The baby wasn’t a surprise, but the hospital bill was: ‘I went where my insurance told me to go’

HENRICO COUNTY, Va. -- Lindsay Mosca is a registered nurse and a veteran mom.  She was supposed to know how to navigate a hospital to deliver a baby.

“I’ve heard all these horror stories of people dealing with insurance companies and then all of a sudden it was me,” Mosca told the Problem Solvers.

Nearly a year after welcoming a healthy son at Henrico Doctors Hospital, Mosca was still receiving bills for a pediatrician she doesn’t remember seeing.

“When you’re giving birth, the last thing you’re thinking about is, ‘wait! Before you do anything, can I have your number to check and see if you’re within-network?’ That just doesn’t happen,” said Mosca.

She says the decision to deliver at Henrico Doctors was made specifically because it was an in-network facility for her health insurance company, Cigna.  Yet an Explanation of Benefits statement from Cigna notes the doctor who attended to her baby was out-of-network.

Bills from Sheridan Children’s Health Services of Virginia, Inc., a company representing the pediatrician, began arriving shortly after the family came home from the hospital.  The invoices added up to more than $1,300.

“I thought it was a mistake.  I went where my insurance told me to go.  I didn’t pick to see this doctor,” said Mosca.

The Glen Allen mother says her numerous phone calls to the billing company and insurance provider stole valuable time away from her family but ultimately lead nowhere.

When the CBS 6 Problem Solvers began making phone calls on her behalf, the companies were responsive and managed to resolve the Mosca family’s bill.

Cigna sent the following statement to CBS 6:

“We looked into it and found a rare error that was causing the family to receive these notices. This was an isolated incident, and we have corrected the information in our system. The claim is being paid at the in-network level and we have notified the family and extended our apologies for the inconvenience. We are also looking into the cause to prevent it from happening to again. “

Mosca tells CBS 6 that Envision Healthcare, the parent company for the billing center that represents the pediatrician, called the family and agreed to pay any remaining charges after Cigna applied in-network coverage to her account.  Envision sent this statement to CBS 6:

“Envision Healthcare made multiple attempts to verify the patient’s coverage and process the claims for services provided; however, the insurance company has continued to deny and incorrectly process them. We continue to work with the insurance company to resolve the claims. The patient should not have received a bill during this period, and we are reaching out to the patient to clarify and apologize for the confusion. Envision is committed to providing patients the highest quality of care and a positive care experience. We will follow this through to resolution for the family.”

The parent company for Henrico Doctors Hospital, HCA, also offered comment:

“Unfortunately, the patient’s claim was incorrectly processed by her insurance company. While we were not made aware of the issues involving Ms. Mosca’s account until this past week, we are sorry to see that she was inconvenienced in any way. Our patient advocates often work with patients and families to coordinate communication with hospital based provider practices when billing issues arise. It is our understanding that Sheridan and Cigna have resolved the billing issue with Ms. Mosca’s account. At Henrico Doctors’ Hospitals, we remain dedicated to serving our patients, and are committed to assisting with individual matters until they are fully resolved.”

If you’ve received a surprise medical bill, the Problem Solvers want to know about it.  Send us your information here. (https://wtvr.com/2019/08/19/working-on-your-bill/)

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