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A woman gets a bill from a medical testing lab she’s never heard of, for $35. Not long after, a follow-up bill arrives. This one says if she doesn’t pay right away, the price is going up — way up ― to nearly $1,300.
This raises a question that comes up a lot with medical billing: Can they freaking do that?!?
On this episode, we go find out. And, the hunt takes us down two paths looking for answers.
One: Into the world of surprise medical bills.
Two: The land of crazy-high late fees.
Surprise Bills
That original $35 bill is what’s called a “surprise bill.” Patients often get waylaid by these bills when a provider that’s covered by your insurance — like the clinic this woman visited — farms out some part of your health care to a provider — like a lab — that’s not in your insurance network and sets its own rates.
Can the lab do that?!? Just send its own bill for whatever rate it wants?
The answer is: Some states have passed laws to protect consumers from surprise billing, but in lots of places people are left on the hook to pay. So Congress has been looking to create federal-level protections with support from both Democrats and Republicans. And now, at the end of the year, the legislation is showing signs of movement.
Late Fees
That $35 bill raises another question: Can medical labs impose a “late fee” of more than a thousand dollars on a $35 charge?
The answer is: They can try. And a lot of the time, they’ll get away with it.
But we found experts who explain how to fight back. If you’ve got the time and the moxie, you may be able to get the other side to accept a fair offer. Easier said than done — and more work than anybody should have to do — but you’ve got the law on your side.
So, listen up, and get psyched. And mad.
Season 3 is a co-production of Kaiser Health News and Public Road Productions.
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This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.