24 December 2020
“{The whole|The entire} door was {crushed|squashed} like {a piece of paper|a notepad|a paper},”Gaston {recalled|remembered} of the October {incident|event|occurrence}. Gaston, 43, {needed|required} {help|assistance|aid} from her {son|child|kid|boy} and {police officers|policeman|law enforcement officer} to {escape|leave|get away} the {totaled|amounted to} {car|vehicle|automobile|cars and truck}. She and her {son|child|kid|boy} suffered injuries, which she {declined|decreased} to {detail|information} beyond a welt on her head from a flying rearview mirror.
Gaston {declined|decreased} treatment from paramedics at the scene. {Instead|Rather}, her {mother|mom} {came to|concerned|pertained to} drive Gaston and her {son|child|kid|boy} to the {emergency room|emergency clinic} at Froedtert {Hospital|Medical facility|Healthcare facility|Health center} in Milwaukee. Gaston, who {lacks|does not have} {health insurance|medical insurance}, {recalled|remembered} waiting {nearly|almost} {two|2} hours {before|prior to} {receiving|getting} an X-ray, ibuprofen, Tylenol and {advice|guidance|recommendations|suggestions} to follow up with her {doctor|physician|medical professional}.
{Three|3} weeks {later|later on}, she {learned|discovered|found out} by {certified|licensed|qualified} mail that the {hospital|medical facility|healthcare facility|health center} {filed|submitted} a $2,314.98 lien {against|versus} her and one {against|versus} her {son|child|kid|boy} for $1,044.34– to cover her {bill|expense|costs} from the {visit|go to|check out|see}. {{But|However} what did that {mean|imply|indicate|suggest}?
| What did that {mean|imply|indicate|suggest}?
} Gaston {initially|at first} {worried|fretted|stressed} the lien was {filed|submitted} {against|versus} the {home|house} she {proudly|happily} {purchased|bought|acquired} {three|3} years {ago|back|earlier} on Milwaukee’s North Side. That was not the case. {Instead|Rather} the legal filing would {reduce|decrease|minimize|lower} {compensation|payment|settlement} she {might|may} {receive|get} from an accident-related {lawsuit|suit|claim}– if one is {filed|submitted}.
“They {just|simply} sent me this {bill|expense|costs} {saying|stating} that they were going to put a lien on my name, and I {just|simply} {kind of|type of|sort of} {panicked|stressed|worried},” Gaston {said|stated}. “I {had to|needed to} {seek|look for} some {advice|guidance|recommendations|suggestions}.”
COVID-19 pandemic. In April, Froedtert dropped more than {a dozen|a lots} {debt|financial obligation} {lawsuits|suits|claims} after a Wisconsin Watch/WPR {investigation|examination} {revealed|exposed} the {hospital|medical facility|healthcare facility|health center} and others in Wisconsin were {suing|taking legal action against} {patients|clients} {during|throughout} the pandemic who {struggled|had a hard time} to pay medical {bills|expenses|costs}. Froedtert {vowed|promised|pledged|swore} to suspend such {small|little} claims {suits|fits|matches}. The {hospital|medical facility|healthcare facility|health center} {has|has actually} followed through on that {promise|guarantee|pledge}– while {filing|submitting} more liens {against|versus} {patients|clients}. Some {hospitals|medical facilities|healthcare facilities|health centers} {elsewhere|somewhere else|in other places}, {including|consisting of} Froedtert South in Kenosha, are continuing to {sue|take legal action against} {patients|clients} over {alleged|supposed} {debt|financial obligation}, a more aggressive {tactic|strategy|technique|method} that can {damage|harm} {credit histories|credit rating|credit report}.
Froedtert {filed|submitted} 362 {hospital|medical facility|healthcare facility|health center} liens through Dec. 11 of this year, {including|consisting of} 251 {since|because|considering that|given that} May. That {outpaces|surpasses|exceeds|outmatches} the 300 liens it {filed|submitted} in all of 2019.
