Wrestling With a Giant: How to Dispute a Hospital Bill
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Wrestling With a Giant: How to Dispute a Hospital Bill
By
Dan Weissmann
March 13, 2023
Wrestling With a Giant: How to Dispute a Hospital BillDan WeissmannWhen Sandeep Swami received a $1,339 bill for a quick and uneventful emergency room visit for his 11-year-old daughter, he pushed back. The charge was a facility fee for the hospital, though the treatment entailed only a six- to seven-minute consultation with a doctor. Because Swami had a high-deductible health plan and had not yet met his deductible for the year, he was on the hook for the entire amount. Swamis attempt to dispute the charge led him to battle the hospital, then his insurer, a bill-mediation service provided by his employer, and finally the debt collector. He didnt win, but learned valuable lessons about advocating for hospital discounts. An Arm and a Leg host Dan Weissmann speaks with Swami about the experience. He also interviews Kaelyn Globig, head of advocacy for the Rescu Foundation, about how to find out what Medicare pays for a given procedure, and April Kuehnhoff, an attorney with the National Consumer Law Center, for advice on filing a dispute with a debt collector. Dan Weissmann@danweissmannHost and producer of "An Arm and a Leg." Previously, Dan was a staff reporter for Marketplace and Chicago's WBEZ. His work also appears on All Things Considered, Marketplace, the BBC, 99 Percent Invisible, and Reveal, from the Center for Investigative Reporting.CreditsEmily PisacretaProducerAdam RaymondaAudio WizardAfi Yellow-DukeEditorClick to open the TranscriptTranscript: Wrestling With a Giant: How to Dispute a Hospital BillNote: An Arm and a Leg uses speech-recognition software to generate transcripts, which may contain errors. Please use the transcript as a tool but check the corresponding audio before quoting the podcast.Dan: Hey thereYou know, sometimes experiments fail. And when were lucky,Nothing life-changingly awful happens, andWe learn stuff.Thats the kind of story weve got today. It starts with a note from a listener named Sandeep Swami, who was in a fighting spirit.Sandeep: the facilities are doing nothing but taking advantage of a vulnerable situation, right, which the patient is already in.Dan: He was fighting a medical bill. And he had a question I didnt know the answer to. But I WANTED to know. And I knew exactly who I wanted to ask. It wasnt an academic researcher, or a lawyer, or whatever. It was somebody whose credentials were a lot more informal. One of my favorite people Ive ever talked with for this show. I wanted to put her together with Sandeep. In the end, Sandeeps experiment didnt work out the way hed hoped. He was disappointed, but hell be OK. Meanwhile, we did get the answer to that question, we had a great conversation with that expert and we learned some useful lessons.This is An Arm and a Leg a show about why health care costs so freaking much, and what we can maybe do about it. Im Dan Weissmann. Im a reporter, and I like a challenge. So our job on this show is to take one of the most enraging, terrifying, depressing parts of American life, and bring you something entertaining, empowering, and useful.Sandeep lives in the Bay Area, works in software, came to this country from India fourteen years ago.Sandeep: Im basically an immigrant. And so the whole system over here was kind of completely new to me.Dan: He was used to something a little more basic, but adequate and way more affordable. The last few years, hes had a high deductible insurance plan, and its gotten him VERY interested in learning more about how to avoid getting ripped off.Sandeep: you start seeing those big numbers being billed to you and you kind of get uncomfortable paying those large amount.Dan: Hes been listening to our show, and hes been reading a book weve talked about here: Never Pay the First Bill, by reporter Marshall Allen. I wouldnt say it had all left him itching for a fight, butSandeep: I had this in mind that, hey, the next time I have a situation where I had to walk into a facility, uh, Im kind of better preparedDan: Then, last spring his daughter wasnt feeling well she was eleven at the time. Just a cold, a cough at first. But her usual medicine an inhaler wasnt working like it usually did. And the cough it was keeping her awakeSandeep: about four or five in the morning. She was still not able to sleep with coughingDan: It got to be like 4 or 5 in the morning, and Sandeep was like, OK. I guess we better get her seen. Now. The trip to the ER was uneventful, and short.Sandeep: the whole consultation lasted probably about six, seven minutes.Dan: The doc said, shes gonna be OK. Maybe up the frequency with the inhaler. That was it. Sandeeps daughter gets better.A few weeks later he gets a bill: One thousand three hundred thirty-nine dollars. And this bill doesnt include the doctors services. That was a separate bill maybe sixty bucks, which he says he paid right away.This is from the hospital. And what did they do for him, exactly?Sandeep: there was no IV, no injection, nothing. There was nothing which was given to us from the emergency facility. And the only recommendation we got, hey, use over the counter medication.Dan: So, Sandeeps like, OK, Im gonna fight this.Sandeep: I think I can afford to pay this amount. Theres no questions that I, I wont be able to but I think its more like a principle thingDan: Im not gonna go through all the work Sandeep had already done before we talked. But it was a LOT.First, he checked: Was this charge even correct?He got an itemized bill, looked up the billing codes, found out he was being charged a facility fee like a cover charge just for walking into the ER.Its legal.In fact, hospitals will tell you: This is how they keep the lights on. And all the life-saving machinery running. And how they keep the nurses and other staff paid. All the people and equipment they need to keep at the ready for WHATEVER walks through the door.In any case, Sandeep was like, thirteen hundred bucks?He made all the phone calls: to the hospital, to his insurance, to a bill-mediation service from his employer.They all told him the same thing:Sorry, man. 13 hundred bucks is the amount your insurer pays for that code. Sandeep: you havent met your deductible. You had to pay, and this is the amount.Dan: He was like, yeah but its ridiculous.Sandeep: I said, even if I rent a hotel for a day, with all the facilities, its not going to come to this price at all.Dan: So even if theres no error, he wants to put up a fight. He goes looking for ammo: dat
Monday, March 13, 2023 at 9:00 am