Saturday, May 17, 2008

Billing issue leaves patients feeling ill

Celina Fuentes, 80, had a heart attack a year ago and was taken by ambulance to La Palma Hospital in Orange County. She pulled through, paid the $250 deductible for the four-day hospitalization, and thought her payment issues, at least, were over.

Then came the shocker: A bill arrived this month from the hospital saying she owed $5,239.85 -- the amount of the $11,000 bill her insurer, Kaiser Permanente, didn't pay. The letter said Fuentes and her husband, Renato, had one month to pay or the matter would be turned over to a collection agency. "The day I got the letter I couldn't sleep for two or three nights," Renato said, fighting back tears. "We live on Social Security. This bill is insurmountable for us."

In recent weeks, Kaiser says, as many as 6,000 of its Southern California members have received similar bills -- some as high as $50,000 -- from Prime Healthcare Services Inc., a hospital chain based in Victorville. Kaiser is involved in separate litigation with Cedars-Sinai Medical Center about similar billing issues. Other insurers, such as Health Net, have faced penalties for such billing controversies.

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According to the Times story, "When Reddy's company, Prime Healthcare Services Inc., takes over a hospital, it typically cancels insurance contracts, allowing the hospital to collect steeply higher reimbursements.

My suggestion is to go to a hospital that has a contract with your insurance company to simplify potential billing issues. Bill

Prime Healthcare Services

Desert Valley Hospital - Victorville