Stephen Schooff, {a spokesman|a spokesperson|a representative} for Froedtert Health, {said|stated} the {hospital|medical facility|healthcare facility|health center}’s volume of lien filings “{aligns|lines up} with the {number of|variety of} Froedtert Health {hospital|medical facility|healthcare facility|health center} cases {resulting from|arising from} {auto|car|automobile|vehicle} {accidents|mishaps}.”
{{Indeed|Certainly|Undoubtedly}, Milwaukee County this year has seen {an increase|a boost} in {serious|major|severe} {car crashes|auto accident}| Milwaukee County this year has seen {an increase|a boost} in {serious|major|severe} {car|vehicle|automobile|cars and truck} crashes}, even {during|throughout} a pandemic that {has|has actually} {limited|restricted} traffic.
“Froedtert Health follows the {process|procedure} for {filing|submitting} liens as {set forth|stated} in the Wisconsin {Hospital|Medical Facility|Healthcare Facility|Health Center} Lien Statute and {only|just} {files|submits} liens to {collect|gather} from {third party|3rd party} settlements,” Schooff {added in|included} {an email|an e-mail}.
The practice {also|likewise} {happens|occurs|takes place} at {nonprofit|not-for-profit} {hospitals|medical facilities|healthcare facilities|health centers} in Wisconsin. SSM Health, which owns {hospitals|medical facilities|healthcare facilities|health centers} and {clinics|centers} {across|throughout} Wisconsin, {filed|submitted} {at least|a minimum of} 116 liens this year though Dec. 11, court records {show|reveal}. UW Health in Madison {filed|submitted} {at least|a minimum of} 67, while La Crosse-based Gundersen Health System {filed|submitted} {at least|a minimum of} 49. Aspirus Wausau {Hospital|Medical facility|Healthcare facility|Health center} {filed|submitted} {at least|a minimum of} another 13 liens.
“{Hospitals|Medical facilities|Healthcare facilities|Health centers} {attempt|try} to {balance|stabilize} their {responsibility|obligation|duty} to be {good|great|excellent} stewards of resources to {ensure|guarantee} they can best serve their {communities|neighborhoods},” {said|stated} Kelly Lietz, a Wisconsin {Hospital|Medical facility|Healthcare facility|Health center} Association {spokesman|spokesperson|representative}. “{Hospitals|Medical facilities|Healthcare facilities|Health centers} {prefer|choose} not to go to court or file liens, so those actions {really|truly|actually} are {a last resort|a last option|a last hope}, taken {only|just} after all other {options|choices|alternatives} are {exhausted|tired}.”
Thomas Russell, a UW Health {spokesman|spokesperson|representative}, {said|stated} {hospital|medical facility|healthcare facility|health center} liens are “{very|extremely|really} {rare|unusual|uncommon} and {only|just} {apply|use} {in the case of|when it comes to} {a personal injury|an injury|an accident} settlement.”
{{But|However} {filing|submitting} a lien without {explanation|description} can leave {patients|clients} {confused|puzzled}.
| {Filing|Submitting} a lien without {explanation|description} can leave {patients|clients} {confused|puzzled}.
}”Their {immediate|instant} {thought|idea} is– like when {someone|somebody} {files|submits} a lien on your {house|home}, or they’re going to garnish your {wages|salaries|earnings|incomes}, {said|stated} Lance Trollop, {a personal injury|an injury|an accident} {attorney|lawyer} in Wausau. “It’s {scary|frightening} when you have all this coming at you {at once|at the same time|simultaneously}, with medical {bills|expenses|costs} and {insurance|insurance coverage} calls and {forms|types|kinds}.”
Liens can siphon off {large|big} {portions|parts} of {a patient|a client}’s injury {compensation|payment|settlement}. {And that|Which} payment is {typically|generally|usually|normally} more than {a hospital|a medical facility|a healthcare facility|a health center} would {collect|gather} from {an insurer|an insurance provider|an insurance company} for the {same|exact same|very same} care.
