As seen on Reddit: Georgia Couple Wrongly Saddled With Surprise Charge After Negotiating Bill With Doctor

Spencer Watson
Public Policy Intern

Thursday, July 28th, 2016

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Preventative care keeps patients healthy, away from the emergency room, and from costly medical bills. Usually. But for one Georgia couple, a routine test instead blindsided them with a sizeable out-of-network charge.

Redditor garycarroll and his wife responsibly searched their insurance company’s provider directory specifically for an in-network hospital for their procedure, and negotiated the bill upfront with the doctor. The doctor explained to Gary and his wife that if the test showed no problems, then the procedure would be fully covered by their insurance as preventative care.

The test showed no health problems for the couple, but their troubles with the provider’s billing department were just beginning. Instead of no charge for their preventative screen as promised, the hospital blindsided them with a charge for an out-of-network anesthesiologist who they had no idea was in the room.

Gary took to Reddit to vent about the unfair charge. He negotiated his bill up front, and should not be responsible for a penny more than what he was promised. Right? But unfortunately, surprise bills like Gary’s are completely legal in states like Georgia where there is no protection against out-of-network surprise medical bills, but change is on the horizon.Advocates in Georgia are looking out for consumers and calling for legislative action. Georgians for a Healthy Future got a bill passed that addresses provider directory errors, a frequent cause of surprise medical bills, and Georgia Watch is putting this on the state’s radar through media and advocacy.

Unless state legislatures or Congress take action to end surprise medical bills, hundreds of thousands of Americans like Gary will continue to be saddled with unexpected charges for out of network doctors and specialists which the patient had no control over.

The good news is, consumers are sharing their stories far and wide, on TV and on social media–and states are responding to consumer pressure. California has a real shot at ending surprise medical bills in a matter of weeks. Landmark legislation in front of the California Senate, A.B. 72, will end the scourge of unfair unexpected medical bills for California patients before the problem gets worse. But the medical industry is busy lobbying to thwart the measure. We must urge CA lawmakers to grant relief for surprise medical bills that people like Gary need now.

If you live in California, write your California lawmakers to vote yes on AB 72 when it comes to the floor next month. If you have ever received a surprise medical bill, please share your story today so we can build our powerful #EndSurpriseMedicalBills alliance.

If you receive a surprise medical bill and don’t know what to do, try our tips to reduce your bill or use our insurance complaint tool.

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