CHARLOTTE, N.C. (WBTV) - A local man went to the hospital thinking his procedure would be covered by insurance, but got a rude awakening when he opened the mail and got a bill for thousands of dollars instead.
Bob Beggs went to Atrium Health for a procedure.
Thinking it had been pre-approved by his insurance, it turns out, it hadn’t. More than a year later, he’s facing a collection agency.
“Medical billing is complex, medical procedures are complex,” Beggs said.
And what happened to Bob Beggs is complex.
Beggs was admitted to Atrium Health for a medical procedure in 2019. He says Atrium filed the insurance claim with BlueCross BlueShield of Illinois.
However, BlueCross only paid $300 instead of the $3,600 charged by his physician. Beggs says Atrium’s facilities charge was $2,400 and Atrium offered to cut that in half.
“The insurance company finally said it wasn’t going to cover the facilities charges from Atrium because they said the procedure was considered experimental,” Beggs said.
Beggs says this was the first time anyone had used the word experimental.
“As it turns out, the procedure wasn’t pre-approved, the doctor never provided me a cost estimate, nobody ever said the procedure might be considered experimental so...,” Beggs said.
Beggs doesn’t believe he should be responsible for either the physician or facilities charges.
He’d already met his deductible for the year – he shouldn’t owe anything.
WBTV reached out to BlueCross BlueShield and Atrium to get a better understanding of what happened in his case.
Atrium as of Wednesday night has not responded.
In a statement, BCBS refused to provide any information, citing Begg’s privacy even though he filled out a waiver authorizing them to discuss his case:
“To protect the privacy of our members, Blue Cross and Blue Shield of Illinois does not disclose their personal or benefit information. Our members are at the center of all that we do and we are committed to providing all of our members access to quality health care consistent with the terms of their benefit coverage. If a member questions any benefit determination we encourage them to file an appeal for a review of the decision.”
But minutes after WBTV contacted BCBS and Atrium, Beggs says he received calls from both indicating they will now be re-examining his case.
“Whatever you’ve done - that has made great progress in six hours that I haven’t been able to make in 15 months,” Beggs said.