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.

[WATCH: Casa Grande man goes to in-network hospital but receives out-of-network bill]

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.

[RELATED: Gilbert mom fighting medical bills she says she shouldn't owe]

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.

 


Copyright 2019 KPHO/KTVK (KPHO Broadcasting Corporation). All rights reserved.

 

Locations

Recommended for you

(16) comments

ObeyLaws

I thought "Obamacare" fixed all this... Apparently only for low income people of color.

MH

Obamacare destroyed affordable insurance in this country. Premiums tripled and will never return to what they were unless a major overhaul takes place with fixed pricing structures.

andthesurveysays

Trump. Whatever happened to the promise of fixing the medical insurance problem in this country, and opening it up to competition, dropping costs, and simplifying the mess. Oh right, someone is too busy worrying about hiding their college exam scores and tax returns...:-(

JustinP

Obama screwed it up too bad

MH

Perhaps if random liberal judges didn't block every attempt at correcting the screwed up systems in place, he'd have time to work on this.

Bearly

Hospitals and doctors are often told what to bill by their corporate entity which in many cases is a bunch of lawyers who hold the reins. You know, the same group infesting our government. Beware wolves in sheeps clothing goes far beyond religion.

Robs

Lucky Doc not pass gas n cause infection , then insurance rejection. Eat your heart out Jim Morrison how's that for new song lyrics ! [scared]

nuusmaan

Would you please give us the English translation?

ObeyLaws

Robs - I couldn't agree with your more! Your insight is always spot on.......

Mark G

“...we discovered a mistake had been made when the claim was originally submitted and that the insurance company or George is not to blame.”

LOL! ...yeah, right! “”””a mistake”””” ...Just a bunch of scumbag criminals trying to drain every-last dime out of the pockets of the poor, sick, and dying.

Funny, ain’t it? ..Just for example, You or I would go to prison for selling sheets of plywood for double their original cost in a time of natural disaster - tornados and whatnot.. Apparently that would be “immorally taking advantage of people to a criminal extent during a time of crisis which may endanger those, poor, people...” ..and yet the medical industry engage in hideous levels of this exact-same behavior day-in day-out? Billing fraud, ...and marking-up vital and necessary treatments and drugs sometimes thousands of percent - which literally kills and bankrupts decent hardworking people - just for the massive profit it brings in. And all that? Oh, that’s just dandy!

Horribly corrupt immoral industries propped up by a deeply corrupt and immorally biased system of government, they call that. ;0)

Not to worry! ...No, really! As you were! ..feel free to continue to fight amongst yourselves over your stupid political rivalries.

...As long as you’re distracted by the pats on the head, and being told that you are better than “them others”, while you tie nooses around your own necks, the real criminals can get away with pretty-much whatever they want... with the government’s blessing. ..you-know ... “the government” ..those people who pat you in the head and tell you just how much better you are than “those other people”. ;0)

Wearenotperfect

100% correct!

Robs

Did you forget to mention something,[scared]

Dean

It is FAR from "a bit of a problem" Gary. It is a MAJOR problem for people who do not get paid like you. Mistake in billing? That happens just about EVERY time one goes to the hospital or even some doctors. Those idiots in the billing department do not give a d@mn about what they do to their victims, as long as they get paid.

BillyWillie

Biden and Trump will RUN ON healthcare reform. Just a premonition/ speculation.

JustinP

Best suggestion is to go to small claims court and sue hospital. They will then start enforcing that the staff accept the in network amounts

nuusmaan

"Do no harm"- a phrase often associated with physicians. Not anymore.

Welcome to the discussion.

Keep it Clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
PLEASE TURN OFF YOUR CAPS LOCK.
Don't Threaten. Threats of harming another person will not be tolerated.
Be Truthful. Don't knowingly lie about anyone or anything.
Be Nice. No racism, sexism or any sort of -ism that is degrading to another person.
Be Proactive. Use the 'Report' link on each comment to let us know of abusive posts.
Share with Us. We'd love to hear eyewitness accounts, the history behind an article.