My wife delivered a baby at the women's hospital in April. The doctors and nurses were professional and nice, but their billing department was a nightmare to work with. It ruined the entire experience. ... more />
Before we checked in, we received an estimation letter from their insurance verification department, which stated that they had contacted our insurance plan and estimated the out-of-pocket amount we would owe to the hospital to be $1,772.
On the day we checked out, their staff asked me to pay off a balance of $1,372. I requested an itemized receipt but the staff said she was unable to provide that and I had to request them afterwards. I asked if it's all we owed to the hospital and she said yes. After the delivery, I had a small window to change my health plan. I was unaware of the extra bills coming and missed the window to put more money into HSA account.
About a month later, I received additional bills of $148 for my wife and a big $1001 bill for my son. Since it was a smooth delivery and the final due was way over the original estimation, I contacted their billing department to find out what caused the extra charges. I had to make several calls due to back-and-forths with their billing department representatives (who often pushed the questions to the insurance company) and my insurance company. In the different calls, I was given different reasons. Not only the reasons inconsistent, they are all unacceptable. Here are the reasons they gave us:
1. The final amount due was higher than the estimation because of the baby's complications.
2. When the original estimation was made, it was assumed the baby's expense would be going under the mother's insurance plan. When the mother's deductible was met, the remaining balance would be covered by the insurance 100%. But the insurance company decided to process mother's and baby's expenses separately, resulting in the final due much higher than the estimate.
3. The original estimation only accounted for the mom but not the baby because there was no way to estimate what needed to be done for the baby.
I was shocked to hear about the first explanation from their billing department, as I wasn't informed of any complication or huge risk on the baby during our stay. So I asked what were the services associated with the complication but he was unable to provide me detail. (he actually asked me to request a medical record and speak with a pediatrician) I read the itemized bill; almost 80% of the bill was under an item called "room and board" which was a standard charge. The rest were mostly blood draws and lab tests which appeared to me as standard checks.
For the second explanation, my insurance company explained to me that it has always been their standard practice to separate mom and baby accounts. According to the insurance company representative, they were never contacted by Saddleback Memorial Hospital regarding to the delivery estimation, which was contradicting what was said in the estimation mail.
The last explanation was the most ridiculous but it appeared to be what Saddleback Memorial Hospital is holding on to. I think this's unacceptable because the estimation mail didn't indicate the estimation was for mom only. The explanation that no estimation could be done for a baby didn't make sense. Why couldn't they include room and board, and other standard checks they would do for a healthy baby? The same baseline they did for the mom could easily be applied to the baby.
With all the misleading information and confusion, the hospital still determined that it's the patient's responsibility. If the estimation was for the mom only, I really feel it's the hospital's intention to mislead its patients. I'd describe this business practice as deceptive and dishonest.
If you consider checking in this hospital, be very careful how much the services end up will be costing you.
The Women's Hospital is a great place to deliver a baby! My husband and I had a great experience. The nurses were so helpful during the labor & delivery process, as well as after birth - helping me learn... more the ropes about being a new mom such as breastfeeding support. Love the room service, free snacks... and fresh baked chocolate chip cookies!!
Just want to say thank you to Carlie in labor and delivery. She worked on this date, and was disrespectful with her snide comments and dirty looks, this made what should have been a great day when our... more daughter gave birth. I'm sorry that I interrupted your visiting with the other nurses at the nurses station when my daughter needed care. When asked for updates we were told you couldn't tell us. I really need to thank you for your lack of communication which made us miss the birth of our Grandchild, and there is no excuse for this, and we cant get that time back. To make matters worse, after speaking with my daughter she asked for me, and you didnt pass on the message. I pray no one else gets treated this way. All I can say is karma, what goes around comes around.
Rate of readmission after discharge from hospital (hospital-wide)
Rate - 14.4% (1.6% below the national rate)
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