Afraid to go to the mailbox…and to another ER.

After leaving the ER, Eva went home. All seemed fine, but it wasn’t until a few weeks later that she realized something was wrong.

Eva Miglionico wasn’t expecting anything more than to rest and elevate her foot. In March 2018, she suffered a foot injury and decided to soak it in warm water. But as she was getting up, she lost her balance and hit her head on a table, creating a laceration that clearly needed stitching.

She called her daughter—an emergency department nurse—to pick her up and bring her to the hospital. While she was waiting for her daughter to arrive, Eva called her insurance company to find out if the hospital she was heading to was covered under her insurance. They ensured her that yes, it was in-network, and that she would be covered. Eva breathed a sigh of relief and made her way to the ER.

Upon admittance, Eva underwent a, CT scan, tetanus shot and stitches and went home. All seemed fine, but it wasn’t until a few weeks later that she realized something was wrong.

Over the course of a few weeks, roughly $4,000 in various medical bills arrived from multiple parties concerning her head injury from weeks prior. When she called the insurer find out why bills were so large, they said her claim was denied. Eva was confused, as she had taken every possible precaution before going to the emergency room to make sure her insurance would cover the care. As it turns out, her claim was declined because the technician who took care of her wasn’t in her insurer’s network. Lab tests, machines, and other procedures performed were also deemed out of network because the technician performing the tests was “out of network.”

“In as many years as I have brought my children to the ER, I have never thought to ask if the doctor or technician was a traveling or contract employee,” says Eva, a real estate agent in Henrico County. “If my insurance says it’s okay to go to a hospital, I feel like it’s the insurance company’s job to make sure they cover every employee in that hospital under their policy.”

“Does this mean I have to check with every nurse or physician before they come in contact with me?” she says. “What if, God forbid, you are brought in unconscious and can’t question everyone that is going to work on you?”

Eva, who says she has never been sent to a collections agency and always pays her bills on time, is being bombarded with bills to the point where she can’t even look at them anymore because of the anxiety she feels when she sees them. She put the matter aside to focus on her daughter’s wedding this fall, but the bills continued to appear and phone calls still came. “You can’t ignore it,” she says, “not even for a week.”

If her charges were considered a co-payment or deductible (or other patient responsibility), she would gladly pay the bill. But these bills are all for out-of-network care. “I do understand I have some responsibility, and I have no problem with that. But this was a huge mess—multiple bills for different things coming from different places—it’s so unorganized,” she says. “I don’t even have a detailed bill describing my charges. What’s the point of even having insurance?”

“At this point, I am afraid to go to my mailbox let alone the emergency room,” she says. “I don’t blame the physicians and nurses—my frustration is with the insurance companies. If they say a hospital is covered, it should be covered—including every employee working inside of it.”

Until then, Eva continues to write letters to her insurance company with a plea to pay a fair portion of her bill if they pay theirs, and she lives in fear of having to make another trip to the ER—or the mailbox.

“Honestly, if I had to go again,” she says, “I would second guess going to the ER. I have to wonder what kind of jeopardy this puts patients in that maybe have heart issues or other life-threatening issues. Imagine if they have chest pain or breathing issues, and are afraid to go to the ER because of being hit with bills they have no control over. I would hate to think that people second guess going in, hoping to get in with their primary doctor, and because of that suffer a heart attack or worse.”