$1400 ER visit?
Cools
Senior Member
Am I crazy to think this is outrageous? My 3.5-year-old son went to the ER a month ago. Busted his chin and got 3 stitches.
Got a bill last week for $800 (insurance paid $650) so I sent in $150. Thought that was a decent price actually.
Then today I got a bill for $1900. After insurance we are supposed to pay $1200.
Haven't been to an ER in eons, is this consistent?
Are there any tactics to get the bill reduced?
Got a bill last week for $800 (insurance paid $650) so I sent in $150. Thought that was a decent price actually.
Then today I got a bill for $1900. After insurance we are supposed to pay $1200.
Haven't been to an ER in eons, is this consistent?
Are there any tactics to get the bill reduced?
Comments
out of network freestanding ER or one associated with a hospital in your network?
I guess we should've just gone to one of those 24-hour urgent care post-ups?
I work in an ER and that is pretty normal. Some ERs will have an Urgent Care (UC) side where they bill a little less. I would suggest a stand alone UC but if it's on the face they might fuck it up. You could easily end up with a shitty UC doctor. If it's in a UC within an ER at least they will know when they need to send you over to the ER.
yeah, the whole freestanding ER model that is exploding in this state is pretty crazy. the out of network stuff is almost criminal if you ask me. in network urgent care should usually do it as mentioned above. good luck with it and definitely call them on it as there is plenty of room for negotiation.
That's exactly what my wife said. If a green doc did it at UC then my son's chin might look pretty bad in a few years. Thanks for the input.
Exactly. Odds are an ER doctor won't fuck that up.
I will say just to walk into my ER is over $1000. If you would have told me what you told me, I would say around $1500 total. But call the billing department up and see if they will give you a break.
It all depends on the summary plan document (policy). It should state the benefit that your dependents are covered at for both in and out of network ER visits. Some plans have exceptions to pay OON ER visits if your PCP refers you or if the ancillary services were related to an in-network visit. Sorry if this is confusing, I'm a medical insurance claims examiner and using too much jargon. You may be able to have your HR dept. or boss help by checking with their insurance payor to confirm that the benefits were administered correctly . I assume this is group health insurance through your employer. I've dealt with many people who were incorrectly balance billed for charges that the insurance administrator actually should have covered and paid so it doesn't hurt to confirm.
If thats your 'normal' then the system in your country is screwed up.
Here a visit to the ER for about 5 stitches cost me around $150. Pretty much any other European or Latin American country has the same prices or cheaper.
For those wondering, it is a very nice thin line right now. Beautifully stitched.
We have AETNA insurance through my wife's work. The first bill wasn't exactly $150 so it wasn't a copay, it was $148 and change. I think this was for the physician but not sure because after I paid it I threw away the bill (mistake). The second seems like it is from the hospital itself, says, "This is the hospital bill for Emergency services from August 11, 2016 through August 11, 2016."
AETNA paid something on both bills. I think the first was around $600 and the second was $691.49.
So I guess my first step is to all AETNA to confirm benefits were administered correctly, or should I go through her work HR? And then call the hospital and see what my options are?
Ok so that is the facility bill from the hospital so it seems that it was an out of network ER visit because AETNA is only paying for about 40% and you are being balance billed for the remaining patient responsibility. Yes contact AETNA to confirm they paid correctly and also what benefit this visit falls under. I would mention that my PCP referred me to this facility as well, you may be able to get some relief because of that. If you don't get a satisfactory answer ask for a supervisor and then get your wife's HR involved. Some reps for the big companies are not very smart or helpful. Your wife can also ask her co-workers or HR if they have received a similar bill in the past for an ER visit. Chances are this situation has happened to someone else there. You will definitely want to figure out what ER's are covered in your network in case you have to go again in the future. However, if it is a non-life threatening situation, you are obviously better off just going to an Urgent Care Center.
As far as the hospital, I don't think you have many options to get it reduced by them if the bill is correct. They usually are not very helpful and often outsource their billing to another company. If you don't pay they will just send it to collections.
I would do the following steps:
1. Call the the number on the bill and ask what the "prompt pay" price is. If they tell you that it is the same price as the sticker price, don't pay anything and then...
2. Let the bill go to collections. Once it is in collections, they surprisingly will take a lesser amount than "sticker price" I have had as much as 1/3 the price reduced, but 25% off seems to be standard... my credit score is still over 800. I have done this over 10 times.
Good luck!
Thanks for your help ACE, good to have someone in the industry weigh in. Hopefully something goes our way in this process.
And thank you, mikie. I like your tactic and will certainly go that route if needed. Thanks again.
I didn't say I agree with it but that is the way it is at this point in time.
Is there nothing you guys can do about it?
Americans just take those exorbitant fee's for granted and pay them? I mean, I could understand it being around 1.5 to 2 times more expensive than in other developed countries,......but 10-15 times is absolutely ridiculous.
And it's not like your salary will become lower, if those fee's get reduced. It's the profit of the big insurance, medical and pharma companies that wil come down.
I remember watching Lou Hobbs Moneylinet in awe way back in the early nineties, when they were announcing another quarterly round of billion-dollar profits for the banks and insurance companies. Now I realise that the more profit they have, the more it's costing me. Not only in my banking and transaction fees, but also in the costs that are being incurred by regular businesses, who then charge me (us) for those costs.
Sure. Quit voting for the usual Democrats and Republicans.
Has little to with them.
Anybody that matters when it come to decision making will get millions thrown at them by the different lobby's.
Very few actually principled politicians....anywhere.
I think there is a huge difference but we can disagree. I don't want to waste anytime debating this. GL.
Thanks for increasing my premiums to subsidize your little scam.
http://healthcare.dmagazine.com/2016/05/18/are-freestanding-emergency-rooms-driving-up-costs/
My credit score is over 800 for a reason, when I owe money, I pay immediately.
In 2012, I had no health issues and neither did anyone in my family. I got a $600 bill for when my daughter was born and I paid it immediately. Well, the bill was sent to me sent before my insurance adjusted it. I now know through lots of experience, this is dirty trick number 1 in their play book. After insurance adjustment, I should have only owed $150. It took me over 2 years and at least 20 hours of my time on various phone calls to get my $450 back. Some less observant people would have overpaid $450 in this situation. That is wrong and criminal.
In 2014 the pedatrition mis-coded my son's post birth wellness visit as a sick visit. Since I have a high deductible health plan, wellness visits are covered, but if you get sick, you pay a minimum of $200 for a doctors visit up to a max of $5k on the year. The doctor would not re-code the visit since it was 4 months after the fact and she could not remember. I was obviously pissed and refused to pay It went to collections and I got it down to about $150. I should have paid $0.
So the way I see it, I am now down 20 hours of work and $150, I want compensated. Then I got cancer and now I max out the $5k each year. I have procedures that are absolutely mandatory get denied on a semi regular basis. I eventually get insurance to cover these mandatory procedures, but it takes several hours. I'm self-employed and my time is money, just like it is for everyone else.
So, I try to negotiate the larger bills before they go to collections, but that usually fails. So I just let the $2k bills go to collections. After 6 months or so of ignoring letters and phone calls, they are happy to take $1500. I wasn't looking to "scam" the system. But it's a dirty game, and I am unfortunately a player in this game. Don't hate the player, hate the game.