Maryland Attorney General Anthony Brown said a unit within the Consumer Protection Division in his office has recovered or saved consumers $2.6 million by challenging denied health care claims.
The state’s annual report, however, showed only 10% of Marylanders appeal their bills when a claim is denied. But in the past fiscal year, the state succeeded in 56% of the cases it challenged.
Brown said consumers pay premiums so that their medical care can be covered. When their claim is rejected, he said, “Too many Marylanders just give up, thinking they have no choice but to accept the denial or to pay bills they can’t afford.”
Among the cases the state’s Health Education and Advocacy Unit looked at are those that have what Brown called “surprise medical bills.” Those are bills for components of care that the consumer believed would be covered.
“Last year, the HEAU saved a family more than $23,000 when their child was moved from a hospital’s emergency room to its inpatient psychiatric unit just two floors apart,” Brown said.
He explained that in that case, the emergency department was considered in-network, while the psychiatric unit was not.
“Although there are laws against these unlawful surprises, too many Marylanders are still charged these fees,” Brown said.
According to the attorney general’s office, in cases where original denials are not overturned, the HEAU is often able to negotiate a reduction of the original amount and set up payment plans for consumers.
Consumers looking for help in navigating the process can call the unit’s hotline Monday through Friday, from 10 a.m. to 2 p.m., at 410-528-1840. Complaints can also be filed online.
