EXCLUSIVE: North Shore couple's ER bill caught in contract dispute

EXCLUSIVE: North Shore couple's ER bill caught in contract dispute

HONOLULU (HawaiiNewsNow)

On March 8 Sumner and Tina drove their son to the emergency room at Kapiolani Medical Center for Women & Children. Little Miles was 17 days old and he was sick.

"I woke up in the middle of the night to change his diaper and he had blood in his stool." Tina said.

The family's health insurance is with HMAA.

"Randomly, I was assigned to a different doctor who I wasn't covered with because of their labor negotiations," Sumner said.

The negotiations he's talking about are between HMAA and Emergency Medicine Physicians (EMP). The doctor assigned to Miles case is with EMP, a company HMAA considers not to be in its network.

"Because of their dispute we're not covered," Tina said.

HMAA paid for the emergency room visit but not for the doctor. EMP told the couple it owes them $871.73.

"I was very confused because that had never happened to us before," Tina said.

HMAA told them to negotiate with EMP. EMP told them they can file an appeal with HMAA. They say they are being bounced around.

"They're telling me to call them, and they're telling me to write a letter," Tina said.

The young parents feel like they're being used. They said EMP told them If enough people complain, HMAA will be forced to negotiate with EMP.

"I'm just disappointed in the way that I'm having to deal with this negotiation they should be doing with each other," Sumner said.

A representative from HMAA told Hawaii News Now: "HMAA is in good faith negotiations with EMP, trying to finalize a contract.  It's our understanding that other local insurance carriers are facing similar challenges with EMP at this particular time."

Tina said her son got great care at Kapiolani and the doctor was excellent. But she wants to remind people that patients don't have a choice about physicians when they go to an emergency room and the doctor that gets assigned may not be in the insurance carrier's network.

"They don't know that maybe in a month they're going to be stuck with a huge bill just because of the random doctor that they got assigned to," she said.

The couple said their son is doing fine, but dealing with payment for the emergency visit is one big headache.

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