NewsLet Joe Know


How a $5000 medical bill became a $1300 refund!

Fighting back against out-of-network charges
Posted at 6:00 AM, Nov 08, 2019
and last updated 2019-11-08 08:59:39-05

When you have sudden, severe pain and head to the emergency room, you're probably not thinking about insurance.

So later, you may get hit with a big bill.

But one Arizona man found it was a bill he didn't have to pay.

Just after Christmas last year, Robert Tucci thought he was having a heart attack.

He went to a nearby emergency room run by Dignity Health, a department of Arizona General Hospital.

Robert says from there they sent him to a hospital.

It turns out it wasn't his heart; it was his gall bladder.

Robert says he was told he'd only have to pay $1,352 out of pocket, which he paid at the time of service.

But when he saw his insurance explanation of benefits, he says he was charged for a CT scan he says he never had.

He says he would be re-billed.

But instead of getting a $300 refund, Robert got a $5,200 new bill!

Robert says despite call after call to Dignity Health, he couldn't get an explanation.

So Robert let me know.

And the Let Joe Know/Better Business Bureau team took over.

Volunteer Kathy used her experience with health insurance issues, and she made quite an impression on Robert.

"I swear she was working four hours a day just for me," Robert said.

Kathy contacted the people at Dignity Health, Arizona General, the insurer, and the hospital.

Kathy found something Robert didn't know.

She found language in his benefits saying, "emergency room, emergency copay waived if hospitalized."

Robert was hospitalized that same day.

So, the expense should not be treated as out of network.

"What a Godsend," Robert says about his help from our volunteer Kathy.

Robert's insurer sent him a letter saying he was "inappropriately balance billed for services" by Arizona General Hospital.

And Robert didn't owe anything.

In fact, he got a check for $1,356.

Robert tells us after his months of working on it, "I couldn't be happier, but I could not have done it without you guys."

Dignity Health in Arizona sent us this statement:

"Federal privacy laws prohibit us from commenting on this patient’s specific billing situation. Our patients’ experience with our health care facilities - including during the billing process - is a top priority. We understand medical billing can be very complicated, and Dignity Health is continually striving to improve the process for our patients."