Rosem Morton/KFF Health News
Thomas Greene had been experiencing pain in his right leg, a complication from diabetes, when doctors recommended a procedure to increase blood flow to the limb.
Retired from a career as an electrician and HVAC technician, he had an outpatient procedure in April 2021 to alleviate his pain by dilating the clogged artery using a balloon snaked into his blood vessel.
Greene, who lives in Oxford, Pennsylvania, came through the procedure without any problems, and it reduced his discomfort, said his wife, Bluizer Greene. She spoke with KFF Health News on behalf of Greene, who is recovering from other health problems.
Greene is covered by Medicare and a supplemental policy through Humana and did not expect to pay anything for the care, Bluizer said.
Then the bills came.
Medical service: Peripheral artery bypass surgery on Greene’s right leg.
Service provider: The operation was performed at Jennersville Hospital in West Grove, Pennsylvania, which closed in December 2021. Anesthesia services were provided by two providers who work for North American Partners in Anesthesia, which is private equity-owned and, with thousands of providers operating in 21 states, identifies itself as among the nation’s largest anesthesia staffing companies.
Total bill: For the anesthesia care, North American Partners in Anesthesia billed $2,965.58: $1,334.51 for a certified nurse anesthetist and $1,631.07 for an anesthesiologist.
What gives: North American Partners in Anesthesia, or NAPA, pursued Greene to pay for his anesthesia care instead of billing Medicare on time, sending the debt to collections before the couple discovered the problem.
Medicare eventually received the claims from NAPA, months after Bluizer said they started receiving collections letters. But Medicare denied them because they were filed late — nearly 17 months after the surgery. Humana also denied the claims.
Medicare requires providers to submit claims within a year of providing their services. And Medicare supplemental policies, like Greene’s plan from Humana, generally do not pay for services if Medicare doesn’t cover them, whether because Medicare has not paid its part yet or because the program denied the claim.
A year after Greene’s surgery, in spring 2022, the couple opened a letter from a collections agency working on behalf of the anesthesia group. It demanded Greene pay about $3,000.
“Something has to be wrong, because this is the first time my husband has ever been asked to pay out-of-pocket and we’ve had the