Limited recourse when faced with billing error by large system

Kaiser Health News published a frustrating story about one woman's difficulties in having her provider correctly bill insurance companies. The gist is that the woman gave birth before the end of the year, but her son needed services after the start of the new year. At the same time, the woman's health insurance company changed at the start of the new year. The health system billed both insurance companies for the full amount, and both insurance companies rejected the bill, because the bill contained one date that was outside of covered time period. Eventually, the health system broke apart the bill into two: one for services rendered in the previous year, and one for services rendered in the new year. The resolution took ten months, meanwhile saddling the woman with a bill for about half a million dollars.

The situation seems less common (services rendered to a patient across year boundaries when the patient changes insurance companies), but it seems that a large health system would encounter these circumstances periodically. However, the health system's billing software was not well-equipped to bill correctly these types of cases correctly. More frustrating is that even after the health system indicated that the problem would be fixed in March of the new year, it was not actually fixed until October, when a Kaiser Health News reporter contacted the health system. The inability or apathy towards correcting the bill seems to be extremely poor customer service, and if the bill were sent to collections, could have had very disruptive effects on the family. Ironically, the health system probably would have done better financially by getting the bill correct early on, but even self-interest seems to be insufficient in this case. Regardless, it seems unfair that the patient would have so little recourse in this case if a reporter did not get involved.