Three years ago, after Christine Malik gave birth to her first daughter, a clinician affiliated with a company called Pediatrix entered the ward and installed sensors and wires for the baby to perform hearing tests.

The tester said that the child did not pass the screening of all newborns required by law and needs follow-up inspections. “As parents for the first time, we were scared,” said Malik, who agreed to the second exam.Malik said that clinicians did not tell them that babies often fail the initial screening because Fluid from the uterus In the ears that quickly dissipated. The second screening revealed that the baby’s hearing was not problematic.

Last year, when her second daughter was born, another pediatric clinician appeared behind her bedside, and Malik refused the hearing test. (Parents can opt out, but rarely do this.)

Infant hearing tests—especially the more advanced technology used by Pediatrix—is an example of how some common medical procedures can bring more profit to their providers.

Pediatrix and related companies have caused a series of complaints from dissatisfied customers like Malik who said she was surprised by Pediatrix’s charges for in-hospital baby care. Such tests used to be free or included in the hospital’s newborn fees. According to regulatory documents, Pediatrix earns tens of millions of dollars in revenue each year.

Pediatrix and its parent company, Mednax, were founded in Florida decades ago and have grown into a network of doctors and other clinicians, providing hearing screening, pediatric intensive care, pediatric surgery and obstetric services. They operate in more than 400 affiliated hospitals in approximately 40 states.

According to the company, Pediatrix now cares for about a quarter of babies in the neonatal intensive care unit and performs hearing tests on nearly 1 million babies every year.

“I have been trying to prevent them from entering the hospital,” said Lisa Hunter, a professor and pediatric audiologist at the University of Cincinnati, who generally opposed Pediatrix’s high cost of hearing screening and the confusion they may cause. “I am very sympathetic to patients who are concerned.”

Pediatrix officials said their doctors and other clinicians usually provide top obstetric and neonatal drugs to small and community hospitals and large systems, not only hearing tests, but also surgery and life-saving care for premature babies.

“Doing the right thing for patients is our top priority,” said Dr. Roger Hinson, President of the Pediatrics and Obstetrics Medical Group.

Dr. Michelle Barhaghi, who is also an obstetrician herself, said she was shocked by the $6,538 charged by a California pediatrician for an accidental C-section during her travel in April.

“When I saw that, my jaw dropped,” she said. “I sent the bill to all my obstetricians and gynecologists.”

According to the benefit statement, the insurance paid Pediatrix USD 2,867. According to the medical insurance’s doctor’s fee schedule, this is still nearly three times the rate for the same procedure. Pediatrix also charged Barhaghi a fee of $1,311, because the insurance does not cover the cost of preparing her baby’s body and leaving the hospital. She said that after KHN contacted for comment, Pediatrix withdrew the bill.

Three years ago, insurance giant Aetna sued Mednax and Pediatrix, claiming that they inflated the cost by more than $50 million, performed unnecessary tests and treatments, and diagnosed that the baby was more serious than it actually was.

Mednax denied Aetna’s allegations, and the case ended in July when Aetna withdrew the case as part of the confidentiality agreement. Neither Aetna nor Mednax will disclose these terms.

As part of the litigation process, Mednax admitted in court that it destroyed Aetna’s internal e-mail seeking as potential evidence for corporate counseling in order to promote doctors’ participation in the “upgrade” process to a higher value.

Pediatrix is ??a “Chief Sponsor” Records show that in the early 2000s, state law required the exercise of hearing tests on infants. Most states Now there is such a law, the American Academy of Pediatrics Recommended initial hearing screening All newborns are before being discharged from the hospital.

The idea is that even if some false alarms worry parents, the rare hearing impaired baby needs to be quickly identified-two or three thousandths, to ensure proper treatment and language development.

A simple screen can measure whether the baby’s inner ear responds to sound. A more expensive hearing screening program, originally designed to evaluate patients with severe neurological or auditory diseases, to measure the electrical response of the brain to sound.

Many hospitals retain this screening for high-risk infants in intensive care or for infants who have failed earlier and cheaper screenings.

Aetna’s claim analysis found that Mednax and its affiliates paid three times the cost of such tests compared to tests provided by non-Mednax clinicians.

Audiologists familiar with the company said that Pediatrix’s test charges are $150 or more. The company charged $326 for the screening of Malik’s first child, and billing records show that the insurance paid a discount of $177.

“The cost of screening should not exceed $50,” Professor Hunter said, including initial testing and in-hospital follow-up. “To pay more and to do this for every baby born, it sounds like a permit to print money to me.”

Hinson said Pediatrix uses the more expensive auditory brainstem screen because it tests the entire auditory pathway. He said the false-positive rate of infant screening is lower compared to cheaper alternatives.

The Joint Committee on Infant Hearing, an expert committee, is considered the authority on screening programs, said Any test can be used At first it was a baby.

But when done in the hospital shortly after birth, both breeds will produce a large number of initial false signs of hearing defects. research shows, Usually because there is fluid in the ears at birth.

This requires a second test in the hospital or sometimes in the doctor’s office a few weeks later. At the same time, family members may think that their child may be deaf. Patient advocates say that when parents receive a baby’s hearing screening in the hospital, they should ensure that the procedure is covered by insurance. If the child fails the test, the parents should be aware that this may be a fleeting result and request follow-up before leaving the hospital.

surprise Pediatrix and Mednax’s bills or improperly handled bills have caused complaints from the Better Business Bureau, and Various types online forum.

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The company stated in its filing with the US Securities and Exchange Commission that when Mednax or Pediatrix clinicians are not outside the patient’s insurance network, “we will charge the patient the balance”. There is at least one hospital, Inova Alexandria Hospital in Northern Virginia, Already warned prospective parents Pediatrix “may not be an approved provider of their insurance company.”

According to data provided by BBB, from the beginning of 2019 to mid-November, 192 people complained to the Better Business Bureau about Pediatrix and Mednax. Data shows that most complaints are related to billing and collection issues.

Hinson said: “We have to do something to make our patients and our payers more seamless.” He said that when Pediatrix goes offline, the company will work with families “to reduce unexpected bills after discharge.”

It took more than a year, made two calls, and solved a wrong $1,010 bill with the help of the Better Business Bureau. In 2018, a pediatric nurse was accused of standing next to Sarah Tela’s twins when they were delivered by an obstetrician.

After research, Tela, who lives near Seattle, realized that “I’m not the only one fighting them.” She added: “I could easily pay the bills. But I knew I was right.”

She said the problem turned out to be an incorrect service date on the bill, which caused the insurance company’s claims software to reject it.

The company stated in an email that Mednax contacted Barhaghi and Malik after reporters brought their case, “believe that their respective problems are being resolved satisfactorily.”

Kaiser Health News is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.