A Montana woman faced a bill of nearly $98,000 for surgery to repair a shattered elbow after she slipped and fell on ice. Deborah Buttgereit, who was uninsured at the time, told KFF Health News she was first told by Bozeman Health officials she would be on the hook for more than $50,000. However, they said that the cost rose due to unexpected complications during the surgical procedure, including more bones shattered than expected and repair to nerve damage.
The health care provider’s estimate also reportedly included a note that read:
“You could be charged more if complications or special circumstances occur.”
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‘Payments the rest of my life’
The final bill included more than $44,000 for the operating room and anesthesia, plus $50,000 for medical supplies, including implanted screws and plates. Even after the hospital applied a 20% self-pay discount, Buttgereit said she was still responsible for more than $78,000 of out-of-pocket costs. She said she found similar operations that cost anywhere from $8,000 to $40,000 and contends there are errors on her bill.
“I’ll make the payments the rest of my life to pay it all off,” she told KFF Health News.
Buttgereit said she left her job a year after her husband died in 2023 at the company where they both worked. As a result, she lost her health insurance benefits and couldn’t afford to purchase new insurance. She fell and broke her elbow two months later.
‘No Surprises Act’
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A study by a Yale University economics professor found that before the No Surprise Act became law, more than 25% of ER visits resulted in a surprise out-of-network bill.
Now, she’s on a mission to dispute her bill and the No Surprises Act, a federal consumer protection law passed under former President Joe Biden, may assist her in her legal fight. The law went into effect in 2022, allowing patients to dispute surprise bills for out-of-network emergency care. It also established a formal challenge process for uninsured Americans or those paying the bill completely on their own if their final bill is $400 or more than the provider’s initial estimate.
Emails reportedly reveal that a Bozeman Health billing staffer wrongly said the law only applies to ER services but later said Buttgereit did have a right to dispute the charges while giving her an incorrect deadline.
Bozeman Health responds
In a statement to KFF Health News, a Bozeman Health spokesperson said it is now reviewing its communications when it comes to billing, noting that during Buttgereit’s surgery, the doctor found nerve damage mid-operation that required additional steps to address.
The spokesperson said that the “situation highlights the importance of clear and compassionate communication.” They added, “In response, our team leaders are revising internal protocols for escalating patient concerns and are reeducating staff on best practices for communicating cost estimate changes.”
Buttgereit contacts White House
Buttgereit said after contacting the White House, she was informed by the Centers for Medicare and Medicaid Services that she can dispute the charges to federal health authorities.
Still, legal analysts insist that the best time to push back against costly procedures is pre-surgery, noting that post-surgery, it’s a much more challenging process.
Buttergereit reportedly accepted a payment plan that allows her to pay $100 a month towards the bill with an additional $7,000 discount as she disputes the charges. But at that rate, KFF Health News reports, it will take about six decades to pay off.
What happens now?
Now, an independent investigator will determine whether the final bill is substantially different from what a health insurance provider would have paid and whether the complications discovered during surgery were predictable. If the probe finds that Bozeman Health made an error in either of these cases, the health care provider may be required to reduce the bill to the original estimate or the average health insurance companies’ pay, according to KFF Health News.
“You’ve got to fight for yourself,” Buttgereit told KFF News. “I don’t know where this is going to end up, but I feel a little more hopeful.”
