3 ON YOUR SIDE (3TV) - It's a problem 3 On Your Side continues to hear about. You go to an in-network facility, and you wind up with an out-of-network bill. It's not supposed to happen, but it appears to still be a bit of a problem.
"You don't know if you go to bed that night, are you gonna wake up the next morning," George Schlemmer said.
Schlemmer gets a little emotional when he thinks back on a recent medical emergency he had that sent him to the hospital.
"When it happens to you, very scary. It's life or death," said Schlemmer.
Schlemmer's emergency room visit stems from the fact that he has high blood pressure.
He says he and his wife, Pam Schlemmer, try to control his blood pressure by eating right. But, Schlemmer also takes medication.
However, it was the blood pressure medication that gave him an allergic reaction and made his mouth and throat start to swell up.
"It's hard to describe your tongue feeling puffy, right, or swelling if you've never had that before, but I'm like something's not quite right," said George.
Concerned and, of course, alarmed, George came to Chandler Regional Medical Center to get checked out, and the reason he chose this hospital is because it is in-network with his insurance carrier.
George was put on different meds and eventually sent home.
But, a few months later, he got a bill for more than $1,500 from the ER doctor who treated him.
Apparently, the hospital was, in fact, in-network, but according to the bill, the treating doctor wasn't.
"When we first got the bill, we were shocked. We went the right avenues to the in-network hospital, and now we have this out of network doctor," said Pam.
A new Arizona law went into law into effect this year that was supposed to help people who get stuck with surprise out-of-network bills.
However, George and his wife say the process was confusing with a lot of paperwork.
So, the couple reluctantly paid the $1,500 out of network bill so the bill wouldn't go into collection and affect their good credit.
"We were up against the clock, we knew by the time we even got through this process of filling out this form that we were gonna be almost past due paying this bill," said Pam.
Feeling they had been taken advantage of, George and his wife contacted 3 On Your Side, and we got a hold of George's insurance company, Blue Cross Blue Shield, which started looking into the matter.
George says he wants to be reimbursed and feels this billing problem is something patients shouldn't have to worry about when they have a true emergency.
"You could die. That's at the forefront of your mind, next to your family. The last thing on your mind is, is the ER doctor seeing me in-network. No, that's not on anyone's mind," said George.
After 3 On Your Side's involvement, we discovered a mistake had been made when the claim was originally submitted and that the insurance company or George is not to blame.
Regardless, George is supposed to be getting his $1,500 back, and 3 On Your Side will give an update when that happens.