CONCORD, N.C. (WBTV) - When you live on a fixed income, every dollar makes a difference.
Surprise medical bills can be a huge problem. That’s what happened to a 74-year-old Charlotte-area woman.
Doris Alton went to Atrium Health Cabarrus to relieve her pain but says the stress caused by her $4,000 bill only made it worse.
“I’m not getting any cooperation with getting this bill cleared,” Alton said.
Alton had surgery at Atrium Health Cabarrus in April of 2019.
“I went to see the surgeon and he thought it was medically necessary because it was causing irritation and pain,” Alton said.
Alton assumed that since she is on Medicare and had met her deductible that the cost for her surgical procedure would be covered by Medicare and her supplemental insurance.
However, she got a bill from Atrium for $4,400 a few months later.
“I do not understand, at 74 wh,y I am being billed this,” Alton said.
Alton said no one at Atrium or Blue Cross Blue Shield ever explained what her actual costs would be after insurance.
“I’m assuming that the surgeon would have gotten pre-authorization and I had to bring in all my medical insurance and stuff,” she said.
In looking at the bills, it appears that Blue Cross paid for medical supplies, but that’s about it.
“I cannot get a resolution from Atrium Health or Medicare,” Alton said.
Alton said Medicare denied her claim, calling the procedure “cosmetic,” even though she produced documentation from her physician indicating the surgery was medically necessary.
If the procedure was “medically necessary”, why was it not covered?
To get answers, WBTV contacted Atrium and Medicare.
Atrium has still not responded to any of our questions, but a spokesperson for Medicare did, indicating, both Atrium and Alton had 120 days to appeal their decision but didn’t.
Alton said Atrium never told her she could appeal the decision.
Shortly after our calls, Alton got a call from Medicare saying Atrium would be clearing the bill so she doesn’t owe anything – something the Medicare spokesperson confirmed.
“WBTV helped me a great deal because I was not really getting any positive interaction or resolution with this bill until they stepped in . . . I thank WBTV so much,” Alton said.