EACH OTHER AT THE VERY SAME HEALTH CENTER. ONE OBTAINED A SHOCK EXPENSE IN THE ONE GOT A SHOCK BILL IN THE MAIL. MAIL. HOW DID IST HAPPEN? HOW DID IST HAPPEN? HAVE A LOOK. TAKE A LOOK. >> > > IT WAS THE FIRST PREGNANCY >> > > IT WAS THE FIRST MATERNITY FOR BOTH PEOPLE. FOR BOTH OF US. IT WAS REALLY FUN TO HAVE IT WAS REALLY ENJOYABLE TO HAVE SOMEBODY TO GO THROUGH THAT WITH. SOMEBODY TO GO THROUGH THAT WITH. >> > > Press reporter: LEILA AND ALSO ERIN >> > > Reporter: LEILA AND ERIN WORKED AT THE VERY SAME PLAN WORKED AT THE SAME PLAN RESEARCH STUDY BUSINESS. RESEARCH STUDY BUSINESS. ERIN’S SPECIALTY HEALTH ERIN’S SPECIALIZED HEALTH AND WELLNESS INSURANCE.INSURANCE.
YOU ARE SOMETHING OF A WELLNESS YOU ARE SOMETHING OF A MEDICAL INSURANCE EXPERT? INSURANCE SPECIALIST? >> > > SOMETHING OF IT. >> > > SOMETHING OF IT. BUT THERE ARE MANY, MANY FACETS BUT THERE ARE LOTS, MANY FACETS AND NUANCES TO MEDICAL INSURANCE. AS WELL AS SUBTLETIES TO HEALTH INSURANCE POLICY. >> > > Press reporter: WHILE EXPECTANT THEY >> > > Reporter: WHILE PREGNANT THEY WENT SHOPPING WITH EACH OTHER FOR THE RIGHT WENT SHOPPING WITH EACH OTHER FOR THE RIGHT DOCTORS AND ALSO MEDICAL FACILITIES. PHYSICIANS AND HOSPITALS. >> > > THE MAIN WORRY WAS DISCOVERING >> > > THE KEY PROBLEM WAS FINDING THE MEDICAL FACILITY THAT REMAINED IN OUR THE HEALTH CENTER THAT REMAINED IN OUR INSURANCE COVERAGE NETWORK BECAUSE WE INSURANCE NETWORK BECAUSE WE BOTH HAD THE EXACT SAME INSURANCE POLICY BOTH HAD THE SAME INSURANCE COVERAGE THROUGH OUR COMPANY.THROUGH OUR COMPANY. >
> Press reporter: THEY BOTH CLEARED UP> > > Reporter: THEY BOTH RESOLVED >> ON THE EXACT SAME HEALTHCARE FACILITY AND ALSO WAIT ON THE EXACT SAME HEALTHCARE FACILITY AS WELL AS WAIT FORD THEIR DISTRIBUTION DATES. FORD THEIR DELIVERY DATES. LEILA ENTERED INTO LABOR FIRST. LEILA ENTERED INTO LABOR FIRST. > > WHEN THE PAIN STARTED TO GET > > WHEN THE PAIN BEGAN TO OBTAIN >> QUITE EXCRUCIATING THEY ASKED IF QUITE EXCRUCIATING THEY ASKED IF I WANTED AN EPIDURAL AND I STATED I WANTED AN EPIDURAL AND ALSO I SAID YES. INDEED. SO THE AN THESEESTHESIOLOGIST CA SO THE AN THESEESTHESIOLOGIST CA PROVIDED ME AN EPIDURAL.GAVE ME AN EPIDURAL.
