Excessive Emergency Room Charges - Options?

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fm3040
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Excessive Emergency Room Charges - Options?

Post by fm3040 » Mon Aug 20, 2018 12:31 pm

I went to an ER facility at a local hospital last month and they sent me a bill to pay $900+ in addition to my co-pay of $300 that I paid during the visit(all this for an ultrasound ($900+ for ultrasound alone), X-ray and an NSAID tablet after my insurance company paid them around $588)

I called the billing services and asked them to bring down the amount substantially so I can pay it off but the lady is not willing to budge. She said that they CANNOT offer me any kind of discount other than financial assistance for low-wage earners if I show proof of income.

Following the ER visit, I have other bills from other providers (neurologist, orthopedic, Quest Diagnostics, etc) where I am expected to pay on top of my co-pay (as insurance had not covered all of it). The total I owe to different medical providers at this point is $2668.

What options do I have?


1) Can I simply ignore all these bills if I do not plan on taking any loans for the next 7 years?

2) Is there any trick to stop them from sending it to collections by, say, mailing the ER billing services (where I owe more than $900) a check for $5 every month?

3) Any other options?

Could it hurt me in terms of new employment if I have to look for a new job in the next few years?

Are medical bills treated differently in computing credit scores so your credit score is not impacted as much?

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climber2020
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Re: Excessive Emergency Room Charges - Options?

Post by climber2020 » Mon Aug 20, 2018 12:35 pm

fm3040 wrote:
Mon Aug 20, 2018 12:31 pm
3) Any other options?
You can pay your bill.

This might be useful information for next time: viewtopic.php?t=238610

Scrapr
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Re: Excessive Emergency Room Charges - Options?

Post by Scrapr » Mon Aug 20, 2018 12:37 pm

When we have had large medical bills we have asked for a payment plan. IIRC 0% interest. They agreed quickly and we paid it off. (Kaiser)

Rupert
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Re: Excessive Emergency Room Charges - Options?

Post by Rupert » Mon Aug 20, 2018 12:39 pm

Just curious, what do you think the services you received should have cost?

fm3040
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Re: Excessive Emergency Room Charges - Options?

Post by fm3040 » Mon Aug 20, 2018 12:40 pm

Much much less. An ultrasound should not cost more than $200.

rantk81
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Re: Excessive Emergency Room Charges - Options?

Post by rantk81 » Mon Aug 20, 2018 12:41 pm

Those dollar amounts seem pretty standard for emergency room charges.

Was the visit at an "in-network" ER or "out-of-network" ER for your insurance?

If In-Network, make sure the bills match up what the insurance company expects you to pay, based on the EOB documents.
If so, pay up.

If Out-Of-Network, did your insurance make a determination to treat it as in-network based on the emergent nature of the visit to the ER? If it was treated as in-network based on that, and you are being balance billed for the rest, are you in a state/locale that protects against balance billing charges?

If out-of-network, and all the EOBs are correct, and you have no protection against balance billing... might be worth calling your insurance to ask them what the "usual and customary" charges are for the billing codes in questions... and I suppose you could play hard-ball with the hospital and offer to pay that amount or let them sell it for pennies on the dollar to a collection company... (Be willing to accept the consequences if that happens..)

fm3040
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Re: Excessive Emergency Room Charges - Options?

Post by fm3040 » Mon Aug 20, 2018 12:47 pm

Yes, the numbers match up with the EOB document from the insurance company.

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whodidntante
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Re: Excessive Emergency Room Charges - Options?

Post by whodidntante » Mon Aug 20, 2018 12:48 pm

They'll be a lot more amenable once it seems likely they will have to sell the debt for pennies on the dollar. Medical debt is not reportable for six months, so you have some time to play with them if that's how you want to spend your time on Earth. Personally I would pay it.

fm3040
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Re: Excessive Emergency Room Charges - Options?

Post by fm3040 » Mon Aug 20, 2018 12:49 pm

Can you keep them from sending to collections if you set up an auto-pay from your bank for $5 a month?

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Re: Excessive Emergency Room Charges - Options?

Post by Nate79 » Mon Aug 20, 2018 12:56 pm

fm3040 wrote:
Mon Aug 20, 2018 12:49 pm
Can you keep them from sending to collections if you set up an auto-pay from your bank for $5 a month?
No, you need to setup a payment plan with the hospital.

What insurance coverage do you have? (deductible/OOP max)

Was this truly an emergency such that you knew you were going to be paying more for services than if you just went to a nonemergency service?

