A local hospital is now refusing to accept a Christian-based medical plan that covered more than 200 patients in the past year.
One of those patients told consumer investigator Jim Strickland she got the news in the middle of her cancer treatment. The hospital told her she needed to pay cash before she left the doctor’s office.
Laura Alley, a 39-year-old runner, discovered a lump on her neck months after giving birth to her fifth child.
“You know, first thing I start to think about is, ‘What am I going do without my wife?’” Laura’s husband, Nick Alley, said.
He said paying for her treatment was not on his mind because they thought they were covered. Then came a phone call from the finance office in the middle of chemotherapy treatment.
“I’m sitting there, with a needle in my arm, receiving chemotherapy in my arm, and they are telling us that we are not going to be able to leave, until we pay them $41,000,” Laura said.
The Alleys have Medi-Share, a medical co-op which satisfies the Obamacare mandate for health coverage. Members pay in and share each other’s medical expenses. It’s not insurance, but does use an insurance network called Private Healthcare Systems to negotiate rates. The Alleys said they made sure Medi-Share was accepted before Laura began treatment at Georgia Cancer Specialists, run by Northside Hospital.
“I sat in front of them, in front of their computers, and handed them my card three or four times, and no problems whatsoever,” Laura said.
A spokesperson for Northside Hospital told Channel 2 by email, in part:
“We have a contract with PHCS. We have never had a contract with Medi-Share. Because we thought Mrs. Alley was part of the PHCS plan (PHCS did not tell us otherwise), we billed PHCS for her care. PHCS gave her bills to Medi-Share, who underpaid on our contracted rates with PHCS.
“When we contacted PHCS about the underpayment, they alerted us that the patient did not have insurance with PHCS, but rather was a Medi-Share member.
“We have never said that we accept Medi-Share. Our contract was with PHCS. Once we realized this confusion, we corrected Mrs. Alley’s account. Because she does not have insurance, she is considered a self-pay patient. We have provided her with multiple options to reduce and satisfy the remaining balance on her account.
“We did not tell the patient that she was “pre-certified.” When our staff called PHCS to ask if pre-authorization was needed, they told us that it was not.”
Strickland asked Laura Alley about the statement: “’We have never said that we accept Medi-Share,’ true or false?”
“That’s false,” Laura replied. “It’s about money. But even then, it doesn’t make sense, because they’re getting paid.”
While the email stated that, even at discounted insurance company rates, Medi-Share underpaid the Alley’s bills, we reviewed bills from Northside Hospital and each one had a zero balance. More than $98,000 had been paid, or discounted like traditional in-network insurance, before the hospital quit accepting Medi-Share.
Health insurance broker Beau Miller, with Your Insurance Advocates, reviewed the Alleys’ bills, and said it appeared Medi-Share did pay the bills like a regular insurance company. Miller said he does not recommend co-op insurance like Medi-Share to his clients.
“It’s hope and pray they pay insurance,” Miller said. “I say that in jest, but it’s the truth.”
Miller said he’s seen co-ops like Medi-Share grow in popularity because of their low rates, but cautions they offer less legal protection.
“Because it is not true insurance and there is no legal contract for them to pay their bills.” Miller said.
The high cost of Obamacare forced patients to choose between providing for their family or not receiving the critical medical care they need.
If Pelosi and the democrats would have read the Bill before passing it, they would have known Obamacare would destroy individual family healthcare.
Even now Pelosi and Schumer refuse to correct their failure to protect American working families.
Politics before people is the democrat mantra.
This is a taste of the progressive/socialism the Democrat party shoved down our throat and wish to keep and expand.
cato – You are being very generous to Pelosi and the democrats by assuming that their passing the ACA Bill was done out of ignorance. I think they knew.
It’s exactly “true” insurance, and not the horrifying pastiche of regulations and caveats invented by accountants. It’s people sharing the cost. The hospital would gladly accept the proceeds from a Patreon or GoFundMe plea for donations. This is simple persecution.
@ joan
Exactly… nothing less than persecution. These people are being singled – out for employing a faith based alternative to the ACA which is anything but affordable and are being made an example of for doing so. The health care industry has it’s own agenda which is about $$$ not health. Comply or else.
Probably needed to bump her out of the line up to provide free treatment to some illegal Mexican with a severe flea infestation.
My experience has been hospitals like to involve out of network providers so they can bill YOU directly, even when you’ve already satisfied the deductible, and suck more cash out of you.
Hospitals are contemptible, but only because government meddling in our healthcare has made it so.
I have dealt with Northside Hospital and their financial department before. They are not to be trusted. But in the Atlanta area it’s difficult to find medical care that isn’t Nortside affiliated.
She needs to immediately sign up retroactively for Obamacare and have her pre existing conditions treated and paid for. Either that or declare that she really is a closet illegal Mexican and have the hospital eat her costs! Or, declare that is she/he is a transgender and believes that the lump on her/his neck is her penis and wants it removed and her/his bill sent to the Marine Corps! Or have them send her bill to any number of left-wing wealthy people who I am sure will gladly cover the costs! See there are many options!
You aren’t leaving until you pay us?! Call the police because they don’t have that power to keep you a prisoner until you pay. Outrageous. All of it.
This is why I have cautioned AGAINST these “sharing plans”. They are not regulated by any agency which means unlike actual health insurers, they are not required to maintain financial reserves in order to pay large claims incurred by multiple members at the same time. This is not the first case, there have been MANY cases of Medi-Share and other sharing schemes leaving members with many thousands in unpaid bills. This is part of the reason a federal judge shut down Medi-Share in 2012. http://www.foxnews.com/politics/2011/02/26/christian-medical-plans-pass-health-law-despite-consumer-complaints.html
Every time we get screwed by the insurance or healthcare industries, just thank Good old Mitch McConnell. We REALLY need a convention of the states. First order of business: an amendment the requires congress to follow the same laws that apply to us.
I considered Medi-Share until I found out they exclude things like:
1. Medical bills from a car accident if you’re charged with DUI
2. Treatment for STDs
3. Anything else they think you “brought upon yourself”
Its just crazy IMHO to pay “insurance” that deny your claims if you offend their morals!
And they call themselves “Christian” – what a joke! How many millions do think the guy in charge is paying himself every year? What? Oh, he doesn’t have to disclose that because ITS NOT AN INSURANCE COMPANY!!!