AURORA, Colo. — Emergency rooms have long been a source of surprise bills for many Coloradans. The state recently passed a law that was supposed to prevent it from happening, but Denver7 Investigates discovered it doesn’t apply to all health plans.
Charles Van Heck said he received what looked like a surprise bill from his insurance after going to the hospital in April and reached out to Denver7 for help.
“I went to the emergency room at Southlands E.R. They found a lesion near my brain,” Van Heck said.
That’s when he said the doctor at Southlands told him he needed to be transferred to University of Colorado Hospital in Aurora to see a specialist. Van Heck said he went by ambulance with a potential brain aneurysm and wasn’t warned of a problem until he got an explanation of benefits from United Healthcare showing he owed $109,586.46.
“They’re claiming I voluntarily went to an out-of-network hospital, which is not true,” Van Heck said.
Denver7 Investigates first exposed how contract disputes between insurance companies and doctors are leaving patients caught in the middle, forced to pay these new unexpected out-of-network costs.
“I can’t pay it. I’m waking up in the middle of the night thinking how am I going to take care of this?” Van Heck said. “I think somebody should have come and told me before I was admitted. They should have given me the opportunity to say no.”
While the insurance company first told Van Heck he went to an out-of-network hospital, Denver7’s investigation found that wasn’t the case. Once United Healthcare investigated the claim further, it found it wasn’t an out-of-network issue.
Instead, it said the hospital coded the bill wrong as a non-emergency. United was able to re-process the claim and correct the error, which left Van Heck with an about $2,700 bill — a much more reasonable cost of care.
“I think when somebody is sick and they truly need medical care, they shouldn’t have to worry about whether they can afford it or not,” Van Heck said.