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Billed by Surprise | Several viewers get unexpected medical bills from the same company

10News has found APP of Tennessee sent a total of around $14,000 in bills to Medicare patients who aren't supposed to receive them.

KNOXVILLE, Tenn. — In 2022, Vickie Maish's brother and mother died. Her brother died early in the year due to COVID-19 and after his death, her mother, Sarah Whillock's health deteriorated. 

"We actually stayed at the hospital more than we did at home, just about," Maish said. 

Whillock died in May. After her death, Vicki Maish got a bill from American Physician Partners of Tennessee for $7,899. 

"Even though she's gone, I still want good standings for her," Maish said. "I still wanted to take care of her debts." 

Maish is one of the viewers who contacted 10News after seeing part of a recent "Billed by Surprise" series. She said she realized Medicare patients should not be billed after visits to the emergency room. 

Credit: Vickie Maish
Vickie Maish was able to spend time with her mother before she died. After her passing, she received an unexpected medical bill of more than $7,000.

After working with United Healthcare, her Medicare Advantage carrier, APP of Tennessee was able to resolve the surprise bills and she did not need to pay them.

Similarly, Don Cameron contacted 10News about his mother — Farris. She got a bill for $1,168 from APP of Tennessee. Ilene Reinhart also got a bill for $1,161. 

In an email to 10News about these bills, APP of Tennessee responded to each of these cases. 

In Cameron's case, APP of Tennessee said "Medicare was never billed because the patient never sent the necessary information to us to bill Medicare on her behalf." 

For Reinhart's case, APP of Tennessee said the claim was initially denied by Medicare, but her insurance company re-submitted the claim.

Neither person should need to pay the surprise medical bills.

"In all three cases, our billing company's actions were accurate and legitimate," said Tracy Young, a spokesperson for APP of Tennessee, in an email. "Patients are informed at least three times over a course of 120 days minimum prior to being sent to collections, which is within our right." 

Credit: WBIR
A list of charges on an unexpected medical bill that one person received from APP of Tennessee.

Bill Maddox, a medical billing and bankruptcy attorney, said this can happen if the healthcare provider isn't billing correctly, and has the wrong information about the patient.

He said insurance companies and the provider should work together to resolve these disputes. 

"Sometimes it just takes some pushing back to make sure everything's coded correctly," Maddox said. "Just because someone says you owe it doesn't mean you owe it." 

He cautions people against just paying bills if they get them. He said people should ask for written proof that they actually owe money if they receive a surprise medical bill. They should also immediately check their credit. If a company reports that someone hasn't paid a bill, regardless of whether they actually owed it, it could affect their credit.

If their credit is impacted, people should contact a lawyer. They should also reach out for help if they receive Medicare since Medicare patients should not be billed directly.

WBIR is looking into how hospitals bill their patients. Hospitals in Tennessee are required to publish a list of standard charges for items and services they provide. 

Patients can report surprises in their medical bills. Sometimes they’re from errors the hospitals make: a procedure that should’ve been preauthorized but isn’t, the hospital billed the wrong code or they incorrectly classified a procedure. 

If you get a bill and see something wrong, contact the hospitals and the insurance company. If they don’t help solve your problem — contact us at: iteam@wbir.com, to see if we can help.

The Tennessee Department of Commerce and Insurance offers mediation, regulates insurance and can take action when they discover situations unfair to consumers. To file a complaint, they ask you to visit their website or call 1-800-342-4029.

RELATED: Billed by Surprise | Two East Tennesseeans charged for thousands in unexpected medical bills from the same company

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