Sunday, July 1, 2007

A $962,120 medical bill error

The patient didn't have to pay, but it's still a useful lesson for others, an economist says.
Helen Dorroh White thought she was doing the right thing when she called a health insurance company to question a nearly $1-million medical bill. Instead, she said, no one seemed to care.

White, a Glendale lawyer, was closing the financial affairs for a deceased client when she came across the insurance statement. It showed a $962,120 bill for her client, Dusanka Mlinarevich, who spent four days at Glendale Adventist Medical Center after suffering minor injuries in a fall at her Burbank home last year.

That struck White as odd, she said, because the hospital had told her the bill was $48,106.

Concerned about the discrepancy, White called the health insurance company, Long Beach-based SCAN Health Plan.

"My first question was, 'Is this some kind of typo or some mistake?' " said White, 73. A customer service representative paid little heed, White said, and insisted that the amount was correct.

"She didn't even bat an eye," White said.

Fearing fraud, White wrote a letter to the U.S. attorney's office and contacted The Times.

After inquiries from a reporter, SCAN's vice president of marketing, Sherry Stanislaw, said the company found a computer glitch that was producing erroneous claim reports for customers.

Actual billings and payments were not affected, Stanislaw said. She confirmed that Glendale Adventist's bill was for $48,106 and said that SCAN paid a negotiated rate of $4,350 and that Mlinarevich, who died in August at age 78, was assessed a $150 co-payment.

Because patients are responsible only for co-payments and deductibles, few consumers ever take a close look at their medical bills, said Devon Herrick, a healthcare economist and senior fellow at the National Center for Policy Analysis.

To help keep rising healthcare costs in check, more consumers should do what White did, Herrick said. "Most insurance companies will agree that they'd want their enrollees to scrutinize their bills."

SCAN said the computer glitch was being investigated. Stanislaw conceded that her customer representative should have heeded White's concerns and contacted a supervisor. The company is sending White a new claim statement, she said.

White wasn't completely pleased.

"It is easy to blame the computer. Well, who programs the computers?" she asked. "The last I checked, computers didn't program themselves."
By Daniel Yi, Times Staff Writer

No comments: