{"id":3194,"date":"2024-08-21T09:57:22","date_gmt":"2024-08-21T09:57:22","guid":{"rendered":"https:\/\/healthynewsusa.com\/?p=3194"},"modified":"2024-08-21T09:57:25","modified_gmt":"2024-08-21T09:57:25","slug":"patient-underwent-one-surgery-but-was-billed-for-two-even-after-being-sued-she-refused-to-pay","status":"publish","type":"post","link":"https:\/\/healthynewsusa.com\/?p=3194","title":{"rendered":"Patient Underwent One Surgery but Was Billed for Two. Even After Being Sued, She Refused To Pay."},"content":{"rendered":"<div>\n<p>\n\t<iframe loading=\"lazy\" allow=\"fullscreen\" frameborder=\"0\" height=\"290\" src=\"https:\/\/www.npr.org\/player\/embed\/nx-s1-5072975\/nx-s1-bfeafd52-0505-49ba-a358-33831e91ecff\" width=\"100%\"><\/iframe>\n<\/p>\n<p>Jamie Holmes says a surgery center tried to make her pay for two operations after she underwent only one. She refused to buckle, even after a collection agency sued her last winter.<\/p>\n<p>Holmes, who lives in northwestern Washington state, had surgery in 2019 to have her fallopian tubes tied, a permanent birth-control procedure that her insurance company agreed ahead of time to cover.<\/p>\n<p>During the operation, while Holmes was under anesthesia, the surgeon noticed early signs of endometriosis, a common condition in which fibrous scar tissue grows around the uterus, Holmes said. She said the surgeon later told her he spent about 15 minutes cauterizing the troublesome tissue as a precaution. She recalls him saying he finished the whole operation within the 60 minutes that had been allotted for the tubal ligation procedure alone.<\/p>\n<p>She said the doctor assured her the extra treatment for endometriosis would cost her little, if anything.<\/p>\n<p>Then the bill came.<\/p>\n<figure class=\"wp-block-embed is-type-rich is-provider-documentcloud wp-block-embed-documentcloud\">\n<p>\n<iframe loading=\"lazy\" title=\"August 2024 BOTM (Hosted by DocumentCloud)\" src=\"https:\/\/embed.documentcloud.org\/documents\/25023419-holmes-collection\/?embed=1\" width=\"570\" height=\"750\" style=\"border: 1px solid #aaa;\" sandbox=\"allow-scripts allow-same-origin allow-popups allow-forms allow-popups-to-escape-sandbox\"><\/iframe>\n<\/p>\n<\/figure>\n<p><strong>The Patient: <\/strong>Jamie Holmes, 38, of Lynden, Washington, who was insured by Premera Blue Cross at the time.<\/p>\n<p><strong>Medical Services:<\/strong> A tubal ligation operation, plus treatment of endometriosis found during the surgery.<\/p>\n<p><strong>Service Provider:<\/strong> Pacific Rim Outpatient Surgery Center of Bellingham, Washington, which has since been purchased, closed, and reopened under a new name.<\/p>\n<p><strong>Total Bill:<\/strong> $9,620. Insurance paid $1,262 to the in-network center. After adjusting for prices allowed under the insurer\u2019s contract, the center billed Holmes $2,605. A collection agency later acquired the debt and sued her for $3,792.19, including interest and fees.<\/p>\n<p><strong>What Gives:<\/strong> The surgery center, which provided the facility and support staff for her operation, sent a bill suggesting that Holmes underwent two separate operations, one to have her tubes tied and one to treat endometriosis. It charged $4,810 for each.<\/p>\n<div class=\"wp-block block--newsletter  \" data-type=\"kaiser-health-news\/newsletter\" data-align=\"center\" style=\"\">\n<h4 class=\"newsletter__title\">\n\t\t<a href=\"https:\/\/kffhealthnews.org\/email\/\"><br \/>\n\t\t\tEmail Sign-Up\t\t<\/a><br \/>\n\t<\/h4>\n<p class=\"newsletter__description\">\n\t\tSubscribe to KFF Health News&#8217; free Morning Briefing.\t<\/p>\n<\/div>\n<p>Holmes said there were no such problems with the separate bills from the surgeon and anesthesiologist, which the insurer paid.<\/p>\n<p>Holmes figured someone in the center\u2019s billing department mistakenly thought she\u2019d been on the operating table twice. She said she tried to explain it to the staff, to no avail.<\/p>\n<p>She said it was as if she ordered a meal at a fast-food restaurant, was given extra fries, and then was charged for two whole meals. \u201cI didn\u2019t get the extra burger and drink and a toy,\u201d she joked.<\/p>\n<p>Her insurer, Premera Blue Cross, declined to pay for two operations, she said. The surgery center billed Holmes for much of the difference. She refused to pay.<\/p>\n<p>Holmes said she understands the surgery center could have incurred additional costs for the approximately 15 minutes the surgeon spent cauterizing the spots of endometriosis. About $500 would have seemed like a fair charge to her. \u201cI\u2019m not opposed to paying for that,\u201d she said. \u201cI am opposed to paying for a whole bunch of things I didn\u2019t receive.