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Patient Stories

Like Mother, Like Son: More Surprise Bills

Claudia Knafo is familiar–too familiar–with our broken medical system. When Claudia’s son got sick last November, she was prepared. Once they arrived at the NYU Langone emergency room, she gave out her insurance information immediately. Her son got an EKG and stayed at the hospital for a few days, and when she found out his cardiologist was out-of-network, she prepared for a fight: her first concern was for her son’s health. “God only knows what I signed saying I agreed I would pay for.”

A few days later, her son developed the same symptoms again. They went back to Langone and spent the night in a pediatric intensive care unit before meeting with two senior specialists. They recommended a new course of treatment, in a clinic Claudia called “not quite a hospital,” focusing on pediatric cancers.

On November 29th, she got a call from a nurse practitioner at Langone, telling her that the clinic’s cardiologist was out of her network. The next day, her son saw a rheumatologist and an infectious disease doctor, and got an MRI. Again on December 15th, later in January, and on February 9th, they kept seeing the clinic. Everything seemed settled – only the cardiologist was out of network.

So when did it go wrong?

Later in February, her son started receiving mail. He got 3 explanation of benefits documents, and checks to pay for his time in the PICU. Then, he got a $4,000 bill that listed every doctor he saw in the PICU—all of them, it seemed, were out of network. The doctor and nurse practitioner at Langone reassured the Knafos that something went wrong, and that things would be settled.

Things, as it turned out, were not settled. He received a letter giving him his last warning before the bills would be sent to collections—and, potentially, to a debt collection suit. Claudia called Langone only to find out they never actually ran her son’s insurance. Instead, the ER simply assumed that because they took United insurance, they also accepted the United Compass insurance Claudia’s son had.

How do we make this better?

Claudia and her son contacted the Community Service Society of New York. Through CSSNY, they were able to avoid a complicated, expensive legal battle—but New York needs to do better than case-by-case solutions. Our medical system unfairly burdens patients: if a hospital doesn’t run your insurance, you shouldn’t be responsible for the bill! There are simple, common-sense steps we can take to fight medical debt—and the legislature should take them now.