The Power of Patient Advocacy
“I thought I was protecting my wife by getting insurance, but I was actually walking into a financial minefield.”
Lew and Pam Ingelido’s story is a masterclass in persistence, resourcefulness, and the power of professional advocacy when navigating the health care system. Together, they saved $18,000 on a staggering $21,000 emergency room bill with the help of Tara Bailey, a Board-Certified Patient Advocate.
Lew, a retired Kennedy Space Center worker and lifelong go-getter, never imagined his wife Pam’s emergency room visit would turn into a financial nightmare. Married for nearly 49 years and longtime residents of Florida, the couple faced a harsh reality: Pam was uninsured after Lew’s recent retirement.
Thinking quickly, Lew purchased what he believed to be health insurance through a website called Health Depot, paying $383.99 for the first month. But the plan turned out to be supplemental insurance—useless for covering the full cost of care—and didn’t even take effect until the day after Pam’s ER visit.
On November 14, 2021, Pam underwent a series of tests at Rockledge Regional Medical Center, including blood work, a CT scan, an IV, and an X-ray. While the tests ruled out major emergencies, the couple was blindsided months later by a $21,263.51 bill—nearly a third of what Lew paid for his house in the 1980s. To make matters worse, Health Depot refused to pay a dime, leaving Lew and Pam on the hook.
Lew, a man of integrity who prides himself on paying his bills, spent months calling the hospital’s billing office, offering to pay cash and pleading for a fair price. Despite his efforts, the hospital only reduced the bill to $19,190.60—a step in the right direction, but far from reasonable for a self-pay scenario. Worse yet, the hospital failed to provide an itemized bill with procedural codes, leaving Lew negotiating in the dark.
This is where Tara Bailey entered the picture. Lew found Tara, a patient advocate and founder of Brevard Healthcare Navigation, and she immediately got to work. Her first move? Requesting an itemized bill with billing codes — a critical step Marshall always emphasizes in his book, Never Pay the First Bill. Without this, you can’t verify charges, identify errors, or benchmark prices against fair rates.
Tara meticulously compared the hospital’s charges to self-pay rates, commercial insurer rates, Fair Health Consumer data, and Medicare rates. She even parsed nearly 17,000 lines of code from the hospital’s Transparency in Coverage pricing file to uncover inconsistencies.
After multiple failed attempts to negotiate with billing representatives, Tara escalated the case to the hospital’s office director. She pointed out errors, including the hospital’s improper submission of the Health Depot card as insurance (despite the scan at time of service clearly stating “This is Not Insurance”), and highlighted their failure to offer financial counseling for uninsured patients — a service outlined in their own policy.
Tara’s persistence paid off. As the calendar year drew to a close — a strategic time when hospitals are often more willing to settle outstanding balances — the hospital agreed to reduce the bill to $3,200. Lew and Pam were thrilled and paid the adjusted amount immediately. “To me, it was like a miracle of God,” Lew said.
A big thank you to Lew, Pam, and Tara for their efforts to make this story possible; You are all rockstars!
Their story is a testament to the power of persistence, knowledge, and professional advocacy.
Key Takeaways
Beware of Supplemental Insurance Pitfalls: Lew’s experience with Health Depot underscores the importance of understanding what you’re buying. Supplemental plans don’t replace primary insurance and won’t cover the full cost of care. Always read the fine print and ask questions before committing to a policy.
Request an Itemized Bill with Billing Codes: This is non-negotiable. Without an itemized bill, you can’t verify charges or negotiate effectively. It’s also crucial for identifying errors, like being billed for services you never received.
Leverage Transparency Tools: Tara’s use of the hospital’s Transparency in Coverage pricing file, along with resources like Fair Health Consumer and Medicare rates, was key to building a strong case. These tools are available to everyone and can help you determine what a fair price should be.
End-of-Year Negotiation Advantage: Timing matters. Health care providers often aim to reconcile their accounts before year-end, making them more willing to settle balances.
Seek Professional Help When Needed: Complex cases like this one highlight the value of hiring a patient advocate. Their expertise can uncover opportunities and achieve results that might be difficult to accomplish alone.
Final Thoughts
Lew and Pam’s story is a powerful reminder that even in a system riddled with inflated charges and predatory practices, patients can fight back and win. By combining persistence, knowledge, and professional advocacy, they turned a financial nightmare into a manageable outcome.
If you’re facing a similar situation, remember: you don’t have to go it alone. Let’s keep fighting for fair charges—one victory at a time!
