Feb 22, 2008 4:51 pm US/Pacific
Insurance Wouldn't Cover SF Hospital Stay
SAN FRANCISCO (CBS 5) ―
Health insurance claims can be tricky. One wrong move and the claim can be denied. 20 year old student Keri Jappell fell off her skateboard in San Francisco's Diamond Heights district last summer.
"I had fractured my skull in two places, I had a brain hemorrhage, and a seizure on impact," said Jappell.
She was knocked unconscious and unable to tell paramedics her insurer's preferred hospital. Her boyfriend was by her side, but rescue personnel couldn't take information from him because he wasn't family.
"They had to use a code name, they couldn't use my I.D., they couldn't use my insurance to figure out where to take me, so they took me to San Francisco General, which is not covered by my insurance" said Jappell.
The cost for Jappell's stay and a return visit to the emergency room was $2,700. Her insurance did not cover the cost because she did not get permission before going out of the insurer's network. Jappell said "I was in what they called, I believe it was a level D coma."
She had no way to pay, and didn't have anyone who could help. "My mom doesn't have the money to spot me for something like that. And she pays a lot of money per month so I can have a health insurance plan, and it just kind of seemed like this doesn't make any sense," added Jappell.
She called Consumer Watch. We put her in touch with John Metz of Just Health, a healthcare advocate. Metz said "It's not an accident, it's not something that just happens occasionally."
He explained that consumers have few rights in cases like this. Despite this, he went to bat for Jappell, and the charges were eventually cleared.
"There's a bigger solution and the bigger solution is we have to change the system. And it's not going to get better until we do ... In fact it's going to get worse and worse and worse" added Metz.
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