From a billing expert successfully knocking thousands of dollars off of her husband's emergency room charges, to Anthem Blue Cross' initial denial of a $40,000 cancer treatment bill, here are five medical bills that Becker's reported in 2022:
1. A billing expert knocked thousands of dollars off her husband's medical bill for an emergency room visit at a Wisconsin hospital after a year-long dispute, Kaiser Health News reported Oct. 25. Sunita Kalsariya, an office manager at her husband's medical practice, requested an itemized bill after he broke his arm in a skiing accident. She discovered the hospital had billed her husband $7,000 for a procedure that never performed. Eventually, the hospital said it had incorrectly coded Dr. Shah's treatment and reduced the bill total to $1,214.
2. An Anthem Blue Cross member went viral on TikTok over a $40,000 cancer treatment bill the payer initially refused to cover. Oak Park, Ill. resident Aaron McManus, who was diagnosed with stage 4 cancer earlier this year and had surgery to remove a kidney tumor. McManus, who uses they/them pronouns, first posted a video to TikTok Sept. 8 titled "Anthem refused to pay for my cancer surgery while making billions in profit."
The company said it had received hundreds of calls about McManus' case after the video was posted. The payer then reversed course on the $40,000 bill, determining McManus owed just $61 in copays. Anthem Blue Cross told CBS Chicago and other news outlets the $40,000 bill was due to incorrect information from McManus' providers.
3. The Colorado Supreme Court ruled that a spine surgery patient was not on the hook for a $229,112 medical bill. Patient Lisa French said she signed a contract in which she agreed to pay "all charges of the hospital" for her care. St. Anthony North Health Campus in Westminster, Colo., allegedly told her the bill would be $1,337 out of pocket, and her insurer would cover the rest. The bill ended up being more than $300,000, of which the patient paid $1,000, her insurance paid $74,000 and the remainder was disputed.
The court ruled that St. Anthony cannot sue Ms. French for payment of the bill because she had no knowledge of, nor consented to, the hospital's chargemaster, a list of billable services and items for patients or their insurer.
4. A Nevada man was charged $13,064 after donating his kidney, despite the fact that living organ donors are not supposed to receive bills for transplant-related care, ProPublica reported Feb. 11. The procedure was performed in September 2021, but the case took several months to resolve. In the end, the man was not responsible for the bill.
5. A couple was charged $80,000 when their gestational surrogate went through an emergency delivery of twins at Provo-based Utah Valley Hospital in April 2020, NPR reported Feb. 23. The bill showcased a loophole in the No Surprises Act, which took effect Jan. 1. Cigna, the couple's insurer, denied that the care was an emergency because the surrogate was admitted to obstetrics by her doctor instead of going through the emergency department.
Under the No Surprises Act, insurers and providers are supposed to negotiate among themselves to decide on a reasonable bill for out-of-network care. But if the insurer decides the care was not an emergency or did not receive the correct documentation, the claim can be rejected.