Paul Manganella

Paul Manganella helped save a man’s life in May and now says that Cape Cod Healthcare is unwilling to correct the bill he received from going to the emergency room for COVID-19 guidance afterward.

Last month Paul Manganella was sent to the Falmouth Hospital emergency department for COVID-19 testing after he performed CPR on a man who had a heart attack while driving on the Mid-Cape Highway.

This week he received a bill for $1,000 for that visit, even though the services he received are covered under the federal CARES Act.

On May 3 Mr. Manganella, who is a Sandwich High School grad, was on his way home to Bourne to deal with a sudden termite infestation. As he approached the Sagamore Bridge, he saw a driver in a pickup truck push another pickup truck to the side of the road. It had turned out that the driver of the truck being pushed—a man from Yarmouth named David—had likely suffered a heart attack while driving and passed out behind the wheel of his truck.

Mr. Manganella and the other man were able to get David out of the truck and got him onto the bed of his truck, where Mr. Manganella performed CPR on David. When paramedics arrived, they told Mr. Manganella that because he was in contact with David’s blood and saliva, he had to go to the emergency room for COVID-19 testing. He was given the option of being taken to the hospital in an ambulance or to drive himself.

He said that he chose to drive himself to avoid being charged for the ambulance ride.

Since Mr. Manganella was not symptomatic, the method of testing that the ER doctor opted for was the 14-day quarantine. Further testing would have been done if he had started to have symptoms, but he did not and David ultimately tested negative for the disease as well.

This week, Mr. Manganella received a bill from Cape Cod Healthcare for charges totaling $1,009.34 for the services he was given on May 3 at Falmouth Hospital. Since receiving the bill he said that he has spent hours on the phone between his insurance company and the healthcare company trying to get the matter resolved, but he said that he has been met with resistance on both sides.

“Everyone I talked to just passed me around,” he said. “No one could be bothered with the fact that I had a problem.”

Mr. Manganella said that his insurance company is willing to amend the charges, but only if Cape Cod Healthcare fixes the way his visit was coded. He said that where he was only in the ER because of a potential COVID-19 exposure, the visit should have been coded as such. While the people he has spoken to from the healthcare company agree that his bill may have been coded incorrectly, they have also told him that it is illegal for them to change the visit code after insurance has been billed.

While it would be considered fraudulent to change the code for the sole purpose of having it covered by insurance, Mr. Manganella said the reason for his visit was for coronavirus testing, which should have been covered.

The CARES Act, which was issued by the federal government in March, states that all medical care related to the coronavirus should be offered at no cost to patients. The legislation states that any diagnostic testing—such as the nasal swab—must be covered. Any other testing done to determine whether COVID-19 testing is needed—such as flu tests and observation—must also be covered.

While he was at the hospital, Mr. Manganella said, he had paid more than $200 in copays and thought that would be the end of it. However, since the hospital did not designate the visit as being related to COVID-19, the remainder of his bill was charged against his deductible.

When asked for comment, Cape Cod Healthcare said it was looking into the situation and was not prepared to make a statement by press time.

Mr. Manganella posted about the bill on the online forum Reddit and within hours had offers from strangers who were willing to pay his bill for him—offers which he has refused and will continue to refuse. He said he is not looking for acts of charity, he just wants Cape Cod Healthcare to code his visit correctly.

“I’m not really interested in anyone paying this but me if I have to pay it at the end of the day,” he said.

(2) comments

earlofsandwich

We are always fighting with the insurance or a healthcare provider about coding. It 's all a scam. Why can't we have national healthcare coverage like every other civilized country?

Gadfly

The Hospital is desperate for cash. Time to do the right thing, FMH!

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