Washington insurance commissioner intervenes in family’s $96K medical bill

  • Small
  • Medium
  • Large

A Washington state woman facing tens of thousands of dollars in out-of-pocket costs for her son's medical emergency has caught the attention of the state's insurance commissioner, according to a KGW report.

Four things to know:

1. Jamie Hansen's 15-year-old son, Ryan Hansen, visited PeaceHealth Southwest Medical Center emergency department in Vancouver, Wash. Emergency room physicians determined there was an infection affecting Ryan's heart, and the hospital got an ambulance to take him to Portland, Ore.-based Randall Children's Hospital at Legacy Emanuel for specialty care, according to the report. Ms. Hansen told KGW she was informed care would be covered at an in-network level "'because it is an emergency admit and you are coming from the emergency room.'" Her son ended up spending a week at Randall.

2. Ms. Hansen received a medical bill for $112,387. She told KGW her insurer, LifeWise Health Plan of Washington, agreed to pay 14 percent of the bill — $15,396 —leaving her out-of-pocket costs at $96,990.

3. Portland-based Legacy Health, which runs Randall, and LifeWise are pointing at each other over the higher-than-expected bill, according to the report. Brian Terrett, spokesperson for Legacy Health, told KGW Legacy was surprised the insurer didn't cover more. LifeWise declined an interview with the TV station, citing patient privacy.

But LifeWise issued the following statement: "We know how shocking and scary it can be when a hospital chooses to bill a patient for the difference between what an insurance company will cover and what the provider is charging for the procedure. … We have asked Randall … to reduce their bill and are hopeful they can provide some financial relief for their patient."

4. KGW reported Legacy agreed to reduce Ms. Hansen's out-of-pocket costs to $24,000, and Washington Insurance Commissioner Mike Kreidler asked LifeWise to reprocess Ms. Hansen's claims.

Mr. Kreidler reportedly is proposing legislation to address unexpected medical bills.

Access KGW's report here.


More articles on healthcare finance: 

Philadelphia wants health systems to buy local, help create jobs
For-profit hospital stock report: Week of Nov. 19-23
Patients frustrated by higher-than-expected lab bills: 5 things to know


Copyright © 2021 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars