Lap Band Surgery Insurance Woes

The ABC News Fixer steps in when billing error almost meant big bill.

ByABC News
May 6, 2014, 1:05 PM
Here are five tips for choosing a health insurance company.
Here are five tips for choosing a health insurance company.
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May 6, 2014 — -- Dear ABC News Fixer: My wife got lap band surgery on in November 2011. Everything was pre-approved though my insurance at the time. Everyone got paid except the anesthesiologist.

I got my explanation of benefits from the insurance company. They said the anesthesiologist submitted incomplete records to them, which resulted in the claim being denied.

The bill is now in collections and continues to grow to the tune of over $3,000. To make matters worse, since this happened, my employer has switched insurance providers and the old call center numbers are disconnected.

I’ve contacted a lawyer, but he wants more than $1,000. Please help me. Our family is trying to buy our first home and this is standing dead in the road of our family dream.

- Daniel Carrillo, Moreno Valley, Calif.

Dear Daniel: If the ABC News Fixer had to rank the most annoying things ever, insurance billing issues would be right up there with buzzing mosquitoes and people who smoke cigars (sorry, William Shatner).

They’re guaranteed to sap your time and energy. By the time we got involved, your original $2,614 bill had grown to a $3,500 whopper at the collection agency – and the kicker is you shouldn't have owed the money in the first place.

Happily, we were able to find a sympathetic soul at the Tri-City Regional Medical Center in Hawaiian Gardens, Calif., who could help with this. Manuela Ochoa, director of business development at the medical center, promised to run interference. She got in touch with the contracted anesthesiology group and the collection agency and zeroed out your bill. Whether they’ll still try to collect from the insurance company is up to them.

So now you’re off the hook for the money. More important, they are following through with the collection agency to make sure the negative information is taken off your credit report.

This is a good time to remind everyone to get a free copy of their credit report every 12 months at www.annualcreditreport.com. It’s worth doing this, just to make sure there’s no incorrect information waiting to derail you later. More tips on credit reports are HERE.

- The ABC News Fixer

Got a consumer problem? The ABC News Fixer may be able to help. Click here to submit your problem online. Letters are edited for length and clarity.