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Springdale Teacher Represents Class of Patients to Stop Hospital’s Fraudulent Billing Practice

Nov 8, 2018

It all started when Jessica Mounce, a Springdale school teacher, was rear-ended in 2013. Jessica was injured, but she felt fortunate to have health insurance to cover her hospital expenses for treatment.

Or so she thought.

For treatment of her injuries, Jessica went to Northwest Medical Center in Springdale, Arkansas. At the time of admission, she presented her health insurance card to the hospital and signed the Assignment of Benefits form required by the hospital. This Assignment of Benefits form is an agreement where the patient “assigns” her health insurance benefits to the hospital for the treatment.

Jessica underwent further treatment for her injuries, and she eventually recovered. However, her problems stemming from this collision were only beginning.

Shortly after completing her treatment, Jessica began receiving notices from the hospital about her bill. Then, the notices became a lien filed in the Washington County Clerk’s office under her name for the total amount billed by the hospital. Eventually, the hospital’s bill collecting agent began bombarding Jessica with collection letters, which turned into collection phone calls at home and at work. This all occurred despite the fact that Jessica had health insurance and her treatment was for covered services.

Jessica later retained a lawyer to resolve her claim against the driver of the car that hit her. Before she could settle that claim, Jessica had to pay the hospital for the lien it filed on her claim against the driver that hit her. The lien the hospital filed prohibited Jessica from recovering anything from the at fault driver’s insurance company without paying the hospital. Jessica had no choice but to resolve the hospital lien in order to settle her injury claim.

As it turned out, the hospital had never submitted Jessica’s bills to her insurance company. And it wasn’t just Jessica who was a victim of the hospital’s billing practice. The hospital realized it could increase profits by going after its patients directly instead of submitting the bills to patients’ health insurance companies. This is because of the reimbursement arrangements that hospitals have  with health insurance companies. Health insurance companies negotiate with hospitals scheduled payments for certain hospital services and supplies, and these negotiated rates that the health insurance companies pay the hospital are much lower than what the hospital would charge if there was no health insurance. So, in order to bill at higher rates, the hospital ignored the insurance of patients like Jessica who faithfully carried health insurance, treating them as if they were uninsured. All for profit.

Jessica eventually had no choice but to pay the hospital’s lien, but she didn’t quit there. Jessica hired Shawn Daniels and Sarah Jewell to do something about this fraudulent billing practice. Jessica knew it was not right for a hospital to bill her for services instead of billing her health insurance, especially when that is precisely why she paid health insurance premiums. Jessica wanted this bad practice stopped, and Shawn and Sarah took action.

A state-wide class action was filed with Jessica as the class representative. In the lawsuit, Jessica represented an entire class of patients who were harmed by this billing practice. Shawn and Sarah worked with others fighting this case for over 3 years. The case was recently settled, and the class member patients will be reimbursed for the bills they were forced to pay directly to the hospital when the hospital refused to bill their health insurance.

We at Daniels Law Firm are incredibly proud of Jessica and the results obtained for the hundreds of patients who were damaged as a result of the hospital’s billing practice.

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