Brittany Giraud Lane gave birth to her daughter Alexandra a few days before Christmas 2018. The baby’s eyes are black and his legs are longer. She also arrived about 13 weeks early and weighed only 2 pounds.
Alexandra initially thrived in the neonatal intensive care unit in western Sinai. Lane, 35, remembers a nurse who described her as a “rock star” because her daughter grew so fast. However, her condition deteriorated rapidly after the infection, and Alexandra died early in the morning of January 15th, 25th.
Small medical spending surges from neonatal scholars and pediatricians soon continued. During her premature birth, Lane had a hard time covering her breast pump because she hadn’t gone through the pre-approval process for health insurance.
Last summer, Mr. Lane began receiving debt collection notices. According to a letter sent by Health Insurance Cigna, after Lane switched health insurance companies, the insurance company has more than $ 257,000 in debt for accidentally covered claims for Alexandra’s care. is.
Mr. Lane was confused: it was Signa who received the first care invoice and paid to the western part of Mount Sinai. Now Cigna was looking for money overpaid to the hospital by looking at the patient.
“For them, it’s just a business, but for us, it means constantly experiencing the trauma of re-experiencing the death of our daughter,” says Clayton Lane, Alexandra’s father and Lane’s husband. I did. “It means facing the threat of financial ruin. It’s very unjust and annoying.”
A medical billing expert who examined the case explained that the patient was stuck in the middle, a dispute between a large hospital and a large insurance company. Experts say such cases are infrequent, but talk about the broader lack of predictability of US medical billing.
Congress passed a ban on a surprising medical bill last year. It will come into effect in 2022. This outlaws certain types of surprising bills. There are many other bills that will surprise patients, such as those received by Lanes, but they may continue.
Lanes describes the process of fighting their astonishing bill as frustratingly Kafkaesque. They spent hours on the phone, sent dozens of emails, and filed complaints with regulators in two states.
“The letter means I’m always reliveing the day, and it’s a very difficult space to enter,” Lane said. “I am very dissatisfied with the hospital’s decision on our potential future and their own profits that affect the memory of our children.”
Systemedic Inc. Susan Null, a medical billing expert at, said: Contact the hospital and ask them to release the funds. “
Americans are familiar with medical debt. About 18% of them have unpaid invoices from hospitals, doctors, or other types of providers of the healthcare system. However, most people do not expect to receive an invoice collection notice that has already been paid by health insurance.
Courtney Jones, Senior Case Manager at the Patient Advocacy Foundation, explained that he is working on a case where a patient receives a similar collection notice for a bill that the insurance company, not the patient, is responsible for covering. This usually happens at high medical costs, like lanes where both insurance companies and hospitals are more at risk.
“They use it as a tactic to pressure medical facilities to reimburse money,” Jones said.
In response to a question from the New York Times, Signa said she “regrets” the letter and, in the light of Lanes’ experience, is considering how to communicate with the patient in such cases.
After Lanes filed a complaint with state regulators, Signa sent them a letter stating that they would no longer receive similar letters. “We sympathize with the pain and confusion that this experience has brought to Mr. and Mrs. Lane,” he said in a statement. “We work with vendors to prevent this from happening to Lane and other customers again.”
Mr. Lane received the first collection notice about 18 months after her daughter died. Her family was switching health insurance while in Alexandra’s hospital to change jobs.
The day Lane gave birth to Alexandra was supposed to be her last day in her first job, a few weeks later, before she got a new job.
“I was afraid of being hit by a large bill, so I was renewing my insurance on Mount Sinai, even during childbirth,” recalls Lane.
The hospital seems to have both Cigna 2018 and United Healthcare 2019 insurance plans enrolled. However, Cigna erroneously covered the entire bill and exceeded $ 257,000 in January infant care payable by UnitedHealthcare.
A representative of Mount Sinai told Lanes that United Healthcare actually paid the invoice, that is, the invoice was paid twice, but did not solve what seemed to be a broader issue for Mount Signa. rice field.
Mr. Lane contacted the hospital when he received the first collection notice. A patient service representative apologized and wrote in an email that “Cigna intends to receive an overpayment.” A third-party contractor who sent a letter on behalf of Cigna also told her that the problem would be resolved within a few days.
“I was supposed to get confirmation. I didn’t, but I was exhausted and didn’t follow up,” she said.
She noticed that no refund was given when another collection notice arrived in early July this summer. When she contacted the hospital again, top executives said she did not know when the refund would be released.
“We cannot respond to Cigna’s refund as it is being discussed as part of a larger settlement agreement in progress,” Gale Spiro, vice president of patient financial services at Mount Sinai, wrote in August. 10 emails. “I apologize again for the time it took to get what I needed.”
In a statement, Mount Sinai West said: It is not common for insurance companies to track patients in this way. “
Lanes also called Cigna several times and eventually filed a complaint with California’s insurance department, which has Cigna’s health insurance coverage.
“Receiving another letter completely destroyed our lives and healing,” Lane said. “It meant a lot of tears.”
In response to the complaint, Cigna sent Lanes a letter stating that the notification was erroneously sent by a third-party vendor called HMS, which insurance companies use to monitor overpayments to hospitals. According to Signa’s letter, the letter was only to “inform” the family of the ongoing dispute with Mount Sinai.
Both notices received by Lanes notified them of the debt and asked them to “pay in full” within 30 days, using the slip at the bottom of the letter intended to be returned with the payment.
HMS declined to comment on this article because of patient privacy practices. Lanes demanded that Mount Sinai and Signa make a statement to Letterhead that the family was not in debt. No such letter has been provided yet, but Mount Sinai states that it will be issued within a few weeks.
Lanes said it was difficult to reconcile the kind and affectionate care she received in the neonatal intensive care unit with her subsequent billing experience.
“She died …