TAPPAHANNOCK, Va. -- A woman covered by both Medicare and Medicaid is shocked by a hospital bill for $92,780.20 and says she has no way to pay it.
Brenda Thomas is confined to a wheelchair, having suffered amputations of both feet and multiple fingers because of a rare disease, CREST Syndrome.
“I’m not supposed to be getting bills. I am disabled, totally. I can’t be out here trying to make this money,” said Thomas.
A resident of public housing in Tappahannock, Thomas lives on less than $800 a month. Her complex medical issues also include esophageal cancer and a recent bout with COVID-19 that landed her in the hospital.
Surgery on her back last September lead to a two-week stay at VCU Medical Center. Nearly six months later, she received an itemized bill totaling $124,676 for charges such as an EKG, anesthesia, and occupational therapy. The bill noted $31,896 in adjustments by Medicaid and Medicare leaving the balance as Thomas’s responsibility.
“I called VCU, they said I’d have to pay it,” Thomas told the Problem Solvers. “I cannot pay this.”
The Problem Solvers reached out to Anthem HealthKeepers, the administrator of Thomas’s Medicaid plan. The company quickly researched the case and found a processing error.
A spokesperson assured the Problem Solvers that Thomas would not be liable for the $92,780 balance. But that’s not the only medical bill Thomas has received in recent weeks.
While unable to comment specifically on Thomas’s case, a representative for VCU Health told CBS 6 their financial counselors regularly help patients with a “Coordination of Benefits” process.
If a person is covered by multiple medical policies, as Thomas is with Medicare and Medicaid, the “Coordination of Benefits” process determines which health insurance company would be the primary or secondary payer of medical claims. A lack of clear guidance on which policy is her primary insurance could be to blame for the bills Thomas is receiving.
The Problem Solvers continue to work with Thomas on clearing her smaller bills from other providers.
VCU Health sent a statement to CBS 6 regarding its billing practices. In part it states:
We are committed to working with anyone who currently has an outstanding balance they are struggling to pay. Today, quality care goes beyond physical and behavioral health. It is equally important that a health care bill is affordable and does not put too much of a strain on a family’s financial wellbeing. Patients can initiate the process by contacting our financial counseling call center at (804) 828-0966.
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