NBC10 Responds

Medical Billing Mistake Leaves Patient with Hundreds of Dollars in Incorrect Charges

Philadelphia nurse says he attempted to dispute the bills, but was told to pay

NBCUniversal, Inc.

Going through cancer treatment can pack a physical and emotional punch.

Doug Pegram sees it during his nursing shifts at a local hospital.

“I interact with patients at their time of crisis,” Pegram said.

Nearly two years ago, the tables turned. Pegram was diagnosed with testicular cancer.  He underwent surgery, but the cancer returned. He decided to get a second opinion for treatment options.

“I went ahead and after my own urologists recommendation, spoke to a physician at Fox Chase,” Pegram told NBC10 Responds. He says he received and paid bills following the July 2019 appointment. He thought he was squared away until December when two more bills arrived.

Fox Chase Cancer Center billed him a total of $500 for facility fees. Pegram said he called his insurance company and Fox Chase Cancer Center to dispute the charges. According to Pegram, he was told there’s no mistake: he must pay.

I went ahead and paid those bills off out of out of frustration.”

Then he called NBC10 Responds.

NBC10 Responds reviewed his bills and didn’t see any explanation of what the facility fees cover.

Fox Chase said facility fees cover “all clinical buildings, equipment, non-physician staff and patient support services.”

"The patient was billed accurately based on negotiated rates with Aetna," Fox Chase said.

When NBC10 Responds brought Pegram’s billing situation to Aetna, it took at second look at his claim.

The insurance company then told NBC10 Responds: “A misquote was given to Mr. Pegram and the claim from Fox Chase Cancer Center should have been processed at the lowest in-network rate. Mr. Pegram was notified this week that his claim has been reprocessed and that he no longer has any responsibility for these charges.”

Aetna did not respond to questions about what caused the error.

Patient advocacy group Health Advocate said billing mistakes can happen due to coding problems, administrative errors, and other issues. Health Advocate says if you believe a bill is incorrect: do not pay it until the company addresses your concerns.

Aetna tells us if you believe there’s a problem with your bill: ask for an appeal. If that’s denied you can request an external review.

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