BernCo Indigent Program Isn't Valid at UNM's Sandoval Regional Health Center

This is the story of a grandmother in her 60s who comes to Centro Savila for food assistance. She has been a resident of Albuquerque for 18 years. She is the mother of 3 adult children and worked as a house cleaner until her knee pain became unbearable.  She has been waiting for knee surgery for more than a year.

Her husband is employed and earned $14,000 in 2016. They own their home and pay property taxes, including the mill levy that goes to UNM Hospital to cover the cost of indigent care.

She had been in a car accident eight years ago that broke her knee.  Her treatment at UNMH for that injury was paid by car insurance at the time. At the time of the accident, she was warned that she would likely need knee replacement in the future.

This woman has been on UNMH self-pay discount program for 10 years. Her primary care doctor is at First Choice. Her PCP gave her an injection. When the injection didn’t work, he referred her to a UNM Orthopedic specialist.  Her first scheduled appointment was in October, 2016, but UNMH called to cancel/reschedule it for December. No reason was given at the time.  In December, they called this patient to cancel the appointment again and reschedule it for January. She said they told her it was because she didn’t have insurance.

She explained that she was in severe pain, and couldn’t walk. So they gave her an appointment in February at the Sandoval Regional Medical Center, even though she is a Bernalillo County resident.  She went to her first appointment at Sandoval Regional in February, and was required to pay a $100 co-pay upfront, even though she is on the Self-Pay Discount Program at UNMH and was accustomed to paying a $5 co-pay, based on her low income. She subsequently received a bill for that visit totaling $850. 

The doctor at Sandoval told her she needed knee surgery and that no other treatment would help because she had no cartilage left in her knee. He wanted to operate in April, but he said he needed to talk to the hospital administrators about whether the self-pay discount would apply to surgeries that he performed at Sandoval, where he had been moved recently.  The next piece of information she received was a call from Sandoval explaining to her that she needed to come up with between $10,000 and $15,000 up front for the surgery, which of course she could not afford. 

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