3 On Your Side

Phoenix woman stuck with $6,312 'out-of-network' medical bill

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(Source: KPHO/KTVK) (Source: KPHO/KTVK)
(Source: KPHO/KTVK) (Source: KPHO/KTVK)
(Source: KPHO/KTVK) (Source: KPHO/KTVK)
(3 ON YOUR SIDE) -

Eve Miner does a lot of walking these days to improve her health. In addition to walking, one of her favorite workouts is getting out her bike and taking it for a spin a couple times a week.

"I'm always going up and down Central Avenue, and everyone is always walking and riding their bikes along the canal, so I thought,'Why not me?,'" Miner told 3 On Your Side.

Seven months ago, Miner lost control of her bike and wound up going head-first over her handle bars.

"And so, I forced my hands up and I slammed onto the concrete. I was dazed and out of it," Miner said.

The accident left one of Miner's hands shattered.  

Emergency crews responded to the scene and immediately transported her to the hospital where she underwent emergency surgery to repair her hand.

"There was actually a bone sticking out of the skin," she said. "So, they had to repair that and put it back in place and put in a titanium plate with screws."

Miner said she knew there would be some medical bills, but she wasn't overly concerned because the hospital was "in-network" with her insurance carrier, United Healthcare.

Miner eventually recovered, and United Healthcare took care of all of her hospital and medical bills.

Well, almost all of them. The doctor from Arizona Center for Hand Surgery who repaired Miner's hand is not contracted with United Healthcare and is considered "out of network."

As a result, Arizona Center for Hand Surgery was paid a reduced amount by United Healthcare. 

So, what did it do in response? The surgery center sent Miner a bill for around $6,300, saying that because her insurance provider didn't pay the entire bill, she would be responsible for paying the balance.

Desperate and unable to pay $6,300, Miner got a hold of 3 On Your Side.

United Healthcare told 3 On Your Side that the issue is out of its hands, and considering Miner's issue was a true emergency, Arizona Center for Hand Surgery should accept the out-of-network payment it received and not stick Miner with the balance.

In an email, a United Healthcare spokesperson told 3 On Your Side: "When an out-of-network physician seeks to perform services at a hospital, the physician should be charging rates that are consistent with the in-network hospitals in which they practice, rather than using the emergencies as an opportunity to bill patients excessive amounts"

Miner agreed, saying the hospital she went to was considered "in-network," and it's not her problem if the hand surgeon or facility isn't contracted with United Healthcare.

"It was a true definition of an emergency. So, I wasn't able to say, 'No, we need to wait to have surgery,'" Miner said. 

However, the Arizona Center for Hand Surgery disagreed, saying emergency or no emergency, it's not willing to reduce or waive the $6,100 balance and needs to be paid.

In an email, the Arizona Center for Hand Surgery said United Healthcare is "the 10,000-pound gorilla that can do whatever it wants to do and vilify the doctor as the one that is gouging the patient."

So, in the end, the surgery center blames the insurance company, the insurance company blames the surgery center, and Miner, the consumer, is stuck with a bill no one wants to pay.

"Unfortunately, I can't. I would love to pay but I can't," she told 3 On Your Side.

By the way, the Arizona Center for Hand Surgery claims Miner does have some options, which include making payments until the full $6,312 is paid or making a one-time cash payment with a 20 percent discount.

Miner said the whole ordeal doesn't seem quite right or fair.

Copyright 2015 KTVK (KPHO Broadcasting Corporation). All rights reserved.

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