{Consumer|Customer} {advocates|supporters} {say|state} the {process|procedure} {illustrates|shows|highlights} one {way that|manner in which} the American {health care|healthcare} system leaves uninsured {patients|clients} on the hook for “{fictional|imaginary}” {health care|healthcare} {prices|costs|rates} that {don’t|do not} {reflect|show} the {actual|real} {cost|expense} of care.
How liens work
Gaston fits the {typical|common|normal} profile of {people|individuals} {facing|dealing with} {hospital|medical facility|healthcare facility|health center} liens, {experts|professionals|specialists} {say|state}: uninsured {patients|clients} who {have|have actually} been {injured|hurt} in {car crashes|auto accident}, although liens {could|might} {also|likewise} be {filed|submitted} in other cases {involving|including} {negligence|carelessness|neglect} or wrongful conduct.
{Unpaid|Unsettled|Overdue} medical {debts|financial obligations} can take years to {evolve|develop|progress} into {a small|a little} claims court {lawsuit|suit|claim}. Liens, on the other hand, {happen|occur|take place} {relatively|fairly|reasonably} {quickly|rapidly}. {Hospitals|Medical facilities|Healthcare facilities|Health centers} {must|should|need to} {file|submit} them within 60 days after {discharging|releasing} the {injured|hurt} {person|individual}, according to Wisconsin law, which {limits|restricts} lien filings to charitable {hospitals|medical facilities|healthcare facilities|health centers}. {Because|Since|Due to the fact that} of the {strict|stringent|rigorous} legal {deadline|due date}, some {health care|healthcare} {industry|market} {lawyers|attorneys|legal representatives} {encourage|motivate} {hospitals|medical facilities|healthcare facilities|health centers} to {file|submit} liens even {before|prior to} {learning|discovering|finding out} {a patient|a client}’s {insurance|insurance coverage} {information|info|details}.
{In the event|In case} of a legal settlement over an injury, {hospitals|medical facilities|healthcare facilities|health centers} {get paid|make money|earn money} {before|prior to} the {discharged|released} {patient|client}.
Wisconsin {hospitals|medical facilities|healthcare facilities|health centers} {mostly|mainly|primarily} {file|submit} liens {against|versus} {people|individuals} {involved in|associated with} {car crashes|auto accident} {because|since|due to the fact that} they are {easier|simpler|much easier} to {file|submit}, {says|states} Trollop. Crashes {typically|generally|usually|normally} {generate|produce|create} {a police|an authorities|a cops} report with the names of {the people|individuals} {involved|included}, their {insurance companies|insurance provider|insurer} and other {useful|helpful|beneficial} {information|info|details}. Those cases are {also|likewise} {more likely|most likely} to yield {a payout|a payment}, Trollop {added|included}.
Lien {recipients|receivers} {usually|typically|normally|generally} {lack|do not have} {insurance|insurance coverage}, {but|however} {hospitals|medical facilities|healthcare facilities|health centers} {treating|dealing with} some {publicly|openly} insured {patients|clients}– those {enrolled|registered} in Medicare, {for example|for instance}– {may|might} {choose|select|pick} whether to bill {the public|the general public} {insurer|insurance provider|insurance company} or {file|submit} {a potentially|a possibly} more {lucrative|profitable|rewarding|financially rewarding} lien.
If {a patient|a client} does not {file|submit} {a lawsuit|a suit|a claim} over their injuries {hospitals|medical facilities|healthcare facilities|health centers} can still {try|attempt} to {collect|gather} {a debt|a financial obligation} in other {ways|methods}– {including|consisting of} by {suing|taking legal action against} the {patient|client}, Trollop {said|stated}.
