They’re going to give me another heart attack, says teacher slapped with medical bill of $108,951
Drew Calver, who is a married father-of-two, received a bill from St. David's Medical Center a month after he had heart surgery that informed him he had to pay $108,951
A high school teacher in Texas had the biggest shock of his life in April last year when a near-fatal heart attack caused him to collapse in his bedroom. This happened only months after he had taken part in a grueling triathlon. The second surprise for Drew Calver, who is also a married father-of-two, came in the form of a bill from St. David's Medical Center a month after he had heart surgery that informed him he had to pay an outstanding balance of $108,951 as his medical insurance covered only $55,840 of the total amount.
44-year-old Calver who is a history teacher and a swimming instructor at Austin High School said that his annual income only covers about half of the $109k balance left over in the bill.
He spoke to Kaiser Health News, which had initially reported the story along with NPR, and said: "They’re going to give me another heart attack stressing over this bill." According to an email that was sent to CBS Austin News from a spokesperson for the medical center, Calver's plight may soon come to an end. The email reads in parts: "Collections efforts are on hold. Our research efforts indicate Mr. Calver will qualify for our financial assistance discount leaving him with a balance due of less than $800." Calver had the reaction of any shocked person and said: "Oh wow… I had not heard this."
For the Calver family, the nightmare started on April 2, 2017, morning shortly after wife Erin went to the store with their six-year-old daughter leaving Calver alone in the house with their eldest daughter who was seven at that time. The teacher and coach was in the bedroom when he was overcome with unbearable chest pains that left him crumpled on the floor. He immediately called his daughter for help and a neighbor helped rush the man to St. David's which happened to be the closest hospital.
Medical tests taken at the cardiac ICU showed that the seemingly fit swim coach had a blockage in his left anterior descending artery, which is commonly known as the "widow-maker", and he needed emergency surgery to get rid of the block. Four stents were to be inserted into the clogged artery to remove the blockage. He remembers asking the staff as he was being prepped for the procedure if his health insurance policy would be able to cover the treatment. St. David's was outside of Calver's network.
He recalled telling the staff: "I'm on Seton, my Austin ISD [insurance] is Seton network, I just want to make sure I'm being covered by this. And they said, 'Yeah, we've accepted your insurance, your insurance has been contacted.' It sounded like they'd said yes."
The operation had been a success and Calver was discharged from the hospital four days later.
One month after that, however, a massive bill of six figures appeared in the family's mail and the amount shown included more than $42,000 for the stents, out of which, two were billed at $19,000 each. Calver initially thought it was a mistake that was made either by the hospital or his insurance company. This is when the phone calls started from debt collectors who demanded that they pay up. The couple explained to them that they did not have the money to pay in full and that they had not been offered financial assistance.
The distraught couple had to try and work their way around the system and finally claimed that the hospital only reached out to them in August this year to try and figure out a solution. This was more than a year after the teacher had been hospitalized.
On August 28, St. David's defended its billing practices and explained that when a patient goes to their center for treatment, their priority is to check if the patient is stable and only then move on to check the insurance coverage. If they find that their hospital is out of coverage for the patient, they them move the person to an in-network facility but this is not always possible especially when dealing with emergencies.
The hospital also told the station KXAN that it has an active financial assistance program that takes a patient's income into consideration. If Calver applies for the program, his bill will be reduced to under $800 and that would make the amount 1% of his current balance. He has said that he will gladly pay the amount in full but cannot understand why the hospital has taken so long to give him this vital information. Referring to the long, drawn-out process, he said: "I need to focus on staying healthy and preventing another heart attack and reducing stress in my life, and this is doing the exact opposite."
A spokesperson for the hospital has denied Calver's claims that they did not convey the information and said that they have been in touch with the teacher regarding the paperwork since April 2018. They have also stressed that the staff did "everything right" when handling Calver's case and have blamed his employer and the insurance for offering a narrow network.