Bethany Birch, a 30-year-old stay-at-home mom, found herself in a difficult situation after undergoing emergency gallbladder removal in 2016. At the time, she was 23 years old and without health insurance. After her surgery, she faced homelessness and struggled to maintain a permanent address. Despite her financial instability, Birch never received a bill for her medical treatment.
Fast forward to 2018, Birch was served with a lawsuit by Ballad Health, the health system that had acquired Indian Path Community Hospital where she had received treatment. The lawsuit claimed she owed $11,590.10 for her hospital visits, including $9,986.40 for the gallbladder removal. It turns out that Ballad Health had attempted to contact Birch for payment and to discuss charity care options, but due to her unstable living situation and lack of reliable contact information, Birch never received their communications.
Under the Affordable Care Act, hospitals are required to notify patients of outstanding bills before resorting to legal action. However, individual circumstances, such as Birch’s, can complicate the delivery of these bills. Additionally, the addition of interest to repayment plans can cause medical debt to skyrocket. In Birch’s case, the court judgment imposed an interest rate of 7%, resulting in an additional $2,715.97 in interest as of May 2023.
Birch, unable to afford an attorney, appeared in court without legal representation. There, she met with a representative from Wakefield & Associates, the debt collection and revenue firm representing Ballad Health. Birch agreed to a payment plan, committing to pay the full amount owed in monthly installments of $100 starting January 2019. The court also mandated a 7% interest rate.
Upon reviewing Birch’s case, it was revealed that she may have qualified for free or reduced-cost care under Ballad Health’s financial assistance policy if she had applied. However, Birch claims that she never received the bills containing information about this option, possibly due to a change in her address and lack of a permanent residence.
Ballad Health has since implemented changes to its financial assistance program to better assist individuals facing barriers, such as financial, housing, and food insecurity. They acknowledge that if these changes had been in place during Birch’s treatment, her situation could have been avoided.
Unfortunately, despite making monthly payments for over four years, Birch has made little progress in reducing her debt. As of May, she had paid $5,270.20 but still owed $9,299.82, including accrued interest.
Birch’s story highlights the aggressive collection tactics employed by many hospitals, including the involvement of third-party debt collectors and the pursuit of lawsuits. It’s important to note that the interest payments made by Birch do not go to Ballad Health but rather cover legal fees incurred by Wakefield.
In an effort to resolve her situation, Birch sought assistance from a patient advocate and reached out to NPR and KFF Health News. However, when they attempted to settle her debt, they were redirected to Wakefield, the debt collector.
Medical debt and its consequences can have a major impact on individuals’ lives, and it is crucial for hospitals and health systems to implement more compassionate and transparent practices to support patients who are facing financial hardship. By addressing these issues, we can work towards a more equitable healthcare system that prioritizes the well-being of all individuals.
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Rohit Malhotra is a medical expert and health journalist who offers evidence-based advice on fitness, nutrition, and mental well-being. His articles aim to help readers lead healthier lives.