Utah man faces massive medical bills following emergency surgery despite having insurance
MANTI, Utah (KUTV) In July 2016, Kris Jorgensen was within minutes of bleeding to death. He was remodeling a home near Manti and took an old mirror out to a dumpster in the home’s driveway. It broke in half.
"The top three feet of the mirror just dropped on me like a guillotine,” he said.
The mirror tore through his arm, stopped only at bone. His injury was so severe he had to be flown by medical helicopter to the Utah Valley hospital in Provo for emergency surgery.
Jorgensen said he thought he was going to die.
“With that much blood coming out of your body, you knew you were in trouble," he said.
Doctors saved his life and even his arm.
Now, nearly two years later, it’s something non-traumatic that is messing with his blood pressure – bills from his time in the hospital that his insurance company is refusing to pay.
The hospital is considered 'out-of-network' with Jorgensen's insurance company. So insurance paid, but the hospital says it didn't pay enough. The hospital is now demanding Jorgensen pay the balance, more than $10,000.
"I didn't have a choice of where I was being taken, it was either be dropped off there or die," he said.
Stuck with a large bill that he doesn't think is fair, Jorgensen asked Get Gephardt to investigate.
Neither the hospital nor Jorgensen's insurance company would talk about any of this on camera, but reading their prepared statements, it seems a miscommunication may be to blame.
The hospital says the insurance company needed to send an explanation of benefits so the hospital could understand why the entire bill wasn't paid. The insurance company, Regence Blue Cross Blue Shield, said they sent it, but they sent it to Jorgensen, not the hospital.
Now, after Get Gephardt’s calls, Regence BCBS sent Jorgensen an additional check for $1,000 and Utah Valley has accepted that extra grand as payment in full.
Federal law says that, in an emergency, all hospitals are supposed to be considered "in network" and insurance companies have to pay. A loophole in Utah law makes it so that hospitals don't have to accept what insurance pays as "payment in full," so the balance of the bills frequently gets sent on to patients.