HAND SURGEON WAS ON MY INSURANCE BUT HOSPITAL WHERE HE DID THE SURGERY WAS NOT (AND I WAS NOT INFORMED IN ADVANCE)
I'm not sure if this is the right subreddit to post this in but please feel free to direct me to the correct place. I'll try to keep this as brief as possible. My son broke his wrist in February 2023 while away in college (in Michigan). He went to the ER and they determined that he needed surgery. So far, so good. I researched hand surgeons in his area (in Michigan) that performed the surgery and, more importantly, ones that took my insurance. We found one that did in fact take our insurance and the surgery was performed successfully.
Over the course of the following weeks, I was receiving various invoices for the ER visit, surgery, follow-up, etc. Many of the invoices were either co-pays or based on meeting my deductibles. No issues so far and I paid each invoice as soon as I received it.
Here's where it gets interesting. In April 2023, I received an invoice for about $37,000! I called the surgeon's office to try to understand what this was all about. It turns out that while the surgeon takes my insurance, the hospital where he performed the surgery does not. This was all news to me and of course had I known that this expense would have been out of pocket, I would have selected a different surgeon/hospital.
For the following couple of months, I was in touch with the surgeon's practice manager (who was really bad about returning phone calls). Her initial suggestion was to file an appeal with my insurance company which was subsequently denied. When that happened, the practice manager said she would do additional research to try to figure out who dropped the ball in her office. Then in July 2023, I received another note in the mail stating that this bill was now going to collections. I called the practice manager again and she told me "the collections/account is now on hold as they investigate and it could take up to 90 days".
I didn't hear anything back after that so I assumed that this was resolved. About two weeks ago in early May 2024 (9 months after the last communication), I received two more invoices for $75 each dating back to February 2023 and April 2023. When I called the number on the invoice, they explained that these were valid charges from the initial surgery and follow-up. When I asked why I hadn't received them prior, I was told that I was on electronic billing (which I never opted for). But then she told me that it looked that that $37,000 bill was not only still pending but it had been sent to collections in August 2023! I have not received anything from any collections agency about this.
Immediately I called the practice manager again (on May 10, 2024) and left her a voicemail. In the voicemail, I mentioned that I'm very upset and I would appreciate a phone call back. She didn't call me back and on May 15, 2024, I spoke with the person answering calls and explained my situation, my frustration, and the lack of a return call. She said she would pass the message along to the practice manager and, as of this writing, still no call back from anybody.
This surgeon is now part of a big healthcare company in Michigan (I'm not sure if I'm allowed to name the company here so I'll leave it out). So my question is who else can I now contact in order to escalate this? I know there's a No Surprises Act/Good Faith Estimate in Michigan which would have been nice to invoke prior to surgery. Clearly I'm not getting anywhere with the surgeon's office and the lack of any returned phone calls is beyond frustrating and really unprofessional. So do I start contacting higher-ups at the healthcare company? Is there perhaps a government agency that is responsible for the No Surprises Act? I'll of course be leaving a review for the practice but I'm not sure that's going solve my issue.
I know this was a little long so thank you in advance for reading and thank you in advance for any advice. Much appreciated!
submitted by /u/Biggmoney21
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