Yes, this can hurt your employment for new jobs depending on the employer. They may do a credit check and unpaid bills in collections is a red flag.

Is your income low such that you can get the financial assistance mentioned by the billing department? If not then why can't you pay your bills?

Not paying your bills and ignoring them is a very bad strategy. Once it goes to collections you will be able to negotiate down (but they will add a lot of fees on it too) and your credit will be hurt for sure.

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Shackleton
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Re: Excessive Emergency Room Charges - Options?

Post by Shackleton » Mon Aug 20, 2018 1:00 pm

I’m curious how you determined that an ultrasound should not cost more than $200? Did you take into account the initial cost of the equipment, overhead of the building, costs for all people that interacted with you from intake until discharge, costs to clean the room/equipment used? I’ve probably left off a few things.

I was just in the ER due to a severe bicycling accident that left me unconscious and several traumatic injuries along with a concusion. I haven’t gotten the bills yet, but can’t wait to explain why their ultrasound changes should be limited to $200. Along with the ultrasound, I also had multiple x-rays of five different body parts. If there is an upper limit for those, please do let me know so I can also inform them.
“Superhuman effort isn't worth a damn unless it achieves results.” ~Ernest Shackleton

runner3081
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Re: Excessive Emergency Room Charges - Options?

Post by runner3081 » Mon Aug 20, 2018 1:05 pm

fm3040 wrote:
Mon Aug 20, 2018 12:31 pm
I called the billing services and asked them to bring down the amount substantially so I can pay it off but the lady is not willing to budge. She said that they CANNOT offer me any kind of discount other than financial assistance for low-wage earners if I show proof of income.
Fairly common when you run it through insurance. The discounts tend to come for cash pay customers. The healthcare facility I work at is the same way. No discount with insurance. It make sense, they are already giving a discount through the contracted rate.

There is no way I would ignore this. It is is such a small amount to tank your credit score, not worth it. Keep in mind, car insurance could go up somewhat as well with a lower credit score.

Rupert
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Re: Excessive Emergency Room Charges - Options?

Post by Rupert » Mon Aug 20, 2018 1:09 pm

fm3040 wrote:
Mon Aug 20, 2018 12:40 pm
Much much less. An ultrasound should not cost more than $200.
Comparing what an ultrasound costs in an ER setting to what an ultrasound would cost in your doctor's office or elsewhere is not an apples-to-apples comparison. Everything costs more in the ER. This is so because it's expensive to keep an ER up and running 24/7 just in case someone needs it. If you have any hope of negotiating with the providers in this case, you have to start from a reasonable position. Threatening to not pay your bills is not a reasonable position.

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nisiprius
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Re: Excessive Emergency Room Charges - Options?

Post by nisiprius » Mon Aug 20, 2018 1:16 pm

fm3040 wrote:
Mon Aug 20, 2018 12:31 pm
...I went to an ER facility at a local hospital last month and they sent me a bill to pay $900+ in addition to my co-pay of $300 that I paid during the visit(all this for an ultrasound ($900+ for ultrasound alone), X-ray and an NSAID tablet after my insurance company paid them around $588)...
Wait, you're saying that you had insurance and that they are "balance billing" you for more than your insurance paid? That may or may not be allowed depending on your insurance, your state laws, and their contract with the insurer. See:

https://www.commonwealthfund.org/public ... g-consumer

(Or are you saying that your insurance is a "high deductible plan," or, at any rate, happens to have a deductible that of many thousands of dollars, but you didn't think you'd ever really need to pay it?)

The amounts you were billed don't seem out of line to me. Emergency medicine is expensive. You aren't paying for an NSAID tablet, you are paying for your share of what it takes to run an emergency facility.

(Not that hospital billing isn't insane. Yeah, I remember the time my son broke a wrist snowboarding, and they put on one splint--but billed us for two.)
Last edited by nisiprius on Mon Aug 20, 2018 1:22 pm, edited 1 time in total.
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earlyout
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Re: Excessive Emergency Room Charges - Options?

Post by earlyout » Mon Aug 20, 2018 1:18 pm

What kind of health insurance do you have? ER visits are usually expensive and In a true emergency, most insurers will cover both in-network and out-of-network facilities.

Since the billing agrees with the EOBs from your insurance company and there are still sizable amounts due, it appears you have minimal insurance coverage of some kind. You should be able to use some of the money you saved on premiums to pay the bills.

fm3040
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Re: Excessive Emergency Room Charges - Options?

