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Add Surprise to Your Misery – you owe the hospital $28,000

Many of us have a sense of comfort that our maximum exposure for healthcare cost is capped at our maximum out of pocket per our insurance coverage, or deductable. Coverage rules about who provides you healthcare can lead to expensive surprises. Your healthcare provider is worried about treating you and is not knowledgeable about the many insurers, employers and their contract terms. CareMoat is there for you day and night, 365 days a year to prevent surprise billings.

Joshua Bates knew something was seriously wrong. He had a high fever, could barely move and felt a sharp pain in his stomach every time he coughed.

The pair drove to the nearest emergency room, the Carolinas Medical Center in Charlotte, North Carolina. After several tests, including a CT scan of his abdomen, the emergency team determined Bates had acute appendicitis. “They said my appendix was minutes away from rupturing,” Bates said.

Not mentioned, he said, was that the hospital was out-of-network with the insurance plan provided through his job. Even so, he could not have jumped up and gone elsewhere. His appendix was about to burst.

Patient: Joshua Bates, a technical recruiter for a staffing firm, who lives in Charlotte, North Carolina. The Continental Benefits insurance plan comes with a deductible of $2,000 and an annual out-of-pocket maximum of $6,350.

Total Bill: $41,212 covering the surgery, one night at the hospital and the emergency room charges. After payments by both Bates and his insurer, the hospital sent Bates a bill for the balance, just over $28,000.

Service Provider: Carolinas Medical Center, owned by Atrium Health, a not-for-profit health system based in Charlotte.

What Gives: Bates was “balance billed” because he went to an out-of-network hospital — and, even though it was an emergency

[From Kaiser Health News -]

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