\u201d<\/p>\n<figure class=\"wp-block-image alignwide size-full\"><figcaption class=\"wp-element-caption\">Holmes figured it was a mistake when she was billed for two surgeries after being on the operating table just once. Her insurer, Premera Blue Cross, declined to pay for two operations, she says. The surgery center billed Holmes for much of the difference.<span class=\"photo-credit\">(Ting-Li Wang for KFF Health News)<\/span><\/figcaption><\/figure>\n<p>The physician-owned surgery center was later purchased and closed by PeaceHealth, a regional health system. But the debt was turned over to a collection agency, SB&amp;C, which filed suit against Holmes in December 2023, seeking $3,792.19, including interest and fees.<\/p>\n<p>The collection agency asked a judge to grant summary judgment, which could have allowed the company to garnish wages from Holmes\u2019 job as a graphic artist and marketing specialist for real estate agents.<\/p>\n<p>Holmes said she filed a written response, then showed up on Zoom and at the courthouse for two hearings, during which she explained her side, without bringing a lawyer. The judge ruled in February that the collection agency was not entitled to summary judgment, because the facts of the case were in dispute.<\/p>\n<p>Representatives of the collection agency and the defunct surgery center declined to comment for this article.<\/p>\n<p>Sabrina Corlette, co-director of Georgetown University\u2019s Center on Health Insurance Reforms, said it was absurd for the surgery center to bill for two operations and then refuse to back down when the situation was explained. \u201cIt\u2019s like a Kafka novel,\u201d she said.<\/p>\n<p>Corlette said surgery center staffers should be accustomed to such scenarios. \u201cIt is quite common, I would think, for a surgeon to look inside somebody and say, \u2018Oh, there\u2019s this other thing going on. I\u2019m going to deal with it while I\u2019ve got the patient on the operating table.\u2019\u201d<\/p>\n<p>It wouldn\u2019t have made medical or financial sense for the surgeon to make Holmes undergo a separate operation for the secondary issue, she said.<\/p>\n<p>Corlette said that if the surgery center was still in business, she would advise the patient to file a complaint with state regulators.<\/p>\n<p><strong>The Resolution: <\/strong>So far, the collection agency has not pressed ahead with its lawsuit by seeking a trial after the judge\u2019s ruling. Holmes said that if the agency continues to sue her over the debt, she might hire a lawyer and sue them back, seeking damages and attorney fees.<\/p>\n<p>She could have arranged to pay off the amount in installments. But she\u2019s standing on principle, she said.<\/p>\n<p>\u201cI just got stonewalled so badly. They treated me like an idiot,\u201d she said. \u201cIf they\u2019re going to be petty to me, I\u2019m willing to be petty right back.\u201d<\/p>\n<p><strong>The Takeaway: <\/strong>Don\u2019t be afraid to fight a bogus medical bill, even if the dispute goes to court.<\/p>\n<p>Debt collectors often seek summary judgment, which allows them to garnish wages or take other measures to seize money without going to the trouble of proving in a trial that they are entitled to payments. If the consumers being sued don\u2019t show up to tell their side in court hearings, judges often grant summary judgment to the debt collectors.<\/p>\n<p>However, if the facts of a case are in dispute \u2014 for example, because the defendant shows up and argues she owes for just one surgery, not two \u2014 the judge may deny summary judgment and send the case to trial. That forces the debt collector to choose: spend more time and money pursuing the debt or drop it.<\/p>\n<p>\u201cYou know what? It pays to be stubborn in situations like this,\u201d said Berneta Haynes, a senior attorney for the National Consumer Law Center who reviewed Holmes\u2019 bill for KFF Health News.<\/p>\n<p>Many people don\u2019t go to such hearings, sometimes because they didn\u2019t get enough notice, don\u2019t read English, or don\u2019t have time, she said.<\/p>\n<p>\u201cI think a lot of folks just cave\u201d after they\u2019re sued, Haynes said.<\/p>\n<figure class=\"wp-block-image alignwide size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"3000\" height=\"2000\" src=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg\" alt=\"A photo of Jamie Holmes standing outside.