Ive here. I hope no reader has come across this horrible, death-defying zombie medical bill you pay. A little advice: when you go to complain, record your calls. In most states, it is legal to record without the other party’s consent.

Another part of the story that is shocking is that parents here feel that they even have to take these so-called write-off bills seriously. Their grown son is dead. They are not responsible unless they contract with the hospital system to be his financial guarantor. The son is bankrupt, so parents are unlikely to protect his property.

If I were them, I would write a fiery letter to their general counsel about potential liability for illegal debt collection practices and improper care.

Kaiser Health News reporter Aneri Pattani, who also airs on NPR and Science Friday, previously wrote for Spotlight PA, a cooperative newsroom investigating the Pennsylvania government.Originally Posted in Kaiser Health News

From time to time, Suzanne Rybak and her husband Jim receive mail addressed to their late son, Jameson. Typically, spam is hardly a concern, Suzanne said.

But on March 5, McLeod Health sent an envelope to Jameson.

Jim saw it first. He turned to his wife and asked, “Have you taken blood pressure medication today?”

He knew showing her the envelope would resurface the pain and anger their family experienced after taking Jameson to Macleod Regional Medical Center two years ago.

AS KHN previously reported, Jameson is experiencing withdrawal symptoms from opioid withdrawal. Fearing for her son’s life, Susannah took him to the emergency room near their home in Florence, South Carolina, on March 11, 2020.

There, they encounter a lack of addiction treatment and potentially high medical costs—two problems that plague many families affected by the opioid crisis and often lead to missed life-saving opportunities.

Suzanne said Jameson was not given medication for emergency room opioid use disorder or referred to other treatment facilities. The hospital wanted to admit him, but with no insurance, Jameson feared the bill would be high. Susannah said the hospital did not inform him of its other financial assistance policies. And he decided to leave.

Three months later, Jameson, 30, died of a drug overdose in his childhood bedroom.

Over the next few months, Rybaks received bills from the McLeod Health system to Jameson. It said he owed $4,928. Susannah called and wrote hospital administrators until September 2020 until the bill was resolved under the system’s financial assistance program.

It was the last time they heard from McLeod Health until the new envelope arrived on March 5, a week before the second anniversary of his visit. That visit was what Susan calls “the beginning of the end of my son.”

When the Rybaks opened the envelope, they found a very familiar $4,928 bill.

“I can’t even describe my anger and sadness,” Susannah said. “It’s always been there, but when we got that statement, we were all stunned.”

There is no national data on how often patients or their families receive medical bills that were previously paid or waived, but hospital billing experts say they see it happen frequently. The patient receives a bill for the claim that has been paid by the insurance company. Reminder statements are received even after the patient submits payment.

unlike “surprise bill,” This is often due to policy gaps when the provider is not in the network, and these bills are settled but continue to come up no matter what. They can have financial consequences—patients end up paying for what they really owe, or Bills are passed on to collection agencies, causing more phone calls and red tape. But often patients suffer the most emotional toll, spending hours with customers every time a bill reappears or revisits the situation that led to the bill Service calls. For a family like the Rybaks, the costs can never end.

Suzanne Rybak refused to have any further contact with McLeod Hospital, but told KHN of the new bill.

In response to KHN’s questions, McLeod Health determined that the bill Rybaks received was an error.

“Unfortunately, due to a technical issue, our software system regenerated this statement,” wrote spokesperson Jumana Swindler. “We are checking to make sure it has not happened to any other patients and we are sorry this family has been wrongly affected.”

A week after KHN’s inquiry, Rybaks received a letter from the hospital explaining and apologizing for the mistake.

Many medical billing cases like these “come down to human error,” he says Michael Corbett, Director of Healthcare Consulting at LBMC, a Tennessee-based firm that consults with the nation’s health systems on issues such as billing and income. “The facility is not short of tools [to avoid this]. This is a breakdown of their process. “

Billing agents may forget to mark accounts as paid, he said. Alternatively, the hospital may contract the bill with an outside company without telling them that the bill is included in the hospital’s financial assistance program.

as a hospital and medical practice increasingly consolidated Under large health systems, the chance for error increases. Even hospitals and clinics within the same system may have different back-end software, and within each hospital can have separate billing and electronic health record programs, Corbett explained.

Larger health systems are also likely to have more people handling any given bill. If responsibilities are not clearly defined, multiple employees may unknowingly take action on the same patient account.

The covid-19 pandemic has exacerbated potential mistakes, Corbett said. New medical billing employees may have received rapid virtual training and are working remotely with little interaction or supervision with team members. He added that some billing departments were understaffed, causing delays in patients receiving bills or follow-up notices.

To curb mistakes, hospitals need more comprehensive training and oversight of billing staff, Corbett said. Develop consistent processes from how patients’ financial information is collected at registration to when they are billed; and, perhaps most importantly, track whether those processes are being followed.

For patients who find themselves in the Rybak family’s situation, Corbett recommends calling the hospital’s billing department and asking to speak with a senior leader in their revenue cycle department. Unlike a customer representative, this person can make decisions, Corbett said.

At the end of the conversation, a written explanation was requested, he added.

“You would expect and want these notes to be recorded,” Corbett said, but that may not be the case. Or the notes might be recorded in a section of hospital files that are excluded from the patient’s legitimate medical records, making it difficult for the patient to access later.

For Suzanne Rybak, the idea of ??calling McLeod Health to settle another bill was too much. Instead, she added the statement to a file binder documenting all of her billing battles with McLeod Health over the past two years.

Still, being out of sight and out of mind doesn’t mean out of mind. The binder is in her craft room, and she remembers Jameson encouraging her as she made beach bags and other items. He would say to use “fruity colors,” Susannah recalls—that’s how he described tropical colors. Now she’s making candles in that room, focusing on tropical fragrances she knows Jameson will love.

“I want hospitals to realize that you don’t just send bills to one address,” Susannah said. “There are people who live in that house and they’ll open that mail and feel it. … It’s a disaster to bring it all up again.”