Little Dylan Kenoyer loves to play outside. He's a happy and healthy boy who turns two in September. But a month after his first birthday. his parents noticed he was struggling to breathe.
Dylan's mom, Maggie, rushed him to the emergency room at Penrose-St.Francis Health Services in Colorado Springs. As Maggie was heading out the door, her husband, Jarrod, checked on-line to make sure the hospital took their insurance.
"I knew we had to know where we needed to go and who we needed to be treated by and that was St. Francis," said Jarrod.
The Kenoyers say Dylan was diagnosed with a severe case of croup, a common respiratory problem in infants. Their insurance covered the ER visit but then they got a bill from the ER doctor.
"I thought okay wait a second I'm getting a separate bill from the doctor," said Jarrod. "Why didn't it go through insurance?"
The Kenoyers claim they were stuck with a $543 bill because the doctor didn't accept their insurance.
"Your goal in going somewhere in-network is to get a discount so then to find out that the doctor you saw does not participate in your insurance, it just seems like an entity like a community hospital they're not serving their patients very well," said Maggie.
The Kenoyers say when they started asking questions they kept hitting roadblocks.
"Everybody wants to pass the buck, blame someone else, it's not my job it's the hopsital, it's the contract service, it's your insurance," said Jarrod.
So they asked KKTV 11 news to look into their complaint.
"I felt like we were put in a position where you either gotta stand up for patients rights or take it," said Jarrod.
Within no time the Kenoyer's phone was ringing. A hospital spokesperson told them the bill would be cut in half.
"There's no doubt in my mind the only reason I got a phone call from someone that imporant is because you sent an email and made some phone calls and said hey how fair is this," said Jarrod.
The hospital declined our request for an on-camera interview but in a statement apologized for the family's bill concerns and said they were working with the family. In a statement, a hospital spokesperson added:
"Many people don't realize that most physicians in our community are not employees of either hospital system. Private practice physicians bill for their services separately from the hospital. Given this structure, patients often receive multiple bills related to hospital treatment, one from the hospital and one from physicians."
And that's what the Kenoyers want others to learn from their experience.
The bottom line is the Colorado Division of Insurance says if your plan is regulated by the state, an ER doctor bill should be paid as an in-network provider. And they say you can file a complaint with the state if the doctor tries to stick you with the full cost of the bill. To check if your plan is regulated look for the letters CO-DOI on the back of your card.