HOUSTON, Texas (KTRK) -- A local man was shocked when he received a $102,000 bill for a surgical procedure he said he was told would be covered by his insurance.
J, whose name we're not using since he works undercover in law enforcement, said he spent months scheduling the surgery with CHI St. Luke's. He said he gave them his name, insurance information and information about the type of surgery he was having so they could pre-authorize the operation with his insurance company.
"Once verifying and paying my co-pay, I asked the young lady if everything was okay, and she said, 'Yes, you have the pre-authorization,' and I was good with it," he told ABC13's Ted Oberg. "I was happy about it. Everything was moving forward."
J paid a $550 co-pay and thought the procedure went well. That is, until he received a bill saying his insurance didn't cover it and that he owed $102,328.
"My heart is what fluttered. $102,000 is a lot of money, so I actually took the time to read over the bill again, make sure it wasn't a typo, and for the next few weeks went through stress mode," J said. "It's not good on the heart."
J said he called his insurance company and the hospital to figure out what happened and why. But, while he was still trying to get it resolved, he started receiving collection notices for the bill.
When he couldn't get a clear answer on why he owed money, despite the pre-authorization, he Turned to Ted.
"You guys seem to make things move faster," J told Oberg. "I appreciate the effort that y'all put into everything you do."
We reached out to the hospital, who started looking into his bill. Within weeks, J received a call from the hospital saying his bill was resolved.
In a statement to ABC13, St. Luke's Health said it reviewed and improved its pre-authorization process.
"Our highest priority is the safety and quality of care for our patients. As such, we appreciate you bringing this patient issue to our attention. After careful review and consideration, St. Luke's Health determined that part of the pre-service process did not work as designed. St. Luke's Health has decided to write off the balance given the special circumstances. We have communicated the outcome of the review process to the patient directly and are taking steps to improve our internal processes to prevent this from happening again in the future," St. Luke's said in a statement.
J's advice for others is to make sure you know your financial obligation prior to surgery and keep a letter or phone call records showing proof of pre-authorization.
"I stayed on the fact that it was verified prior to having surgery and looked for channels to resolve this matter and reach out to people that I know could get things going," J said. "You never give up. If you know you're in the right, you keep going."
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Surprise! Houston man Turns to Ted after getting $102,000 surgery bill
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