I visited the Stony Brook Southampton Hospital ER in May with my son. He had a respiratory illness, a history of asthma and was coughing up blood. It happened at 3 a.m.
Oxford Freedom is our health insurance. We pay roughly $1,000 a month out of pocket for a family of four. Southampton Hospital is an in-network facility.
I paid our $200 copay amount for an ER visit. 24/7 Emergency Care received $806 from Oxford for the visit. By definition, our insurance is fully funded and issued in the state of New York; therefore, legislation passed in New York State in 2015 protects patients from an out-of-network physician coming after the patient for the difference in an emergency visit. It’s called “balance billing.”
I received a bill from 24/7 Emergency Care; Dr. Darin Wiggins is the company’s “authorized official.” I tried to find a contact number or email for him — there was nothing. The bill then went to collections. Needless to say, I was frustrated and angry.
I finally had the opportunity to speak with Dr. Wiggins. I explained to him that under these circumstances, balance billing is unethical and illegal. I also filed a complaint with the State Department of Health. In my conversation with Dr. Wiggins, I explained to him that if he felt he was underpaid for his services, it was his responsibility to negotiate directly with Oxford — not to go after the patient for the difference.
His response was that if it is under a certain dollar amount, Oxford will just say no. In response, I said, then you think it is okay to go after the patient?
I am a former healthcare provider. I understand insurance. But what I do not understand is taking advantage of patients from a financial perspective.
Laura A. Sinski McMahon
To see what’s new, click “Start the Tour” to take a tour.
We welcome your feedback. Please click the
“contact/advertise” link in the menu bar to email us.
One fine body…