A Diagnosis of Kidney Stones Leaves Patient With 27 Different Bills
A simple case of kidney stones, or so Chandak thought.
"With severe back and stomach pains, I rushed to the emergency room. A number of doctors from various specialties spoke with me because of confusion with the diagnosis. Ultimately, a CT Scan diagnosed kidney stones. I was prescribed pain medications, warned about more pain when passing the stones, and then I was discharged to go home."
27 bills and many threats of debt collection later, Chandak was emotionally drained by his experience.
"Although fully insured, in the following days, I started receiving separate bills from the hospital emergency department, emergency physician, gastroenterologist, nephrologist, radiologist, laboratory, and radiology department. Each bill stated I was responsible for payment until my insurance company paid and that, if the bills weren’t paid by a certain date, they would be sent to collection agencies, affecting my credit adversely. Every few weeks, I’d get new billing statements from everyone, each with the same threat of damaging my credit. By the time my insurance paid, a few months after my visit, I had received 27 different billing statements! Dealing with all those separate bills with their threatening language was extraordinarily draining emotionally and psychologically."
A 75-Year Old New Yorker Overwhelmed On All Sides By Medical Debt
A long and difficult medical journey begins.
2009
John’s struggle with medical debt began when he was diagnosed with Charcot foot, a condition that hurts John so much, it limits his mobility. John underwent two surgeries to treat his foot – one at Mount Sinai and one at New York Presbyterian Hospital. After each surgery, John was discharged to a different nursing home where he stayed for several weeks. Medicare covered 80% of the costs, but his 20% co-insurance quickly amounted to several thousands of dollars.
He gained hospital financial assistance to cover the outstanding hospital bills but the two nursing homes do not offer financial assistance and continue to bill him. They will not offer him a reduction based on financial hardship and will only accept a monthly payment plan, which is going to take him years to pay off. Additionally, John received seven at-home infusions for his foot by CVS Coram. The infusions ranged from a few hundred to over a thousand dollars each. He could not afford the 20% co-insurance and he was soon turned over to collections.
2015
John suffered a heart attack that required surgery. He was hospitalized at Northwell Health and referred for follow-up at NYU Langone. During this time his partner was very ill, and John forgot about his hospital bills. Northwell did not inform John about hospital financial assistance and instead sent him to collections. He worked with CSS's Community Health Advocates program to apply for assistance and renegotiated his payment plan with Northwell from $1000 per month to a more affordable amount.
2018
John was diagnosed with colon cancer. He grew very ill and was hospitalized at New York Presbyterian multiple times. John received hospital financial assistance to cover his New York Presbyterian hospital bills. However, the physicians at NY Presbyterian bill separately for services through Weill Cornell Medical College. Therefore, the hospital’s financial assistance policy does not apply to the physician bills. John then received dozens of pages of confusing Weill Cornell physician bills, including separate bills for imaging services, that amounted to nearly $4,000. John couldn’t afford these bills and he was sent to collections.
Most heartbreaking, in March 2018, while he was in the hospital, his lifelong partner died from complications of AIDS. John was so ill that he was not informed about his partner’s passing until May 2018 and he never had the chance to say goodbye.
John’s medical debt caused a ripple effect.
John's unsurmountable medical debt has devastated his life and caused him a great deal of stress. As a result of his numerous hospital stays, John fell behind on paying his rent and was sued by his landlord. With help from an elder care organization and the New York Times Neediest Cases Fund, he was able to avoid eviction. However, he couldn't afford to properly furnish his apartment, including purchasing a special chair needed for his foot. He postponed doctor visits because he couldn't afford cab fare and his foot condition didn't allow him to use public transportation.
Sadly, John recently passed away. Through the end of his life, John continued to be inundated with confusing medical bills and harassed by aggressive debt collectors, worrying about how he would afford follow-up visits with his oncologist. This bill was created to honor John’s life and to ensure no other patient spend their final days the way John did, fighting with their hospital, insurance company and worrying about how they will afford the care they need.
"Nickel and Dimed to Death" Over a $142 Facility Fee
Sintora went in for a breast exam at Chelsea Medical Center at Mount Sinai. She signed all routine medical documents, paid her copay, saw her doctor, and had her exam. Or so she thought.
Next came a $142 facility fee.
Sintora told the doctor’s office she would not pay the bill. She pointed out, “if she had known they would charge her an additional fee, she would have just gone somewhere else.” Consumers aren’t taught to look out for hidden fees when we go to the doctors. “If there is one place you should feel safe, it’s your doctor’s office. This felt like a sneak attack,” said Sintora.
Mt. Sinai fought back, telling her she signed a waiver allowing their office to charge a facility fee. If she did not want to pay, her insurance company, Blue Cross Blue Shield (BCBS), had to pay. BCBS responded and told Sintora to write a letter telling the insurance company why they needed to pay the fee. “I felt like I was ping-ponging between my insurance and the doctor,” Sintora said.
She did not write a letter to BCBS.
“Why should I have to write them a letter?" Sintora said. "They are a multi-million-dollar company and they are nickel and diming people to death? It already costs so much to see a doctor, you pay for insurance, the co-pay, and now an additional fee? No way.”
Sintora refused to bend to her insurance or doctor’s office scare tactics. She held strong even when aggressive calls from debt collectors began to flood her phone. Eventually, BCBS paid the facility fee.
Now she asks every doctor’s office, do you charge a facility fee?
She reads every waiver form carefully. She checks with the administrative staff about any hidden fees or charges. She even declined to sign a waiver when she went back to Mt. Sinai. She read it over and it stated she would be responsible for a facility fee again. She already experienced fighting a facility fee, and she’s not going through it again.
Ultimately, she doesn’t know who she is more frustrated with: her insurance company for fighting with her to pay a small fee, or her doctor’s office for what felt like a sneaky practice of slipping in an additional fee.
