Unraveling the Cost of Care: A Bozeman Woman’s Battle with Medical Bills
In December, Deborah Buttgereit, a 60-year-old resident of Bozeman, Montana, faced a life-altering incident when she slipped on ice outside her apartment. The fall resulted in a severe fracture of her left arm, specifically a distal humerus fracture, a rare injury that accounts for only about 2% of all adult fractures. The pain was immediate and excruciating, and Buttgereit knew she needed medical attention. However, the circumstances surrounding her injury would soon lead her into a complex web of medical billing and financial distress.
The Immediate Aftermath
Upon arriving at the emergency room, Buttgereit underwent scans that confirmed her worst fears: she required surgery to repair her fractured elbow. Unfortunately, at that time, she was uninsured, having struggled to afford health coverage after the sudden death of her husband in 2023. The local health system, Bozeman Health, provided an initial estimate of $50,560 for the outpatient surgery. This figure, however, came with a caveat: “You could be charged more if complications or special circumstances occur.”
Four days later, Buttgereit underwent a three-hour surgery. During a follow-up visit, her doctor revealed that the procedure had been more complicated than anticipated, a revelation that would have significant financial implications.
The Financial Burden
The final bill for Buttgereit’s surgery totaled a staggering $97,998. This included over $44,300 for the operating room and anesthesia, along with more than $50,000 for medical supplies and implants. After applying a self-pay discount, Buttgereit was still left with a bill of $78,398.40. The unexpected increase in costs stemmed from complications during the surgery, where the surgeon encountered more shattered bone fragments than initially expected, necessitating additional time and resources.
“I’ll make payments the rest of my life to pay it all off,” Buttgereit lamented, highlighting the emotional and financial toll of her situation.
A Struggle for Coverage
Buttgereit’s journey into the world of medical billing began after her husband’s death. Following his passing, she left her job, which had provided health insurance for both of them. Moving to Bozeman to be closer to her daughter, she initially found a subsidized health plan through healthcare.gov. However, the higher cost of living in Bozeman soon made it impossible for her to maintain that coverage, leading her to drop her health insurance just two months before her fall.
After receiving the exorbitant surgery bill, Buttgereit began reaching out to the hospital’s customer service team to understand the drastic increase from the initial estimate. Despite the hospital applying a self-pay discount, she was still left with a daunting financial obligation.
Navigating the Complexities of Medical Billing
Buttgereit’s attempts to dispute her bill were met with confusion and misinformation. A Bozeman Health billing employee incorrectly informed her that the No Surprises Act, a federal law designed to protect patients from unexpected medical bills, only applied to emergency services. This miscommunication added to her frustration as she sought clarity on her options.
Erin Schaible, a spokesperson for Bozeman Health, acknowledged the complexities involved in Buttgereit’s case. She emphasized that online estimates do not always reflect the specific details of a patient’s care, particularly in cases involving unexpected complications.
The Fight for Fairness
Refusing to accept the inflated charges, Buttgereit sought to challenge the bill. Utilizing Healthcare Bluebook, a price comparison tool, she discovered that similar procedures ranged from $8,000 to $40,000. Buttgereit believed that the complications cited did not justify the exorbitant price she was being charged.
“I felt like going through financial assistance means that I’m OK with the price of the bill,” she stated. “I want to get the bill reduced on the front end and then, if I need financial assistance, go through it.”
In May, a billing employee offered an additional $7,000 discount if she set up a payment plan. However, Buttgereit remained resolute in her quest for a fair resolution. She agreed to a payment plan of $100 a month, but at that rate, it would take her approximately 60 years to pay off the debt.
Seeking Help from Higher Authorities
In a bid for assistance, Buttgereit reached out to the White House, hoping to draw attention to her plight. Shortly thereafter, she received a call from an official with the Centers for Medicare & Medicaid Services (CMS), informing her that she could dispute the bill with federal health officials.
This development marked a turning point in her struggle. Buttgereit learned that the No Surprises Act not only protects patients from unexpected bills but also provides a formal dispute process for uninsured patients facing significant discrepancies between initial estimates and final charges.
The Importance of Advocacy
Patricia Kelmar, director of health care campaigns at U.S. PIRG, a national consumer advocacy group, emphasized the importance of patients advocating for themselves in the healthcare system. She noted that while patients often find themselves at a disadvantage post-surgery, the No Surprises Act offers a pathway for those who feel they have been unfairly charged.
The law allows patients to initiate a dispute process if their final bill exceeds the initial estimate by $400 or more. An independent reviewer evaluates whether the final price is drastically different from what an insurance company would have paid and whether the complications were predictable.
Conclusion: A Call for Change
Buttgereit’s experience underscores the urgent need for transparency and fairness in medical billing. As she prepares to navigate the dispute process, she remains hopeful that her efforts will lead to a more equitable resolution. “You’ve got to fight for yourself,” she said, reflecting the resilience many patients must summon in the face of overwhelming medical costs.
Her story serves as a poignant reminder of the challenges faced by uninsured individuals in the healthcare system and the importance of advocating for fair treatment. As the healthcare landscape continues to evolve, it is crucial for patients to be informed and empowered to challenge unjust medical bills, ensuring that they receive the care they need without the burden of insurmountable debt.
