Helping Patients Deal with Confusing Medical Bills Through Calm Perseverance

Luis Pico

Weill Cornell Medicine patient, Sharon, was shocked when she received a large bill after an appointment. As it turned out, she didn’t know that the physician she saw was not enrolled in her insurance plan, so she wasn’t covered.

Needing help, Sharon called Weill Cornell Medicine’s Business Office, where she spoke with Luis Pico, a Customer Service Senior Account Administrator. “In these types of cases, we try to piece together the puzzle for the patient,” he explains. “With Sharon, this began with a conversation about exactly what happened and then reviewing her account carefully to provide her as much information as possible. In her case, Sharon’s insurance company failed to inform her of her insurance plan’s tier information.” 

Luis, Sharon, and the Business Office team believed that the best course of action was to appeal the insurance company. Luis worked closely with Sharon, giving her guidance on specific wording and points to make when speaking with insurance company representatives.

Persistence and Compassion

“Appeals of this nature involve lots of logistics and details,” says Luis. “We’re the patient’s ally throughout the entire process. That sometimes involves assisting with conference calls with insurance companies, explaining which questions to ask, and helping keep all the information organized.”

While Sharon waited for a response from the insurance company, Luis put her account on hold so that she would stop receiving statements. After several months of conversations with the insurance company and multiple appeals (and denials), Sharon’s insurance company finally paid the bill in full.

“It was a waiting game,” says Luis, “and the end result was good.” 

Supported by Weill Cornell’s Team

Luis has worked in medical billing for 20 years and with Weill Cornell Medicine for the past five years. He enjoys his work because it’s unique, challenging, and involves working closely with so many different groups of people. “I’m an average guy,” says Luis. “Patients seem to appreciate that I’m a straight shooter.” 

Luis and his colleagues at the Business Office are the liaisons between the patient, their care teams, and the insurance companies. When patients, like Sharon, call the Business office, it is usually after they have received their statement. Many are still in recovery or the middle of treatment for a long illness.

“Patients need to know someone is listening, someone cares, and someone is going to help them,” Luis explains. “We always remember that these are patients. Patients and their family members cannot focus on their treatment and recovery if they are worried about their financial situation. We have to help them.” 

Driven to Help Patients

Luis advises, “If you ever receive a medical care statement that surprises you, don’t assume that it is what it is. Give the Business Office a call. We may be able to help.”

Sharon’s story exemplifies this well; she could have easily believed that it was her fault that she scheduled an appointment with the wrong physician. With Luis’s help, however, she realized that the insurance company did not give her proper notice.

After Sharon received payment from her insurance company, she wrote to Luis to express her gratitude. “You and Weill Cornell Medicine are just such a step above most medical groups and billing departments that one has to work with,” she explained. “Even though I wish I didn’t have to deal with this issue with my insurance, I am glad it was with Weill Cornell.”

Luis echoes Sharon’s respect for Weill Cornell Medicine’s dedication to patient care. “What’s great is that everyone at the Business Office here wants to help,” he says. “No one says, ‘That’s not my job.’ Instead, they say, ‘Let’s find out together.’ Everyone here—in all departments and all levels—feels they have a responsibility in the care of the patient.” 

Do you have a billing question? Contact Weill Cornell Medicine or call 1-855-880-0343.