PHA Case Study – Unexpected charge for emergency care

Situation:

 Laura received a bill for an emergency service after her husband Joe, stricken with colon cancer, had to be rushed to the emergency room and admitted. Because Laura had not notified her insurance company of the admittance within 24 hours, they imposed a 50 percent penalty, resulting in a shocking $20,000 hospital bill. Laura’s Personal Health Advocate helped her successfully appeal the bill and the denial was overturned. Unfortunately, during the appeal process, Joe passed away, leaving Laura with three small children and overwhelming debt. The sizeable sum saved by the appeal helped to ease the burden during this challenging time.

 What The Healthcare Survival Guide says:

 To avoid surprises, don’t assume that your health plan covers every aspect of your hospitalization. Make sure before you are admitted that procedures and all doctors including the anesthesiologists, for example, are covered (pg. 41). Check to see if there are exclusions that include emergency room servicees. Get familiar with your plan’s appeal process. One important step to dispute a claim: gather papers, take careful notes of each conversation and every person you talked to (pg. 44).

If you would like a free copy of The Healthcare Survival Guide: Cost-Saving Options for the Suddenly Unemployed and Anyone Else Who Wants to Save Money, you can download it at www.healthcaresurvivalguide.com.

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