A letter of sympathy should have arrived at the home of Gerald and Elizabeth Hawkins 10 days after their son Scott was beaten to death.

Instead, UC Davis Medical Center officials were apologizing Tuesday to the Hawkins family over a clerical error that instead sent them a $29,000 bill and a form letter suggesting their slain son was medically indigent.

Hospital officials Tuesday continued to scrutinize how the error occurred when the 23-year-old California State University, Sacramento, student, was brought to the UCD emergency room Oct. 21 after being beaten by a roommate.

On Tuesday, the hospital's chief executive officer, Ann Madden Rice, called the family to apologize. So did Ann Frankel, the medical center's assistant director of finance, who oversees the billing department.

"It's all they can do at this point. … It doesn't take away what we felt. There's no way a telephone apology could take that away," said Gerald Hawkins, the victim's father.

Despite the apology, a swirl of unanswered questions continued to trouble the Hawkins family.

Why, for example, did the hospital continue to classify the slain student as indigent when the hospital managed to track down a permanent address? "Why didn't they call to ask us if our son had insurance?" Gerald Hawkins asked.

Instead, a $29,000 bill arrived in Santa Clara along with a form letter addressed "Dear Patient" intended to inform the student that emergency services provided by UC Davis would not be paid for by the county program for the medically indigent.

In fact, the slain student was not indigent but was fully insured by Kaiser Permanente.

The mistake brought further anguish to the Hawkins family.

"Why, in any civilized society, would a hospital send the parents of a murdered boy a bill and letter like this?" Gerald Hawkins asked Tuesday.

Carole Gan, a spokeswoman for the medical center, called it an unfortunate mistake.

"It was a clerical error," Gan said Tuesday.

"We have reviewed our system and strengthened our internal processes, which will prevent letters like these from going out improperly in the future," she said.

"Our hearts go out to the Hawkins family for the terrible grief and pain they are experiencing. We deeply regret that a clerical error caused them to receive a letter that brought even more distress," she said.

When the student died in the emergency room, his record should have been flagged and a hold put on billing activity, Gan said.

After 10 days, a letter of sympathy would have been sent, Gan said. It would have informed the family that the insurance company had been billed or "let them know that we did not have insurance information and to contact us."

Adding to the confusion was that fact that Hawkins apparently arrived without a wallet, prompting a hospital clerk to classify him as indigent.

"I can understand the confusion," said Mindi Russell, a senior chaplain with the Sacramento Area Law Enforcement Chaplaincy, a nonprofit group that aids victims of crime.

"We live in this world of computers, and mistakes still do happen," she said. "I'm saddened that there was a snafu. You don't want to harm the family any more."

State officials who regulate hospitals and health insurance companies said they had no apparent authority to intervene.

Lynne Randolph, a spokeswoman for the state Department of Managed Health Care, said she was "saddened by the tragic outcome" and hoped the hospital and student's insurer would now settle the claims without further distressing the Hawkins family.

All agree, the billing mix-up should not have occurred.

"This certainly was not intentional," said Scott Seamons, regional vice president for the Hospital Council of Northern and Central California. "When you consider the number of bills they process, some mistakes happen. … Hospital have such a huge backlog of bills. You have to remember that they still have to operate like a business."

Because of federal law, emergency room doctors are forbidden from asking patients about finances until the patient has been stabilized.

"We never ask first. We treat first, we ask later," Seamons said. "They didn't ask first – and appropriately so – but they didn't ask later either."

Call The Bee's Bobby Caina Calvan, (916) 321-1067.