/ Wisconsin Watch ){How much|Just how much} would Gaston owe if Froedtert pursued payment {outside of|beyond} the lien? That’s {not clear|unclear}. {{But|However} {possibly|potentially|perhaps} {very|extremely|really} little if she {applied for|requested|made an application for|obtained|got|looked for} charity care.
| {Possibly|Potentially|Perhaps} {very|extremely|really} little if she {applied|used} for charity care.
} Like other {nonprofit|not-for-profit} {hospitals|medical facilities|healthcare facilities|health centers}, Froedtert {offers|provides|uses} a charity care program— part of its {commitment|dedication} as {a nonprofit|a not-for-profit} to serve the {community|neighborhood} in exchange for tax breaks and other {benefits|advantages}. {Patients|Clients} who {earn|make} {up to|as much as|approximately} {two|2} and a half times the federal {poverty level|poverty line} {could|might} {qualify for|get approved for|receive} {free|totally free|complimentary} care under the program, while {patients|clients} above that {threshold|limit} {may|might} be {eligible|qualified} for {discounts|discount rates} of 65- to 90% on {a sliding|a moving} scale.
Froedtert {debts|financial obligations} {resolved|dealt with|fixed|solved} through an injury settlement are {ineligible|disqualified} for charity care, Schoof {said|stated}.
Gaston {described|explained} her {earnings|profits|incomes|revenues} as {a business|a company|a service|an organization} {analyst|expert} as “{just|simply} a little above” the $43,100 {annual|yearly} {limit|limitation} for she and her {son|child|kid|boy} to {qualify for|get approved for|receive} {free|totally free|complimentary} care as {a family|a household} of {two|2}.
{When she {visited|went to|checked out} Froedtert in October, Gaston {said|stated} {someone|somebody} {gave|provided|offered} her {information|info|details} about the {hospital|medical facility|healthcare facility|health center}’s {financial|monetary} {assistance|support|help} policy and {told|informed} her {someone|somebody} would call about her billing {options|choices|alternatives}.|Gaston {said|stated} {someone|somebody} {gave|provided|offered} her {information|info|details} about the {hospital|medical facility|healthcare facility|health center}’s {financial|monetary} {assistance|support|help} policy and {told|informed} her {someone|somebody} would call about her billing {options|choices|alternatives} when she {visited|went to|checked out} Froedtert in October.} Gaston did get a voicemail about billing. She {received|got} the {hospital|medical facility|healthcare facility|health center} liens a week {or two|or more|or 2} {later|later on}, she {said|stated}.
{How much|Just how much} does {a patient|a client} owe?
In filing {roughly|approximately} $3,300 in liens {against|versus} Gaston and her {son|child|kid|boy}, Froedtert is {likely|most likely} {seeking|looking for} to {recoup|recover} “chargemaster {prices|costs|rates}”– {sticker prices|price tag} for {medical care|healthcare|treatment}.
“It’s been my experience in {defending|protecting|safeguarding} {hospital|medical facility|healthcare facility|health center} {lawsuits|suits|claims} that it’s {difficult|challenging|tough|hard} for {hospitals|medical facilities|healthcare facilities|health centers} to {prove|show} {reasonable|sensible|affordable} {value|worth} of their services,” {said|stated} Mary Fons, {a consumer|a customer} {protection|security|defense} {attorney|lawyer} in Stoughton. “They {just|simply} have their {prices|costs|rates}.”
Nicholas Bagley, a University of Michigan law {professor|teacher}, {described|explained} chargemaster {prices|costs|rates} as “{basically|essentially|generally} fictions” that {should|ought to|must|need to} {serve as|function as|work as|act as} the {starting|beginning} point for {cost|expense} {negotiations|settlements}.
“{Insurance companies|Insurance provider|Insurer} are {supposed|expected} to be our {agents|representatives},” Bagley {said|stated}. “And they’re {supposed|expected} to {negotiate|work out} {hard|difficult|tough} with these {big|huge} {hospital|medical facility|healthcare facility|health center} systems to come up with {reasonable|sensible|affordable} rates for the services they {provide|offer|supply}.”
