Hospital Doesn’t Know The Difference Between Copay And Deductible, Sticks Patient With $3,900 Bill

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When a California man checked with the hospital about the copay for his daughter’s treatment, the hospital told him it would $500. Except what they meant to tell him was that his insurance deductible would be $500, but that he’d be stuck with a bill for nearly $4,000.

The man tells the L.A. Times’ David Lazarus that he got the $500 copay estimate in writing from UCLA Medical Center.

But after his daughter’s first treatment, a simple injection administered by a nurse, he received a bill for $3,908.

Making matters worse, his 9-year-old daughter’s full treatment would require multiple visits. At this rate, he’d be looking at a final bill of closer to $20,000.

After Lazarus got involved, a rep for UCLA explained that the problem was an “error in our insurance verification process,” and that the father should have been told that he’d still have the pricey copay on top of his deductible.

UCLA defended the high price of the treatment by saying that the hospital adds “our overhead expenses to the wholesale cost [of the drug] which was paid to our supplier.”

But as Lazarus notes, the hospital may be grossly overpaying for this medication. It put a price tag of $19,827 on a single injection, but the drug can be found elsewhere at the still-expensive-but-not-outrageously-so price of between $5,000 and $7,500 for the same dose.

The father says had UCLA not misled him about the copay, he would have looked around for other providers to make sure he wasn’t getting taken for a ride. Now that he knows how much UCLA charges, he says he’s looking elsewhere for the remainder of his daughter’s injections.

Even after realizing it screwed up, UCLA continued to tell the dad that he needed to pay the full $3,908. It wasn’t until after the L.A. Times got involved that the hospital agreed to only charge him the $500 it had put in the estimate.

by Chris Morran via Consumerist