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Henrico mom celebrates potential end of surprise medical bills: 'It's the right thing to do'

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Posted at 3:11 PM, Dec 21, 2020
and last updated 2020-12-21 18:20:34-05

RICHMOND, Va. -- Senator Mark Warner (D-Virginia) told CBS 6 one year ago he thought Congress would ban surprise billing by the end of 2019, and it appears, one year later, they will finally get it done.

"I think it's awesome, I think it's the right thing to do," Lindsay Mosca, who received surprise bills after giving birth to her son Briggs in November of 2018, said.

Mosca said she chose Henrico Doctors Hospital for his birth based on advice from her insurance company.

"I had delivered him there because that's where my insurance told me I had to have him," Mosca said.

But, shortly after giving birth, Mosca said she started getting some surprise bills.

"I got bills from different doctors that apparently were not covered under my insurance plan, and there were thousands of dollars on top of what I had already paid," Mosca said.

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She assumed that since her insurance told her to use a particular hospital, all of the providers working there would be considered "in network" with her insurance, but that was not the case.

"If you're following what your insurance has told you, it doesn't seem fair that you're then penalized for a random doctor that you didn't choose to see that isn't in network," Mosca said.

What happened to Mosca has happened to millions of people across America.

It's commonly known as surprise or balance billing, which is where a patient unknowingly receives care from a doctor that is "out of network" with their insurance, at a hospital that is "in network" with their insurance.

The resulting bills can be large.

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"My family got almost a $90,000 bill," Senator Warner said.

This exact situation happened to Senator Warner's daughter and he has been working to try to ban surprise bills ever since.

Finally, Congress is on the verge of ending surprise billing.

"Consumers really are going to win. Consumers will not be receiving these surprise medical bills," Warner said in a conversation over Zoom on Monday afternoon.

The $900 billion spending bill that includes stimulus payments for millions of Americans has bi-partisan support and Senator Warner is hopeful it will pass both the House and the Senate on Monday.

"Hopefully the President will sign it before Christmas," Warner said.

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If insurers and providers cannot work out a payment rate, a third party arbiter will decide one.

"Seems fair to me. Health care seems to be a booming business, especially right now, so I think they should be able to work together and figure that out," Mosca said.

Even though this is expected to pass, the ban on surprise bills will not take effect until January 1, 2022.

If you’ve received a surprise medical bill, the Problem Solvers want to know about it. Send us your information here.