Make health providers explain charges before you pay

Posted: Updated:
Lois Hatfield said she didn't owe a second copay for an emergency room visit but her health insurance thought overwise. (Source: CBS 5) Lois Hatfield said she didn't owe a second copay for an emergency room visit but her health insurance thought overwise. (Source: CBS 5)
SUN CITY, AZ (3TV/CBS 5) -

A Sun City woman says she understands a provision of her health plan very well but a west Valley hospital seems to be confused.

Some health plans limit what a hospital can charge patients who visit the emergency room twice on the same day for the same problem. Sometimes this can create confusion, so never pay a health care bill unless the provider can explain it.

Last November, Lois Hatfield took her husband Willie to the emergency room at Abrazo Arrowhead Hospital. She paid the $75 copay required by her health plan and Willie was treated and released. But hours later he was feeling worse and had to return.

"I knew if I had to take him back within 24 hours, I would not owe a second copay, you only pay one time for every 24 hours," Hatfield said.

It's in Hatfield's insurance manual; there's no additional ER copay if you return within 24 hours for the same condition. Hatfield says Abrazo refused to confirm or deny this but did bill her another $75.

"You know, send me a reason, what it is, if it's something else, or whatever, I'll be happy to pay it, but I don't owe a second copay," Hatfield said.

Hatfield says she provided Abrazo her receipt of payment that day and a copy of her insurance explanation saying she only owed $75. Neither seemed to work and after six months trying to resolve, she got a notice from a debt collector.

"I was talking to them all the time, trying to get it figured out and for them to go ahead and turn it into collections and ruin my credit like this," Hatfield said.

She can't believe her perfect credit is in jeopardy over a tiny charge she doesn't owe.

"How many other people get a bill like that and goes ahead and pays it and they don't ask questions. I usually ask questions," Hatfield said.

CBS 5 News asked Abrazo to look into this issue. It seems the bill was for an additional copay which Hatfield clearly didn't owe.

Hatfield says Abrazo removed the matter from collections and wiped out the bill. CBS 5 News thanks Abrazo for quick work in resolving this complaint.

Don't just pay a small health care bill. Make providers first explain why you owe it.

Click/tap here to download the free azfamily mobile app.

Copyright 2017 KPHO/KTVK (KPHO Broadcasting Corporation). All rights reserved.


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