TULSA, Okla. — A missed question before a medical test left a West Tulsa man facing a hospital bill of nearly $10,000.
When Mark Brady’s doctor ordered an echocardiogram and a stress test, he scheduled the appointment at Ascension St. John Hospital, assuming his insurance would cover the cost as it had in the past.
"I've had these tests done there at the hospital before, never got a bill. It's always been covered," Brady said.
However, when Brady scheduled the test, he did not ask if the hospital still accepted his specific insurance plan. The hospital was no longer in-network.
"I realized I didn't ask, so that's on me, my fault, didn't know to ask," Brady said.
At first, Brady tried appealing the nearly $10,000 bill but was unsuccessful.
"Got nowhere," Brady said.
To protect himself against going to collections, Brady agreed to a payment plan with the hospital. Then, he received an email from Ascension stating the entire bill had been paid off.
"I couldn't believe it. And then a few weeks later, I got another bill. Now, it had been reduced by a couple of thousand, $2,000, but still a lot of money," Brady said.
Brady told 2 News Oklahoma that when he called Ascension’s billing department, he was told that sending the notice saying the bill was paid was an error.
"It was our mistake, you still owe. For the remaining balance," Brady said.
At that point, Brady reached out for help.
"I feel like someone needed to help. Let's see what Channel 2 Problem Solvers can do that might help the situation," Brady said.
2 News reached out to the Oklahoma Insurance Department about Brady's bill. Commissioner Glen Mulready said Brady’s billing issue comes down to one question every patient needs to ask before scheduling any medical appointment, test, or hospital stay.
"Are you in-network with my plan? And it also isn't adequate to just say, you know, are you in-network with ABC Insurance Company? Because there are numerous different plans, and those networks are different, too. So, you've got to be specific on which plan," Mulready said.
Mulready added that the federal "No Surprises Act" protects patients with private health insurance against unexpected bills from out-of-network providers working for in-network hospitals. However, it does not apply when a patient chooses an out-of-network facility.
"This person chose to go to a non-network facility," Mulready said.
When facing a billing issue, Mulready recommends consumers start by contacting their employer.
"Lay this all out to them and ask for their help," Mulready said.
Mulready noted that this is because many insured people in Oklahoma are on self-funded employer-sponsored health insurance plans.
"About 60% of the people in our state who are insured are through a self-funded plan that state laws really don't apply to. It's governed by the Department of Labor and the federal laws," Mulready said.
Mulready added that consumers need to be familiar with providers covered by their policy and should check their network status each time they schedule an appointment, as providers frequently change which insurance they accept. A provider that may be in-network this month may not be the next time you book an appointment or procedure.
2 News reached out to Ascension about Brady's billing issue. Two days later, on April 22, Brady called us to say Ascension had contacted him and lowered his bill to the cash price it offers to uninsured patients.
Mulready told 2 News that medical providers can choose to offer the cash price to patients with insurance, but are not obligated to do so.
A spokesperson for Ascension St. John provided this statement in response to our questions about Brady's billing issue.
We understand that billing concerns can be frustrating, and we are committed to transparency, accuracy and supporting our patients throughout the billing process. We take all feedback seriously and are actively reviewing this matter. We hold the privacy of our patients in the highest regard and do not comment on specific patient cases or patient-related matters.
This story was reported on-air by a journalist and has been converted to this platform with the assistance of AI. Our editorial team verifies all reporting on all platforms for fairness and accuracy.
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