In May 2023, Dan and Helen Lococo entered Ascension Hospital Southeast in Milwaukee for their first-ever annual wellness checkup.
The couple sat in the room together for the appointment as their doctor checked their height and weight and ticked through a series of questions about their medical history.
When they left, they anticipated Medicare would cover the routine appointment.
But when a billing statement landed in their mailbox in September, the couple found that Dan Lococo had been charged for two additional services — an "established patient periodic preventive medicine examination" for $399 and an "office/outpatient established low MDM" for $180.
Helen Lococo, who had sat through an identical appointment, was not charged at all.
The billing discrepancy caused Dan and Helen Lococo over six months of emails, calls and sleepless nights while the couple pushed for answers from Ascension, culminating in a collections warning letter they received in the mail in December.
"This is your FINAL NOTICE," the letter read. "Your account may be placed with a collection agency and reported on your credit report if we do not receive payment immediately."
Then, on Jan. 23, Dan Lococo received a voicemail from Ascension letting him know all charges from the visit had been suddenly dropped, including some that he never disputed. The company's representative didn't give an explanation.
Now, the Lococos are asking why Ascension, one of the country's largest health care systems, was unable to explain the incorrect charges.
"(An annual wellness checkup) seemed like the right thing to do," Dan Lococo said. "But I have to say, I don't know that I'll ever do one again."
Experience working with insurance companies provides some answers
When Dan Lococo got the initial bill, he assumed Ascension had accidentally charged him too many times. When he asked Ascension, representatives told him he had to contact his doctor, he said.
He said his doctor attempted to dispute some of the charges, without success. By the end of October 2023, Dan Lococo still maintained over $600 in overdue payments to Ascension.
November and December were restless months for him and Helen Lococo, who said they toiled over documents, emails and old communications with Ascension. At night, she lay in bed replaying the appointment and billing dispute process in her head.
Early in their careers, both had worked in the health care industry on insurance billing and financial analysis. Based on their experience, the couple decided to request their appointment's insurance codes from Ascension.
Insurance codes are the set of letters and numbers representing the health care treatment or service given to a patient during a visit.
Through the codes, the Lococos confirmed that their annual wellness visit, coded G0439, was covered and not subject to copays and deductibles. According to the Centers for Medicare and Medicaid Services, an annual wellness visit includes a personalized health issue prevention plan.
Still, Ascension maintained the validity of the charges.
"Somebody did contact us back, left a voicemail and simply said, 'Yes, we looked at the billing, and the coding is all correct,'" Dan Lococo said. "'These are valid charges. If you have any other questions, you have to contact customer service.'"
The couple said the struggle to speak with someone who could justify the extra charges became increasingly frustrating.
At one point, the Lococos said they requested a meeting with a representative from the hospital and a patient advocate to negotiate their case. Ascension did not respond, according to Dan Lococo.
By the time the couple received the collections notice in December, they had not spoken to Ascension in more than a month, they said. They decided to ignore the notice.
When Dan Lococo received the news in January that the charges had suddenly been dropped, he felt relieved, but remained frustrated with the lack of explanation.
Because Ascension also dropped his vaccination charges that he had never disputed, he suspects Ascension simply didn't want to deal with him anymore.
"I don't want to be that person that just (says), 'Well, you know what, I'll just be a complete jerk, and they'll back down,'" Dan Lococo said. "That doesn't sit well with me."
Shortly after Journal Sentinel inquiry, Ascension calls with explanation
The Public Investigator team contacted Ascension Wisconsin on Feb. 5 for an explanation of the Lococos' dropped charges.
Dan Lococo said the following day — Feb. 6 — he received a voicemail from Ascension's director of revenue cycle operations, Karly Wagner.
When he called her back the next day, Wagner confirmed that he never should have been charged in the first place, he said.
"She went on to explain that this was an educational issue at the practice and customer service level, and that education will take place to avoid future problems," he said.
The same day, Matthew Hanselman, Ascension Wisconsin's chief financial officer, told Public Investigator that he could not comment on the Lococos' situation for patient privacy reasons.
In general, he attributed potential errors in billing and other "reimbursement challenges" to variations in insurance companies' internal systems for processing claims.
As commercial insurance companies, Medicare and Medicaid have widely varying reimbursement and coverage policies, as well as different prior authorization and medical necessity requirements.
"These variations create reimbursement challenges, and payers, clinics, billing departments, and other parties occasionally make mistakes which could impact the consumer’s balance due," said Hanselman.
He added that Ascension appreciates when patients ask questions about their bills.
"We thoroughly investigate those instances and work to put solutions in place, so subsequent patients benefit from those learnings," Hanselman said.
Even with their charges removed, Dan and Helen Lococo worry that other patients might fall victim to billing mistakes if they lack the free time and energy to dispute incorrect charges.
"I got the sense that the goal of the call was to provide me with the impression that this was an isolated incident and to solicit a response indicating that I was completely satisfied with the outcome," Dan Lococo said in an email to Public Investigator reporters following the call.
The couple wonders if similar incidents have happened to others.
"I can't imagine people who have tons of bills, how they keep that straight and go through at all," Helen Lococo said. "This was just one bill."