Post by fm3040 » Mon Aug 20, 2018 1:38 pm

Nisiprius,

I looked at the link you posted and Texas has "Insurer hold harmless requirement". What would be my next step here?

Insurer hold harmless requirement A requirement that insurers pay providers their billed charges or some lower amount that is acceptable to the provider.

Broken Man 1999
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Re: Excessive Emergency Room Charges - Options?

Post by Broken Man 1999 » Mon Aug 20, 2018 1:45 pm

OP, I don't think it is that difficult to get a hospital to set up a payment plan for you. MIL was on two 0% interest payment plans at hospital when she passed. She had satisfied two payment plans set up by our local fire department for their transportation services.

Might start by asking what payment plans your ER provider offers. And, you might receive an offer to get a discount for paying immediately.

I received an offer for a discounted hospital bill last year when I called in to ask about a payment plan. The offer of a discount was not asked for by me, but I jumped on it.

Not paying doesn't seem right to me. But, everyone has their own beliefs.

Broken Man 1999
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nguy44
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Re: Excessive Emergency Room Charges - Options?

Post by nguy44 » Mon Aug 20, 2018 1:56 pm

fm3040 wrote:
Mon Aug 20, 2018 12:47 pm
Yes, the numbers match up with the EOB document from the insurance company.
I do not think you have much choice beyond paying it.

That much out of pocket for an emergency room visit, particularly with all that was involved (unless you can prove than one of the parties who is billing you was not in fact involved) does not seem unusual these days.

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dm200
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Re: Excessive Emergency Room Charges - Options?

Post by dm200 » Mon Aug 20, 2018 2:08 pm

fm3040 wrote:
Mon Aug 20, 2018 12:31 pm
I went to an ER facility at a local hospital last month and they sent me a bill to pay $900+ in addition to my co-pay of $300 that I paid during the visit(all this for an ultrasound ($900+ for ultrasound alone), X-ray and an NSAID tablet after my insurance company paid them around $588)
I called the billing services and asked them to bring down the amount substantially so I can pay it off but the lady is not willing to budge. She said that they CANNOT offer me any kind of discount other than financial assistance for low-wage earners if I show proof of income.
Following the ER visit, I have other bills from other providers (neurologist, orthopedic, Quest Diagnostics, etc) where I am expected to pay on top of my co-pay (as insurance had not covered all of it). The total I owe to different medical providers at this point is $2668.
What options do I have?

1) Can I simply ignore all these bills if I do not plan on taking any loans for the next 7 years?
2) Is there any trick to stop them from sending it to collections by, say, mailing the ER billing services (where I owe more than $900) a check for $5 every month?
3) Any other options?
Could it hurt me in terms of new employment if I have to look for a new job in the next few years?
Are medical bills treated differently in computing credit scores so your credit score is not impacted as much?
Why do you think you should not pay legitimate bills for services that, apparently, you agreed to in seeking medical help? To go to the ER, it would seem that you must have been very concerned about the immediacy of an "emergency" vs seeing physician(s) the next day or seeking care from an urgent care" facility. From the list of types of specialist and tests, it seems to me that you must have shown many potential and possibly serious problems. I also wonder if this was really just an ultrasound - or some other, more expensive, test?

It is very common (and DW experience) that hospitals are very willing to set up a repayment plan.

I would go through the EOB fully and in detail and discuss why your insurance did not pay more of the bill(s). Then, after verifying the EOB fully, pay the bills.

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dm200
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Re: Excessive Emergency Room Charges - Options?

Post by dm200 » Mon Aug 20, 2018 2:09 pm

Broken Man 1999 wrote:
Mon Aug 20, 2018 1:45 pm
OP, I don't think it is that difficult to get a hospital to set up a payment plan for you. MIL was on two 0% interest payment plans at hospital when she passed. She had satisfied two payment plans set up by our local fire department for their transportation services.

Might start by asking what payment plans your ER provider offers. And, you might receive an offer to get a discount for paying immediately.

I received an offer for a discounted hospital bill last year when I called in to ask about a payment plan. The offer of a discount was not asked for by me, but I jumped on it.

Not paying doesn't seem right to me. But, everyone has their own beliefs.

Broken Man 1999
I agree.

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knpstr
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Re: Excessive Emergency Room Charges - Options?

Post by knpstr » Mon Aug 20, 2018 2:19 pm

I'd pay it.