A FEW HOURS LATER MY SON A FEW HOURS LATER MY CHILD ARRIVED. ARRIVED. > > Reporter: HOW ABOUT FOR YOU >>, > > Reporter: HOW ABOUT FOR YOU, >> ERIN? ERIN? > > THEY PUT THE EPIDURAL IN > >> > THEY PUT THE EPIDURAL IN >> AROUND TWELVE O’CLOCK AT NIGHT APPROXIMATELY. AROUND TWELVE O’CLOCK AT NIGHT OR TWO. THEN THE NEXT MORNING I HAD A THEN THE NEXT EARLY MORNING I HAD A REALLY, REALLY LONG DELIVERY. REALLY, REALLY LONG SHIPMENT. > > Reporter: WAS IT YOUR FEELING > >> > Press reporter: WAS IT YOUR REALLY FEELING >> THAT YOUR INSURANCE PROVIDER WAS THAT YOUR INSURER WAS GOING TO BE PAYING FOR THE HUGE GOING TO BE PAYING FOR THE HUGE MAJORITY OF THIS? BULK OF THIS? > > YES, THAT WAS MY > > >> YES, THAT WAS MY >> UNDERSTANDING.UNDERSTANDING. > > Press reporter: BUT A FEW WEEKS >
> Reporter: BUT A >> FEW WEEKS LATER LEILA OBTAINED A BEAL FROM LATER LEILA GOT A BEAL FROM THE ANESTHESIOLOGIST FOR $1,600. THE ANESTHESIOLOGIST FOR$1,600. > > I KEEP IN MIND TELLING MY > > I REMEMBER TELLING MY SPOUSE>, THIS APPEARS REALLY OTHER HALF, THIS APPEARS REALLY STRANGE. WEIRD. WHY WOULD I GET THIS BIG EXPENSE? WHY WOULD I OBTAIN THIS BIG EXPENSE? I DIDN’T WISH TO GET REMINDERS I DIDN’T INTEND TO OBTAIN POINTERS AS WELL AS HAVE IT GO TO COLLECTIONS IF AND HAVE IT GO TO COLLECTIONS IF I TRIED TO IDENTIFY WHAT IS I ATTEMPTED TO DETERMINE WHAT IS HAPPENING, SO I PAID IT AS WELL AS GOING ON, SO I PAID IT AND ALSO IDEA I’LL FIGURE IT OUT IDEA I’LL FIGURE IT OUT LATER.LATER. > > Press reporter: DID YOU INFORM ERIN > > Press reporter: DID YOU INFORM ERIN YOU HAD GOTTEN THIS WHOPPING> YOU HAD GOTTEN >> THIS WHOPPING BILL IN THE MAIL? EXPENSE IN THE MAIL? > > I SAID TO LOOK OUT FOR A > > I STATED TO VIEW OUT FOR A$1,600 COSTS. $1,600 BILL >>. SHE WAS PRETTY SURPRISED. SHE WAS PRETTY SURPRISED. > > Press reporter: WHY WERE YOU > > Press reporter: WHY WERE YOU >> STUNNED? AMAZED? > > WE HAD THE >> EPIDURAL PLACE IN IN >> > > WE HAD THE EPIDURAL PUT IN IN THE MIDDLE OF THE EVENING. THE MIDDLE OF THE EVENING. WHO IS GOING TO STOP AS WELL AS ASSUME THAT IS GOING TO STOP AND ALSO ASSUME TO ASK THE PARTICULAR DOCTOR OR TO ASK THE SPECIFIC PHYSICIAN OR ANESTHESIOLOGIST THAT CAME INTO ANESTHESIOLOGIST THAT ENTERED INTO THE SPACE, FORGIVE ME, ARE YOU ON THE AREA, EXCUSE ME, ARE YOU ON MY INSURANCE BEFORE YOU DO THIS MY INSURANCE POLICY BEFORE YOU DO THIS TO ME? TO ME? I DON’T WANT TO OBTAIN A BIG COSTS I DON’T INTEND TO GET A BIG EXPENSE IN THE MAIL.IN THE MAIL. >
