Utah Man’s Medical Bill Denied Despite Double-Checking Coverage

May 10, 2021, 6:15 PM | Updated: 7:53 pm

SALT LAKE CITY, UtahThere’s a lot a person can do to avoid medical billing nightmares, but one Centerville man said he did everything right and still got stuck with a bill.

Steve Blackham knew the importance of making sure a new doctor he wanted to see was covered by his insurance plan with Molina Healthcare.

“I don’t use the phone because of this,” Blackham told KSL Consumer Investigator Matt Gephardt. “I do everything as much as I can via the internet.”

In summer 2020, Blackham went straight to his Molina insurance portal to find an in-network endocrinologist.

He took screenshots of the website, showing that the doctor was covered, and got a referral from his primary care physician.

“I thought I was doing exactly what I should have been doing,” said Blackham.

Two months after his doctor’s visit, Blackham said Molina denied the payment, leaving him to pay the $224 bill.

When Blackham asked why the visit was denied, he said he was told Molina had two Medicare plans and his was not accepted by that doctor.

Blackham protested, emailing the Molina representative the screenshots of the portal showing he was covered, but the denial remained.

“I went through the process and was basically misled by Molina,” he said.

KSL Investigators reached out to Molina on Blackham’s behalf through the company’s corporate communications.

In an email, their spokesperson said, “Molina Healthcare resolved the situation to the member’s satisfaction and is making improvements to the My Molina web portal. We regret the frustration that the member experienced.”

Blackham confirmed his bill had been accepted by his insurance, leaving him responsible only for the copay of the visit.

Have you experienced something you think just isn’t right? The KSL Investigators want to help. Submit your tip at investigates@ksl.com or 385-707-6153 so we can get working for you.

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Utah Man’s Medical Bill Denied Despite Double-Checking Coverage