The email’s subject line was blunt.
“Outrageous bill being PAID by the insurance company.”
Dave Altman wrote me many months ago after seeing our “Show Us Your Bills” series on 9NEWS.
The series highlighted some of the absurdities associated with health care billing.
In general, we spoke with a lot of patients upset over just how much they were being asked to pay.
“Chris,” Altman’s email stated, “I have kind of a reverse situation than most of what you have showcased.”
The phone call that followed helped fill in many of the gaps. Here’s the general outline:
In 2015, his wife Debra underwent a six-hour back surgery at Parker Adventist. The surgery was largely unsuccessful in relieving Debra’s pain, but that wasn’t his main gripe.
More than a year after the surgery – long after numerous claims for the expensive surgery itself had been processed – the Altmans received a check from their insurance, UnitedHealthCare, for $169,600.
“We really felt like there was a mistake,” explained Dave Altman. “It straight out didn’t make sense.”
A few weeks later, however, it all started to make a bit more sense when a bill arrived in the mail. BHLH LLC. wanted $169,600.
The bill, sent from a P.O. Box in Osakis, included a hand-written entry that asked the Altmans to forward the UnitedHealth check to a business address in Plano, Texas.
“Please make check payable to BHLH,” wrote a woman named “Edie.”
“Who is Edie?” I asked the Altmans.
“We don’t know,” replied Dave.
“Who are any of these people?” I asked.
“We don’t know,” replied Dave.
What is IONM? 9NEWS Chris Vanderveen explains.
What they did know was that the money was meant to pay for something known as intraoperative neuromonitoring. We’ll talk about what that is in a moment.
But first let’s get into a bit of a side note here, if only for clarity sake.
It’s not unusual for insurance companies to forward money to patients in order to pay out-of-network claims. In this case, BHLH was not in network with United, and thus it had no contract to help facilitate a payment.
Instead, United forwarded its payment to the Altmans with the assumption that the Altmans would simply forward the funds to the biller.
So let’s get back to the bill itself.
What exactly is intraoperative neuromonitoring (or IONM, for short)?
While it sounds complicated and relies on some fairly fancy equipment, IONM is relatively simple in its intent.
Using IONM, a typically off-site neurologist can monitor readings taken inside an operating room and help alert the surgeon if he or she is coming close to doing any long-term damage to the patient’s nervous system.
In other words, it can be very important during some surgeries.
In 2014, a national study found IONM can, on average, add $3,000 to $4,000 to the cost of a surgery. So why did Debra’s IONM cost so much more?
And who was in charge of BHLH LLC. and its IONM company South Downing LLC.?
While finding an answer to that first question has proven tricky, the answer to the second one can readily be found in Colorado Secretary of State records.
In Colorado, both BHLH and South Downing are registered to a man named Adrian Panther. Panther, a part-time resident of Colorado, devotes a good portion of his time these days running Panther Distillery in Osakis, Minnesota.
His website proudly proclaims, “In 2011, Adrian Panther set out with a simple idea: bring great spirits to Minnesota. Adrian has always been an entrepreneur and a whiskey aficionado.”
His Facebook profile highlights a picture of him with a cigar in his mouth. A friend suggested he looked like Jose Cuervo.
“No way. I look like Johnny [sic] Walker,” replied Panther.