DELRAY BEACH, Fla. — Delray Beach resident Fritz Hinterberger’s medical billing nightmare started with a checkup.
“There was one biopsy done which was positive for melanoma,” Hinterberger said.
Another sample was sent to the lab, turns out the mole was benign.
The good news was followed by a massive medical bill.
“That was the surprise,” Hinterberger said. “I was not prepared for that.”
He didn’t expect to owe anything above his copay but his insurance told him they wouldn’t pay for any of it.
“I said - what? $8,500 out of my pocket?” Hinterberger said. “It was like a shock. I don’t have deep pockets like that, I can just say never mind I can pay that.”
While the first test was covered, the second was suddenly not. The insurance said the lab was a non-participating provider.
“I feel strongly that this should be covered by the insurance,” Hinterberger said.
His dermatologist was in-network, but not the lab he sent Hinterberger’s sample to.
A difficult system to understand for patients.
“It is because I would not be normally involved at all in this procedure,” Hinterberger said.
But suddenly he was involved, disputing bills and calling his insurance, Blue Cross Blue Shield.
The insurance said they do not cover experimental procedures. Requests by Contact 5 for comment have gone unanswered.
“I have the insurance and I’m expecting that everything is covered except my co-pay,” Hinterberger said.
He said the provider told him they would never bill him directly so he keeps hoping that will be the end of it.
Hinterberger said he learned his lesson for the future and will always check that the lab and the test will be covered by his insurance.