In the future you have the option that when you have a lot of pain or a health scare you can choose to stay home and save a few bucks and hope it just passes.

**Disclaimer: this is not medical advice**
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HomerJ
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Re: Excessive Emergency Room Charges - Options?

Post by HomerJ » Mon Aug 20, 2018 2:35 pm

dm200 wrote:
Mon Aug 20, 2018 2:08 pm
Why do you think you should not pay legitimate bills for services that, apparently, you agreed to in seeking medical help? To go to the ER, it would seem that you must have been very concerned about the immediacy of an "emergency" vs seeing physician(s) the next day or seeking care from an urgent care" facility.
This is not a fair question. The system is broken.

It's not like they give you a list of prices, and you get a chance to "agree" to pay that amount.

You get to agree or disagree if they should try to save you during a medical emergency. You don't get to haggle over the prices. You don't even get to KNOW the prices.

It's perfectly legitimate to want to question the prices after the fact, since they were not disclosed to you before the fact.

You (while having problems breathing, with a pounding headache, and feeling like you're going to throw up or pass out): "How much will this cost?"
Doctor: I don't know. Do you want me to help you or do you want to go home?
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dm200
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Re: Excessive Emergency Room Charges - Options?

Post by dm200 » Mon Aug 20, 2018 2:41 pm

HomerJ wrote:
Mon Aug 20, 2018 2:35 pm
dm200 wrote:
Mon Aug 20, 2018 2:08 pm
Why do you think you should not pay legitimate bills for services that, apparently, you agreed to in seeking medical help? To go to the ER, it would seem that you must have been very concerned about the immediacy of an "emergency" vs seeing physician(s) the next day or seeking care from an urgent care" facility.
This is not a fair question. The system is broken.
It's not like they give you a list of prices, and you get a chance to "agree" to pay that amount.
You get to agree or disagree if they should try to save you during a medical emergency. You don't get to haggle over the prices. You don't even get to KNOW the prices.
It's perfectly legitimate to want to question the prices after the fact, since they were not disclosed to you before the fact.
However, the OP chose a Hospital ER and disclosed, apparently, symptoms where it was relevant to consult several different medical specialties. It is not clear to me from the OP whether there were other, reasonable and lower cost alternatives.

I am in my 70's and have only ever been in a hospital ER twice in my life. Once was with our then 12 year old son and once when I had some chest palpitations. While it is true that I have been fortunate, I also believe there are many situations I have encountered where others would immediately go to the hospital ER.

MichCPA
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Re: Excessive Emergency Room Charges - Options?

Post by MichCPA » Mon Aug 20, 2018 2:44 pm

Anecdotally, if you go to the ER and its more than purely a scare (requires a stay and/or follow up); you are going to hit/get close to your deductible a pretty significant percentage of the time. By the time you would get to that 7 years the $900+ interest and fees would be enough that even if the debt is forgiven, the taxes on that debt forgiveness and the credit issue would mean the whole process wasn't worth it for me.

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Re: Excessive Emergency Room Charges - Options?

Post by bottlecap » Mon Aug 20, 2018 2:45 pm

fm3040 wrote:
Mon Aug 20, 2018 12:40 pm
Much much less. An ultrasound should not cost more than $200.
I don't know what your ultrasound should have cost, but you can't expect ER costs to be close to those involving a scheduled appointment at a doctors office.

It is not the same business model. It runs 24/7 and is available to give care whether it happens to be needed or not. Thats a lot of equipment and people sitting around waiting for your specific emergency. You are paying for on demand emergency services. That model costs more to run and prices are higher.

JT
Last edited by bottlecap on Mon Aug 20, 2018 2:49 pm, edited 2 times in total.

123
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Re: Excessive Emergency Room Charges - Options?

Post by 123 » Mon Aug 20, 2018 2:45 pm

If you went into an ER, where they are prepared to tackle any kind of medical emergency imagineable, and you came out with a bill for less than $5,000 out-of-pocket you should consider yourself one of the luckiest people on the planet and pay them immediately.
The closest helping hand is at the end of your own arm.

BusterMcTaco
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Re: Excessive Emergency Room Charges - Options?

Post by BusterMcTaco » Mon Aug 20, 2018 2:45 pm

You could consider paying it then taking them to small claims court (after following any pre-lawsuit procedures as required by your state), if there's anything you can point to as evidence of excessive pricing.

