Insurers like to lay the blame for surprise medical bills on providers. Sometimes, they’re even brazen enough to blame their own members, claiming that they have failed to scrutinize their insurance coverage closely enough to understand what’s covered. But, as Taylor Houston’s story shows, there’s really no amount of research or close reading that can prevent a patient from being burdened with bills—if their insurer has decided not to pay them, that is.
Spectrum News 1 laid out the chain of events in Houston’s story. Motivated by the birth of his daughter, Houston made the choice to undergo a long-awaited cochlear implant surgery. He most definitely did his homework in advance, calling both the hospital and his insurance company, UnitedHealthcare, multiple times to make sure that every stage of the procedure was covered.
His surgery went off without a hitch—but then he received a $2,000 bill from the anesthesiology team who assisted his surgeon. Houston had confirmed that the procedure was in network before the surgery, but it turned out that United had subsequently terminated its contract with the anesthesiology group, putting Houston (and countless others) on the hook for services they had no way of knowing were no longer in network. So, while this particular bill came from providers, it’s clear that the root causes are United’s behaviors and failures to communicate.
While United is not the only insurer actively creating coverage gaps by booting providers out of network, it’s currently the most aggressive one. To the point where we question whether United is more in business to support the financial needs of its shareholders than the healthcare of its members. Perplexingly, United seems to treat the people it writes checks to much better than those it collects them from.