Family slammed with $17,000 bill after going to in-network hospital


When Reid Rupp was rushed to McCullough Hyde Hospital in Oxford, Ohio last year with a broken jaw and knocked-out teeth from a bicycle accident, he needed to be transferred to a larger hospital.

>> Read more trending news 

The 20-year-old Miami University student’s parents, Lisa and Christopher Rupp, were asked to pick whether the ambulance should take him to a hospital in Cincinnati or Miami Valley Hospital in Dayton.

They picked Miami Valley. It was in-network, near their home in Oakwood, and the family had been there before.

Even though the hospital was in-network — the term used to describe agreements for reduced rates negotiated between providers and insurance companies — the plastic surgeon who operated on Reid Rupp was not. Five weeks later, the Rupps received a medical bill for more than $17,000.

It’s common for hospitals to contract with doctors who are not on staff, and patients aren’t always told they will be billed separately by the doctor. If the doctor and insurance network don’t have an in-network agreement to keep costs down, patients can get stuck fighting a high bill they thought would be covered by their insurance plan.

>> Related: Empty beds, high costs contribute to Good Sam closing

Hospitals and doctors say it’s difficult to pre-emptively explain what the total patient cost will be, particularly in emergencies. Out-of-network physician groups have also argued that the reimbursement rates they get from insurance companies aren’t adequate for them to join a network plan, leaving them little choice but to pass their costs onto their customers.

Surprise bills more common

Surprise billing — the term used in the industry — has become more common as hospitals contract out for more services. About 65 percent of U.S. hospitals contract out their ER staffing and management, according to 2014 data from Merritt Hawkins, a physician staffing company.

A 2016 study in the New England Journal of Medicine of more than 2 million claims from one large insurer found 22 percent of its ER billings involved an out-of-network provider. And in almost every case, the patient had gone to an in-network hospital.

Congress and legislatures in different states have attempted to tackle the problem, but there is no legal protection against surprise billing in Ohio.

Lisa Rupp, a Beavercreek City Schools teacher whose insurance covers her college-age son, said the family is now fighting the $17,000 bill they received for his treatment.

Rupp said it was an emergency situation, but that Reid was stable by the time a plastic surgeon was called. She said she and her husband would have searched for a different doctor if they knew the size of the bill they were facing.

“We were not afforded that choice,” she said.

“It’s not by accident”

The plastic surgeon who operated on Reid Rupp, Dr. Kenneth Christman of Miamisburg, charged about $19,000 — $2,000 of which was picked by the family’s employer-funded insurance plan. The family hasn’t paid any of the balance, appealing to anyone they thought might be able to help: their insurance company, benefits broker, Christman’s office, Miami Valley Hospital, their state representative and the Ohio Attorney General’s office.

Christman’s debt collection agency, Doctors Credit Service, said in an Oct. 17, 2017, letter to the Rupps’ attorney that the doctor would like to discuss his out-of-network fees with the patients and their families “but all the hospitals that he has worked out of have blocked/prohibited him from doing this.”

Read more here.


Reader Comments ...


Next Up in Nation World

Marine’s murder in Belize remains unsolved one year later
Marine’s murder in Belize remains unsolved one year later

Brandon Barfield has kept his best friend’s room just the way he left it. Drew DeVoursney’s black suit still hangs in the closet of the West Palm Beach home they shared. And his guitar — the one he used to perform Lynyrd Skynyrd and Allman Brothers songs while they were both deployed in Iraq — rests beside the bed he slept in...
Delta warns of flight cancellations due to subtropical storm Alberto
Delta warns of flight cancellations due to subtropical storm Alberto

Delta Air Lines is warning that it expects it will have to cancel flights due to subtropical storm Alberto. The storm is expected to make landfall just west of Panama City on Monday afternoon with heavy rain and strong wind affecting areas in Alberto’s path, according to Delta. Atlanta-based Delta said it expects delays and cancellations...
15-year-old girl missing since Tuesday in Mississippi, parents want answers
15-year-old girl missing since Tuesday in Mississippi, parents want answers

A Mississippi family is desperate for answers after one of their own, 15-year-old Eileen Betlinski-Brown, went missing Tuesday in Horn Lake, Mississippi. “It’s just way, way, way too real. I guess you call it stressful to say the least. Scary. Not knowing what’s happening,” said Eileen’s grandfather, James Betlinski. Betlinski...
Man, 79, pleads no contest to raping girl, 5, sentenced to 90 days house arrest
Man, 79, pleads no contest to raping girl, 5, sentenced to 90 days house arrest

A California businessman pleaded no contest to statutory rape of a 5-year-old girl Wednesday, and, as part of a negotiated deal with the San Joaquin County Superior Court, was sentenced to 90 days house arrest and will not have to register as a sex offender. Lyle Burgess, 79, of Stockton, sexually assaulted the girl, who is now 7, after her family...
Germany’s largest amusement park reopens after massive fire 
Germany’s largest amusement park reopens after massive fire 

There were no injuries among the thousands of people who evacuated from Germany’s largest amusement park after a fire ignited Saturday, destroying the Pirates of Batavia ride.  About 250 firefighters battled the blaze at Europa-Park into Sunday morning after the fire started in a warehouse, according to Sky News. Some firefighters...
More Stories