The Lanes describe the process of fighting their surprise bill as frustrating and Kafkaesque. They have spent hours on the phone, sent dozens of emails, and filed complaints with regulatory agencies in two states.
“The letters mean I’m constantly reliving the day, and that is such a hard space to be in,” Ms. Lane said. “I feel so frustrated that the hospital is making decisions about their own bottom line that influence our potential future, and the memory of our child.”
“This patient had no control over what was paid, and she has no control over whether it gets returned,” said Susan Null, a medical billing expert with the firm Systemedic Inc. “Sometimes things like this might be done to motivate the patient to contact the hospital, to get them to release the funds.”
Americans are familiar with medical debt: About 18 percent of them have an outstanding bill from a hospital, doctor or other type of provider in the health system. But most do not expect to get collection notices for bills that were already paid by their health plan.
Courtney Jones, a senior case manager with the Patient Advocate Foundation, described working on cases in which patients have received similar collection notices for bills that the insurer, not the patient, was responsible for covering. It usually happens with large medical bills, as with the Lanes, in which the insurer and hospital both have more at stake.
“They use it as a tactic to put some pressure on the medical facility to refund the money,” Ms. Jones said.