In January 2020, Bridget Narsh’s teenage son, Mason, had urgent psychiatric needs. He had tried running away from home and was destroying furniture, among other behavioral issues caused by his autism, post-traumatic stress, and attention deficit hyperactivity disorders. If Narsh couldn’t get him into a psychiatric bed at Central Region Hospital, Butner North Carolina’s state-run mental health facility, she feared that Mason posed a threat not only to the family’s safety but to his own as well
“The wait times in the emergency room can be long, and it is not uncommon to wait for a psych bed in the state for over 30 days,” Narsh told Independent Women’s Forum. She explained how, in recent times, North Carolina has had limited psychiatric services, and when a bed is available, it often comes at a high cost.
“Once a psych bed becomes available, you do not get a choice of where you get to go,” she said. The opportunity arose for Narsh to bring Mason into Central Regional Hospital, but their standard rate was more than Narsh could afford.
For Mason to receive care, Narsh would be charged $1,338 per day. She spoke with a patient relations representative, who was able to negotiate a much more reasonable daily cost of less than $60. Narsh and her husband Nathan then signed an agreement with Central Regional Hospital for this rate.
Mason remained hospitalized for over 100 days on two separate occasions at Central Regional Hospital, and during this time, the entire nation dealt with lockdowns and health mandates due to the COVID-19 outbreak. The following year, the Narsh family received a shocking bill from Central Region Hospital totaling $101,546.49.
“When I received that huge bill unexpectedly, I was shocked,” Narsh said. “Receiving this brought up memories of this difficult period when Mason would cycle in and out of the hospital.”
One bill had been sent previously for half of Mason’s stay, but it was not in accordance with the modified rate she had signed off on Narsh asked for it to be corrected, but a bill with the appropriate amount was never sent to Narsh. In 2022, she instead received the aforementioned bill from the attorney general. It was marked “final notice,” did not include an itemized list, and demanded she pay $101,546.49.
Narsh explained that, during the height of COVID-19 lockdowns, the state attorney general stopped collecting. She was taken aback by the fact that the hospital wanted the full amount in 30 days, so she contacted her attorneys. Historically, Mason’s multiple ER visits had added up over time, but his care is covered by the family’s private insurance. Additionally, Medicaid’s Community Alternatives Program (CAP) has a reserved capacity innovations waiver, which opens up various services to individuals like Mason that may not be available under private insurance.
“I was not contacted prior to getting the final notice letters. They did not give a reason to the attorneys why I had received them,” Narsh said, explaining that her attorneys then spent nine months in contact with the attorney general’s office.
After the federal Hospital Price Transparency Rule went into effect, hospitals and insurance companies are now mandated to post prices upfront. Narsh had been provided with an estimate based on her discounted rate for less than $60 a day and understandably was expecting a bill closer to $6,700.
However, as Patient Rights Advocate has explained, price estimates are not binding and do not hold healthcare providers accountable. Patients and family members given estimates instead of actual prices for planned care are “vulnerable to overcharges, errors, and fraud.” When Narsh inquired about why she was charged the standard rate instead of the upfront price she and her husband had agreed to, the state psychiatric hospital did not state a reason.
The family was able to negotiate an agreement with the state of North Carolina through their attorneys to pay $4,300 in increments of $100 per month, but now the Narsh family is among the millions of Americans who have been impacted by shocking, unexpected medical bills for planned care.
“This surprise bill just meant I had to use my precious time to be in contact back and forth with the attorneys for a long nine months,” Narsh said. “I value the knowledge the attorneys have given me over the years, but it is not a free service. I did gymnastics for 16 years at a very high level that prepared me to be mentally tough for this and to never give up no matter what. If I feel my child desperately needs something, I’m going to advocate for them to get it like most parents would.”
