Georgia hospital resolves billing issues regarding woman's coverage through Christian ministry

Atlanta-based Northside Hospital said it has resolved billing issues for a woman who receives coverage through Christian healthcare-sharing ministry Medi-Share.

The woman, 39-year-old Laura Alley, was receiving treatment at Georgia Cancer Specialists, which is affiliated with Northside, when she learned she is considered a self-pay patient and would need to pay $41,000 before leaving the facility, reports WSB-TV. She was under the impression she was covered.

"I sat in front of them, in front of their computers, and handed them my [insurance] card three or four times, and no problems whatsoever," Ms. Alley told WSB-TV.

Ms. Alley uses a Christian healthcare-sharing ministry, Medi-Share, where members pay a monthly cost and share each other's eligible medical bills. The healthcare-sharing ministry contracts with Private Healthcare Systems, a health insurance provider, for rate negotiation, according to the report.

Northside provided a statement to WSB-TV last week explaining the situation.

"We have a contract with PHCS. We have never had a contract with Medi-Share. Because we thought Mrs. Alley was part of the PHCS plan (PHCS did not tell us otherwise), we billed PHCS for her care. PHCS gave her bills to Medi-Share, who underpaid on our contracted rates with PHCS.

"When we contacted PHCS about the underpayment, they alerted us that the patient did not have insurance with PHCS, but rather was a Medi-Share member."

The hospital added, "We have never said that we accept Medi-Share. Our contract was with PHCS. Once we realized this confusion, we corrected Mrs. Alley's account. Because she does not have insurance, she is considered a self-pay patient. We have provided her with multiple options to reduce and satisfy the remaining balance on her account. We did not tell the patient that she was 'pre-certified.' When our staff called PHCS to ask if pre-authorization was needed, they told us that it was not."

Medi-Share told WSB-TV that it also was working to resolve the billing issues.

In a follow-up statement emailed to Becker's Hospital Review, Northside says Ms. Alley's care "has been our top priority from the beginning of her treatment," and that "in the time since WSB-TV first contacted Northside for this story, the patient has continued her medical treatments with no delays, interruptions or cancellations."

The hospital added, "We consistently worked with the patient on her billing status, and all billing issues have been resolved."

 

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