RICHMOND, Va. -- Another family reached out to the Problem Solvers about confusing bills from a home healthcare company.
Despite slightly elevated levels of bilirubin, Ashley Dade and her family welcomed a healthy baby boy in June. His mild case of jaundice required daily blood draws.
The family pediatrician referred Thrive Skilled Pediatric Care. Dade says she was given the impression that she had met her insurance policy's deductible and would not receive separate bills.
Yet this month, she opened invoices from Thrive SPC totaling $420 for four visits.
“I am so confused and I do not understand what any of that means,” Dade told the CBS 6 Problem Solvers.
Each invoice charged $370 for a skilled nurse that her initial service agreement quotes at $250.
“It's very concerning, especially for a new mom,” said Ashley Dade. “I'm thinking I won't get a bill. You know, I'm already getting all of these bills from the hospital. And then three months later, I'm slapped with another bill that I was not expecting.”
The Problem Solvers contacted Thrive SPC about the Dades' bills, which were similar to another family of triplets we helped clear almost $3,000 in overdue accounts.
In the Dades' case, Thrive SPC says it adjusted their original $370 charge per visit based on her insurance policy. The company submitted a claim with the insurer but believes the family deductible had not been met at the time of service, leaving the Dades responsible for $105 per visit.
"My first concern was I didn't want this to go to collections," said Dade.
The Dades are filing an appeal with their insurance company and asking them to take another look. Thrive SPC tells the Problem Solvers it will suspend any collections efforts until the appeal gets worked out.
Meanwhile, the company acknowledges its service agreement in Virginia and third-party generated billing statements are both in need of modification, in order to eliminate confusion for future patients. Multiple families have also reached out to the Problem Solvers to express difficulty in reaching a helpful and courteous customer service representative in Thrive SPC's billing department.
"The communication was terrible," claims Dade who says she spent multiple days calling and leaving messages for Thrive SPC before contacting the Problem Solvers. "I just kept telling them, 'you guys need to be better with this. This is very confusing, especially for somebody like me. I'm not in the healthcare field. I don't know anything about it.'"
For its part, the Massachusetts based executive team vows to learn from the experiences of patients in Central Virginia.
"We also acknowledge that a customer service improvement opportunity exists and as part of our Quality Improvement program, an internal root cause analysis will be conducted to identify interventions that can be instituted to prevent recurring confusion and miscommunications with future patients and their families," the Chief Compliance and Regulatory Officer, Roberta Verville, wrote in an email to CBS 6.
Thrive SPC continues to encourage new parents to immediately add newborns to their health insurance policies to help avoid delays in processing claims. The company points out that the addition of a child to a health plan policy could potentially raise the family's deductible amount. Finally, Thrive SPC stresses that even if a patient believes a service is “covered” by insurance does not mean that it will not incur out of pocket expenses for deductibles or coinsurance amounts.
The Problem Solvers are Working on Your Bill. If you’ve received a medical bill you weren’t expecting, click here and send us as many details as possible.