\" class=\"wp-image-1901182\" srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg 3000w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=150,100 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=500,333 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=768,512 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=1270,847 1270w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=1536,1024 1536w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=2048,1365 2048w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=770,513 770w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=840,560 840w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=570,380 570w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=370,247 370w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=270,180 270w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=170,113 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=100,67 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=120,80 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=1170,780 1170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=300,200 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=200,134 200w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=315,210 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=630,420 630w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2024\/08\/BOTM_Holmes_03-resized.jpg?resize=1200,800 1200w\" sizes=\"auto, (max-width: 3000px) 100vw, 3000px\"\/><figcaption class=\"wp-element-caption\">Holmes says she tried to explain her situation to the surgery center\u2019s staff, to no avail \u2014 then refused to back down when she was sued for the debt. \u201cI just got stonewalled so badly. They treated me like an idiot,\u201d she says. \u201cIf they\u2019re going to be petty to me, I\u2019m willing to be petty right back.\u201d<span class=\"photo-credit\">(Ting-Li Wang for KFF Health News)<\/span><\/figcaption><\/figure>\n<p><em>Emily Siner reported the audio story.<\/em><\/p>\n<p><em>After six years, we\u2019ll have a final installment with NPR of our Bill of the Month project in the fall. But Bill of the Month will continue <\/em><a href=\"https:\/\/kffhealthnews.org\/news\/tag\/bill-of-the-month\/\"><em>at KFF Health News<\/em><\/a><em> and elsewhere. We still want to hear about your confusing or outrageous medical bills. Visit <\/em><a href=\"https:\/\/kffhealthnews.org\/send-us-your-medical-bills\/\"><em>Bill of the Month<\/em><\/a><em> to share your story.<\/em><\/p>\n<aside class=\"meta-authors meta\">\n<p>\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"author-name\">Tony Leys: <\/span><br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/kffhealthnews.org\/news\/article\/bill-of-the-month-one-surgery-charged-for-two-collections-lawsuit\/mailto:tleys@kff.org\">tleys@kff.org<\/a>,\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/twitter.com\/tonyleys\" target=\"_blank\" rel=\"noopener\"><br \/>\n\t\t\t\t\t\t\t@tonyleys<\/a>\n\t\t\t\t\t\t\t\t\t<\/p>\n<\/aside>\n<section class=\"block--category-tag-list \">\n<div class=\"category-tag-list__content-wrapper\">\n<h3 class=\"block--category-tag-list__title\">\n\t\t\t\tRelated Topics\t\t\t<\/h3>\n<p>\t\t\t\t<a class=\"category-tag-list__contact-link\" href=\"https:\/\/kffhealthnews.org\/contact-us\/\"><br \/>\n\t\t\tContact Us\t\t<\/a><br \/>\n\t\t<a class=\"category-tag-list__tip-link\" href=\"https:\/\/kffhealthnews.org\/tips\/\"><br \/>\n\t\t\tSubmit a Story Tip\t\t<\/a>\n\t<\/div>\n<\/section><\/div>\n<p><script async src=\"\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Jamie Holmes says a surgery center tried to make her pay for two operations after she underwent only one. She refused to buckle, even after a collection agency sued her last winter. Holmes, who lives in northwestern Washington state, had surgery in 2019 to have her fallopian tubes tied, a permanent birth-control procedure that her [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":3195,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-3194","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-industry"],"_links":{"self":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts\/3194","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3194"}],"version-history":[{"count":1,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts\/3194\/revisions"}],"predecessor-version":[{"id":3196,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts\/3194\/revisions\/3196"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/media\/3195"}],"wp:attachment":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3194"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3194"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3194"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}