San Diego

NBC 7 Responds Sorts Out An $8,000 Medical Bill Mishap For One Rancho San Diego Woman

Local woman asks for NBC 7 Responds aid when the aid of a non-profit was cut off due to a technicality.

Diane Nelson was diagnosed with Multiple Sclerosis in 2009.

Since her diagnosis, Diane has tried several treatments in an effort to slow the disease from progressing.

In 2015 Diane’s neurologist told her about a new treatment. If successful the treatment, a series of infusions over the course of two-years, would make Diane’s condition more manageable and would end the need for future treatments.

But like most medical procedures, the treatment came with a hefty price tag.

“I had to go through an approval process with my insurance company,” Diane told NBC 7 Responds. “And, then I found a foundation to cover my out of pocket expenses.”

The foundation, The Multiple Sclerosis Assistance Fund, agreed to pay $7,825 of Diane’s treatment.

In 2015, Diane received her first round of infusions.

Before getting the second phase of the treatment, Diane was forced to switch medical providers to Sharp Healthcare. But she nor her insurance provider notified The Assistance Fund of the change.

In 2017 she underwent the second round of infusions.

Then in June Diane said she received a bill in the mail from Sharp Healthcare for $7,825, the amount that The Assistance Fund had pledged to pay.

“I had no idea how I would pay,” Diane said.

Diane says because providers was changed that The Assistance Fund had not received any follow-up on her second treatment and the funds that were set aside for her instead went to someone else in need.

Meanwhile, bills for the treatment arrived at Diane’s Rancho San Diego home.

 “I’m on Social Security and disability so I could maybe afford $10 a month, otherwise, well, I could just die.”

Diane says Sharp HealthCare said they submitted an appeal to The Assistance Fund but because the foundation said the appeal deadline had already expired.

Diane says the stress weighed heavy on her and her health.

Until one day, while inside her doctor’s office she saw a commercial on the television screen that gave her some much-needed hope.

“I saw this thing on TV with NBC 7 Responds and I thought, well, what do I have to lose,” said Diane.

Diane contacted NBC 7 Responds and we got to work.

In May, after NBC 7 Responds contacted Sharp HealthCare, Diane’s insurance company, and The Assistance Fund, Diane received another bill in the mail.

However, this time instead of listing $7,825 in the amount owed, the new amount was at zero.

“I was so relieved, like able to really breathe again,” Diane said. “The [NBC 7 Responds Team] really came through for me.”

In a statement CEO for the Assistance Fund, Mark McGreevy, wrote, “Patients are at the center of everything we do. We aspire to see a day when no one goes without the medication they need due to their inability to pay. In Diane’s case, we were ready and willing to cover her copay for her supported MS medication, but when no claim was submitted we were obliged to use the funds that had been allocated to Diane to support other patients. We are more than happy to sort out this issue and address Diane’s needs.”

Diane told NBC 7 Responds in a follow-up interview that despite the billing mishap the treatment was a success and helped address the constant fatigue and other symptoms she experienced since her diagnosis.

Added Diane, “NBC 7 Responds was amazing. They are my A-Team.”

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