Medical bill mistake doubles cost for Clayton man's treatment
CLAYTON, North Carolina (WTVD) -- Paying attention to your medical bills is crucial as you never know if you'll catch a mistake.
Robert Roesemann has been receiving the same Lupron injection for 20 years to help keep his prostate cancer at bay. He receives the shot every 4 months. His daughter Marie Campos says there have been no changes in her father's billing of the injection until recently.
"They actually billed $18,949 for the same shot that's been that $9,570 forever," Marie said.
She says the increase happened when UNC Health Care took over the billing.
The shot has always been expensive but a difference of $9,000 is something that Marie could not overlook. Robert does have Medicare so he is not responsible for the entire $18,000, but this still made his copay increase by $1,000.
"Medicare paid $6,000 instead of $600," Marie explained. "And his copay $1,200 and something instead of $200."
Marie is actually a nurse in the urology field so she took a close look at the bills to compare the statements to see why the price increased so drastically. She quickly noticed, "It's not the right code."
For years, Robert's Medicare statements show he's been billed under the male billing code for prostate cancer. When it comes to the most recent bill, Marie says it's been filed as a female billing code.
"The 3.75 dose is usually typically used in females for endometriosis and infertility," she added.
Marie filed a dispute with UNC Health Care and she says they insisted they were correct in their billing. She also filed an appeal with Medicare.
"I said to Medicare, doesn't it bother you that for all of these months and year you've been paying $619 and now you're paying $6,000 for the same shot, the same exact medication just because someone typed the wrong billing code?"
She says she got nowhere. She continued to receive the incorrect bills and says they even threatened to turn her over to collections.
"Very, very frustrating because I feel like you know, he's afraid, he's like 'I don't want to go to the doctor anymore,'" Marie said.
Marie got in touch with me because she said she was concerned about the affects this could have on people who might not recognize the change in dosage.
"How many other people do they do this too? I don't think it's just him," she states.
I reached out to UNC Health Care and they investigated. A representative provided me with this statement:
"At UNC Health Care and our affiliated hospitals and clinics across North Carolina, we take great pride in providing excellent care to all patients, regardless of their ability to pay. With Mrs. Campos, there was a billing error that led her father to be overcharged. We have fixed the mistake and submitted a corrected claim.
We appreciate Mrs. Campos's efforts to bring this error to our attention, so that we could correct it and ensure this type of mistake doesn't happen again. We apologize that this situation created additional hassle and stress for her and her father. We wish them all the best."
Robert did get a new Medicare statement from his most recent Lupron injection and it did have the correct billing code and dosage and his copay was the correct amount. Marie and Robert are both happy.
