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New Ga. law will add protections against surprise medical billing

Surprise billing happens when you go to a facility for surgery or the emergency room. The...
Surprise billing happens when you go to a facility for surgery or the emergency room. The hospital is covered by your insurance. But you’re surprised to later learn that some of the doctors or providers you saw there are not covered.(WRDW)
Published: Sep. 11, 2020 at 8:12 AM EDT
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SAVANNAH, Ga. (WTOC) - Tara Conway channeled her frustration into a series of paintings after waiting for hours on hold to resolve a surprise medical bill.

“I just started burning holes and I had all of these old photos and kind of put them together,” she said.

She painted the series over about two months' time as she waited on the phone with a collections agency to resolve a bill from an emergency room visit.

“There’s some pretty dark paintings from that time,” Conway said.

Surprise billing happens when you go to a facility for surgery or the emergency room. The hospital is covered by your insurance. But you’re surprised to later learn that some of the doctors or providers you saw there are not covered.

Surprise medical billing has ruined people’s credit and left others with insurmountable debt. It’s a problem all over the country.

In Georgia, the governor signed a new law in July aimed at cracking down on surprise billing in hospitals.

But does it go far enough to protect consumers?

Conway believes more needs to be done to protect consumers from unscrupulous billing practices.

Her billing frustration stems from August of 2019 when her then 3-year-old daughter Miriam had a mishap.

“She kind of like fell forward. And then (my husband) realized that she had a little doll and there was a little hair piece that she had put in her nose,” she said.

After trying to remove the barrette, and unable to dislodge it. Her husband took Miriam to Memorial Health’s emergency room.

The hospital took her husband’s insurance and a $200 co-pay would cover the visit, she said a receptionist explained.

“We never heard another word of it until a couple months ago, in March, when we applied for a mortgage and our lender informed us that there was about $900 in hospital debt on my husband’s credit, and it had bumped my husband’s credit and it had bumped his score down to the point that our interest rate was significantly higher.”

The bill that bumped their credit was from the ER doctor group - not the hospital. As it turns out, the doctor’s group sent the bill to collections.

"Which was very confusing and alarming to us because at that point we had not seen any bill or any notice or anything, "she said.

The doctor’s group Georgia Emergency Physicians Specialist called it a billing error that never should of happened.

“We are trying to rectify some of the issues. This is not an isolated incident,” said Johnny Sy, president of Georgia Emergency Physicians Specialist.

Dr. Sy is part a small physician’s group that works in Memorial Health’s emergency room. The group outsources its billing to a company in Indianapolis.

“To me, it’s baffling to me how someone never gets a bill - regardless if we’re talking about the surprise billing issue, but then the first place it ends up in collections,” he said “To me, I don’t know how that happened. That’s why I’m trying to rectify the situation.”

Surprise billing is an issue Dr. Sy said he worked to stop. He supported House Bill 888 and worked with the Georgia General Assembly to pass it. He supports the changes, which keeps the patient out of the fight between the insurance company and the provider.

Georgia is now one of at least 26 states in the nation with surprise medical billing protections. Neighboring South Carolina does not have one in place.

Dr. Ben Watson, who is a Georgia state senator for District 1, championed the law change.

“We had failed for five years trying to get that passed., and as I said earlier if we didn’t get this bill passed this year, I would have considered the whole session a failure. To me, it was the most important bill.”

The new law paints a new picture for consumer protections in Georgia.

“Once that (medical) bill is settled, (the billing company) won’t be able to turn it over to a credit sources and that bill with the patient would not be put in the middle,” Sen. Watson said. “It would go between the provider and the insurance company and the patient would be left out.”

So that what happened to Tara Conway and her family won’t happen again.

“If I hadn’t had that time, and the kind of energy and former experience as an attorney. I don’t think I would have gotten to the bottom of it. I think I would have just paid the settlement amount which would have been a slightly lower amount, and we would have ended up paying a higher mortgage.”

Tara’s tenacity saved her family $50,000 on their mortgage note.

To do that, she badgered the collections company Profit Services Group to write a letter saying what happened was a mistake and it was wiped from their credit.

WTOC called the physician’s billing company. After more than 40 minutes on hold, an agent transferred WTOC to the voicemail of a supervisor. No one from the company has returned a call.

Profit Services Group had no comment.

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