The {arrangement|plan} works for {insurers|insurance providers|insurance companies}, he {added|included}, {because|since|due to the fact that} the {companies|business} hold {leverage|take advantage of|utilize} over {{hospitals|medical facilities|healthcare facilities|health centers} and {clinics|centers}|{clinics|centers} and {hospitals|medical facilities|healthcare facilities|health centers}}; they pay {health care|healthcare} {bills|expenses|costs} of {many|numerous|lots of} {patients|clients} and can threaten to {exclude|omit|leave out} {hospitals|medical facilities|healthcare facilities|health centers} and {providers|service providers|companies|suppliers} from their networks. {{But|However} that {process|procedure} breaks down for the {{poor|bad} and uninsured|uninsured and {poor|bad}}, sticking them with a “{fictional|imaginary} {fee|charge|cost}” for care.
| That {process|procedure} breaks down for the {{poor|bad} and uninsured|uninsured and {poor|bad}}, sticking them with a “{fictional|imaginary} {fee|charge|cost}” for care.
} {Individual|Private|Specific} {patients|clients}– even those with {attorneys|lawyers}– {lack|do not have} the bargaining power of {an insurance company|an insurance provider|an insurer}. Trollop, the Wausau {attorney|lawyer}, {said|stated} {hospitals|medical facilities|healthcare facilities|health centers} have no {obligation|responsibility|commitment} to budge, although {sometimes|in some cases|often} they do.
James Payne, {a personal injury|an injury|an accident} {attorney|lawyer} in Kenosha, {said|stated} even a lien {negotiated|worked out} down to half {price|cost|rate} in a settlement will cost {a patient|a client} more than {private|personal} {insurers|insurance providers|insurance companies} would {pay for|spend for} the {same|exact same|very same} care– and {far more|much more|even more} than Medicare and Medicaid would pay.
Some {hospital|medical facility|healthcare facility|health center} liens can {jeopardize|endanger|threaten} an injury settlement, {particularly|especially} if they are {large|big}, Trollop {said|stated}. Settling makes little sense, {for instance|for example}, if {a hospital|a medical facility|a healthcare facility|a health center} {demands|requires} {a sum|an amount} near the cap that the at-fault {driver|chauffeur|motorist}’s {insurance policy|insurance coverage|insurance plan} {is willing|wants} to pay.
“My {client|customer} isn’t going to {sign off on|accept|approve|validate} a settlement that {only|just} {pays back|repays} the {hospital|medical facility|healthcare facility|health center} lien,” Trollop {said|stated}. “The uninsured {person|individual} is going to {walk away with|leave with|win} less {money|cash} in the end.”
No {lawsuit|suit|claim}, {but|however} {debt|financial obligation} {lingers|remains|sticks around}
After considering her {options|choices|alternatives} with {a lawyer|an attorney|a legal representative}, Gaston {said|stated} she {probably|most likely} will not {sue|take legal action against} the {driver|chauffeur|motorist} who totaled her {car|vehicle|automobile|cars and truck}. The {driver|chauffeur|motorist} {doesn’t|does not} have {car|vehicle|automobile|cars and truck} {insurance|insurance coverage}, she {said|stated}, {adding|including} that he {might|may} {{face|deal with} a hit and run|run and {face|deal with} a hit} charge. {Avoiding|Preventing} legal action would render the Froedtert lien moot. {{But|However} her medical {bills|expenses|costs} {remain|stay} {unpaid|unsettled|overdue}, {and that|which} {issue|problem|concern} {could|might} take longer to {resolve|deal with|fix|solve}.
| Her medical {bills|expenses|costs} {remain|stay} {unpaid|unsettled|overdue}, and that {issue|problem|concern} {could|might} take longer to {resolve|deal with|fix|solve}.
