On Dec. 1, Robert Hansen suffered a ministroke.
The Woodridge resident was taken to the emergency room at Edward Hospital & Health Services in Naperville, where he underwent a series of tests, including several CT scans.
There was no evidence of further damage, and Hansen was released.
"We were thinking all is fine and good," said his wife, Chris Hansen. "Then we started getting the bills."
The bill from Edward Hospital was no problem. The original charges totaled $29,747, but were reduced by $20,049.48 after the negotiated insurance discount was applied. Blue Cross Blue Shield of Illinois paid $8,272.52, bringing the balance down to $1,425, which equaled Hansen's copay and deductible.
He paid the $1,425 and thought he was done.
He was told Blue Cross Blue Shield had rejected the claim and he was responsible for the $263.
Hansen appealed to Blue Cross and was denied. The insurer insisted the CT scan was "experimental" for his diagnosis and therefore not covered.
The Hansens fought on but could gain no traction. They filed an appeal through the federal government but were similarly unsuccessful.
Upset and confused, the couple emailed What's Your Problem?
They said they weren't sure who dropped the ball — the insurance company, the hospital or the radiologist.
"The amount of money isn't that horribly horrible, but we shouldn't have to pay," Chris Hansen said.
It wasn't as if they had any choice whether to get the testing done.
"The next time an emergency arises, does that mean we need to contact the insurance company at 3 a.m. from the emergency room to get permission for any test the doctor in charge suggests?" Chris Hansen asked.
She said the couple felt like they were adrift in an ocean without a paddle. The paperwork and bills were overwhelming.
"Trying to read all this stuff, it's like you might as well be reading Polish to understand what it is," she said. "Who can explain all this stuff to you and who can you trust?"
The Problem Solver forwarded Robert Hansen's file to Mary Ann Schultz, a spokeswoman for Blue Cross Blue Shield of Illinois.
After doing some research, a Blue Cross Blue Shield representative contacted the radiologist's office about the $263 charge.
The situation was quickly resolved.
"The test in question is considered experimental, investigational, and unproven, and is not covered under medical policy," Schultz said in an email. "We contacted the provider, and they have written the charge off. As of today, Mr. Hansen's account has a zero balance and is closed."
Robert Hansen said he was relieved to have the $263 erased but still doesn't understand why the charge existed in the first place.
From what he could tell, there was no corresponding charge from the hospital for that CT scan.
"I can't even prove they did it," Robert Hansen said. "I think it's quite ridiculous, in a nutshell."