“Both of the surgeries were completely necessary,” Gaimon said. “I was just in tremendous pain all around.”
Trending News He made a quick recovery at home, but then the bills came.
“So when I woke up, it was excruciating pain,” Gaimon said. “I’d broken all the ribs on my right side, my collarbone, and … my scapula, my shoulder blade.” Gaimon was rushed unconscious to a nearby ER, at Lehigh Valley Hospital in Allentown, Pennsylvania.
Gaimon received collarbone surgery at Lehigh Valley Hospital and a second surgery on his shoulder bone at the Hospital for Special Surgery in New York. In 2019, Gaimon was racing in an Olympic qualifying race when he collided with another cyclist. He was thrown from his bike at about 40 miles an hour, breaking seven bones.
Dr. Elizabeth Rosenthal, editor-in-chief of Kaiser Health News, told “CBS This Morning” about the situation. “Hospital billing is filled with landmines. And Phil hit three of them — out-of-network hospitals, high costs, and here’s the biggy in his case — insurance from one state often doesn’t work very well in another.” Rosenthal said Gaimon got hit with something called balance-billing, a type of surprise bill. “They hit you with the bills when you’re literally least capable of handling anything,” Gaimon said. “I get a stack of bills every month. I get collection notices every day.”
He realized Lehigh Valley Hospital was out of network. And his shoulder surgery was classified as an “elective” procedure instead of an “emergency” — which could have saved him money. They totaled over $200,000 from both hospitals. His two insurances paid a total of only $52,000 — leaving him on the hook for about $150,000.
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