The following excerpt is taken from a Memorandum of Law filed by the Office of Minnesota Attorney General Lori Swanson in a lawsuit the state filed against Accretive Health, a hospital bill collector, based on allegations of conduct that violates state law. An excerpt (begins on page 16):- E. Baby Prison and Patient Overbilling.
Accretive uses its own software program, known as AHtoAccess, or A2A, to get money from patients. A hospital registration employee using A2A cannot process a patient electronic record unless he or she first processes informational “balls” that pop up on the screen. SAC ¶ 96.
The system is derisively referred to by hospital employees as the “Blue Balls” program. A2A purportedly determines the financial responsibility of insured patients for co-pays, deductibles, co-insurance, and for past balances, as well as the amount to be asked of uninsured patients for past balances and present bills. Id. Based on the information in A2A, patients are then told to pay money to the hospital. Id. The amount calculated by A2A for patients to pay often exceeded the amount owed by the patient. Id. As a result, Minnesota patients sometimes paid more than they owed.
For instance, Amy Zumwalde works with disabled kids at Richfield Public Schools. She and her husband’s first child, Max, was born at Southdale Hospital in March of 2011. As Amy was proudly leaving the hospital to take her new baby home, a woman stopped her and said she must cough up a credit card to pay for the delivery.
Amy replied that she had insurance and thought she had 30 days to pay any balance. The woman replied that Amy owed about $800 and that her newborn couldn’t be discharged unless she paid.
Fearful that she wasn’t going to be allowed to take her new infant home, Amy gave the woman her credit card. As it turns out, Amy had already met her deductible and was overcharged about $800. Affidavit of Amelia Zumwalde.
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