} Gaston {said|stated} she {doesn’t|does not} have {an extra|an additional} $3,300 {just|simply} {sitting around|relaxing}, {but|however} she {plans|prepares} to {prioritize|focus on} the {bill|expense|costs} if {necessary|required|needed|essential}.
Schooff, the Froedtert {spokesman|spokesperson|representative}, {said|stated} a lien rendered moot by {a lack|an absence} of {a lawsuit|a suit|a claim} would not {preclude|prevent} {a patient|a client} from {applying for|requesting|making an application for|obtaining|getting|looking for} charity care. (He {could|might} not {respond|react} {directly|straight} to Gaston’s case {because|since|due to the fact that} of {privacy|personal privacy} {considerations|factors to consider}.)
“Froedtert Health continues to {work with|deal with} {patients|clients} {related to|associated with|connected to} {financial|monetary} {counseling|therapy} and {allows|enables|permits} {patients|clients} with {financial|monetary} {hardship|difficulty|challenge} who are on a payment {plan|strategy} to {defer|delay|postpone} payments while {financial|monetary} {assistance|support|help} is {discussed|talked about|gone over} with them,” he {wrote|composed} in {an email|an e-mail}.
As she {sorts out|figure out} the {aftermath|consequences|after-effects} of her {collision|accident|crash}, Gaston is {also|likewise} {recovering|recuperating} from COVID-19, which she {caught|captured} {a few|a couple of} weeks {before|prior to} Thanksgiving.
After she emerged from 10 days of {isolation|seclusion}, Gaston {learned|discovered|found out} that her {grandmother|grandma|granny} {died|passed away} from conditions {unrelated|unassociated} to COVID-19, making {a hard|a difficult|a tough} year even harder. She is now taking solace in how {funerals|funeral services} bring {families|households} together.
Do you have {debt|financial obligation} {trouble|difficulty|problem}?
The Department of Financial Institutions {offers|provides|uses} {general|basic} {advice|guidance|recommendations|suggestions} to debtors here, and {residents|locals|citizens|homeowners} {may|might} {file|submit} {a complaint|a grievance|a problem} here.
The {agency|company|firm}’s {Office|Workplace} of {Consumer|Customer} Affairs can be reached at 800-452-3328 or 608-264-7969.
ABC for Health {{also|likewise} {assists|helps} Wisconsin {residents|locals|citizens|homeowners} who have {problems|issues} with medical {debt|financial obligation} or other {issues|problems|concerns}.|{Assists|Helps} Wisconsin {residents|locals|citizens|homeowners} who have {problems|issues} with medical {debt|financial obligation} or other {issues|problems|concerns}.} You can reach the {organization|company} at 608-261-6939.
Legal Action of Wisconsin, {a nonprofit|a not-for-profit} public interest {law firm|law practice|law office}, is {also|likewise} {offering|providing|using} {a range of|a variety of|a series of} {assistance|support|help} to low-income {people|individuals} {struggling with|battling with|fighting with|dealing with|having problem with} {debt|financial obligation} or other {issues|problems|concerns} {during|throughout} the COVID-19 crisis. You can call 855-947-2529.
This story {comes from|originates from} {a partnership|a collaboration} of Wisconsin Watch and WPR. Bram Sable-Smith is WPR’s Mike Simonson Memorial Investigative Reporting Fellow {embedded|ingrained} in the newsroom of Wisconsin Watch (wisconsinwatch.org), which {collaborates|works together|teams up} with WPR, PBS Wisconsin, other news media and the University of Wisconsin-Madison School of Journalism and Mass {Communication|Interaction}. All works {created|produced|developed}, {published|released}, {posted|published} or {disseminated|distributed|shared} by Wisconsin Watch do not {necessarily|always} {reflect|show} the views or {opinions|viewpoints} of UW-Madison or any of its affiliates.
Source: milwaukeenns.org