Government corruption. Corporate wrongdoing. Consumer complaints. Medical scams. Public Investigator is a new initiative of the Milwaukee Journal Sentinel and its sister newsrooms across Wisconsin. Our team wants to hear your tips, chase the leads and uncover the truth. We'll investigate anywhere in Wisconsin. Send your tips to watchdog@journalsentinel.com or call 414-319-9061. You can also submit tips at jsonline.com/tips
Ascension is notorious for failing patients regularly. I'm an Aurora client. They are no better. I have been lied to by their doctors numerous times. When called on their lies, the doctors drop you as a patient. At this point, I've gone through numerous doctors. Thirty years ago, when I first went to Aurora, things were quite different. However, all of my doctors from that time have retired and the "new breed" are absolute crap. There is an MD there that will kill someone, if she hasn't already. Completely incompetent. She had Aurora send me a threatening certified letter. Of course, a patient has no chance against one of their MDs. They will gladly take your money but they suffer criticism very poorly. I wish we had a Froedtert in this area.
Preston Kite, a former Racine County Sheriff's Office deputy who is accused of child sex crimes, appeared in court via Zoom from the Kenosha County Detention Center next to Judge Timothy Boyle on Thursday morning.
Hanna Van Den Einde
RACINE — Preston Kite, a former Racine County Sheriff’s Office deputy accused of sex crimes against children, was granted more time to retain an attorney in court Thursday morning.
Kite, 37, was charged Feb. 8 with possession of child pornography, five counts of sexual exploitation of a child, lewd and lascivious behavior and disorderly conduct. During his initial appearance Feb. 8, a judge set a $150,000 cash bond.
Kite is accused of exposing himself to a man in a public restroom. During the investigation into the incident, deputies from the Kenosha County Sheriff’s Department reportedly found child sexual abuse material on Kite’s phone, according to the criminal complaint filed in the case.
Kite was immediately removed from duty and placed on unpaid administrative leave pending the termination process, according to Lt. Michael Luell, public information officer for the sheriff’s office. Luell said Kite’s disciplinary process was completed Feb. 8, resulting in his termination.
The sheriff’s office also requested that the Kenosha County Sheriff’s Department lead the investigation.
Kite appeared via Zoom from the Kenosha County Detention Center without an attorney for a preliminary hearing Thursday.
Kite said he has made attempts to get counsel through the State Public Defender Office in Racine and his family is trying to retain an attorney for him.
Judge Timothy Boyle found good cause that Kite was trying to find an attorney and waived the required time limits for holding a preliminary hearing.
Kite will appear in court again March 7 for a status conference.
Richard Brunson, a former University of Wisconsin professor who sexually harassed students and went on to land two other jobs in education, was fired by his most recent employer a week after the Milwaukee Journal Sentinel reported on his disciplinary history.
The story highlighted the unusual steps the UW System took to bring Brunson's background to light and how, despite those efforts, both a Wisconsin school district and an out-of-state college hired him.
Contacted for comment on the termination, Brunson's lawyer, Michael Brown of DVG Law Partner, asked the Journal Sentinel to "please leave us alone."
Brown has previously argued UW's actions amounted to overreach. He asked the student newspaper of the Indiana college where Brunson most recently worked: "At what point do ongoing punishments of Dr. Brunson become excessive (and unending)? … How, if at all, can Dr. Brunson ever have an opportunity to move forward with his career and community life and have a chance to prove he has changed, and is changing, for the better?”
Here's what to know:
Where did Richard Brunson work?
Brunson was a music professor at the UW-Stevens Point Marshfield campus for just over a decade.
A UW System investigation found he sexually harassed several of his students in a pattern going back several years, records show. Six students told investigators they received sexually suggestive messages from Brunson, often about masturbation.
While the disciplinary process was playing out, Brunson applied for a job teaching choir to middle and high school students in the Medford School District, about 40 miles north of the Marshfield campus.
Brunson resigned before the UW Board of Regents could vote on firing him. So instead, five months after Brunson quit, the board revoked his unused sick leave. A day later, a UW System lawyer called Medford's superintendent to share what had happened.
Is what UW System did in this case rare?
Yes. Proactively volunteering information on a former employee's disciplinary history is "unusual," one education risk-management expert told the Journal Sentinel.
But it's something more schools should consider doing if their state laws allow them to do so, Brett Soklow of TNG said. It can help curb a common problem in education known as "pass-the-trash," where someone commits misconduct, quietly leaves and is hired elsewhere.
How did Medford School District respond?
Medford put Brunson on paid leave for the next seven months until he resigned at the end of the 2022-23 school year, according to a settlement agreement Brunson struck with the district. Medford agreed to provide a neutral letter of reference for Brunson.
Medford Superintendent Pat Sullivan declined to answer questions about the district's hiring process.
How did Brunson land job at Goshen College?
Brunson applied for a music professor position at Goshen College, a private Mennonite liberal arts school in Indiana, two hours east of Chicago. He also sued UW System to prevent releasing public records associated with his time at UW-Stevens Point.
The chair of Goshen's music department contacted UW-Stevens Point's human resources office about Brunson in June 2023, UW System spokesperson Mark Pitsch said. The HR office responded, saying Brunson hadn't been employed there since June 2022 and an ongoing court case prevented the university from releasing public records.
A judge last August ordered the documents be turned over. Goshen had already hired Brunson by then.
What has Goshen College said about its hiring process?
Goshen College spokesperson Jodi Beyeler said the college had not submitted a formal records request to the UW System and did not know the reasons behind Brunson's resignations until the Journal Sentinel contacted the school in late January.
The UW investigation "was not revealed to us through references or background checks," Goshen College human resources director Marlene Penner later said in an email to students and staff.
The school put Brunson on leave a day after the Journal Sentinel story published Feb. 5. On Monday, Penner emailed the campus to say Brunson had been terminated.
"We take all reports of sexual harassment very seriously, including from previous employers, and have sought to act with both due diligence and speed," Penner wrote to the campus community. "We are committed to examining our systems to strengthen our prevention and responses in the future."
Kelly Meyerhofer