In 2023, our nationwide reporting team has been hard at work on a holiday gift to you: a packet of advice for navigating the labyrinthine American medical system.
In the sixth year of KFF Health News-NPR’s “Bill of the Month” series, readers shared more than 750 tales of medical billing problems, contributing to our ongoing effort to investigate the financial consequences of becoming sick or injured in the United States — and empower patients to advocate for themselves.
Reporters analyzed more than $730,000 in charges, including more than $215,000 owed by 12 patients and their families.
The investigations were cited by decision-makers on Capitol Hill and at the White House. Last summer, the Biden administration announced plans to lower health costs, such as by targeting a loophole that has allowed health providers to evade the federal surprise-billing law — a loophole identified by “Bill of the Month.”
More changes are on Washington’s agenda next year; federal regulators are expected to develop a Biden administration plan to bar medical debt from affecting credit scores. But as this important project has shown since its start in 2018, patients are often their own best advocates.
“If I’m able to push back a little bit against this massive system, well, hey, maybe other people can, too,” said Jered Gebel of Alaska, who fought back against disparities and outright errors in charges for his wife’s chemotherapy. “And who knows, maybe eventually health care prices can come down.”
Check out this year’s stories below to learn more about how you can protect yourself and your loved ones from a big, unexpected, or downright wrong bill.
From all of us at “Bill of the Month,” happy holidays — and, when in doubt, don’t pay the bill.
A Baby Spent 36 Days in an In-Network NICU. Why Did the Hospital Next Door Send a Bill?
By Harris Meyer,
January 30, 2023
A baby spent more than a month in a Chicago NICU. A big bill revealed she was treated by out-of-network doctors from the children’s hospital next door. Her parents were charged despite a state law protecting patients from such out-of-network billing — and sent to collections when they didn’t pay up.
Surprise-Billing Law Loophole: When ‘Out of Network’ Doesn’t Quite Mean Out of Network
By Harris Meyer,
February 28, 2023
Billing experts and lawmakers are playing catch-up as providers find ways to get around new surprise-billing laws, leaving patients like Danielle Laskey of Washington state with big bills for emergency care.
ER’s Error Lands a 4-Year-Old in Collections (For Care He Didn’t Receive)
By Daniel Chang,
March 29, 2023
A Florida woman tried to dispute an emergency room bill, but the hospital and collection agency refused to talk to her — because it was her child’s name on the bill, not hers.
Expectant Mom Needed $15,000 Overnight to Save Her Twins
By Renuka Rayasam,
April 27, 2023
Doctors rushed a pregnant woman to a surgeon who charged thousands upfront just to see her. The case reveals a gap in medical billing protections for those with rare, specialized conditions.
He Returned to the US for His Daughter’s Wedding. He Left With a $42,000 Hospital Bill.
By Sarah Jane Tribble,
May 23, 2023
After emergency surgery, an American expatriate with Swiss insurance now carries the baggage of a five-figure bill. Costs for medical care in the U.S. can be two to three times the rates in other developed countries, so foreigners and expats with good insurance in their home countries need travel insurance to protect themselves from “crazy prices.”
The Hospital Bills Didn’t Find Her, but a Lawsuit Did — Plus Interest
By Bram Sable-Smith,
June 27, 2023
Recovering from emergency gallbladder surgery, a Tennessee woman said she spent months without a permanent mailing address and never got a bill. She was sued by the health system two years later.
His Anesthesia Provider Billed Medicare Late. He Got Sent to Collections for the $3,000 Tab.
By Phil Galewitz,
July 28, 2023
Medicare was supposed to cover the entire cost of his procedure. But after the anesthesia provider failed to file its claims in a timely manner, it billed the patient instead.
She Paid Her Husband’s Hospital Bill. A Year After His Death, They Wanted More Money.
By Samantha Liss,
August 29, 2023
A widow encountered a perplexing reality in medical billing: Providers can come after patients to collect well after a bill has been paid.
She Received Chemo in Two States. Why Did It Cost So Much More in Alaska?
By Arielle Zionts,
September 29, 2023
A breast cancer patient who received similar treatments in two states saw significant differences in cost, illuminating how care in remote areas can come with a stiffer price tag.
When That Supposedly Free Annual Physical Generates a Bill
By Julie Appleby,
October 30, 2023
Completing a routine depression screening questionnaire during an annual checkup is cost-free under federal law. But, as one woman discovered, answering a doctor’s follow-up questions might not be.
Out for Blood? For Routine Lab Work, the Hospital Billed Her $2,400
By Rachana Pradhan,
November 21, 2023
Convenient as it may be, beware of getting your blood drawn at a hospital. The cost could be much higher than at an independent lab, and your insurance might not cover it all.
When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill
By Darius Tahir,
December 19, 2023
For the patient, it was a quick and inexpensive virtual appointment. Why it cost 10 times what she expected became a mystery.
Bill of the Month is a crowdsourced investigation by KFF Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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