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Why a common cold cost a Lake Geneva woman over $1K

Posted at 8:25 AM, Feb 24, 2020
and last updated 2020-02-24 23:34:48-05

LAKE GENEVA -- Shelly Principe was so sick of her lingering cough in October of 2018, she finally went to see her doctor.

“It was a pretty routine appointment. The doctor said it was probably something viral, but he wanted to make sure it was not actually bacterial, so he said we'll just do a quick test,” said Principe.

So, a nurse did a nasal swab on Principe. It was for what's called a Respiratory Pathogen Panel. It tested Principe for 21 viruses, including H1N1, influenza A, B, various Coronavirus strains and so on.

“Did you know you were being tested for all of those viruses?” the I-Team asked Principe.

“I didn't. I mean, they did not explain to me that they were going to do this test that would be every potential influenza bug and/or other things that I've never even heard of frankly,” Principe said.

Then she got a more than $1,200 bill from the doctor’s office. Then she got her test results.

“The results came back that it was nothing serious. They said it was pretty much a common cold,” she said.

Expensive cold

Principe called her medical provider and insurance company and tried to fight her bill. She thought it was under review, but it was sent to collections. She said there were also errors on the bill, added charges bringing the bill to around $1,700.

“Well, I think I’m frustrated about first of all, about the fact that there was no communication about the fact that this test was so expensive,” Principe said.

She admitted looking back on the situation, she would have asked how much the lab test would cost her. But, she argues that shouldn't have to be how the healthcare system works.

“I think doctors should have a sense of what tests cost that they are directing be done to their patients,” she said.

Attorney Ryan Woody with Matthiesen, Wickert & Lehrer, handles medical billing disputes for companies' employees around the country including Wisconsin.

“The problem is, even if you ask the doctor what it might cost, he's probably not going to know,” Woody said.

The medical billing system in our state he says isn't consumer-friendly.

“When you walk in and sign that admission form, you're signing a blank check,” Woody explained.

He insists that doesn't mean as a patient you are powerless.

“Patients really need to understand their health insurance coverage,” he said.

He suggests, if possible, before walking into your doctor's office, call your insurer and make sure the procedure or test you're getting done is in-network.

He urges consumers to check out Wisconsin Price Point.

On the website, you can view the average cost of common procedures in the state and price compare with other Wisconsin hospitals.

Principe plans to negotiate pay with the collections agency handling her bill.

The I-Team reached out to Principe’s insurance company as well as her medical provider. Due to privacy reasons, neither could provide comment on her specific case.

But she filed a complaint with Wisconsin’s Department of Agriculture, Trade and Consumer Protection. Through an open records request, the I-Team obtained her complaint which included email exchanges between the state and her medical provider.

In one of the emails, a customer care representative with her medical provider said, "multiple reviews for this dispute have already been completed" and that "we must reaffirm our positions that the care and resulting bill to Ms. Principe was accurate."

Principe also wrote letters to Sen. Ron Johnson and the White House, expressing her concern with the lack of transparency with medical billing.

The I-Team asked Sen.Ron Johnson’s office if it received Principe’s letter. His office provided the below statement:

“Sen. Johnson agrees that we need to reform our health care system to make it more affordable for patients.”

"I don’t know of any other service provider that has no idea what something might cost,” said Principe.

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