HARRISBURG, N.C. — Mike and Megan Burnham said in October their daughter, Paige, was born in May and was “a pretty easy baby for the first week. Everything was going well.”
But, then, the Burnhams say -- a few weeks later -- Paige was struggling.
“Her muscles started not working as well like overall. She just couldn’t turn her head. She stopped being able to recognize us,” Megan said.
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“It just kind of spiraled downward and that’s when we had to bring her to the emergency room,” Mike said.
“[At] one point, the doctor came in and looked us in the eye and said, ‘Your daughter’s body is shutting down.’ You don’t care about anything else than getting her better at that point,” Megan said.
“We were sitting there, waiting for results of a brain MRI to see if our kid’s going to have something wrong with her for the rest of her life. We’re not worried about what the bill’s going to say at that point. We just expected it to be a normal insurance bill,” Mike added.
They even expected to pay a few thousand dollars, but they ended up with a bill for more than $56,000.
“I got home from work and she showed me the bill and I was just like, ‘What are we going to do?’" Mike said.
Megan called Atrium Health, but couldn’t get it resolved on her own. The Burnhams thought they may have to fight the bill in court, so they started talking to the well-known law firm -- James, McElroy and Diehl -- and lawyer Alex Heroy suggested Action 9′s Jason Stoogenke.
“And I had seen the work that you did, Jason, and I thought maybe this is a good fit that she could get some quick help and some really good help and solve the problem and not need to hire a lawyer,” Heroy told Stoogenke.
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Stoogenke started with the provider, Atrium Health. They spent about three weeks emailing back and forth and talking on the phone and, it ultimately told Stoogenke, the insurance made a mistake.
So Stoogenke emailed the insurance company, Independence Blue Cross (of Pennsylvania). It told Stoogenke, yes, it made an “error.” Stoogenke asked for details. All it would say was it was an “administrative error.” But that it is “reprocessing the claim.”
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Stoogenke told the Burnhams the good news.
“Oh my gosh. I like immediately called my husband and I was like, ‘You’re never going to guess what. [Jason] figured it out.’ Just like this big weight was lifted off of our shoulders,” Megan said.
Stoogenke followed up with the family in December. Paige is doing better.
The new bill the insurance company sent the Burnhams was $7,800, the couple told Stoogenke in December.
If you are shocked by a medical bill:
- Realize medical bills aren’t always final
- Read EOBs well
- Ask questions
- Don’t be afraid to challenge your bill
- If you don’t get anywhere with the provider, ask your insurance company to explain it to you
- Do what the Burnham’s did, be persistent
- If you can’t get it resolved on your own, ask Action 9
Independence Blue Cross statement:
“Thank you very much for contacting us. We carefully reviewed the claim and found an error. We are reprocessing the claim now according to the family’s benefits. We sincerely apologize for the frustration this has caused the Burnham family. We appreciate you bringing this to our attention, it will help us improve our services in the future.”
Atrium Health statement:
“Atrium Health frequently helps navigate billing concerns between patients and their insurance company. We are pleased to have helped the Burnham family identify the insurance company’s mistaken denial of their insurance benefits, and we’ve been assured her insurer is re-processing the claim for payment. We encourage all patients to reach out to Atrium Health, as we are willing to work with them and look into their individual concerns.”
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