One can always argue that the you weren't given the opportunity to give informed consent. If you know the NSAID pill would cost you <whatever> you would have declined.

There's absolutely no guarantee that you'll win, and it may end up just wasting your time.

ETA: I once had an ER visit where the attending came in towards the end (after the resident treated me), checked on how everything was going, and then billed my insurance $250 for that minute. I had a dentist do the same thing. All good? Awesome, here's another $90 bill for that question... I would have absolutely fought these if I was paying out of pocket. I didn't ask for an exam from multiple doctors (not to mention this one accused me of drug seeking because--and get this--I was in severe pain).

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dm200
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Re: Excessive Emergency Room Charges - Options?

Post by dm200 » Mon Aug 20, 2018 2:49 pm

On the other hand, a quick visit to the hospital ER can save your life. A friend had severe abdominal area pain and his wife and daughter made him go to the ER. He had a ruptured abdominal aorta and his immediate surgery (and that an experienced surgeon was there) saved his life.

Jags4186
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Re: Excessive Emergency Room Charges - Options?

Post by Jags4186 » Mon Aug 20, 2018 2:50 pm

Don’t pick a high deductible health plan if you are going to be upset when you have to pay that deductible. My wife and I have an $8000 deductible, $12,000 out of pocket max. I do that because I save roughly $7000/yr on premiums vs my employers copay insurance plan. Seems like a good tradeoff to me. But I never kid myself—I know at any time I could have to write a $12,000 check.

frugalmama
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Re: Excessive Emergency Room Charges - Options?

Post by frugalmama » Mon Aug 20, 2018 2:53 pm

I recommend you pay it as I think it will come back to haunt you if you don't. I was in the ER twice earlier this year and I think your bill is pretty normal for an ER bill. Also, be prepared that you just received the hospital portion. You will most likely receive a bill from every doctor who participated in your care. Generally, you sign something that says that you understand that the amount is just an estimate. Once they bill insurance and get the results back, they bill you the rest. I recommend calling while the bill is NOT late and get on a 0% interest payment plan. If they charged you more than you EOB says they can, then I'd call them and talk to them about that (both insurance company and hospital). However, hospitals are just expensive...which is why I try my hardest to stay out of them!

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DaftInvestor
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Re: Excessive Emergency Room Charges - Options?

Post by DaftInvestor » Mon Aug 20, 2018 2:56 pm

If the amounts match up with your insurance coverage plan and EOB agreements then you should pay them.
If you can't afford to pay them, then there is usually a procedure you can follow for a payment plan (sounds like the hospital already mentioned this - provided your income is low enough it sounds like they are willing to work with you).
I haven't heard how, exactly, you feel these charges are excessive.
Reading between the lines it sounds like what you really might want is a better or different Health Coverage - if you have options to switch plans perhaps consider doing so. (Personally - I have stuck with a plan with far better coverage than what high-deductible plans provide. It means I do NOT have access to an HSA but the coverage I get makes up for the loss of that additional tax-advantaged savings space).

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knpstr
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Re: Excessive Emergency Room Charges - Options?

Post by knpstr » Mon Aug 20, 2018 2:57 pm

HomerJ wrote:
Mon Aug 20, 2018 2:35 pm
dm200 wrote:
Mon Aug 20, 2018 2:08 pm
Why do you think you should not pay legitimate bills for services that, apparently, you agreed to in seeking medical help? To go to the ER, it would seem that you must have been very concerned about the immediacy of an "emergency" vs seeing physician(s) the next day or seeking care from an urgent care" facility.
This is not a fair question. The system is broken.

It's not like they give you a list of prices, and you get a chance to "agree" to pay that amount.

You get to agree or disagree if they should try to save you during a medical emergency. You don't get to haggle over the prices. You don't even get to KNOW the prices.

It's perfectly legitimate to want to question the prices after the fact, since they were not disclosed to you before the fact.

You (while having problems breathing, with a pounding headache, and feeling like you're going to throw up or pass out): "How much will this cost?"
Doctor: I don't know. Do you want me to help you or do you want to go home?
If you've determined you are in need of EMERGENCY medical attention does price really matter? In this case he says his ultrasound should have been closer to $200 instead of $900. So for $700 are you willing to go to the next town over during what you consider is an EMERGENCY!!!

I guess some people would be willing to do that over $700.
Very little is needed to make a happy life; it is all within yourself, in your way of thinking. -Marcus Aurelius

strongboy2005
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Re: Excessive Emergency Room Charges - Options?

