A Cancer Patient Stood Up to Her Hospital CEO and Saved $6,950

Linda got inspired when she read my book and went to the top. "I still have goosebumps from it," she said.

When I met Linda two weeks ago she was in a terrible predicament. 

The 60-year-old was fighting a rare form of cancer. To make things worse the hospital treating her had made a billing mistake and was expecting her to pay for it.

Linda, who lives in Idaho, is in a fight for her life against neuroendocrine cancer. The disease causes tumors to grow inside her. Every month she gets an expensive shot at her local hospital that keeps the tumors at bay. (I’m not using her last name or naming the hospital at her request because she depends on the facility to keep her alive.) 

Linda does accounting for a janitorial company. The hospital gets paid more than $23,000 each time it administers the shot. So her initial dose easily exceeded her insurance plan’s $7,000 out-of-pocket max. Thankfully, the drug is effective, and Linda qualified for a co-pay assistance program to cover her share of the cost through the drugmaker. But the program required the hospital to file the correct paperwork within six months, and that’s where the situation took a turn for the worse. 

The hospital made an error when signing her up for the co-pay assistance program. It processed the paperwork under a different patient ID. Linda kept getting bills from the hospital and asking about them, but the hospital officials said not to worry. By the time they caught the mistake it was past the six-month deadline. Linda couldn’t get the drugmaker to cover her portion of the hospital bills.  

Here’s where things get especially cruel. The hospital made the administrative mistake, and even admitted it. But it still went after Linda to pay the bill, which came to $6,950 — the remaining amount before she hit her out-of-pocket max.

The hospital billing department pursued Linda for payment. At the one year mark she would be sent to collections if she didn’t go on a payment plan. Linda has never had a bill go unpaid, so the dispute stressed her out. Even worse, stress activates her cancer tumors!

Linda’s health insurance broker referred her to me, to see if I could help. I love digging into cases like these. I help people help themselves by coaching them through the steps I lay out in my book, Never Pay the First Bill, or my videos, The Never Pay Pathway.

In complicated cases I take it to the next level. I use the funds I’ve raised from the paid subscribers to this newsletter to hire a patient advocate to help the patient. This has led to some awesome victory stories. In previous newsletters I shared how we helped save a patient $224,000, how we helped a patient whose insurer had denied 273 claims at once, and how we helped a patient get more than $350,000 of medical bills covered. It’s inspiring to see the generosity of my paid subscribers at work! 

The day I spoke to Linda I referred her to a patient advocate. I figured we’d work this one out. I felt like a hospital that’s making $23,000 per monthly injection could be convinced to waive the bill caused by its mistake. But in the time it took them to get connected, Linda started reading my book and she got inspired. Never Pay the First Bill is like The Art of War for health care. Linda read it and got empowered and fired up. She got so excited she bought five copies to give to her loved ones and to leave in the HR department at her office. Then she did what I hope every patient will do after they read my book and realize they’re getting ripped off - she took action!

One of my tips when fighting a bogus bill is to bypass the powerless frontline customer service reps and take your dispute to the top. 

Linda took my advice to heart. A week ago she emailed the hospital CEO. She explained the situation and warned that she might sue the hospital in small claims court, which I also recommend in my book. Here’s how she closed her email:  

If the billing department would have submitted it in a timely manner with the correct ID, I would have not lost my funds…I am 60 years old, have cancer and NEVER had a bill not paid. Now due to (your hospital), I am facing a debt of $7,000 that I am contesting. Can you please help me out because if not I will have to take it up in court.

“I hope I was not too bold,” Linda wrote to the patient advocate, when she forwarded the email she had written to the hospital boss.  

Linda’s email got results! The hospital CEO referred her case to the finance department and they waived the bill that same day!

“Guess what, I did it!” she exclaimed to me when she told me about it on the phone. “I still have goosebumps from it.” 

Linda admitted to bluffing a little with the threat to sue in small claims court. The limits in Idaho are $5,000 and the bill was greater than that. But she knew it could help get the CEO’s attention. “Like you said in your book, you gotta be bold, right?” she said.

Linda never got an apology from the hospital billing department. “I’m not surprised,” she said. “They’re just a big machine. It’s all numbers for them.”

Takeaways

1. Get educated! Read my book or watch my health literacy videos. Subscribe to this newsletter. You’ll get informed and you’ll get inspired.

2. Push back. Don’t give up when you’re fighting a bogus bill. You never know where the victory will come from.

3. Go to the top. Take your dispute to the CEO or any other decision maker that has the power to fix the problem.

Let’s spread the knowledge, people!

I’m looking for bold employers, community organizers, churches and other groups who want to equip their peeps with my Never Pay Pathway health literacy videos. They’re based on my book, Never Pay the First Bill, and the knowledge will transform the way your people engage the health care system.

Let’s empower some folks, shall we?

The videos are an ENGAGING resource that will save money for people who are currently getting buried by ridiculous health care costs. Let’s stop overpaying for our health care, shall we? Email me at neverpay@marshallallen.com for more information.