RICHMOND, Va. -- Caryl Burtner estimates she’s received nearly 20 mammograms in her 65 years of life but only one has caused her any stress. The medical results were clean but the bill for the screening totaled $709.80.
“I thought, well, surely there's something wrong,” Burtner told the CBS 6 Problem Solvers of the invoice HCA Retreat Doctors’ Hospital mailed to her for a March 2020 visit.
Most insurance plans cover the entire cost of annual mammograms for women over the age of 40 as a preventive care measure. Burtner called her policy provider at the time, Oscar Insurance Corporation, in an attempt to straighten everything out.
“It was complicated. I spent hours fighting with both of them. Eventually, I thought I pretty much had it under control,” said Burtner.
Then came the notice from Medicredit, a debt collection agency also owned by HCA, the hospital’s parent company.
Burtner filed grievances with Oscar and the Better Business Bureau. She says she made multiple attempts to reach a Patient Access Manager at HCA as well. Eventually, after a year of trying to resolve the issues, she turned to the Problem Solvers for help.
“It just made me mad because it's supposed to be covered,” said Burtner.
We contacted both HCA and Oscar. Both companies assured the Problem Solvers that Burtner would not be responsible for the account in collections.
HCA says it continues to pursue payment from the insurance company. A representative for Oscar sent the following statement:
“We are upset that Ms. Burtner received a balance bill and had to go through this. Oscar's commitment to our members is core to everything we do. Our Care Team is working directly with the hospital system to ensure Ms. Burtner's outstanding bill is reduced to $0 and no longer in collections.”
It is important to note that not every mammogram is covered at 100 percent by insurance policies. If the mammogram is determined to be diagnostic in nature because of some other unusual finding or symptom, patients could be subject to cost-sharing responsibilities such as copays or deductibles.
Even still, experts urge patients not to delay those follow-up exams. Patients should talk to their healthcare providers about resources for those without insurance or the ability to pay for care. Additional information can be found on the Susan G. Komen organization website.
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