Milwaukee woman tells I-Team she was charged $8,523 by doctor who watched her surgery

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Posted at 7:04 AM, Mar 03, 2021

MILWAUKEE — When you get a medical bill, you expect it to be from the doctor who did the check-up, procedure, or surgery.

Damia Causey, of Milwaukee, received that charge. But, she tells the I-Team she was also billed by a doctor who was in the room and watched her surgeon perform a parathyroidectomy on her in August of 2020.

Causey's medical provider is Froedtert, but five months after her surgery, she says she received a bill and noticed a separate charge on it for $8,523. Causey found out it was for a doctor with the Medical College of Wisconsin who watched her surgery.

Causey says she was under anesthesia and says no one asked her if it was OK for someone else to be in the room. The large bill was a shock.

"Who would agree to that? Nobody would agree to that!" said Causey.

Causey contacted her health insurer Blue Cross Blue Shield of Texas and tells Consumer Investigator Kristin Byrne an agent explained the $8,523 charge.

"She said what occurred was that they had an assistant in the operating room, it was not part of my insurance and that person was not covered," Causey said.

Causey learned her insurance classifies the Medical College of Wisconsin as "out of network" meaning Causey would have to pay.

But, two hours after Byrne emailed the Medical College of Wisconsin asking about Causey's case, a spokesperson responded saying "This issue has been resolved."

Under anesthesia, Causey says she wasn't aware any of this happened.

"Do you think if you were awake, you would say, who is this other person?" Byrne asked Causey.

"Even if you are awake and you say who is this other person, and they say well this person will be assisting me. Do you know to ask at that moment, 'Hey before you cut me open, is this person covered under my insurance?'" Causey answered.

"How are we as patients supposed to be able to advocate for ourselves if there's information that we don't know?" she asked.

When Byrne last checked with Causey, she doesn't owe anything for the surgery. She says this experience has made her more vigilant. She encourages everyone to question anything on a bill you aren't comfortable with and to ask if there's going to be anyone else attending your procedures or surgeries.

We contacted Causey's insurer, Blue Cross Blue Shield Texas and they provided the below statement:

Out of respect for our members’ privacy, we do not comment on individual member situations. However, we understand how balance bills can be costly and frustrating for our members.

Many hospitals – including those in our network – choose to staff physicians and other healthcare providers who are not in our network.

Unfortunately, non-contracted providers can expose our members to significantly greater out-of-pocket costs. These charges often have no connection to underlying market prices, costs or quality.

The Medical College of Wisconsin issued this statement:

"It is not MCW’s practice to bill for observation of a surgical procedure. While we cannot comment on the specific case due to HIPAA, there is often another surgeon who assists during a surgical procedure. This person is referred to as the Assistant Surgeon. The billing issue was with the insurer and it has been resolved."

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