N.C. woman seeks in-network hospital services, gets surprise $1,200 bill

Updated: Jun. 10, 2020 at 6:53 PM EDT
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HICKORY, N.C. (WBTV) - Imagine going to the hospital for in-network services you thought would be covered by your healthcare insurance, only to be blindsided by a big bill.

Lori Parsons, for five months, has battled with her insurance provider over $1,200 in medical bills.

“Well, it was unfair. It kind of made me feel like, okay are you trying to slip something in?” said Parsons.

In January, Parsons went in for a scheduled C-section at Catawba Valley Medical Center in Hickory.

Before the procedure, she carefully selected the hospital after verifying that it was in her insurance network, so there would be no additional, out-of-network fees.

“Everything went great, but later when I was out of the hospital, I started receiving bills. I received one from the anesthesiologist and noticed the insurance was not helping with anything on that bill,” Parsons said.

In February, Parsons received the first bill from Western Piedmont Anesthesia for $1,261 dollars for the anesthesia. Why the bill? Because, according to her insurance provider UnitedHealthcare, the anesthesiologist used for the procedure was “out of her network,” meaning Parsons had to pick up the full cost without any insurance coverage.

“I’m kind of at loss at what to do and who I need to go to or help take care of figuring out why an out-of-network provider was used without my knowledge to begin with,” Parsons said.

WBTV contacted Catawba Valley Medical Center to see why Western Piedmont Anesthesia, an out-of-network provider, was utilized for her procedure.

A spokesperson tells WBTV-Investigates, “Western Piedmont Anesthesia providers are not Catawba Valley Medical Center employees but they are credentialed to provide anesthesia services.”

Parsons says she specifically went to Catawba Valley Medical Center because they were identified as an in-network provider - to avoid these type of out of network charges. Parsons tried contacting her insurance, UnitedHealthcare, but says her claims were denied.

“It just made you feel like you had no control over a situation and that you, in turn, are being held responsible for,” Parsons said.

To get Parsons some answers, WBTV reached out to UnitedHealthcare to find out why an out of network anesthesiologist was selected for her procedure.

In a statement, UnitedHealthcare indicated, “People should not be unfairly exposed to surprise bills and higher out-of-network costs when they appropriately seek care through in-network hospitals and physicians. We will continue to look into this matter to address Ms. Parsons’ bill.”

Within a few hours, Parsons says she received a call from Western Piedmont indicating her bill of $1,200 will be reduced by 30 percent.

"I don’t think I would have gotten this without you guys, without your help,” Parsons said.

Parsons also says she will no longer have to deal with the different parties as UnitedHealthcare and Western Piedmont will be working together to handle her case from here.

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