CBS4 Problem Solvers helps patient get refund 15 months after paying surgery deposit

Data pix.

LEBANON, Ind. -- A year after undergoing spinal surgery, a man said he still couldn't figure out why he had to pay $1,000 before his doctor would operate.

Phillip Ford contacted CBS4 Problem Solvers for help with his medical billing case. A doctor with Indiana Spine Group operated on Ford in the spring of 2018, but as he was preparing for surgery in a pre-operative bed, Ford said he was told he had to pay a deposit.

"He says, 'Well, I’m not touching you until your deposit’s made. You owe me over a thousand dollars.' I said, 'Excuse me?'" Ford said.

Ford and his husband paid the deposit, and he underwent a successful surgery, but as he started looking over insurance documents, he still couldn't understand why they had paid that money.

"I started inquiring, 'Why did I have to make this deposit? Where’s my money?' It was total silence on their end," Ford said.

CBS4 Problem Solvers got in touch with Indiana Spine Group, and a representative said in March that she would review Ford's case. A week later, she confirmed via email, "We do believe there is an overpayment on (his) account."

Ford didn't get a refund right away, though. Representatives told him that they had to process a Medicaid claim first.

"They keep saying, 'Oh, it could be 60 days, it could 90 days, it could be 30 days, it could be 120 days,'" Ford said.

It ended up taking more than four months. In mid-August, Ford finally received a check in the mail for the $1,000, minus a small balance he owed for other procedures.

"(It had) nothing on the explanation except 'refund,' that's it," Ford said.

A representative with Indiana Spine Group issued CBS4 Problem Solvers this statement:

"Due to HIPAA regulations, we are unable to discuss any of the patient information. However, all procedures require patients' signatures for services rendered.

Indiana Spine Group's Financial Policy and Authorization states in part, 'Payment Prior to Surgery/Procedures/Injections: I understand that I may be asked to provide payment in full for any deductible or co-insurance prior to the scheduled date of surgery, procedure or injection,' and 'Pre-certification/Prior authorization/Referral: If my insurance requires any form of prior notification for any services rendered, I understand that it is my responsibility to obtain it. I agree to be held financially liable for any services provided by Indiana Spine Group, P.C. that are denied or reduced by my insurance carrier because I failed to obtain the necessary type of prior approval.'

Refunds are issued following insurance reimbursement."

Ford said he still doesn't understand why his doctor asked for the deposit in the first place, and he hopes other patients will learn from his case.

"I'm glad it's over with because it (was) a stresser in my life. It's done, over with, completed," Ford said.

If you get a medical bill that you don't understand, AARP suggests that you compare your medical bills to the Explanation of Benefits, or EOB, that you get from your insurance company. If you think you overpaid, talk to your doctor's office and insurer. You can even request an itemized bill, your medical record, and file an insurance appeal if necessary.

You can find more information from AARP at this link, from the American Hospital Association at this link, or from Consumer Reports at this link.

If you have a problem that you'd like CBS4 Problem Solvers to consider, contact us at 317-677-1544 or ProblemSolvers@cbs4indy.com.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Notice: you are using an outdated browser. Microsoft does not recommend using IE as your default browser. Some features on this website, like video and images, might not work properly. For the best experience, please upgrade your browser.