How one consumer's attempts to solve a simple billing issue went nowhere.
When this consumer affairs column was born, it had a simple mandate: to help consumers who believed they were being wronged by a company or government agency. We would step in when consumers couldn't resolve an issue despite their own attempts, and we would cut through the red tape and encourage organizations to do the right thing.
It's a rewarding column to write, actually helping real people with real problems, but it's also incredibly frustrating to see issues come across our desk that should have been corrected without outside intervention.
Here's one of those cases.
We received an email from a consumer who had a very simple billing issue after a hospital visit. She had figured out the solution to the problem, but for more than six months, no one would help her solve it.
We stepped in, and in a couple of days, the billing issue was resolved.
Why was this so hard to fix without a nudge from the media?
Unfortunately, we don't have an answer.
Here's what happened.
JoAnn Corry of Edison needed four rabies shots.
Her cat Harry is an outside cat - he doesn't like it inside, Corry said - so her husband built the cat a heated enclosure that's attached to her basement window. Harry lives there, is fed there, sleeps there, and can go out whenever he wants.
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Harry, JoAnn Corry's cat, sits in his heated enclosure attached to her basement window. In March 2018, Corry said, she heard a commotion in the enclosure. At first, she thought another cat had entered Harry's home and had started a fight.
On closer examination, she saw it was a raccoon.
Corry hurried outside and opened the enclosure to save a wounded Harry, and she was scratched and bitten in the process. (Harry turned out to be okay after treatment with a veterinarian.)
For her own injuries, Corry went Robert Wood Johnson University Hospital's emergency room.
"I wasn't sure I was exposed to rabies, but the alternative is death, so I wanted the treatment," Corry said.
It would be four shots in all given at very specific intervals over several weeks.
The emergency room bill for the initial shot was covered in full by Corry's insurance.
She would be away on vacation during the time she would need the second and third shots, so she visited a local hospital while she was away.
Those shots, too, were covered by her insurance.
When it was time for the final shot, Corry said, she asked her doctor if she could avoid the emergency room and get the shot in his office instead.
"He reported to me that the ER was the only place to get the vaccine," she said. "No doctors' offices carried the vaccine."
So she returned to Robert Wood Johnson's emergency room for her final shot.
Every month since April, she's been receiving bills from Rutgers Health System - which supplies the doctors in the emergency room - for $202.
Looking for a resolution
Corry said her insurance covers all emergency room visits, so that's not the problem.
The issue is how Rutgers Health is coding the claim. Rather than call it an ER visit, it coded the claim as a routine visit, documents show.
Corry's insurance company said the solution was easy, Corry learned during a phone call. Rutgers Health simply needed to resubmit the bill with the correct code for an ER visit.
But, Corry said, Rutgers Health has refused to do so.
"In other words, they are saying I should not have gone to the ER, but the ER is the only place that had the vaccine," she said. "I have appealed the decision, but Rutgers Health insists on coding the visit as a routine visit to the ER, and therefore my insurance will not pay."
After months of trying to get Rutgers Health to change the billing code and worried the bill could damage her credit score if it was sent to collections, Corry asked Bamboozled for help.
Cutting through the red tape
We reviewed the bills and Corry's timeline of events, and we asked Rutgers Health to take another look.
It did, and the problem was solved.
"The bill has been properly recoded and will be resubmitted to the insurance company for payment," said a spokeswoman. "We apologize for any inconvenience this may have caused."
Okay, that's great. But what happened? Why did this have to be escalated? Why did it take a call from a consumer columnist to fix something that the organization's billing reps should have been able to correct on their own?
Our request for more information was denied because of patient privacy, the spokeswoman said.
But Corry did receive a phone call and apology.
"They said if for any reason, if my insurance does not pay, they will waive the bill for all the trouble I have been put through," Corry said.
She said the reps called it a clerical error.
"My point was that their reps would just not listen to reason about why the bill needed to be recoded," Corry said. "I asked that what if this had happened to someone else who might not have been savvy enough to go to the media? Their credit rating would be in jeopardy due to a clerical error?"
Getting your own fix
So what can you do if you discover a simple fix for a wrong medical bill?
Do what Corry did. Ask questions. Talk to the provider and to your insurance company. In most cases, we hope, the fix would be made.
If you can't get anywhere, try the hospital's ombudsman or patient services office. These employees are supposed to problem-solve for patients.
You can also file a complaint with Consumer Affairs if the dispute is with a doctor or hospital. You can do that here or by calling (973) 504-6200.
If the issue is with an insurance company and you can't get a supervisor to help, consider filing a complaint with the Department of Banking and Insurance here, or by calling (800) 446-7467.
If that's not enough, you know where to find us.
Email your questions to Ask@NJMoneyHelp.com.
Karin Price Mueller writes the Bamboozled column for NJ Advance Media and is the founder of NJMoneyHelp.com. Follow NJMoneyHelp on Twitter @NJMoneyHelp. Find NJMoneyHelp on Facebook. Sign up for NJMoneyHelp.com's weekly e-newsletter.