>>>
>>> LET'S
>>> LET'S SAY YOU HAVE MEDICAL INSURANCE.
INSURANCE. LET'S SAY YOU GO TO THE
EMERGENCY ROOM.
EMERGENCY ROOM. YOU WOULD ASSUME YOU'RE
COVERED, RIGHT?
COVERED, RIGHT? THAT'S NOT NECESSARILY THE
CASE.
CASE.
CASE. >>
CASE. >> PATIENTS IN WASHINGTON ARE
GETTING HIT WITH SURPRISE
MEDICAL BILLS THAT AREN'T
COVERED BY INSURANCE EVEN
THOUGH THE HOSPITAL IS IN
NETWORK.
NETWORK.
NETWORK. >> WE HAVE MORE.
KYLE, THIS IS SCARY.
>> EARLIER THIS YEAR AREA HEAR
LAWMAKERS CLOSED THE LOP HOLE--
LOOPHOLE.
LOOPHOLE.
LOOPHOLE. >> I WAS HAVING CHEFLT -- CHEST
PAINS.
PAINS.
PAINS. >>
PAINS. >> Reporter: TEST RESULTS
SHOWED SHE WAS AT RISK FOR
BLOOD CLOTS AND NEEDED TO GET
TO THE EMERGENCY ROOM RIGHT
AWAY.
AWAY.
AWAY. >>
AWAY. >> WHAT THE HECK IS GOING ON.
>> Reporter: BEFORE LEAVING FOR
THE HOSPITAL, PATRICIA'S
HUSBAND CALLED THEIR INSURANCE
COMPANY SEEKING DIRECTION.
>> I WANT TO KNOW WHICH ONE DO
I GO TO, PEACE HEALTH OR
LEGACY.
LEGACY.
LEGACY. THEY SAID GO TO PEACE HEALTH.
THAT'S THE ONE THAT'S COVERED
AND IN NETWORK.
>> Reporter: PEACE HEALTH
EXAMINED PATRICIA.
EXAMINED PATRICIA. AFTER A FEW TESTS SHE WAS
RELEASED.
RELEASED.
RELEASED. THEY PAID A COPAY AND INSURANCE
COVERED THE REST.
THEY THOUGHT THEY WERE COVERED
UNTIL A FEW WEEKS LATER WHEN A
SEPARATE BILL SHOWED UP FROM A
MEDICAL GROUP PATRICIA AND HER
HUSBAND NEVER HEARD OF AMERICAN
ASSOCIATIONS.
ASSOCIATIONS. THEY DEMANDED $693.
>> I WANTED TO KNOW WHO ARE
THESE GUYS.
THESE GUYS. >> Reporter: TURNS OUT ONE OF
THE DOCTORS WHO TREATED HER
WASN'T COVERED EVEN THOUGH THE
HOSPITAL IS IN NETWORK EYE
DIDN'T KNOW --
>> I DIDN'T KNOW UNTIL THE BILL
COMES.
COMES.
COMES. >>
COMES. >> Reporter: IT'S CALLED
BALANCED BILLING.
BALANCED BILLING. YOU MAY BE TREATED BY A DOCTOR
WHO ACCEPTS YOUR INSURANCE BUT
IF SOMEONE ELSE COMES IN, THE
PATIENT IS LIKELY TO END UP
WITH A SEPARATE BILL FROM THAT
PROVIDER.
PROVIDER.
PROVIDER. WE REPORTED ON THIS
EXTENSIVELY.
EXTENSIVELY. IN MARCH A NEW LAW WENT INTO
EFFECT IN OREGON PROTECTING
CONSUMERS FROM THE SURPRISE OUT
OF NETWORK BILLS BUT IN
WASHINGTON THERE'S NOTHING TO
STOP BALANCED BILLING IT'S
PERFECTLY LEGAL.
PERFECTLY LEGAL. >> PEOPLE ARE LOSING MONEY.
THEY'RE GETTING RIPPED OFF.
