FORT WAYNE, Ind. (WANE) — In August, 2022, WANE 15 received an email.

“I am writing this message on behalf of my parents,” the email began.

It shared the story of Dwight and Paula Taylor, who in the middle of renovating their retirement home had been seemingly sucker punched by a $41,000 medical bill for Dwight’s non-emergency hernia surgery at the end of 2021.

Because appeals to the insurance and medical providers had been unfruitful, the email ended with “my parents are trying to stay positive, but this appears to be another example of good, honest, hardworking people getting rolled over in a system where people don’t care.”

As 15 Finds Out peeled back the unlikely chain of events that led to the bill, a number of caring individuals emerged who either tried to solve the problem or shared the steps to help prevent it from happening to someone else.

Preparation for retirement and surgery

In order for Dwight to retire in 2020 at the age of 60, he had saved some money in his Health Savings Account to help pay for healthcare until he and his wife became eligible for Medicare at 65. Because they were in good health, they felt comfortable with a short-term major-medical plan from United Healthcare to cover significant procedures during the gap.

Surprisingly, it paid for more than that.

“Routine checkups, medical exams, bloodwork,” Dwight recalled. “It was smooth sailing.”

Part of his retirement routine included more exercise, which Dwight believed led to new abdominal discomfort. His Parkview doctor diagnosed a small hernia, easily fixed by routine surgery.

He submitted his insurance card and received an estimate via Parkview’s MyChart. It priced the surgery at $27,004 but his out-of-pocket would be $2,039 since insurance would cover the rest. Comfortable with that price, he scheduled the out-patient procedure for December, 2021.

The care and the bill

“The medical care was outstanding,” Taylor told WANE 15 multiple times in our 30 minute on-camera conversation.

On his surgery day, Parkview offered a day-of-service discount price of $1,600 for his portion, which he paid in full. The surgery and recovery went well. He was quickly back to his new level of activity and thought the entire episode was behind him.

Until five months later.

“I got an invoice in the mail from Parkview for $41,000,” he said.

At first, he thought it was part of the normal back-and-forth he had seen between medical and insurance providers, as the coding and billing don’t always line up.

But when his wife called, he learned, no, Parkview had spent those months appealing on his behalf. United Healthcare denied the appeal for the simple reason his insurance plan specifically excluded non-emergency hernia surgery.

Since his doctor had discovered and repaired a small second hernia during the procedure, Taylor was now on the hook for the full amount of the new total, which would grow closer to $48,000 if not paid in full by the end of the month.

Parkview offered to set up a payment plan for $964.00 a month for 48 months.

“Just like, oh, it’s no big deal,” he added bemusedly.

15 Finds Out

In August, Dwight gave WANE 15 permission to learn more on his behalf.

United Healthcare emailed that they could not comment on the cost information Parkview might have provided prior to surgery and would not comment on the appeal process.

“We encourage members to review their benefits before having medical procedures, particularly elective surgeries, by reviewing their benefits documents, using member-specific cost estimator tools, if available, and/or calling the phone number on their ID cards,” the full statement said.

Parkview gave a longer explanation:

Prior to scheduling his surgery, Mr. Taylor contacted Parkview to get an estimate of his anticipated costs. Parkview’s financial team contacted his insurance company to get information for the estimate and confirm whether a prior authorization would be needed for his surgery.

While the insurance company confirmed that no prior authorization was needed, they did not share that Mr. Taylor had a limited-benefit policy that wouldn’t cover the procedure at any facility. Relying on the information shared by the insurance company, Parkview based the estimate on Mr. Taylor’s outstanding deductible and co-insurance values.

Though we strive to make estimates as accurate as possible, patients are informed that actual out-of-pocket costs may vary. A financial estimate does not guarantee coverage, and patients also have a responsibility to confirm their benefits with their insurance company prior to receiving treatment.

We understand Mr. Taylor’s frustrations, which is why we enlisted attorneys to appeal the claim with the insurance company on his behalf. Unfortunately, the appeal was denied.

Parkview is working together with Mr. Taylor to find a resolution. We have offered to help him apply for financial assistance, which is an important step that will allow us to fully understand and explore all options that may be available to him. We have also connected him to a support service that will help him understand his current coverage, as well as other insurance options for the future.

“A very nice [Parkview] person called me after you [WANE 15] got involved,” Dwight said. “She wanted to help with improved communication so that we could get a resolution that would be acceptable to both parties.

“I thanked her but said ‘my resolution is that I don’t want to pay another dime because I don’t think I should have to,'” he added firmly.

However, at Parkview’s suggestion, he agreed to submit numerous family financial records, including tax returns, bank and 401k statements, to see if he would be eligible for payment assistance.

The nub of the problem

WANE 15 asked attorney David Farnbauch, a partner at Swinney Law on Lima Road, to look at some of the exchanges between Dwight and the hospital billing department.

“In this case, I think the nub of the problem is they never really obtained preauthorization from the insurance carrier.”

An earlier MyChart message to Dwight seemed to indicate the system had not spoken to the insurance provider but obtained its information online. “We show that we did review the insurance website prior to your procedure for pre approval and per your insurance website no pre approval was needed for outpatient procedures. We would have not known that this procedure would not be covered until it was processed by your insurance.”

Michelle Walters, Executive VP at Health Insurance Shop on Lake Avenue, said hospitals rely on accurate information from the insurance companies.

“The [insurance] cards all look very similar,” she sympathized. “So [the medical provider] is relying on whoever they are calling for that prior authorization to be able to state, ‘no, this particular plan doesn’t cover that type of procedure.'”

Farnbauch strongly recommended reading your insurance policy; Walters said “for peace of mind” to double check your authorization by calling the number on the back of your insurance card.

Neither Farnbauch nor Walters were involved in the matter other than to comment for WANE 15.


In early December, 2022, Dwight emailed WANE 15 to say “Christmas came early.”

“They have canceled all remaining charges and described it to me as a ‘Parkview error’ if I recall what he told me correctly,” he wrote.

Parkview, in a final statement to WANE 15, confirmed the case was closed but made no mention of error.

“The discrepancy on Mr. Taylor’s account has been resolved and he has expressed his appreciation to Parkview for helping address his concern.

“Parkview is often asked to help navigate the challenges of health insurance coverage for patients. To help Mr. Taylor avoid future concerns with his limited-benefit policy, we were able to connect him with a third-party resource that could explain his options, including an insurance plan with expanded coverage.”

Taylor was thankful but declined the help.

“The most affordable they could offer was a ‘bronze plan’ which was over $1500 per month,” he wrote. “And it was still a high deductible policy.”

His final thoughts?

“The hospital was great. The Parkview medical providers were outstanding, terrific,” he said, then paused. “But the administrative part of that… I’m not sure if there’s an insurance or patient advocate but that would seem to me the thing you would want to have.”