• 9 Investigates: Health insurance billing errors

    By: Christopher Heath

    Updated:

    ORLANDO, Fla. - Florida Gov. Rick Scott in 2016 signed HB-221, a bill that limits what's referred to as balance billing, but some patients said they're still receiving bills. 

    "I got the bill when she was eight months old," said Emilie Frederick, an Orlando mother. "I didn’t even know what that company was, because we had been paying her bills through Orlando Health."

    Pediatrix is the company that had billed Frederick.

    Pediatrix describes itself as the "nation’s leading provider of maternal-fetal, pediatric medical and surgical subspecialty physician services."

    Read: The best ways to deal with out-of-pocket medical expenses

    The company also said it's among the nation's largest providers of newborn hearing screens.

    Frederick was unsure what services she had received from Pediatrix when she gave birth to her daughter. But she received a bill for $1,484 months after she left the hospital.

    Frederick spent weeks contacting her insurance company and Pediatrix, and the bill was eventually forgiven.

    Read: Florida county loses suit, faces $300M in hospital bills

    Pediatrix told 9 Investigates' Christopher Heath in an emailed statement that Frederick shouldn't have been billed.

    "This was a billing mistake caused by human error," a spokesman said. "MEDNAX has since taken the appropriate action and the matter has been resolved -- the patient now has a $0 balance."

    It's unclear if Frederick’s situation was a case of balance billing, but it illustrates a common problem experienced by patients when they receive bills from third-party companies that they don't recognize.

    Read: Florida man pays mom's bills with $23K poker tournament win

    Balance billing happens when a physician or medial provider bills a patient for an outstanding balance after their insurance company has paid its portion of the balance.

    Complicating the matter, out-of-network providers that don't have spending agreements with insurers are able to bill for an entire balance.

    Florida law requires out-of-network providers to negotiate with insurance providers, leaving the patient out of the billing.​

    Read: Lake County officials look to bring emergency services under their wing

     

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