Stop Utah Hospitals from Blocking Insurance Reimbursements

24

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The Issue

When Lori Brown, a middle school teacher in West Valley City, lost her voice, doctors told her she needed urgent surgery. The only hospital with the equipment to perform the procedure was out-of-network, so Lori did what thousands of Utahns are told to do: she paid over $5,000 upfront and expected her insurance to reimburse her under out-of-network benefits.

But when she submitted the claim, her insurance denied it—not because the procedure wasn’t covered, but because the hospital didn’t use the proper billing codes. Lori reached out again and again asking the hospital to provide a corrected bill. They refused.

She was stuck. Her insurance wouldn’t pay without correct documentation, and the hospital wouldn’t send it. Only after her story went public did the hospital agree to refund her and resubmit the claim.

This isn’t rare. It’s just rarely exposed.

Across Utah, patients who do everything right—seek care, pay upfront, submit claims—are being left behind because hospitals won’t use standardized medical codes or issue the right paperwork. Insurance companies blame providers. Providers blame insurers. And patients are left holding thousands in medical debt they never should have owed.

This is a policy failure. And it’s fixable.

We are calling on the Utah Legislature, the Utah Department of Insurance, and the Utah Division of Consumer Protection to take immediate action. Patients should have a legal right to receive insurance-compliant billing records from any licensed health provider, regardless of when or how they pay. Insurance companies must be required to accept corrected claims when provider errors are the reason for denial. And Utah must step in when hospitals or insurers drag their feet—because no one should lose money over paperwork.

Add your name if you agree that Utah patients deserve protection from medical billing failures and a fair shot at the insurance benefits they’ve paid for.

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Community PetitionPetition Starter

The Decision Makers

Jim Dunnigan
Utah House of Representatives - District 36
Curt Bramble
Former Utah State Senate - District 24

Petition Updates