How the "Health Insurance Bodyguard" helped reduce an OUTRAGEOUS hospital bill from $12,479 to $200
Overpriced CT scans, imaging tests and other types of treatment are an everyday occurrence in American health care. Here's how you fight back and win.
Lisa’s gut hurt so bad she couldn’t comfortably stand up, sit down, lie down, cough or laugh. And the debilitating pain had been going on for almost a week.
The paralegal, who lives near Tampa, Florida, got examined in an urgent care clinic. But it was July 17, 2021 — a Saturday. So when the physician assistant told her she needed a CT scan she had only one option for the imaging test: the nearby hospital.
Yikes.
There’s an incredible amount of unjustified price variation in health care — and it’s especially crazy for medical images, like X-rays, CT scans and MRIs. My book, “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win,” highlights this problem and shows how patients can protect themselves from getting ripped off. In cases like this, you can often get the same high quality image, for a MUCH lower price, at an independent imaging center. Stay away from those hospital imaging centers whenever you can.
Lisa was about to learn this the hard way.
She got the CT scan and, thankfully, the gut pain went away after a few days. Maybe it was gas, or something she ate, but her stomach turned out to be fine. Then the hospital bill arrived — and suddenly her head was hurting. Here’s an image of it:
Lisa could not imagine how the total bill could be $12,479.12. It was a walk-in, walk-out appointment. The whole visit took under an hour. Nothing complicated and no intensive treatment. And when she saw the itemized bill she could see that the bulk of the cost came from the CT scan — $11,694 for the test!
Meanwhile, the cost estimator on the hospital website listed the price of the scan at $152.
You cannot be serious.
This illustrates the pricing absurdity that’s run amok in American health care. A CT scan should cost hundreds of dollars. On the overpriced side it would be thousands. So this hospital - which I won’t name since Lisa is concerned about retribution - gets a gold medal for price gouging.
When patients can’t afford their bills, hospital billing departments typically suggest setting up a payment plan. As if piling on medical debt is the solution to profiteering from someone’s sickness. In this case, Lisa said the hospital helpfully suggested a $519/month payment plan, and also threatened to send her to collections.
Lisa had to fight it, and thankfully she was not alone. She had purchased her individual insurance plan through a broker in Tampa, Rob Hohmann. Rob, pictured above, refers to himself as the “Health Insurance Bodyguard,” and his mammoth muscles underscore the moniker. “I’m trying to protect our policyholders,” Rob told me.
Beefcake aside, Rob knows that this is a battle of wits, not weights. His secret weapon is his wife Carmel, who takes on these type of disputes for their company, Benefits Management Team. Overcoming this type of price gouging often requires more than one approach. You may need to try one tactic, then another, then another, to win the battle. Winning might be easy, or it could require persistence and tenacity. But with so much money at stake it’s worth the battle.
I mention in my book that patients in these type of disputes should file complaints with their state regulators. Often the attorney general’s office, or other department, handles consumer protection.
With Lisa’s consent, Carmel filed a price gouging complaint on her behalf with Florida’s Department of Agriculture and Consumer Services. (Ag and Consumer Services? Don’t ask my why they lump those two together!) Here’s an excerpt from the complaint:
Carmel told me she had a conversation with someone from the regulator’s office. “The guy was pretty good,” she said.
Then Carmel also took a different approach. She filed for financial assistance with the hospital, on Lisa’s behalf. Nonprofit hospitals get huge tax benefits, so they are required by the IRS to provide charity care to patients. The nonprofit Dollar For has a guide to check your eligibility and apply. Dollar For can also help if you need assistance.
Carmel said she always has patients file for financial assistance, no matter how much money they make. The policies are often more generous than you might think. She helped Lisa complete the forms and submit a tax document to verify her income. She didn’t even have to call the hospital. “It wasn’t much trouble at all,” Carmel said.
In December, Lisa got a call from the financial office at the hospital. The hospital had approved her request for financial assistance. She only needed to pay $200, the hospital rep said. That’s a discount of $12,279! And it came right before Christmas!
Lisa couldn’t believe it.
“Are you referring to the $12,000 bill?” Lisa clarified on the phone.
Indeed, it was true.
Lisa wasn’t going to miss that deal. She immediately paid the $200 and cleared the account. Then she called Carmel, crying, to tell her the great news.
Lisa, Carmel and Rob do not know how the hospital came to its decision. They do not know whether the complaint to the state played a role. They are just thankful they got a big win, and they want to share their Victory Story, so others can be encouraged and learn.
Here are some takeaways and action items we can follow:
Price gouging and billing errors are incredibly common. You simply must stand up to this type of bullying. My book, “Never Pay the First Bill,” is a step-by-step guide to show you how.
Get an itemized bill to see the individual charges. Use the billing codes to look up fair prices on hospital websites or at FairHealthConsumer.org.
File a complaint with state regulators. Google “consumer protection” and your state to find the appropriate office. You never know what type of pressure they might apply. It also creates a paper trail of accountability for this bad behavior by health care power players.
File for financial assistance at hospitals. See the charity Dollar For to learn how it’s done and get help.
Keep an eye out for my “Never Pay Pathway” health literacy videos - which take the tactics of my book and present them in engaging 3-5 minute videos. I’m equipping and empowering consumers every day and my video curriculum is going to bring this work to scale.
Share this column with others - and subscribe to my Substack! Let’s spread the word that patients are not powerless. This newsletter is free, but please consider a paid subscription. *I’m donating all the proceeds to assist patients in need.*
Share your Victory Stories with me. I love these stories where the little guys - working Americans and employers - stand up to the health care giants and win. If you’ve had a similar win, please share it so we can encourage others.
It would be wonderful if the American health care system would find a way to give employers and working Americans a fair deal. But so far it’s not happening - and it’s destroying people financially. Fortunately, when we push back against these injustices, we can overcome them. Let’s keep pushing folks!
Thank you for this and for sharing your knowledge.
I spent 10 YEARS as a young person in my twenties paying off an operation to remove a kidney stone, because I had no idea how the system worked and worked 2 jobs that didn't offer health insurance.
Never experienced the added value that Health Insurance Bodyguard gives. In the past, here is some coverage and then see ya'll. The Hohmanns and their team really take care of their clients.