Jamie Holmes says a surgery center tried to make her pay for two operations after she underwent only one. She refused to buckle, even after a collection agency sued her last winter.
By Tony Leys
During the operation, while Holmes was under anesthesia, the surgeon noticed early signs of endometriosis, a common condition in which fibrous scar tissue grows around the uterus, Holmes said. She said the surgeon later told her he spent about 15 minutes cauterizing the troublesome tissue as a precaution.
She said the doctor assured her the extra treatment for endometriosis would cost her little, if anything. Then the bill came.
The medical procedure
A tubal ligation operation, plus treatment of endometriosis found during the surgery. The doctor said he finished both procedures within the 60 minutes that had been allotted for the tubal ligation procedure alone.
The final bill
$9,620. Insurance paid $1,262 to the in-network center. After adjusting for prices allowed under the insurer’s contract, the center billed Holmes $2,605. A collection agency later acquired the debt and sued her for $3,792, including interest and fees.
The billing problem
Holmes was only on the operating table once, but the surgery center, which provided the facility and support staff for her operation, sent a bill suggesting that Holmes underwent two separate operations — one to have her tubes tied and one to treat endometriosis. It charged $4,810 for each.
Premera Blue Cross covered bills from the surgeon and anesthesiologist, but the insurer declined to pay for two separate operations, she said.
Holmes figured someone in the center’s billing department mistakenly thought she’d been on the operating table twice. She said she tried to explain that there was only one operation — to no avail.
She refused to pay.
Holmes said she was willing to pay for the extra procedure, but not for an entirely separate operation that didn’t happen. “I’m not opposed to paying” for the 15 minutes the surgeon spent cauterizing the spots of endometriosis, she said. “I am opposed to paying for a whole bunch of things I didn’t receive.”
Sabrina Corlette, co-director of Georgetown University’s Center on Health Insurance Reforms, said it was absurd for the surgery center to bill for two operations and then refuse to back down when the situation was explained. “It’s like a Kafka novel,” she said.
Corlette said it wouldn’t have made medical or financial sense for the surgeon to make Holmes undergo a separate operation for the secondary issue, she said. Surgery center staffers should be accustomed to such scenarios, she said. “It is quite common, I would think, for a surgeon to look inside somebody and say, ‘Oh, there’s this other thing going on. I’m going to deal with it while I’ve got the patient on the operating table.’”
The resolution
The surgery center was later sold and closed, and the debt was turned over to SB&C, a collection agency. SB&C, based in Mount Vernon, Wash., filed suit against Holmes in December 2023, seeking $3,792, including interest and fees.
Representatives of SB&C and the defunct surgery center declined to comment for this article.
The collection agency asked a judge to grant summary judgment, which could have allowed the company to garnish wages from Holmes’s job as a graphic artist and marketing specialist for real estate agents.
Holmes said she filed a written response, then showed up on Zoom and at the courthouse for two hearings, during which she explained her side, without bringing a lawyer. The judge ruled in February that the collection agency was not entitled to summary judgment.
So far, the collection agency has not pressed ahead with its lawsuit by seeking a trial after the judge’s ruling. Holmes said that if the agency continues to sue her over the debt, she might hire a lawyer and sue the agency back, seeking damages and attorney fees. She could have arranged to pay off the amount in installments, but she said she’s standing on principle.
The takeaway
Don’t be afraid to fight a bogus medical bill, even if the dispute goes to court. Corlette said that if the surgery center was still in business, she would advise the patient to file a complaint with state regulators.
Debt collectors often seek summary judgment, which allows them to garnish wages or take other measures to seize money without going to the trouble of proving in a trial that they are entitled to payments. If the consumers being sued don’t show up to tell their side in court hearings, judges often grant the request.
However, if the facts of a case are in dispute — for example, because the defendant shows up and argues she owes for just one surgery, not two — the judge may send the case to trial. That forces the debt collector to choose: spend more time and money pursuing the debt or drop it.
Berneta Haynes, a senior attorney for the National Consumer Law Center, reviewed Holmes’s bill for KFF Health News. “It pays to be stubborn in situations like this,” Haynes said.
Bill of the Month is a crowdsourced investigation by KFF Health News that dissects and explains medical bills. Since 2018, this series has helped many patients and readers get their medical bills reduced, and it’s been cited in statehouses, the U.S. Capitol and at the White House. Do you have a confusing or outrageous medical bill you want to share? Tell us about it!
