After the parents of a newborn baby girl got hit with a bizarre bill, 7NEWS discovered it’s part of a big problem that could also be hidden in your medical bills.
The Jawranis welcomed little Zoey into their lives in May, and she quickly stole her parents’ hearts.
“She’s the best thing that’s happened to us,” said Nikhil Jawrani, Zoey’s father.
But soon after the Jawranis welcomed their bundle of joy, they were asked for a bundle of cash that they shouldn’t have owed. And 7NEWS discovered that they’re not the only ones.
“I’m like, ‘Wait a minute. That makes no sense,'” Jawrani said of the explanation of benefits that they got in the mail.
The hospital where Zoey was delivered told the insurance company that her care cost about $2,500. But the insurer still wanted to bill her parents $3,000 to fully cover their co-pay and deductible – that’s about $500 more than the hospital even wanted!
Jawrani said he called the insurer, but got nowhere.
“They told me that, ‘That’s it. This is the charge, but this is what we allow, and this is what you’ll have to pay,’” Jawrani said. “It’s just wrong. If I have to use one word, I think it’s wrong.”
7NEWS took the Jawranis’ bill to Beth Morgan with Medical Bill Detectives. Morgan has spent 20 years helping patients fight errors and overcharges on medical bills.
We asked her whether such discrepancies should ever happen.
“No,” Morgan replied. “It goes to show you that the insurance company did not read the bill.”
“I think the system failed to catch it. They should have caught it, but they didn’t,” Morgan said.
Morgan said that insurers often set contracted rates with hospitals for specific procedures. She said she suspects that the insurer blindly approved that rate, even though it’s far higher than what Zoey’s care actually cost.
“The rep tried to explain that it is based on a contract,” Jawrani said.
But when 7NEWS contacted the insurer, the company called the error a “payment anomaly” and blamed it on the “sophisticated automated systems” that help process insurance claims. The company insisted this kind of mistake happens rarely, but that when it does, their systems can’t catch it.
“It’s not acceptable. Someone should be looking,” Jawrani said.
After 7NEWS started asking questions, the insurer agreed to fix Zoey’s bill, saving her parents more than $500. The company also said that it found a small number of other patients with similar overcharges, and it is re-training its staff to catch them.
Experts like Morgan said it’s a reminder to always take a close look at your medical bills.
“Not everyone has money to throw away,” Jawrani said.
Experts say that if you have a problem with a medical bill, always ask the provider for an itemized bill or what’s called a UB-04 form. Make sure the documents have medical billing codes and descriptions of which services were provided.
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