Post by strongboy2005 » Mon Aug 20, 2018 3:04 pm

BusterMcTaco wrote:
Mon Aug 20, 2018 2:45 pm
I once had an ER visit where the attending came in towards the end (after the resident treated me), checked on how everything was going, and then billed my insurance $250 for that minute.
Residents can’t bill. The attending takes total responsibility and liability for your care. The resident is there to learn. All of their decisions have to be cleared by the attending. This is why you get a bill from the attending and not the resident even though the resident spends more time with you. Note also that the separate bill from the physician is all the money they get. Exactly $0 of the other hospital charges goes to paying the emergency physician.

ResearchMed
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Re: Excessive Emergency Room Charges - Options?

Post by ResearchMed » Mon Aug 20, 2018 3:08 pm

strongboy2005 wrote:
Mon Aug 20, 2018 3:04 pm
BusterMcTaco wrote:
Mon Aug 20, 2018 2:45 pm
I once had an ER visit where the attending came in towards the end (after the resident treated me), checked on how everything was going, and then billed my insurance $250 for that minute.
Residents can’t bill. The attending takes total responsibility and liability for your care. The resident is there to learn. All of their decisions have to be cleared by the attending. This is why you get a bill from the attending and not the resident even though the resident spends more time with you. Note also that the separate bill from the physician is all the money they get. Exactly $0 of the other hospital charges goes to paying the emergency physician.
Also, that physician probably spent some additional time reviewing your chart (and records if you had been there before) and discussing your status with the resident and possibly nursing staff.

And you are also paying in part for the physician's "down time", given that physicians are often there for the full shift, patients or not.
That is, you are paying part of the convenience of having that physician *there* at the specific time that you need him/her. That's what ER's "do".

RM
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dm200
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Re: Excessive Emergency Room Charges - Options?

Post by dm200 » Mon Aug 20, 2018 3:13 pm

Posts and experiences like this cause me to feel so, so happy with the 24x7 Health plan urgent care facility available to us - and which DW has used several times - once at 3:30 am on Sunday. We have a current copay of $45 plus some fees for some tests - but nothing like the $900 cited. They are equipped and staffed to handle, in my opinion, about 99% of anything I would consider going to a hospital ER for.

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Elsebet
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Re: Excessive Emergency Room Charges - Options?

Post by Elsebet » Mon Aug 20, 2018 3:14 pm

I'm all in favor of questioning prices for medical services but in the end you are responsible for the charges and shouldn't try to get around them. Set up a payment plan with the hospital if you can't pay it off immediately and pay the balance in full. Anything less is irresponsible and pushes the cost of your care to the rest of us.

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dm200
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Re: Excessive Emergency Room Charges - Options?

Post by dm200 » Mon Aug 20, 2018 3:21 pm

One thing I would recommend is, before needing medical services, scout out any Urgent Care facilities in the area, hours of operation, services available, insurance options, etc. I have never used any of them, but I notice over the last few years, many of these are popping up all over the place. There are two, in fact, within a mile of our house.

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Re: Excessive Emergency Room Charges - Options?

Post by rooms222 » Mon Aug 20, 2018 3:23 pm

Jags4186 wrote:
Mon Aug 20, 2018 2:50 pm
Don’t pick a high deductible health plan if you are going to be upset when you have to pay that deductible. My wife and I have an $8000 deductible, $12,000 out of pocket max. I do that because I save roughly $7000/yr on premiums vs my employers copay insurance plan. Seems like a good tradeoff to me. But I never kid myself—I know at any time I could have to write a $12,000 check.

We have no choice at our governmental employer but to have a high deductible plan, including employees making $24,000 a year gross,

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DaftInvestor
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Re: Excessive Emergency Room Charges - Options?

Post by DaftInvestor » Mon Aug 20, 2018 3:26 pm

rooms222 wrote:
Mon Aug 20, 2018 3:23 pm
Jags4186 wrote:
Mon Aug 20, 2018 2:50 pm
Don’t pick a high deductible health plan if you are going to be upset when you have to pay that deductible. My wife and I have an $8000 deductible, $12,000 out of pocket max. I do that because I save roughly $7000/yr on premiums vs my employers copay insurance plan. Seems like a good tradeoff to me. But I never kid myself—I know at any time I could have to write a $12,000 check.

