Tuesday, June 18 2013, 09:14 AM MDT
Huge Bills For Newborn After Insurance Co. Error
By Matt Gephardt
Photography by Brian Morris
Edited by Aaron Colborn
(KUTV) When Hadlee Knowlton was born last July, she needed a little extra help.
"About 30 minutes after she was born she was taken into the [Neonatal Intensive Care Unit],” said her dad, Dallas Knowlton.
Hadlee got the attention she needed and today is doing great. But a surprise for Dallas and his wife Valerie when they got a $6,196.88 bill from the neonatal specialist group. The insurance company, Humana, is refusing to pay because the neonatal specialist is a doctor not in Humana’s Network.
At first, Dallas says he was confused.
"We went to an in-network hospital,” he said. “Davis Hospital is in network."
Not only is Davis Hospital is in Humana's network, but the Knowlton’s say they did everything they could in advance of Hadlee's birth to make sure the bills would be covered.
“My wife's doctor was in-network,” Dallas said. “The pediatrician was in-network. We preregistered. The only thing that wasn't in network was the neonatologist that the hospital assigned."
The Knowlton's appealed Humana's decision but that appeal was denied. In the denial letter Humana stated, “it was determined that the claim was processed correctly."
Now, the neonatal specialist group is demanding immediate payment threatening to turn the bill over to a "collection agency" and reporting the bill to the “credit bureau[s]."
Out of options, Dallas and Valerie decided to Get Gephardt to investigate.
When we contacted Humana about all of this, their spokesperson said that they do cover out-of-network doctors when they are working at in-network facilities. She said that Dallas should "appeal," and that would result in the claim being "re-processed at the in-network level."
We pointed out that Dallas already had appealed and it didn't do him any good. Now, after our calls, Humana has re-processed the claim at the in-network level.
Just like that, Hadlee's doctors have been paid and the Knowlton's are off the hook for the bill.
We wanted to ask Humana why when the Knowlton's appealed on their own Humana didn't fix the billing problem. Humana refused to comment on this specific case citing federal privacy laws.
(Copyright 2013 Sinclair Broadcasting Group)