While Rothbauer spent 10 days in a medically induced coma and another six days in the cardiac unit of the same hospital, she unwittingly racked up over $100,000 in health care bills.
Megan Rothbauer, a 30-year-old from Madison, WI, was unconscious when she was taken to the emergency room on Sept. 9. Channel 3000 reports that, while Rothbauer spent 10 days in a medically induced coma and another six days in the cardiac unit of the same hospital, she unwittingly racked up over $100,000 in health care bills. The issue is not that Rothbauer is uninsured. Rather, she was taken to a hospital that was not covered by her insurance and is now facing bankruptcy.
This issue, known as “balance billing” is a common practice in health care. According to the Huffington Post, most people believe that, with medical insurance, they are protected from debilitating financial loss from everyday medical incident to catastrophic accidents or illnesses. Balanced billing simply means that the health provider is able ot collect whatever portion of the provider’s bill that the insurance company did not pay on behalf of the patient. This is not a co-pay or a deductible. It is the entire unpaid balance.
In general, it is legal for health care providers to bill patients. Kaiser Family Foundation reports that only 13 states have restrictions on balance billing. These restrictions are limited to specific scenarios and emergency services are only specifically protected in four states. Wisconsin does not have any legal restrictions on balance billing by providers outside of the insurance network.
Rothbauer was billed for about $98,000 of unpaid bills from the hospital, which does not include additional bills from each provider. Her insurance company, Blue Cross Blue Shield, has helped negotiate down the bill from the hospital. Rothbauer is now excused from 90 percent of that bill.
Still, with her other bills she’s facing, Rothbauer has $50,000 in bills and her only way to handle it is by declaring bankruptcy. With more and more individuals being covered under Obamacare, cases of balance billing may become even more frequent and public.