We have no choice at our governmental employer but to have a high deductible plan, including employees making $24,000 a year gross,
In that case, make sure your Emergency Funds Account has enough money in it to cover the deductible. If your income is only $24,000 a year you may not be able to do this but you can probably apply for financial hardship assistance as the hospital mentioned to the OP.

fm3040
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Re: Excessive Emergency Room Charges - Options?

Post by fm3040 » Mon Aug 20, 2018 3:27 pm

I know I will pay my bills as I always have. I was just upset that Billing Services was not willing to work with me on reducing what seemed like and likely are exorbitant charges. When I asked about monthly payments, she did not offer me anything more than 6 equal payments.

As they will not report it to collections immediately, maybe I should cool off and call again, and hope to get a different rep on the line that is willing to work with me and offer me a long time horizon to pay the bill or reduce the bill so I can pay it immediately.

I was wondering if I could force them not to send it to collections by sending an automatic monthly payment from my bank and take, say, a year or two to pay off all my current bills plus more that I am expecting in the future for the medical event that I am still not out of.

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DaftInvestor
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Re: Excessive Emergency Room Charges - Options?

Post by DaftInvestor » Mon Aug 20, 2018 3:33 pm

fm3040 wrote:
Mon Aug 20, 2018 3:27 pm
I know I will pay my bills as I always have. I was just upset that Billing Services was not willing to work with me on reducing what seemed like and likely are exorbitant charges. When I asked about monthly payments, she did not offer me anything more than 6 equal payments.

As they will not report it to collections immediately, maybe I should cool off and call again, and hope to get a different rep on the line that is willing to work with me and offer me a long time horizon to pay the bill or reduce the bill so I can pay it immediately.

I was wondering if I could force them not to send it to collections by sending an automatic monthly payment from my bank and take, say, a year or two to pay off all my current bills plus more that I am expecting in the future for the medical event that I am still not out of.
I believe the timeline before a bill is sent to collections is very very long (like 2 years). Once a bill is sent to collections - the collections agency gets to keep a fair portion of it. Calling and asking for longer payment terms seems a fair solution. Going forward I'd consider making sure your Emergency Fund can cover your insurance deductibles.
I once had a bill sent to collections due to several errors on the doctor's part (I had never received the particular bill myself; nor had my insurance). I didn't get the collection notice from the collection agency until 4 years later so it took at least 3 years in this case before the bill went to the agency.

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Re: Excessive Emergency Room Charges - Options?

Post by dm200 » Mon Aug 20, 2018 3:33 pm

rooms222 wrote:
Mon Aug 20, 2018 3:23 pm
Jags4186 wrote:
Mon Aug 20, 2018 2:50 pm
Don’t pick a high deductible health plan if you are going to be upset when you have to pay that deductible. My wife and I have an $8000 deductible, $12,000 out of pocket max. I do that because I save roughly $7000/yr on premiums vs my employers copay insurance plan. Seems like a good tradeoff to me. But I never kid myself—I know at any time I could have to write a $12,000 check.

We have no choice at our governmental employer but to have a high deductible plan, including employees making $24,000 a year gross,
You do not have an HMO choice for health insurance?

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dm200
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Re: Excessive Emergency Room Charges - Options?

Post by dm200 » Mon Aug 20, 2018 3:36 pm

Medical billing and "collections" - example of intentional deception!!

One, very common billing "technique" is, very quickly when a bill becomes "past due" is that you receive a bill that looks just like it is from a "Collection Agency". In reality, however, it may not really be from an outside collection agency, but rather just a different "department" of the medical facility/provider.

Good Listener
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Re: Excessive Emergency Room Charges - Options?

Post by Good Listener » Mon Aug 20, 2018 4:08 pm

OP, you say that the EOB matches what the hospital and others are asking. But I am confused that insurance would pay such a low percentage. It doesn't look like you have a high deductible plan. Could you show us a photo of the EOB.

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Re: Excessive Emergency Room Charges - Options?

Post by MichCPA » Mon Aug 20, 2018 4:10 pm

fm3040 wrote:
Mon Aug 20, 2018 3:27 pm
I know I will pay my bills as I always have. I was just upset that Billing Services was not willing to work with me on reducing what seemed like and likely are exorbitant charges. When I asked about monthly payments, she did not offer me anything more than 6 equal payments.

As they will not report it to collections immediately, maybe I should cool off and call again, and hope to get a different rep on the line that is willing to work with me and offer me a long time horizon to pay the bill or reduce the bill so I can pay it immediately.

