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Emry Health Resolves $10,000 Hospital Billing Error for New Mother

A new mother was billed $10,380 after giving birth—despite having coverage. Emry uncovered it was the hospital’s error and, after nearly a year, resolved the dispute, reducing her bill to $2,500.

Situation

An Emry member gave birth and required an induction. She was insured through her employer, and maternity services were covered under her plan. Going into the hospital, she anticipated paying her standard out-of-pocket expenses: approximately $2,500 in coinsurance.

When her bill arrived, she was shocked to see charges totaling $10,380. The hospital denied financial assistance, leaving her to face what appeared to be an unexplained, unaffordable balance.

Service Provided

Upon calling Emry, the member learned that the bulk of the charges stemmed from a prior authorization penalty. The hospital claimed she was responsible for not securing authorization for her induction. However, Emry’s advocate quickly uncovered the truth:

For maternity admissions, the hospital—not the patient—is responsible for initiating prior authorization upon admission.
The hospital failed to follow this required process.
The hospital’s billing department attempted to transfer the burden of this oversight onto the member.

Recognizing the unfairness of the situation, Emry stepped in to manage the dispute:

Took over hospital communications, relieving the member from aggressive and insistent billing calls.
Documented the case, securing written confirmation that authorization was the hospital’s responsibility.
Escalated the issue, moving the dispute beyond billing to hospital leadership for review.
Provided ongoing advocacy, standing firm against repeated denials and demands from the hospital over many months.

Outcomes

After nearly a year of persistence, Emry secured a full resolution:

The hospital admitted its procedural failure.
The penalty charges were removed in full.
The member received a revised bill for only her expected $2,500 coinsurance.

The Impact

Without Emry’s intervention, the member would have been forced to pay more than $10,000 for a hospital error. Instead, she paid only what she rightfully owed under her insurance plan.

The member shared that she never could have managed this dispute on her own. The hospital’s billing team was aggressive and insistent that the charges were final. Emry’s expertise, persistence, and ability to escalate on her behalf turned an overwhelming and unfair financial burden into a fair resolution.

Initial Bill Amount:

$10,380

Final Bill Amount:

$2,500

Total Savings:

$7,880

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