When Daly City resident Rosalinda Miran-Ramirez woke up one morning in April to find her left breast bleeding from the nipple, she panicked. The shirt she had been sleeping in was saturated with blood. So her husband took her to the emergency room at Seton Medical Center.
"In my mind I know something serious is going on," said Miran-Ramirez. "I need to see a doctor."
Doctors found a tumor and initially told her she had breast cancer. A biopsy later proved that assumption false; the tumor was benign.
But Miran-Ramirez said the real shock came when her insurance company, Blue Shield of California HMO, which had initially approved the claim for the emergency room visit, reversed course and sent her a new bill three months later requiring her to pay the total charges for that visit: $2,791.00.
Why? Documents from Blue Shield indicate the company had reviewed the case and determined Miran-Ramirez "reasonably should have known that an emergency did not exist."
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