A Delavan man contacted Call 4 Action after being billed a significant cost for a skin tag being removed.
But the price isn't the problem for this consumer; it's how he's being billed that's concerning.
Patrick Austin had a doctor's visit in March to remove a skin tag from his scalp. His visit to the Aurora Lake Geneva clinic was fast and easy.
“So, it was really quick, really simple,” he said.
“They sprayed some sort of thing on there to freeze it off,” he said.
Austin showed TODAY’S TMJ4 the total bill. It was $691.
Since Austin has health insurance with a high deductible, he's figured out he can save on medical costs by not using it.
“Typically, because I know that there's a big discount, if you pay cash, that's why I chose that,” he explained.
However, Austin saw something appealing on his Aurora bill, an opportunity for a discount.
"Patients who do not have health insurance will receive a 45 percent discount on medically necessary services."
Even though Austin has health insurance, he paid $380 in cash to try and save through the discount.
“Have you had success paying with cash for other medical procedures or things like that before?” TODAY’S TMJ4 asked Austin.
“Yeah. Not necessarily through them but when I was with a different provider or what not, I had paid cash and you get a discount with it, so that's why I chose the plan I did,” he explained.
He thought this case would be the same. He learned it wasn't.
“About a month later, I get another invoice from them because they ran it through my insurance company,” Austin said.
Austin’s insurance covered $18, meaning he still owes Aurora nearly $300. The provider had his insurance on file from a different visit.
“If they have my credit card information on file, are they going to run that too just because they have it? I mean that's not right,” Austin said.
“So, your main gripe is, you wanted to pay with cash, and the provider billed your insurance?” TODAY’S TMJ4 asked Austin.
“Correct. It's my understanding there's no state law that says I have to run it through my insurance company,” he answered.
There isn’t. TODAY’S TMJ4 verified that with the Wisconsin Office of the Commissioner of Insurance. TODAY’S TMJ4 reached out to Aurora asking for an on-camera interview. Instead, a spokesperson sent us the following statement:
“We are available to help our patients navigate the medical billing process, which we understand can be complex. We strive to achieve a satisfactory outcome for our patients whenever possible. patient privacy laws prevent us from commenting further,” said Cheri Mantz, Public Relations Manager for Aurora Health Care.
TODAY’S TMJ4’s I-Team team took Austin's case to Healthcare Bluebook, a web service dedicated to price transparency in the medical field.
“Is it an option for everyone to pay with cash for a medical service even if they have health insurance?” the I-Team asked Bill Kampine, Co-founder of Healthcare Bluebook.
“Sure, absolutely. Patients should always ask about a cash pay price for services,” Kampine said.
But, there's a catch according to Kampine.
“Many times, providers like a hospital system or an ambulatory surgery center or a group of providers may have a contractual agreement with the carrier,” Kampine continued.
He explained that means the provider is required to run your health insurance if you have it. The I-team asked Aurora twice in emails if it has a contract like this with a carrier. The spokesperson responded saying all she could offer was the previous statement.
Patrick Austin plans to fight the bill.
“I think this is a major issue for a lot of people and I don’t think it’s right and I think that the healthcare providers and the insurance companies need to step up and start doing something about it,” Austin said.
Bill Kampine with Healthcare Bluebook suggests consumers ask their providers if they have any kind of an agreement that would prevent them from honoring a cash price.