Htet Htet isn’t new to our health care system. She is a psychiatrist (at NYU), wife of a doctor (also at NYU), and mother to a child who suffers from an ongoing medical condition. Htet Htet’s life, which is devoted to taking care of others, was derailed in 2017 when her daughter Emma needed special swallow therapy treatment. Emma, who could not move her tongue, chew or eat solid foods without gagging or spitting up, started weekly therapy sessions.
What Htet Htet did not expect is what came after discharge.
A year later she was hit with a mess of confusing medical bills and explanations of benefits (EOBs) – that she thought were already taken care of. Her mailbox was filled with conflicting paperwork. Bills which appeared to be half paid, EOBs that said she owed zero dollars, multiple bills for the same visit. What was going on?
It turns out she was misled. Before starting her daughter’s 40 therapy sessions Htet Htet was vigilant to acquire prior authorization. She even checked in halfway through the sessions with her clinic to ensure the treatments were covered and NYU said they were. Despite Emma being covered by both her mother’s and father’s health insurance (United Healthcare) and (EmblemHealth), part way through the sessions United Healthcare clawed back the authorization, deeming her daughter’s treatments unnecessary and not falling under the scope of her health insurance. NYU did not notify her when she had been switched to self-pay and she did not realize she signed a waiver that put her on the hook for all payments not covered by Emma’s insurance.
Htet Htet got caught in the middle of a paperwork nightmare between her doctor and insurance company, trying to pin the bill on one another only to find their way to Htet Htet a year after her daughter’s care ended. Leaving her to sort out the billing remains and ultimately pay the surprise bills which were not covered by insurance.
Since this experience Htet Htet says she can’t sleep, she is stressed and feels like giving up. “I would do anything for my child and pay whatever the price so that she is healthy. Even though it resulted in this mess. I feel bad because I work for NYU, we should be better than this.”
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