Dallas Woman Calls NBC 5 to Help Fix Erroneous ER Bill

In March of 2016, Carla Spurgeon heard a thump in another room and found her husband lying on the floor.

Spurgeon said it's one of the hardest things for a caregiver to witness. At first, she thought it was just a minor scrape, but a couple days later the cut got worse.

Spurgeon said she wasn't taking any chances, so she took him to a nearby free-standing emergency room in Richardson called First Choice.

"I said all the right things when I went in," she explained.

Spurgeon said the receptionist confirmed they were in network, so they went on with the appointment. Their insurance covered most of the bill, but First Choice apparently forgot to bill Medicare, leaving her with a balance of $269.

Health care providers that accept Medicare are required by law to submit bills on the patient's behalf, but Spurgeon says that never happened.

"So I called and, 'I said you need to charge Medicare,'" she said.

But a year later, Spurgeon said she received a collection notice for $6,098. She then called First Choice and was told they'd look into it, but months later, nothing. 

So she got NBC 5 Responds on the case.

We reached out to Adeptus Health, the parent company that owned First Choice ERs at the time of their visit. The company never got back to us and has since filed for Chapter 11 Bankruptcy.

But days after we reached out, Spurgeon said she got a call from First Choice letting her know they would stop all collection attempts and that her bill was taken care of.

The NBC 5 Responds team has received a half dozen complaints about first choice facilities. The state is now cracking down on free-standing ERs and a  new law went into effect that requires these facilities to post which providers are in-network.

But if you're having issues with a Medicare claim, like Spurgeon did, you should visit medicare.gov. You can also call 1-800-MEDICARE if you believe a health provider hasn't billed Medicare.

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