A bill from the blue

After paying about 10% of a $40,000 healthcare invoice, a Newport Beach man thought the ordeal was behind him. Almost two years later, another four-figure bill arrives, with no explanation.

Flavio de Pecol hit the trifecta after taking his daughter to the emergency room for a horse-riding injury: hours of waiting, a 16-mile ambulance ride to a different facility and bills for more than $40,000.

At least, he thought, that was the end of it.

But nearly two years after his daughter's whirlwind tour of the U.S. healthcare system, De Pecol, of Newport Beach, has received yet another bill, this time for $1,054.53 that UC Irvine Medical Center failed to charge him the first time around.

"How can I trust that this isn't a mistake when a hospital takes 21 months to bill me?" De Pecol asked. "What's to prevent them from sending me another bill for some other charge?"

Hospital bill: In the June 25 Business section, a column about UC Irvine Medical Center billing a new charge nearly two years after treatment stated that hospital spokesman John Murray said he had no idea when the hospital's online "patient portal" would be operational. Murray said Tuesday that the portal is up and running.

Good questions, and yet another example of the way consumers are at the mercy of the healthcare industry's opaque and byzantine billing practices.

De Pecol, 53, said his then 10-year-old daughter was thrown from a horse in September 2011. No bones were broken. There was no blood. But the girl complained that her leg hurt, so De Pecol drove her to nearby Hoag Hospital in Newport Beach.

"We were there until 3 in the morning," he said. "They would test her and then we would wait, and they would test her and we would wait."

The doctors finally decided the girl may have had a torn muscle, but they said they couldn't admit her because Hoag wasn't a pediatric hospital. Nor would they permit De Pecol to take her home.

Instead, they arranged for the girl to be transported a few miles by ambulance to UC Irvine Medical Center. She stayed there one night, receiving a painkiller but no other treatment, De Pecol said.

The cost for all that healthcare? A $5,193.05 bill from Hoag, $4,200.95 for the ambulance and $33,155 from UC Irvine.

De Pecol paid about $4,000 out of pocket, and his insurer, Blue Shield of California, covered the rest of the tab.

"It was expensive," he said, "but at least it was done. That's what I believed."

Then, a few weeks ago, came another bill from UC Irvine for an unspecified $1,054.53 related to the hospital visit almost two years ago.

"There was no explanation," De Pecol said. "No nothing."

He said he called Blue Shield and asked what was going on. No one at the insurance company had an answer. De Pecol was advised to just pay the bill.

"But that doesn't seem right," he told me. "I have no idea what it's for."

John Murray, a spokesman for UC Irvine Medical Center, said he could understand De Pecol's misgivings.