I was wondering if I could force them not to send it to collections by sending an automatic monthly payment from my bank and take, say, a year or two to pay off all my current bills plus more that I am expecting in the future for the medical event that I am still not out of.
Unfortunately, there is no way to 'force them' to keep you out of collections. Based on how we do collections (in a different industry), there is probably some type of A/R clerk looking at an aging schedule and once you hit a certain bucket, they will sell you to collections. Best wishes on your continuing health issues. Since you have given them your insurance card they know that you are employed and can probably pay. I am skeptical you are going to get the type of reduction you are seeking as the amount is not high in relation to a normal income even if you don't feel that way.

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Re: Excessive Emergency Room Charges - Options?

Post by dm200 » Mon Aug 20, 2018 4:12 pm

Good Listener wrote:
Mon Aug 20, 2018 4:08 pm
OP, you say that the EOB matches what the hospital and others are asking. But I am confused that insurance would pay such a low percentage. It doesn't look like you have a high deductible plan. Could you show us a photo of the EOB.
It has been a while since I was on a plan where I would receive an EOB, but as I recall - the EOB would have code(s) and/or explanations of why they did not pay certain charges. The EOB may also indicate how much is (or should be) the patient's responsibility.

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Re: Excessive Emergency Room Charges - Options?

Post by Nate79 » Mon Aug 20, 2018 4:49 pm

Typically the hospital contract with the insurance company does not allow them to negotiate down the charges. They have specific contracted amounts that if you want your insurance to cover (vs paying cash) then you must pay the contracted amount which is what shows on your EOB. Typically since you have already billed thru insurance they are not even allowed to offer you the cash price which probably isn't lower anyways.

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Re: Excessive Emergency Room Charges - Options?

Post by Dottie57 » Mon Aug 20, 2018 5:06 pm

HomerJ wrote:
Mon Aug 20, 2018 2:35 pm
dm200 wrote:
Mon Aug 20, 2018 2:08 pm
Why do you think you should not pay legitimate bills for services that, apparently, you agreed to in seeking medical help? To go to the ER, it would seem that you must have been very concerned about the immediacy of an "emergency" vs seeing physician(s) the next day or seeking care from an urgent care" facility.
This is not a fair question. The system is broken.

It's not like they give you a list of prices, and you get a chance to "agree" to pay that amount.

You get to agree or disagree if they should try to save you during a medical emergency. You don't get to haggle over the prices. You don't even get to KNOW the prices.

It's perfectly legitimate to want to question the prices after the fact, since they were not disclosed to you before the fact.

You (while having problems breathing, with a pounding headache, and feeling like you're going to throw up or pass out): "How much will this cost?"
Doctor: I don't know. Do you want me to help you or do you want to go home?
Homer , I really don’t think You are being fair. Emergency room care has always been much more expensive than urgent or normal care. We had a thread about how to cut emergency care. One of the options is to wait. You can ask about charges, but you can’t expect a procedure will be the same under emergency circumstances as under ordinary circumstances.

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Re: Excessive Emergency Room Charges - Options?

Post by Doom&Gloom » Mon Aug 20, 2018 5:15 pm

OP, I agree with the consensus that you are likely tilting at windmills here. I think I would have accepted their offer of an interest-free six-month payment plan.

But out of curiosity, what were your financial expectations when you went to the ER, while you were there, immediately afterward, etc? The general feeling about hospital care, particularly ERs, is that the costs are outrageous. That is well-publicized and a topic of discussion for almost anyone who has been to a hospital or ER for the past few decades. As mentioned upthread, there is even a lengthy stickied thread on the subject at the top of this page. I am curious as to whether you were surprised or if it confirmed an existing belief that the prices are out-of-whack.

Good luck to you with your health care!

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Re: Excessive Emergency Room Charges - Options?

Post by jj45 » Mon Aug 20, 2018 5:40 pm

fm3040 wrote:
Mon Aug 20, 2018 12:31 pm
What options do I have?
Are you being charged because the emergency room and doctors are out-of-network and the insurer paid the in-network rate? If so you have some options. This is called balance billing. You can probably appeal to your insurance company and they might pay it. Check with your insurance company about their appeal procedure. We had an issue with balance billing for an emergency ambulance and after appeal the insurance company paid the full amount. I seem to recall the key phrase in the appeal was "I had no control over the choice of provider". Each state has different laws and each insurance company has different appeal processes. Consumers Union has a page where you can find information for each state:
https://consumersunion.org/insurance-complaint-tool/

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