Outstanding Bill from Baby’s Birth
What a tough start. We had a young mom who reached out. Just so worried about her baby’s $5,620.40 medical bill. The letters kept coming in. The bill was for newborn nursery care – for two days. The day she was born, and the day after that.
Why wasn’t this bill paid? The mom’s bill was paid – and she was even proactive (and smart) enough to call the insurance company the day after birth to let them know that her little girl was born, and would they please add her to the insurance plan.
Insurance Company Went Bust!
Unfortunately…..this really happened. The insurance company went bust - the week the baby was born. Because there was a contract between the hospital and the insurance company pre-birth, the hospital covered the delivery. But the baby….nope. She was not on the list.
The letters kept coming. The bill went into collection, and after that was directed to a Law Office in Princeton. The mom tried to explain over and over that the baby would have been covered under her plan, thus she should be covered. The hospital stood its ground. The baby was not on the list provided to them by the insurance company.
Help Is On The Way
This young mom, after two years of stress over the bill, reached out to Lorie Gardner at HealthLink Advocates. Lorie listened to the story and was as outraged as you probably are reading about it.
What did we do? First, we took a look at all of the paperwork. The mom’s bills. The baby’s bills. The nurse advocates did not see anything untoward or out of line. The care was textbook. The insurance advocate was heartened to hear this. No extenuating circumstances. Just about as average a bill one could get for the birth of a child. We were able to confirm that the mom's bill was paid in full, less her deductible. None of the baby's bill had been paid. The lawyer’s letter said that the family had thirty (30) days to respond. Either dispute the “validity of the debt” or make payment.
Research on the Bankrupt Company
After that, we dove in and did some research on the now-bankrupt insurance company. There were a lot of people in a sticky situation. However, we could not attune the baby’s birth into any of the scenarios we were seeing in the published legal papers. The agreement with the insurance company was that they be informed. They were. Within a short time of birth, with a record to show for it.
Game plan. We printed out as much relevant information we could about the plan, and the state bankruptcy/insurance actions against the plan. We saw that the state was taking a big part in the recoup of some of the funds, and it was pretty sticky. Many of the hospitals and physicians would be paid pennies on the dollar by the state – not by the patients.
Kindness Works!
But….you should never discount the common sense and kindness of people. On a whim, we called the hospital and asked to speak with an administrative representative – not a billing representative. The job of a billing representative is to collect on the bills and make the balances move to zero. However, the administrative representative had a different job and a different mindset. After we explained that we were advocating for this young family, she asked for us to send her all of the information we had gathered. We sent it all. The posted affidavits, the hearings, the court papers. Anything we thought would be relevant.
A week later, the call came in. The hospital agreed that the baby and her family should not be held responsible for the bill – that the baby would have been covered under the mom’s plan, and thus they would zero out the family’s bill, and pursue the funds through the bankruptcy courts and insurance avenues now being administered by the State.
As advocates, we live for these days. We work together, brainstorming, trying to figure out what we can do for each and every situation to make a positive change. Yes, it was a win for our client. It is why we do what we do.