On September 9, 30-year-old Megan Rothbauer from Madison, Wisconsin, was sent to the emergency room at St. Mary’s Hospital, which was out of her insurance network, rather than to Meriter Hospital, which was covered by her insurance and was only three blocks away. As a result, instead of $1,500 maximum out-of-pocket expense, Megan is now facing $50,000-plus in bills, which in her case means bankruptcy. She recounted her experience in an interview with a local CBS TV station — Channel 3,000:
I was unconscious when I was taken to the hospital. Unfortunately, I was taken to the wrong hospital for my insurance. I was in a coma. I couldn’t very well wake up and say, ‘Hey, take me to the next hospital.’ It was the closet hospital to where I had my event, so naturally the ambulance took me there. No fault to them. It’s unfortunate that Meriter is in network and was only three blocks away from St. Mary’s.
Scott Larrivee, public relations director for Anthem Blue Cross Blue Shield — Megan Rothbauer’s insurance company — placed the blame for her situation on St. Mary’s Hospital and its cost for services. He wrote in an email:
(Megan) received care by a hospital that is not in our Wisconsin network. Since we have no contract with this hospital, we have very little influence over what the hospital is charging in this situation.
The hospital, for its part, said it empathizes with the patient’s situation, but it had already written off tens of thousands of dollars in costs and that, instead, the conversation should also focus on the fact its doctors and nurses saved Rothbauer’s life. (Scroll down for the video report.)
1. 30-year-old Megan Rothbauer from Madison, Wisconsin faces bankruptcy after being sent to the emergency room at St. Mary’s Hospital, which was out of her insurance network, rather than to Meriter Hospital, which was covered by her insurance and was only three blocks away.
2. Rothbauer and her fianc├⌐ Ben Johnsen are holding off their engagement until her economic situation becomes clear.
Cyn Gunnelson, manager for Managed Care Contracting for the Wisconsin region of SSM Health Care, said:
When you’re looking at saving a life, you’re not looking at whether or not you can save them money. I can only do so much. The hospital can only do so much. And I think the best outcome is the person walked away from the emergency room.
Rothbauer does credit the doctors and nurses at St. Mary’s for their work, but she feels very differently toward the hospital’s accounting department and her insurance company. She and fianc├⌐ Ben Johnsen are holding off their engagement until her economic situation becomes clear. Megan is waiting the resolution of her latest appeal to Blue Cross Blue Shield, before she negotiates the reduction of the doctors’ bills. In the meantime, both she and Johnsen need to get second jobs, cash out retirement accounts and take a loan from the hospital, if she is to avoid filing for bankruptcy. Megan adds:
My hardest issue is I had no control and I still have no control over what is my future. I don’t want this to happen to anyone else. I don’t know if this can be fixed for me at this point, but I think it’s unfortunate that it can happen to anyone.
There you have it, here is the video report itself:
Source: Channel 3,000.
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