woman is handed $17,979 bill for breast cancer screening because she had insurance. $2100 if none

[Demovictory9]

Woman, 36, is handed $17,979 bill for breast cancer screening despite being insured - and could have paid $2,100 if she did NOT use her insurance
Dani Yuengling, from South Carolina, was seen for a lump on her right breast
The hospital refused to tell her the price, but she says its calculator suggested she would need to pay about $1,400 for the procedure
But when the bill arrived she found out she was charged 12-times this amount
Experts warned hospitals regularly charge more to people who have insurance
They said everyone should always ask for the cash price of a procedure
The Conway Medical Center nearby said it would charge $2,100 cash price for the same procedure she got at Grand Strand Medical Center

A 36-year-old woman has been charged nearly $18,000 for a breast biopsy despite having health insurance — only to find out she could have been billed just $2,100 if she had offered to pay the cash price.

Dani Yuengling, from Conway, South Carolina, went to see her doctor early this year after noticing a lump on her right breast. She feared the worst because her mother had died from breast cancer five years earlier.

The HR worker was referred to the Grand Strand Medical Center, in Myrtle Beach, for a biopsy — with a quick check of the hospital's expenses calculator showing an uninsured patient would be charged $1,400. Yuengling hoped her health insurance with Cigna — one of the nation's largest insurers — would help offset the cost.

But after having the procedure in February — and no cancer being found — she was billed $17,979. Yuengling said the mammoth bill left her struggling to sleep at night, distressed and suffering migraines. She secured a 36 percent discount after calling the hospital, but is now refusing to return for a follow up.

Her health insurance negotiated rate saw the bill cut to $8,424.14, with Cigna offering to pay $3,254.47. They lumped Yuengling with the remaining $5,169.67 — or the amount left of her deductible.

After calling the hospital to complain, she secured a 36 percent discount — taking the bill to $3,306.29. She put this on her credit card, and says she now wants nothing more to do with the hospital.


https://www.dailymail.co.uk/health/article-11138297/Woman-35-handed-17-979-bill-breast-cancer-screening-despite-insured.html

[Eliot Rosewater]

1. Just for the stress already caused she should be able to sue for millions and win.

[bullimiami]

2. Its a fucking criminal racket.

[Celerity]

12. +100

[Celerity]

13. +100

[OAITW r.2.0]

3. Fucked up.

Medicare reform can happen if we elect enough intelligent people in our national Congress.

[hedda_foil]

5. Medicare isn't relevant to this case. She's 36.

[KentuckyWoman]

4. Deductable over $5000

Apparently well over $5000.

This needs to be fixed. We don't need coverage. We need access to medical care.

In the meantime, there is a lesson here.

[IcyPeas]

6. Damn health insurance companies.

Making profits off of sick people. It's sick.

[Takket]

7. this is fraud. Fraud is still illegal, isn't it?

[yourout]

8. Not suprised....my CPAP supplies COPay was more than if I went and bought them.

Its a racket.

[keithbvadu2]

14. My CPAP supplies copay is zero but the list price is up in the sky.

My CPAP supplies copay is zero but the list price is up in the sky.
--------------------------------

My dental is fully covered.
Looks like it is billed accordingly.

[progree]

9. Here's the NPR National Public Radio story

https://www.mprnews.org/story/2022/08/23/npr-an-18-000-biopsy-paying-cash-might-have-been-cheaper-than-using-her-insurance

though I don't see anything inaccurate in the OP - its a good summary.

Here's some additional info

Jacqueline Fox, a health care attorney and a professor at the University of South Carolina School of Law, said she isn't aware of any law that would prohibit a patient from doing that ((paying cash rather than using her insurance -Progree)). After all, she pointed out, patients with health insurance pay cash prices for prescription medications all the time. It stands to reason they could do the same for medical procedures.

But some facilities make this difficult. Grand Strand Medical Center, for example, offers "self-pay" patients an "uninsured discount," but that discount is limited to people who have "no third party payer source of payment or do not qualify for Medicaid, Charity or any other discount program the facility offers," according to the hospital's website. Only patients confirmed to have no health insurance are offered information about the discount.

In some cases, paying a cash price for a procedure might not make financial sense in the long run because none of it would be applied toward the deductible. Patients might save money on one procedure but end up paying their full deductible if unexpected medical expenses mount later during the calendar year.

Insured patients should reach out to their health plan for a good-faith estimate before a procedure. Under the No Surprises Act, health plans are supposed to give members an idea of their total out-of-pocket costs upon request. Ask for an "Advanced Explanation of Benefits," said Sabrina Corlette, a research professor at the Georgetown University McCourt School of Public Policy, though she points out this part of the law isn't being enforced yet.

The No Surprises Act also allows patients to file complaints with the federal government regarding their medical bills — whether or not they carry health insurance.

Her medical plan has an annual deductible of $6,000, and she had previously used some of that, leaving her with $5,169.67 remaining on her deductible.

Compare to Medicare, had she been Medicare eligible --

Grand Strand charged Yuengling's insurance an extraordinarily high price for her procedure. By comparison, according to the federal government's website, Medicare patients who need an ultrasound-guided biopsy similar to the one Yuengling received would pay only about $300 — their required 20 percent coinsurance for outpatient care. Medicare would pay the hospital the remainder of the bill, about $1,200. The hospital expected more than five times the Medicare price from Yuengling and her insurer.

[Skittles]

10. it is legalized extortion

it is wrong, wrong, WRONG

[Maeve]

11. Insurance deforms the health care system

Hubby got a charge of $1000 for a procedure...insurance knocked it down to $70, of which he paid half. This is f*ing INSANE. No one knows cost/value because it's a freaking game.
SINGLE PAYER, EVERYONE COVERED. NO PROFIT MEDICINE.

[Chuuku Davis]

15. Just to be technical

That was not for CA screening.
That was a diagnostic test.

[Ron Green]

16. One risk pool is a health care system. Multiple risk pools is an investment scheme.

We have enough investment schemes in this country; we need a health care system.

[RANDYWILDMAN]

17. When is the karma coming for these people !!!! healthcare is not for profit

you aholes are killing people and you know it !!

[Hermit-The-Prog]

18. Somehow we have been convinced that paying for healthcare deniers makes it cheaper.

We have healthcare providers and healthcare recipients separated by an entire, self-enriching healthcare denier industry. We shouldn't pay for mansions, skyscrapers, consultants, and deniers on top of what health care costs. Let's cut out the "middle man".