Wilmington woman left with $42,000 worth of medical bills after unexpected clawback

Wilmington woman left with $42,000 worth of medical bills after unexpected clawback
Published: May. 9, 2023 at 4:41 PM EDT
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WILMINGTON, N.C. (WECT) - Medical bills are a common stressor but one woman has been living a nightmare ever since she was blindsided with $42,000 in bills she thought had already been paid.

“It’s not fair,” said Stephanie Christy, who suffers from chronic migraines. “I paid my bill every month on time. It was taken auto-draft out. The tax credit was paid, it was through Obamacare. So why did you take the money back?”

Not long ago, Christy led a normal life. In 2015, however, everything changed.

“It feels like a chunk of my face falling off sometimes,” said Christy. “It feels like it’s just going to fall down.”

Christy can’t work on a computer, look at her phone or even read for too long. Too much light can trigger an episode, so she’ll sometimes sit in the dark to draw.

Because she can’t work, she started applying for Medicare coverage in 2018. In 2021, she was approved. It should have been a time to celebrate but instead, that’s when another kind of headache began.

Medicare backdated her coverage to 2018. That opened the door for her previous insurer, Blue Cross Blue Shield North Carolina (Blue Cross NC), to claw back $42,000 worth of payments made to Christy’s doctors to cover 273 claims between 2018 and 2021.

“I had no idea what was going on,” said Christy. “Emotionally, I was very upset because I had no idea what steps to take. It was just causing pain. Pain, pain, pain.”

WECT reached out to Blue Cross NC for comment. They released a statement, saying:

“Blue Cross and Blue Shield of North Carolina (Blue Cross NC) was considered the secondary health insurance provider for Mrs. Christy. When made aware of the primary insurance change, we notified and requested that all providers resubmit claims to the primary insurance provider. We are grateful for the opportunity to serve as her secondary insurance plan and are happy to answer any further questions from Mrs. Christy.”

Christy says that same miscommunication is what she has been running into from the beginning and no one from either insurance company seemed to know how to help her. That’s why Christy reached out to Marilyn Whitley, an independent patient advocate based in eastern North Carolina. She says this happens to patients far too often.

“If you look up some statistics on billing, you know, billing errors, you know, they have 80 to 90 percent error rates so getting a bill that has an error on it is very common,” said Whitley. “Of course, Stephanie’s case is complicated just because it was a backdating of claims and then double-insurance and you have to file with Medicare and do the appeal process.”

Whitley says they filed a complaint with the North Carolina Department of Insurance about the problem.

It’s been a long process but together, Christy and Whitley have been able to chip away at the medical debt by calling both insurers to get them to cover the claims.

“Some of them did not take Medicare or Medicaid originally, so [Whitley] would just talk them through the process and that’s however way they would get however return,” said Christy. “ [She’d say] ‘It’s like getting blood from a turnip,’ or something. ‘You’re not going to get the money from her that you think you’re going to get so we’re going to do it this way.’”

While the two have made progress, there is still a long way for Christy to go before she’s debt-free. She estimates that she still has about $10,000 worth of bills to cover.