>> Reporter: THE COMMISSIONER
BELIEVES CONSUMERS SHOULDN'T BE
CAUGHT IN THE MIDDLE OF
DISPUTES.
DISPUTES.
DISPUTES. >> WE SHOULD BE ABLE TO FIGURE
IT OUT.
IT OUT.
IT OUT. >> Reporter: ALTHOUGH PREVIOUS
EVIDENTS HAVE FAILED.
>> WE'VE GOT THE PROVIDERS,
HOSPITALS AND DOCTORS AND
INSURANCE COMPANIES ON THE
OTHER SIDE.
OTHER SIDE. HEY, YOU GUYS FIGHT IT OUT BUT
GET THE CONSUMER OUT OF IT.
>> Reporter: PEACE HEALTH SAID
IN PART IT'S WORKING WITH OTHER
HEALTHCARE PROVIDERS TO ENSURE
A PATIENT SEEKING HEALTH CARE
IN AN EMERGENCY SITUATION WILL
BE COVERED.
BE COVERED. FOR PATRICIA AND HER HUSBAND
THEY'RE STUCK WITH A HUGE BILL.
AMERICAN MEDICAL ASSOCIATES
OFFERED A DISCOUNT BUT WHEN
THEY SAID THEY WOULDN'T PAY.
>> TIGHT BUDGETS.
>> Reporter: AMERICAN MEDICAL
ASSOCIATES SENT THEM TO
COLLECTION DEMANDING THE FULL
AMOUNT.
AMOUNT.
AMOUNT. >> IT'S NOT RIGHT.
>> Reporter: FOR PATRICIA THE
NIGHTMARE GOES ON.
FIRST SHOW GOT A LETTER FROM
COLLECTION SAYING SHE DIDN'T
OWE AND THEN A BILL FROM
EMERGENCY MEDICAL SERVICES
SAYING SHE DID.
>> YOU SAID OREGON HAD THE
PROBLEM.
PROBLEM.
PROBLEM. THEY HAVE FIXED THIS.
WHAT ABOUT WASHINGTON.
>> Reporter: SOME LEGISLATION
WILL COME IN JANUARY.
HOPEFULLY THEY CAN CLOSE IT.
>> WHAT ABOUT IN THE MEANTIME
WHAT CAN PEOPLE DO.
>> BE YOUR OWN ADVOCATE.
IF YOU COULD LIVE IN WASHINGTON
SPOKE UP.
SPOKE UP.
SPOKE UP. TALK TO YOUR LAWMAKER.
THEY CLOSED THAT LOOPHOLE IN
MANY STATES BUT NOT WASHINGTON.
>> SO THESE WERE FROM OUR
FACEBOOK PAGE.
FACEBOOK PAGE. WE ASKED HAS THIS EVER HAPPENED
TO YOU.
TO YOU.
TO YOU. ONE VIEWER WRITES YES.
HEART SURGERY AFTER NETWORK.
NO FOLLOW-UP CARE.
HAD TO FIND ALL NEW DOCTORS
WHILE RECOVERING AND FIGURE OUT
WHAT I COULD AND COULD NOT DO,
NOT FUN.
NOT FUN.
NOT FUN. EXTREMELY SURGERY.
EXTREMELY SURGERY. WE WISH UPWELL.
ALSO, CHRISTINA, ONE OF OUR
VIEWERS WROTE YEP, WHEN I HAD
MY DAUGHTER.
MY DAUGHTER. THE DOCTOR WASN'T COVERED BY MY
INSURANCE EVEN THOUGH THE
HOSPITAL WAS.
HOSPITAL WAS. VIEWER SERENA WRITES, YES.
ER PHYSICIANS ARE NOT ALWAYS
CONTRACTED THE SAME AS THE
HOSPITAL.
HOSPITAL.
HOSPITAL. IF YOU TROY TO CONFIRM, YOU GET
THE RUN AROUND.
IT'S TERRIBLE.
IT'S TERRIBLE. SO PLEASE GIVE HIM A CALL.
THE NUMBER IS