Stories from You: Careful Planning and Still a Surprise Medical Bill

Zoe Harris
Assistant Policy Analyst

Monday, April 11th, 2016

Your campaign to end surprise medical bills is gaining momentum in California. California lawmakers have a real opportunity to pass legislation this year that would protect Californians from out-of-network surprise medical bills. AB 533, sponsored by Assembly Member Rob Bonta, would protect consumers from out-of-network surprise bills for scheduled services at in-network healthcare facilities. With California advocates banding together to ensure lawmakers stand up for consumers, it is the perfect time to share the experiences of Californians who have had to face and fight these unfair surprise medical bills.

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Daren of Temecula, California was meticulous in planning for his son’s spinal surgery. His in-network orthopedist referred his family to an in-network spinal surgeon, who performed the procedure at an in-network children’s hospital. However, the surgery included one out-of-network provider: a nerve monitoring specialist. Daren knew nothing about the specialist at the time but later learned that he was pre-approved by spinal surgeon.

After his son’s surgery, Daren received a bill from an unfamiliar company. Unbeknown to Daren, the nerve specialist billed his insurance separately as out-of-network and refused to bill secondary insurance. His primary insurance paid a few hundred dollars, leaving Daren with a balance bill of $2,000.

Two years later, Daren’s surprise medical bill still weighs on him. “The Nerve Specialist continues to send me statements,” he said, worried about the potential for this surprise medical bill to affect his good credit.

Stories like Daren’s show that even if a patient does everything they can to avoid a surprise medical bill, they can still end up stuck in the middle of a billing battle between insurance companies and providers. It’s imperative that California lawmakers pass legislation to shield consumers who unwittingly receive services from out-of-network providers at in-network facilities.

We will continue to raise our voice in California and across the nation so consumers like you can get the protections you need. Join our fight to end surprise medical bills by signing our petition. Have you received a surprise medical bill? Share your story now we can pressure lawmakers to act.

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