Editorial: Dartmouth Hitchcock billing error requires proactive response

  • Dartmouth-Hitchcock Medical Center in Lebanon, N.H., on March 6, 2014. (Valley News - Will Parson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Will Parson

Published: 7/30/2022 8:03:12 PM
Modified: 7/30/2022 8:00:02 PM

Dartmouth Health has made a concerted effort over many months to inform its patients and the public more generally about the benefits of getting the COVID-19 vaccines. So it is puzzling that the health system would allow a billing snafu to undermine that worthy message.

Regrettably, though, that seems to be the case. Our colleague Nora Doyle-Burr reported earlier this month that a Strafford man, Matt Barnes, had received a bill for $64.01 for the COVID vaccine booster he received at Dartmouth Hitchcock Medical Center, and DH had inexplicably failed to move promptly to rectify the situation.

The vaccines, of course, are free to individuals under federal rules, given that the taxpayers underwrote the effort to develop and distribute them and that the shots are the best way to combat the pandemic. Indeed, DH’s own website indicates that it does not charge for them, although it does bill insurers for a $64 “professional charge.”

How this charge ended up on Barnes’ bill is a bit of a mystery; a DH spokeswoman says that if any patient receives such a bill, it is the result of an error “possibly caused by an automated process.”

A bigger mystery is why DH continues to ask Barnes for payment after he alerted the customer service office to the error. When he asked to have it removed, a representative advised him to contact his insurance company, which had so far declined to pay. (Under federal rules, providers may bill insurers or the government directly for administration fees, not patients.)

The spokeswoman declined to disclose how many DH patients have received such bills, citing privacy rules.

We guess that would be the privacy of whoever is responsible for the screw-up, since merely citing the number would have no effect on any individual patient’s right to health-care privacy.

More troubling is the possibility that DH does not know how many erroneous bills were issued; or how many people who received the vaccines at DH affiliates have simply paid the bill because they did not know that they could not be charged for the shots; or paid it because they simply didn’t want to spend the time and effort of getting the charge removed.

The DH spokeswoman advises patients who got a similar bill to contact the customer service office. This seems to us to have it backwards.

If the error originated with the health system or a contractor, then DH should take responsibility and affirmative steps to fix it, rather than shifting the burden to those who received an unwarranted bill.

Many people lead busy lives, and generally speaking, contacting customer service at many businesses and organizations results in a time-consuming and frustrating back-and-forth before problems are resolved. For his part, Barnes was not appeased by his interaction with DH customer service. “You’d think you’d get a more considerate response,” he said, rather than being shunted off to his insurance company.

DH is a behemoth by New Hampshire and Vermont standards. It surely has the resources to monitor its billing practices and aggressively move to make things right when they go wrong. Particularly in this case, every effort should be made to avoid discouraging people from getting the vaccines, which are safe and effective (and not incidentally, free.)

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