My family doctor suspected I suffered from sleep apnea and scheduled a sleep study for me with a pulmonologist who works out of Baptist Shelby. After I filled out the paperwork, I presented my insurance card to the intake worker, who made a copy of my card, as usual (I have BlueCross/Blue Shield, Open Enrollment Plan - which is a ripoff of sorts as well). As she went over my paperwork I told her I doubted that my insurance would cover the test. She told me not to worry, that they had seen people on my plan before, and that they had "creative ways of filing" so that they would be paid. And so I proceeded to schedule the test.
After spending a five-hour evening in their sleep suite, the doctor found that I was waking myself up at least once every minute, and that I was never drifting into deep enough sleep to rest, and that I needed a CPAP. So the test was successful.
The following week I received a letter from Blue Cross, denying the claim because my policy did not cover the test. That was followed by a $6,776 invoice from Baptist Shelby. Upon contacting them about bill, I explained to them an employee of theirs had represented that their billing office would be able to successfully file on my insurance; they told me they had no recollection of such a thing happening, and that it would be illegal for them to do so. I went further, asking them to charge me the same thing they would accept from Blue Cross on any other BCBS plan - they told me that, too, would be illegal.
Since then I have not been able to negotiate with Baptist Shelby. The only thing they will offer is more months to pay the bill. It has since gone to a collections attorney, who has tacked on more than $2,300 in lawyers fees and the bill is now more than $9,000. I fear that I will be sued any day, and if I am, I will have no way of defending myself, since they have my signature, and all I have is their word.
Some very rudimentary research on the internet shows that the average Blue Cross reimbursement for my test is around $1,800. I think it is reprehensible for a gigantic non-profit institution like Baptist Health System of Alabama, with their huge portrait of Jesus in the lobby, to fee-shift at the rate of about 350 percent, and to misrepresent themselves by lying to their patients.
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