Auburn woman calls $46,000 medical bill excessive

KING 5's Danielle Leigh reports.

Following the series 'Buyer beware' KING 5 received well over 100 emails from viewers asking for help with their medical bills.

Among the most shocking came from a viewer in Auburn who complained that a hospital had nearly tripled their prices from one year to the next.

Rachel Ayers received a special type of X-ray two years in a row known as an angiogram and while she believed the procedures were largely the same, she said the bills couldn't have been more different.

The trouble started when Ayers suffered a brain aneurysm while backpacking near Lost Lake. She was rushed to Harborview Medical Center where she spent 19 days.

"It's almost like I wouldn't be here to complain about the bill if it wasn't for the care I received," Ayers said.

Ayers wasn't complaining until she went back to Harborview for a follow up angiogram the next year.

As far as she knew it was the same procedure she had received right after her emergency.

"There is just no explanation for the rise in cost," Ayers said. "Then you get an almost $48,000 bill."

Her insurance was covering all but 15 percent of the cost. Ayers' problem was with the overall bill, which she believed was nearly three times higher than the year before.

"I said there must be some mistake. There has got to be a mistake in this billing," Ayers said.

Part of Ayer's shock came from a federal change in billing guidelines allowing hospitals to combine multiple fees related to the angiogram into one charge making the procedure itself look more expensive.

"There is no transparency on that," Ayers said.

But even taking the billing changes into consideration, Harborview's prices still appeared to have roughly doubled.

"It's just basically, this is what we can charge you because we can," Ayers said.

KING 5 took the bills to two separate billing experts who agreed with Ayers.

The co-founder of Bill Crew determined, "The patient was grossly overcharged."

Even the American College of Radiology, experts on the procedure, called the charge "very high."

"Billing is really complex," said Mary Kay Clunies-Ross, spokesperson for the Washington State Hospital Association.

Clunies-Ross said hospitals are not taking advantage of consumers by setting high prices for procedures.

"More than 90 percent of Washington hospitals are non-profits. So the money motive is about maintaining that access to care. If a hospital can't pay its providers, then the providers won't show up," Clunies-Ross said.

Harborview declined KING 5's request for an on-camera interview but explained by email they work hard to offer fair prices.

"We work diligently to ensure that our charges/prices are benchmarked appropriately against other hospitals in the region and follow standard billing policies and protocols. The prices for these angiography and radiological procedures are well aligned with the regional rates," wrote Harborview Spokesperson Susan Gregg.

KING 5 requested estimated costs for the angiogram Ayers received from several area hospitals and regionally, Harborview it not the most expensive.

Harborview Medical Center's estimate values the procedure at $16,251.

By contrast Swedish Medical Center quoted KING 5 $15,615; Virginia Mason $19,805; and Providence Regional Medical Center in Everett $8,459.38.

So, Ayers could have saved by going somewhere else and nearly cut her bill in half by visiting Providence instead of Harborview.

"It's got me all spooled up again," Ayers said.

Patient advocate Karen Vogel says there's a reason why Harborview prices are higher.

"It is also a teaching and research facility and has a trauma center. Their charges are going to be high," Vogel said.

Ayers is still frustrated, but she says understanding the bill is helping her let it go.

"It's truly a miracle between God and the doctors someone kept me alive," Ayers said. "I'm not going to waste the time I have been given."

Ayers experience offers an important reminder: prospective patients can ask any doctor, hospital or provider for the estimated cost of a procedure and that provider is required to provide an estimate.

When it's not an emergency, taking the time to shop around, like you do with a car, will save money.

If you have a frustrating medical bill, you can email KING 5 at ShareYourBills@king5.com. 

Copyright 2016 KING


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