since 2018, this sequence has helped many sufferers and readers get their medical payments decreased, and IT has been cited in statehouses, on the U.S. Capitol, and on the White Home. Do you could have a complicated or outrageous medical invoice you need to share? Inform us about IT!

We encourage organizations to republish our content material, freed from cost. Right here’s what we ask:

You could credit score us as the unique writer, with a hyperlink to our kffhealthnews.org website. If doable, please embody the unique writer(s) and KFF Health Information” within the byline. Please protect the hyperlinks within the story.

IT’s vital to notice, not every part on kffhealthnews.org is accessible for republishing. If a narrative is labeled “All Rights Reserved,” we can not grant permission to republish that merchandise.

Have questions? Tell us at KHNHelp@kff.org