Colorado health system sues patient over $229K surgery bill, jury awards $766

A jury awarded Centennial, Colo.-based Centura Health $766 in a lawsuit seeking more than $229,000 from a former patient.

Here are six things to know about the lawsuit:

1. In 2014, Lisa French had surgery on her back at St. Anthony North Health Campus in Westminster, Colo., part of Centura Health. Her employer had a self-funded Employee Retirement Income Security Act insurance plan, and she was told prior to surgery she would have to pay $1,336 out of pocket for the procedure. She immediately paid $1,000, according to Law.com.

2. The hospital billed Ms. French's insurance plan $303,888 for the surgery and two presurgical consultations. Including the patient's copays and payments from her insurance plan, the hospital was reimbursed $74,597, which an audit found was the "reasonable value of the goods and services" the hospital had provided Ms. French.

3. In 2017, Centura Health sued Ms. French in an attempt to collect the additional $229,000 it had billed for.

4. The hospital used its chargemaster billing schedule to determine the amount Ms. French owed. Her lawyers argued those charges were unreasonable and that the contract Ms. French had with St. Anthony was ambiguous because it did not contain a price.

5. The jury agreed with the defense. After a six-day trial, the jury answered "no" when asked whether Ms. French's bills were reasonable. They agreed that Ms. French was obligated to pay "all charges of the hospital" under the contract she had with St. Anthony. However, the jury determined that those charges were "the reasonable value of the goods and services provided," not those included in the hospital's chargemaster.

6. The hospital's lawyers said they will file post-trial motions and appeal the verdict, according to the report.

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