> Press Reporter: ERIN NEVER GOT THAT > > Reporter: ERIN NEVER OBTAINED >> THAT COSTS. COSTS. EVEN THOUGH SHE MOSTED LIKELY TO THE VERY SAME ALTHOUGH SHE WENT TO THE EXACT SAME HEALTHCARE FACILITY, HAD THE SAME HOSPITAL, HAD THE SAME INSURANCE COVERAGE. INSURANCE POLICY. HER ANESTHESIOLOGIST WAS HER ANESTHESIOLOGIST WAS COVERED. COVERED. AT THE SAME TIME, HER CLOSE FRIEND WAS STUCK ON THE OTHER HAND, HER FRIEND WAS STUCK HAVING TO CALL THE INSURANCE COVERAGE HAVING TO PHONE CALL THE INSURANCE PROVIDER. COMPANY. >> > > AND ALSO THEY KIND OF DID A LITTLE >> > > AND THEY SORT OF DID A LITTLE DIGGING AS WELL AS CLAIMED, OH, IT’S DIGGING AND SAID, OH, IT’S DUE TO THE FACT THAT YOU PICKED AN OUT OF BECAUSE YOU SELECTED AN OUT OF NETWORK COMPANY WHEN YOU WERE NETWORK SERVICE PROVIDER WHEN YOU REMAINED IN THE HEALTH CENTER. IN THE MEDICAL FACILITY. I DESCRIBED, I DIDPASS BY I CLARIFIED, I DIDPASS BY ANYTHING. ANYTHING. I REMAINED IN LABOR AS WELL AS THIS IS FOR I WAS IN LABOR AS WELL AS THIS IS FOR OBTAINING THE EPIDURAL. GETTING THE EPIDURAL. THE LADY ON THE PHONE JUST KIND THE WOMAN ON THE PHONE SIMPLY TYPE OF KEPT REPEATING YOU PICKED AN OF KEPT REPEATING YOU SELECTED AN OUT OF NETWORK PROVIDER.OUT OF NETWORK
COMPANY. >> > > Press reporter: DID IT NOISE TO YOU >> > > Press reporter: DID IT NOISE TO YOU THAT SHE WAS UTILIZING THE LANGUAGE THAT SHE WAS UTILIZING THE LANGUAGE SHE IS TOLD TO USE WHEN SOMEBODY SHE IS TOLD TO USE WHEN SOMEBODY CALLS IN WITH A CRAZY BILL? CALLS IN WITH An INSANE EXPENSE? >> > > YES, EXACTLY >>. >> > > YES, EXACTLY. > > Reporter: YOU WERE GETTING A > > Reporter: YOU WERE GETTING A TYPE OF FORMULAIC ACTION? SORT OF FORMULAIC RESPONSE? >> > > YES. >> > > YES. > > Reporter: IT TOOK SEVERAL > > Press Reporter: IT TOOK SEVERAL CALLS AND ALSO LOTS OF DISAPPOINTMENT. CALLS AS WELL AS LOTS OF STRESS. LAY A LAY A LEILA EVENTUALLY GOT HER CASH LEILA ULTIMATELY GOT HER CASH BACK. BACK. SOMETHING THAT DOESN’T ALWAYS SOMETHING THAT DOESN’T ALWAYS HAPPEN.HAPPEN.
> > I HAD NO SUGGESTION THAT OUT OF >> > > I HAD NO CONCEPT THAT OUT OF NETWORK PROVIDERS COULD BE IN AN NETWORK PROVIDERS COULD BE IN AN IN-NETWORK HEALTH CENTER. IN-NETWORK MEDICAL FACILITY. I BELIEVED IF YOU SELECTED AN I BELIEVED IF YOU CHOSE AN IN-NETWORK HEALTHCARE FACILITY, EVERY PERSON IN IN-NETWORK HOSPITAL, EVERY PERSON IN THE HEALTHCARE FACILITY IS IN NETWORK. THE HEALTH CENTER REMAINS IN NETWORK.
>> > > WHEN PEOPLE DO THEIR FEE >> > > WHEN PEOPLE DO THEIR FEE DILIGENCE AND ALSO STILL OBTAIN STUCK DILIGENCE AND ALSO STILL GET STUCK WITH SEVERAL OF THESE CRAZY BILLS, WITH SEVERAL OF THESE CRAZY BILLS, THAT’S A FAILURE IN THE SYSTEM THAT’S A FAILING IN THE SYSTEM TO SHIELD CUSTOMERS AND HELP.
