KAKE NEWS INVESTIGATES: Surprise medical bills

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WICHITA, Kan. (KAKE) -

Surprise medical bills can stick patients with hundreds, if not thousands of dollars in costs, even if they are insured.

The White House is endorsing a bipartisan bill to fight health care costs.

The goal is to limit “surprise” medical bills, which is when patients are unknowingly treated by providers from outside their insurance networks. The measure is supported by the Senate Republican and House Democrat who chair key health committees in their respective chambers.

That bill couldn’t come soon enough for a lot of patients suddenly stuck with bills for thousands of dollars.

Experts say medical expense are one of the leading causes of debt in the state of Kansas. And the method in which those bills come have some demanding to know why.

“All of these say ‘date of service’ but why it went up three times? I don’t have a clue,” said Ralph Brankel. “All of this paperwork right here is only for the emergency room.”

More than a year ago he went to the emergency room, after his heartbeat skyrocketed to 200 beats per minute. He’d hoped another doctor’s office could help him but they referred him to Emergency instead.

“I get this bill here of $1190, and I was perturbed here, but then later I got another one for $1,236,” he said.

His first bill was for less than $600, of which he’d covered a portion. But it kept getting higher with additional charges and he wanted to know why. An answer that was getting difficult to obtain.

“They want their money and they want it now,” he said.

Do a search for medical expenses in Wichita alone and you’ll see crowdfunding sites like GoFundMe, are filled with people asking for help. Requests are made anywhere from $5,000 to $25,000. Those are all out of pocket expenses, and in most cases what’s left after insurance.

So after searching for solutions, KAKE News Investigates got hold of Christine Van Haren. She’s and Individual Patient Advocate, based in Wisconsin.

“Advocates, in general, perform a lot of service and it’s really individualized based on what a person needs,” she said. “If somebody needs billing services, we do address denials. There are people who can specialize in that.”

She doesn’t represent Brankel but was not surprised when KAKE News told her what he’d gone through.

“I am seeing more of the claims getting out of hand,” she said. “It has changed with the payment models. It’s more difficult for facilities to get their payments from insurance companies.”

Not only do hospitals send specific bills for specific charges, but insurance companies go deeper. They’ll search for misspellings in records, or any other technicality to deny a claim. Or in some cases, they’ll charge for different services if they’re out of network. So even if your doctor is in your insurance network, the anesthesiologist or secondary service may not be. And then your bill soars.

“Be proactive about it,” Van Haren said. “Contact the financial department.”

She recommends finding an advocate and challenge insurance companies on their policies and decisions.

While no patient advocates are currently active in the state of Kansas, that doesn’t really matter. Advocates can take clients on across state lines to help negotiate health care needs.

For more information on the role they play, click here.

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