What Happens If I Get A Medical Bill Years After Service

Suzanne and Jim Rybak, inside the arts and crafts room where their son, Jameson, would encourage Suzanne to brand colorful beach bags, received a $iv,928 medical bill months after information technology was supposedly resolved. By Gavin McIntyre/Kaiser Health News hide caption

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By Gavin McIntyre/Kaiser Health News

Suzanne and Jim Rybak, inside the craft room where their son, Jameson, would encourage Suzanne to make colorful beach bags, received a $4,928 medical pecker months after it was supposedly resolved.

By Gavin McIntyre/Kaiser Health News

Every now so, Suzanne Rybak and her hubby, Jim, receive pieces of mail addressed to their deceased son, Jameson. Typically, it'southward junk postal service that requires little thought, Suzanne said.

But on March 5, an envelope for Jameson came from McLeod Health.

Jim saw information technology first. He turned to his wife and asked, "Have you lot taken your blood force per unit area medication today?"

He knew showing her the envelope would resurface the pain and acrimony their family had experienced since taking Jameson to McLeod Regional Medical Center in Florence, Due south.C., two years ago.

As KHN previously reported, Jameson was experiencing withdrawal symptoms from quitting opioids. Suzanne feared for her son's life and took him to McLeod'south emergency room on March xi, 2020.

There, they encountered a paucity of habit treatment and the potential for loftier medical costs — two problems that plague many families afflicted by the opioid crisis and often lead to missed opportunities to save lives.

Jameson was non offered medications to treat opioid utilise disorder in the ER, nor was he given referrals to other handling facilities, Suzanne said. The infirmary wanted to admit him, merely, being uninsured, Jameson feared a loftier bill. The hospital didn't inform him of its financial assistance policy, Suzanne said. And he decided to leave.

Three months later, Jameson, thirty, died of an overdose in his babyhood bedroom.

Months of red record

In the following months, the Rybaks received bills from McLeod Health addressed to Jameson. He owed $iv,928, the bills said. Suzanne called and wrote to hospital administrators until September 2020, when the nib was resolved under the health system's fiscal help program.

That was the last they had heard from McLeod Health until the new envelope arrived March v — i week before the two-yr anniversary of Jameson's ER visit. That visit was what Suzanne calls "the beginning of the terminate for my son."

When the Rybaks opened the envelope, they establish a strikingly familiar bill for $four,928.

"I tin can't even describe my anger and sadness," Suzanne said. "It's always present, just when we received that statement, nosotros were just stunned."

There's no national information to indicate how often patients or their families receive medical bills that were previously paid or forgiven, but hospital billing experts say they often see it happen. Patients might receive bills for claims their insurers already paid. A reminder statement may arrive even after a patient has submitted payment.

Unlike "surprise bills," which often effect from policy gaps when a provider is out of network, these are bills that were resolved but go on to pop upward anyhow. They can carry financial consequences — patients wind up paying for something they don't truly owe, or bills go passed on to debt collection agencies, triggering more phones calls and red tape. But often it's the emotional cost that wears on patients most, spending hours on the phone with customer service each time the bill resurfaces or reliving the situations that led to the bill in the beginning place.

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For families like the Rybaks, the cost tin experience never-ending. Suzanne Rybak refused to appoint with McLeod Health again but told KHN about the new beak. In response to questions from KHN, McLeod Health determined the bill that the Rybaks received was a mistake.

"Unfortunately our software organisation regenerated this statement due to a technical issue," wrote spokesperson Jumana Swindler. "Nosotros are checking to ensure that it has not happened to any other patients and nosotros are lamentable this family was impacted by the error."

A week after KHN'south research, the Rybaks received a letter from the hospital explaining and apologizing for the mistake.

Many bills issue from human error

Many medical billing cases similar this "eddy down to human error," said Michael Corbett, managing director of health intendance consulting for LBMC, a Tennessee-based firm that consults with health systems nationally on issues similar billing and revenue. "Facilities don't accept a lack of tools [to avoid this.] It's a breakup in their processes."

A billing agent may forget to marking the account every bit paid, he said. Or the hospital might contract its billing to an exterior visitor and neglect to inform them that the bill was covered under the hospital's financial assistance program.

As hospitals and medical practices increasingly consolidate under large health systems, the chances for errors increase. Fifty-fifty hospitals and clinics within the same organisation may have different backend software, and within each hospital there can be separate programs for billing and electronic health records, Corbett explained.

Larger wellness systems may as well accept more people processing any given pecker. If responsibilities are non clearly defined, multiple employees could unknowingly act on the same patient account.

The COVID-19 pandemic has exacerbated potential errors, Corbett said. New medical billing employees may have received quick, virtual grooming and are working remotely with little interaction with team members or oversight. Some billing departments are understaffed, leading to delays in patients receiving bills or follow-up notices, he added.

To curb mistakes, Corbett said, hospitals need to invest in more comprehensive training and supervision for billing employees; enact consistent processes for everything from how patients' financial information is collected at registration to when they're sent bills; and, perhaps most important, track whether those processes are beingness followed.

For patients who find themselves in a situation like the Rybak'southward, Corbett advises calling the infirmary billing department and asking to speak with a senior leader in its revenue cycle partition. Different an account representative, this person could make decisions, Corbett said.

At the cease of the chat, ask to get the caption in writing, he added.

"You lot'd anticipate and promise those notes are existence recorded," Corbett said, but that may non be the case. Or notes might get recorded in a section of infirmary files that are excluded from a patient's legal medical record, making it difficult for patients to access later.

A binder of documents

For Suzanne Rybak, the idea of calling McLeod Health to straighten out nonetheless another neb was too much. Instead, she added the argument to a binder of paperwork, in which she'due south documented all her billing struggles with McLeod Health over the past two years.

Still, out of sight hardly means out of mind. The folder sits in her craft room, where she remembers Jameson encouraging her as she made beach bags and other items. He'd say to use "fruity colors," Suzanne recalled — his way of describing tropical colors. Now she makes candles in that room, focusing on tropical fragrances she knows Jameson would accept loved.

"I want hospitals to realize that you're non but sending this bill to an accost," Suzanne said. "At that place are people who alive in that house, who are going to open up that mail service and have feelings. ... It's a disaster to bring all that upwards over again."

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health problems. It is an editorially contained operating program of KFF (Kaiser Family Foundation).