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Woman charged over $300,000 for surgery after hospital 'misread' her insurance wins court battle over bill

May 24, 2022, 20:24 IST
Insider
In this photo provided by the University of Maryland School of Medicine, members of the surgical team perform the transplant of a pig heart into patient David Bennett in Baltimore on Friday, Jan. 7, 2022. On Monday, Jan. 10, 2022 the hospital said that he's doing well three days after the highly experimental surgery.Mark Teske/University of Maryland School of Medicine via AP
  • A woman was charged over $300,000 for spinal surgery after being quoted a fraction of the cost.
  • She'd been in a 2014 car wreck that threatened to paralyze her.
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A woman won a years-long lawsuit against a Colorado hospital that misquoted her surgery by more than $300,000.

Lisa Melody French, a 60-year-old clerk at a trucking company, was left in need of spinal-fusion surgery after being injured in a 2014 car accident. French's doctors told her that her spinal injury was "so bad" that if she were to fall in another instance, she'd be paralyzed, French told Insider.

"It wasn't really a choice. I had to have the surgery," she said.

St. Anthony North Hospital, run by Centura Health, initially quoted her $57,601.77, a bill her employer's insurance would primarily pay. She was told that her out-of-pocket expenses would be $1,336.90.

The hospital later said it "misread" her insurance card, court documents said.

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Centura Health then billed her $303,709. Her insurance and ELAP Services — a health-insurance firm — paid about $74,000 for the surgery. But French still owed $229,000 out of pocket when Centura decided to sue her.

French eventually filed for bankruptcy.

"It's not unlike that of everyday Americans who go to hospitals with a medical need and sign paperwork placed in front of them to create contract about the medical treatment about to be rendered," Ted Lavender, French's attorney, told The Washington Post. "It was very telling in Ms. French's case."

Lavender told the outlet that $197,000 of the total $303,709 bill was allotted to 13 pieces of spinal equipment that originally cost about $31,000.

"I was never really knowledgeable about insurance," French told Insider, adding that this operation was her first surgery.

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Centura Health argued that since French signed two contracts agreeing to pay "all charges of the hospital," she was required to pay "predetermined rates set by Centura's chargemaster."

The term "chargemaster" refers to a hospital's list of services and costs. French referred to the chargemaster as a "mysterious thing that we're not really allowed to see."

"I didn't think of that as a contract. And I certainly didn't know that it was a blank check," she added.

In a unanimous opinion, the court ruled that French would pay Centura Health $766.74 in damages, The Denver Post first reported.

"Because French had no knowledge of and did not clearly and knowingly assent to the terms of Centura's chargemaster, we conclude, under long-settled principles of contract law, that the chargemaster was not incorporated by reference into the HSAs that French signed," Justice Richard L. Gabriel wrote in the opinion.

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Gabriel added that chargemasters "have become increasingly arbitrary" and instead represent "inflated rates set to produce a targeted amount of profit for the hospitals."

French told Insider that she felt "really good" about winning the lawsuit.

"I feel like, not to be blunt, that the hospital got it back. They've been keeping things hidden and prices hidden for such a long time," she said. "They fought really hard, and they came after me pretty good."

French's attorneys and Centura Health did not immediately respond to Insider's request for comment.

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