A Colorado family says they were sent to collections for a medical bill they never received from a doctor they never met.
David and Jennifer Piwonski of Lakewood have been through a lot in the last year and a half.
"This was Dec. 14, 2021. I ended up having a triple A, an abdominal aneurysm," said David Piwonski, who spent eight days at Sky Ridge Medical Center in Lone Tree.
Soon, the medical bills started coming.
"We've paid a lot of medical bills," said David. "We scrutinize every single one."
But there was one bill they say they never received, until an officer showed up at the door with a court summons. The Piwonskis had been sent to collections for a nearly $900 medical bill they knew nothing about.
"Maybe they sent bills to an old address, but we set up mail forwarding, and we gave the hospital and insurance company our new address," Jennifer Piwonski said. "The other bills certainly got here."
Then, they discovered discrepancies in the bill itself.
The Piwonskis' documents show that while David was receiving in-patient care, the bill is for an outpatient visit. While he was in the intensive care unit (ICU) on Dec. 15, 2021, he was charged for an emergency room (ER) visit.
While David was at an in-network hospital, the bill was from an out-of-network provider — Dr. David Jones with South Denver Acute Surgery Center — whom the Piwonskis say they have never met.
"I have no recollection of this doctor," David said. "Nothing about this makes sense."
It makes sense to Adam Fox with the Colorado Consumer Health Initiative, who helped look into the case.
"So, we call this sort of 'drive-by doctoring,' where a provider essentially just popped into the room for a few minutes and uses that essentially as an excuse to send a surprise bill," Fox said.
Fox said other cases have been reported to the Colorado Consumer Health Initiative about Jones.
He added that this sort of surprise/balance billing for out-of-network physicians at an in-network hospital is not legal — now. But David was in the hospital from Dec. 14 through Dec. 22, 2021. The law protecting consumers went into effect on Jan. 1, 2022, less than two weeks later.
"It is pretty ridiculous for a consumer to get a bill like this for out-of-network services, considering that there are robust legal protections now in place," said Fox.
Fox believes this sends a message about our medical billing system.
"That it is broken, that it is overly complex, and unfortunately, in many cases, it takes advantage of consumers and patients," he said. "But also, we need to modify the time frame that providers are allowed to bill. Because if a provider or hospital bills six years later, you might have different insurance. You might have moved. You might not even be able to find your medical records from the services, which makes it incredibly hard to verify what you're being charged for."
Contact Denver7 reached out to Dr. Jones but has not received a response. We were also referred to the physician's billing service, Aspen Medical Management, which has yet to respond.
"We're going to fight back," Jennifer said.
The Piwonskis plan to file their response in court on Thursday, hoping other patients are aware that doctors can bill for up to six years after services. They are also calling for more protections.
"It needs to continue to be addressed for other people so that they don't go through this like we have," said Jennifer.
If you believe you have been sent to collections for a medical bill you never received, Fox recommends filing a complaint with the Colorado Attorney General's Office and the Colorado Division of Insurance. Colorado Consumer Health Initiativemay also be able to help.
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