CHICAGO (WLS) — It may be an amazing feeling, getting slapped with a hospital invoice that you do not imagine you owe.
The ABC7 I-Group is investigating “surgical procedure overcharge.” A neighborhood man was billed $47,000 greater than he ought to have been.
The south suburban man mentioned he had his surgical procedure pre-approved with the hospital and insurance coverage. However then got here the sticker shock and a surgical procedure overcharge for a invoice for eight instances greater than he thought. He referred to as the I-Group for assist.
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Lansing resident Joe Dubczak was relieved to know he beat prostate most cancers, however he could not imagine his eyes when he obtained this surgical procedure invoice for greater than $53,000.
“It was a shock,” Dubczak mentioned. “And, , actually, the surgical procedure was straightforward and studying you could have most cancers is horrifying. However that complete course of was straightforward. This has been ten instances extra nerve-racking than the surgical procedure itself and the restoration.”
Dubczak thought his invoice was going to be about $5,800, as famous on this preliminary doc. He obtained the surgical procedure pre-approved by way of Advocate South Suburban Hospital in Hazel Crest and Blue Cross Blue Protect of Illinois.
“Every thing went as deliberate till a month after the surgical procedure, after I obtained a invoice for $53,500 plus,” Dubczak mentioned. “Straight away I believed blue cross could not have seen this but or they’re sitting on it or one thing.”
Nonetheless, after making calls to the hospital and his insurance coverage firm, he discovered that $53,000 was the ultimate invoice, and he needed to pay up.
“And so the final 5 months now has been backwards and forwards between Blue Cross and the hospital,” Dubczak mentioned. “Neither considered one of them wanting to repair this, though they each acknowledge one thing’s improper. So the hospital has been very aggressive at making an attempt to get funds.”
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He mentioned when he wasn’t getting solutions, he referred to as the I-Group.
“I simply type of gave up,” Dubczak mentioned. “And that is after I contacted [the I-Team].”
ABC7 emailed the hospital and the insurance coverage firm, sending them the paperwork displaying Dubczak’s pre-approved estimate and paperwork displaying that he was solely purported to pay $5,800. Inside weeks, Dubcazk obtained a name.
“The vp of shopper affairs for the corporate that oversees advocate or well being and apologetic, and we’re engaged on this with Blue Cross,” Dubczak mentioned.
This has been ten instances extra nerve-racking than the surgical procedure itself and the restoration.
Joe Dubczak, contacted the I-Group
Weeks later, he obtained up to date payments displaying he now longer owes the additional cash.
“I’m so grateful that you simply had been in a position to do that,” Dubczak instructed the I-Group. “I do not know what you mentioned of their electronic mail, however I actually respect your assist.”
Neither the Advocate South Suburban Hospital or Blue Cross Blue Protect of Illinois commented particularly on the affected person’s case, however despatched ABC7 the next statements.
Advocate mentioned, “We’re dedicated to guiding sufferers as they navigate and plan for the price of their care, and we now have a course of in place to work with sufferers and insurers to resolve points when acceptable.”
Blue Cross Blue Protect of Illinois mentioned “We’re dedicated to placing members first and dealing with suppliers to assist them obtain acceptable, lined companies. Anybody who has a priority about protection ought to attain out to us on the quantity on their member ID card.”
Dubczak by no means obtained an in depth rationalization for the error, however mentioned he was instructed by insurance coverage that there was coding problem. Dubczak mentioned the hospital was out-of-network, however he had an out-of-network waiver as a part of his pre-approval.
“it’s extremely nerve-racking,” Dubczak mentioned. “And it is unacceptable.”
Customers ought to all the time fastidiously evaluation all hospital payments. If there’s a drawback, battle the invoice earlier than sending any cash.
You may formally dispute them with the hospital and insurance coverage and assortment businesses. If you cannot get your problem resolved, you can even file a criticism with the Illinois Division of Insurance coverage.
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