Billing dispute left gunshot victim in limbo
Nicki Vold was 16 years old when she put up her hand to stop a bullet.
It didn’t work. The bullet tore through her hand, shattering bones, and slammed into her face. She was shot two more times and left for dead in the driver’s seat of her parent’s car.
Eleven surgeries and five years later, the 21-year-old Chandler resident is still trying to recover from her injuries and regain the use of her hand, a situation made even more difficult last year when two Valley hand surgeons left Vold in a temporary brace for three months and delayed needed surgery in what her family called a billing dispute.
The case raises issues about costs associated with using an “out of network” doctor or specialist for care, even during emergencies or trauma surgery when insurance is the last thing patients and their families are thinking about.
It also illustrates how a billing problem can potentially delay treatment.
“She was denied surgery and left in a cast,” Vold’s mother, Kim Schneider, said last week.
“What angered me was the way they were treating my daughter. They knew she was the victim of a violent crime.”
Schneider said that her daughter’s primary surgeon at the Arizona Center for Hand Surgery in Phoenix first refused to perform a scheduled surgery unless Vold made a $5,000 payment on a previous bill. Then, she said, he refused to provide referral information that would allow a second surgeon to do the work.
The surgeon, Lloyd Champagne, did not respond to re-
peated interview requests.
The center’s practice administrator said last week, “Our only comment ... is no comment.” Administrator Katherine White called the situation unfortunate and said her office “tried to work it out with the patient.”
Schneider said she made various payment offers to try to resolve the medical debt, which involves an issue with her insurance carrier. She said Champagne’s office demanded the full $5,000. In frustration, Schneider said, she found another surgeon who agreed to take over her daughter’s case.
The second surgeon, Douglas Bobb of Sun Valley Hand Surgery, scheduled the operation but canceled when Champagne’s office did not turn over a referral letter.
“They (Champagne’s staff) were trying to hold the letter hostage for the $5,000 payment,” Schneider said. “How could they leave her in a splint when both doctors agree she needed the surgery?”
Bobb’s office declined comment.
Champagne’s relationship with Vold goes back to the day she was shot in 2008. He was the surgeon who worked on her hand when she was brought to the hospital, and he continued to treat her through 2012 and six additional hand surgeries.
Vold declined to talk about her case. Her mother said she is traumatized by the shooting in which her friend was killed.
Schneider said her daughter was in the wrong place at the wrong time. On April 16, 2008, Vold was on her way to the mall to pick out a tie for her prom date. Her friend Xaivier Garcia asked if she could give him and his friend a ride.
Schneider said the ride ended when Garcia’s friend, Phillip Montoya, directed them to a stop near Pecos and McQueen roads. As the car pulled to a stop, Montoya started shooting. He shot Garcia five times in the head and then shot Vold.
Schneider said Vold doesn’t remember raising her hand, only white flashes coming from the backseat. She faked being dead and later testified against Montoya, who was sentenced to life in prison.
Schneider said billing problems began when her daughter was brought to the hospital and treated by an out-of-network surgeon. Her health-insurance provider, UnitedHealthcare, billed Schneider more than $52,000 for the surgeries because Champagne was not among the doctors covered under her plan.
She said Champagne helped the family. He agreed to bill Vold’s surgeries under a “gap exception,” meaning the surgeries would be classified as “in-network” while Schneider filed appeals over the designation.
Schneider said UnitedHealthcare ultimately covered the majority of the costs and left her owing about $10,000 to Champagne. She said health-insurance representatives told her the remaining debt likely would be written off.
Instead, the Arizona Center for Hand Surgery agreed to put her on a $25-per-month pay- ment plan that she made faithfully until 2011. That’s when she said the center contacted her, told her that a new office policy was being implemented and she needed to pay the balance.
“They said they needed meto apply for Care Credit,” said Schneider, who is a real-estate agent in Chandler. “They were not willing to go with the original agreement.”
Schneider, who is divorced, said she knew she could not afford the interest and monthly premiums on a $10,000 line of credit. She said Champagne’s office threatened to send her account to collections, and last year she stopped making payments.
Meanwhile, her daughter turned 21and was managing her own affairs, Schneider said. When Vold started having pain in her hand last year, she called Champagne to make an appointment.
Schneider said the surgery was scheduled for September. But the center contacted Vold and told her the surgeon would no longer offer her the gap exception. Schneider said the center also demanded a $5,000 down payment.
Vold sought an in-network doctor to reduce costs and met with Bobb, who agreed she needed additional surgery because the bones in her hand were not growing back.
Schneider said Champagne’s office initially agreed to provide a referral to Bobb’s office, then refused. Without the referral, Bobb wouldn’t do the surgery.
Schneider said her daughter was being punished by Champagne because of her own billing dispute with the office.
When the surgery had still not been done in December, Schneider reached out to Call 12 for Action, which contacted UnitedHealthcare.
Within hours, a United representative called Schneider and told her that Champagne agreed to perform the surgery and that it would be covered under the gap exception, saving Vold about $6,000 in out-of-network costs.
“We got our medical director involved,” United spokeswoman Cheryl Randolph said last week. “(Vold) was in a cast. We said, ‘She needs surgery now. Let’s get this done.’ ”
Randolph said her office contacted both Champagne and Bobb to resolve the problem so the surgery could go forward.
“I haven’t dealt with an issue like that before,” Randolph said. “I don’t know what the issue was between the physicians.”
Randolph said United was glad Call 12 for Action brought the case to the company’s attention. She said United wants to do what’s best for all of its customers and representatives would have worked with Schneider regardless of whether she contacted the media.
Champagne performed the surgery in January, putting pins and plates in Vold’s hand where the bones did not fuse.
Schneider said Champagne was patient and cordial during the surgery and in follow-up visits. The issue of costs was never mentioned. She said her daughter is in physical therapy and no longer feels pain in her hand.
“Before this, I had a picket line planned,” Schneider said. “I had seven mothers lined up. I was prepared.”