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Insurance company sticks new mom with $20,000 bill after contract dispute with hospital

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A family in North Carolina says they were at a loss after receiving a bill for more than $20,000 for the birth of their daughter, despite being insured. Our affiliate WLOS Ashevillle reports.

Melina Coogan says her daughter was born October 9, 2017, days after Mission Health went out of network with Blue Cross Blue Shield (BCBS) in a contract dispute.

"It's scary to get a bill for $20,000 and be told you're responsible for it. It's terrifying," Coogan said.

Coogan said she reached out to Blue Cross and Mission and was eventually told she would get a check from BCBS for her emergency cesarean section. Despite having been approved for Continuity of Care, she says she would still be stuck with the remaining $5,000 to $6,000.

"I said, 'What about these other bills?' They said, 'We're not covering those because we were out of network,'" Coogan recalled. "I said, 'I understand that, but I filled the Continuity of Care form that is good for 30 days.' And they said, 'That's only good for 48 hours.'"

Coogan said she was concerned when she thought she was going to have to pay more than $20,000 out of pocket, so she posted on social media and heard from other parents going through the same thing.

News 13 reached out to both Mission Health and BCBS about the situation. They responded with the following statements.

Mission Health:

In an effort to mitigate any negative impact on our patients during the time Mission Health was out of network with BCBSNC, we established additional discounts for BCBSNC members, offered interest-free payment plans, and offered financial assistance after taking a patient’s personal financial responsibility into account.
In addition, we set up a dedicated line for BCBSNC members to call us at (828) 213-1500 (Option #1) and speak with a representative who could assist with any problems, whether caused by Mission or not. It’s also important to note that Blue Cross pays a patient directly under these circumstances, unlike many other insurers and a practice that has been outlawed in other states.
For any questions regarding a patient’s specific reimbursement from a payor, such as BCBSNC,we recommend those questions be directed to BCBSNC.

Blue Cross Blue Shield:

Generally speaking, customers who were in maternity care at a Mission Health facility would have been approved for our Continuity of Care program. This means they would not be paying out of pocket and would be covered despite Mission Health’s termination of our contract. When a customer is approved for Continuity of Care, they get a check from Blue Cross NC for the cost of the procedure. The hospital would bill the customer, and it would be customer’s responsibility to pay the bill using our check. The hospital could only bill the customer up to the amount that we paid.

Late on Tuesday, Mission Health contacted Coogan and said they would work with her on these bills as a "gesture of goodwill," but Coogan said she's still concerned for other mothers stuck with bills.

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