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Trusted Contributor
Posts: 1,783
Registered: ‎03-06-2020

Outrageous ER charges or the norm?........

[ Edited ]

About 3 weeks ago 14 year old wound up in the ER; fractured elbow and wrist, did not have a concussion or broken shoulder. From start to finish 2.5 hours. No complaints about the care. X-rays of wrist, arm, elbow, shoulder and skull. Cast was used to set elbow and wrist. No meds other than Tylenol we had at home. Saw the orthopedic surgeon 4 days ago; cast came off, the bones were set correctly (by someone but not the doc) and everything is mending well.

 

Hospital is not in our network we have found out. It was the third place we went to as the first two did NOT offer pediatric X-rays. 2nd place told us about this hospital, we found it and off we went. 

 

Spoke to insurance this afternoon (about something else) and asked if the claims had been presented; they had. I about fell off my chair when he told me the charges:

 

*ER doc spoke to us at the beginning and then at the end. His charge is $14,000.

*Resident we never saw but heard her voice discussing X-rays charged $10,000.

*Hospital/ER charge is $20,000.

*Radiology has NOT sent in claim as of yet but insurance does state it is not part of hospital charge. 

 

So far it's $44,000.  It's been about 8 years or so since we've been to an actual ER; is this the amount hospitals usually charge or is it over the top? Just looking for feedback on the amount charged for the care he received. Thank you!

"Coming to ya from Florida"
Super Contributor
Posts: 399
Registered: ‎03-12-2010

Re: Outrageous ER charges or the norm?........

The charges will probably be reduced when the insurance processes it.  In 2019 I was in a trauma unit for 5 days after a head on car accident left me with a shattered ankle.  I had 4 surguries on my ankle in 6 months.  My bills were over 750K which I had to use my health insurance for since the person at fault had 25k in insurance.  I paid the out of pocket amount and the insurance paid the rest.  The amounts paid were greatly reduced when paid, so don't panic yet....like I did...lol.

Honored Contributor
Posts: 69,382
Registered: ‎03-10-2010

Re: Outrageous ER charges or the norm?........

If your insurance refuses to pay, I'd appeal it on the basis of it being an emergency and no other facility available. 

 

Yes, the charges are ridiculous but I'm not surprised.  I understand they can be negotiated. 

New Mexico☀️Land Of Enchantment
Trusted Contributor
Posts: 1,379
Registered: ‎03-09-2010

Re: Outrageous ER charges or the norm?........

@FiddleDeeDee   If you went into the hospital throught the ER I would think you would have some type of coverage.  Call your insurance & have them work with you - you do not specially choose a doctor when you are treated in the emergency room.

Esteemed Contributor
Posts: 5,889
Registered: ‎03-11-2010

Re: Outrageous ER charges or the norm?........

[ Edited ]

I wound up in the hospital several weeks ago. I was quite ill, had to go by ambulance to the ER and even wound up in the ICU for a day out of the 5 days I spent at the hospital.

 

Despite having Medicare plus supplemental insurance, I am terrified about the bills. My husband's Alzheimer's has worsened so I now have help in the house 24/7. My taking care of him without any help contributed to my hospitalization. Our supposedly large nest egg could be cracked quite soon.

Honored Contributor
Posts: 13,481
Registered: ‎11-24-2013

Re: Outrageous ER charges or the norm?........

@FiddleDeeDee In addition to other advice, contact the hospital's Patient Advocate or Patient Ombudsman (all hospitals have this) and discuss the situation with them

Esteemed Contributor
Posts: 5,188
Registered: ‎03-11-2010

Re: Outrageous ER charges or the norm?........

19 yrs ago, the index finger on my right hand got infected. I didn't have a doctor and I just moved to a different area - so a relative of mine went with me to the ER. Before leaving my house, I called St. Johns Hospital to tell them I didn't have insurance. When I arrived at the ER, I told the female at the front desk that I didn't have insurance. Neither employee said a word. The nurse that checked my finger said, "I have never seen anything like this" and tried to deal with it - unsuccessfully. She told me to come back in 2 weeks - and she gave me a prescription - which I filled. A few weeks later, I received a bill for almost $400 - which shocked me as they did nothing - but I paid it. I then went to a regular doctor's office - who told me to soak my finger in epson salt and he gave me an ointment. HEALED in a couple of days.Total bill $85.00

I then received a bill for $2,000 from the hospital - and another $1,600 bill from the ER - totalling $4,000.

Luckily for me, I was able to stop payment on the check I sent to St. Johns Hospital. I called their Business Office and she reduced the bill by a few hundred dollars.

I then saw a story on Dateline - about how hospitals overcharge patients who have no money or no insurance. 

So - I looked up the name of the President of the Hospital on-line and sent him a letter stating: I assume u saw Dateline last night about how hospitals overcharge patients. Two days later, they waived the whole bill.

YES - Greedy Hospitals.

Years ago, hospitals were run by humans - until sleazy business people took over!!!!

Respected Contributor
Posts: 2,664
Registered: ‎05-13-2010

Re: Outrageous ER charges or the norm?........

@Vivian I'm so sorry.  Would residential care for your husband cost less than in-home?

Esteemed Contributor
Posts: 5,188
Registered: ‎03-11-2010

Re: Outrageous ER charges or the norm?........


@Vivian wrote:

I wound up in the hospital several weeks ago. I was quite ill, had to go by ambulance to the ER and even wound up in the ICU for a day out of the 5 days I spent at the hospital.

 

Despite having Medicare plus supplemental insurance, I am terrified about the bills. My husband's Alzheimer's has worsened so I now have help in the house 24/7. My taking care of him without any help contributed to my hospitalization. Our supposedly large nest egg could be cracked quite soon.


Everything is negotiable. The hospitals' bills are out of control. There are people who know how to read the codes on these bills. Your insurance companies should also be able to help u.

Trusted Contributor
Posts: 1,783
Registered: ‎03-06-2020

Re: Outrageous ER charges or the norm?........

Thanks everyone for your feedback.

 

To be clear, I'm not concerned about what we will have to pay. The max out of our pocket will be $5000 (PPO and per our policy). What I  AM trying to find out is this:

 

Are these charges the NORM today for ER care? Is 15 minutes worth $14,000? Is a doctor who you never see, never speaks to you worth $10,000 because they discussed an x-ray with another doctor? 

 

Because those near and dear to me do not. It certainly would explain how it bankrupts people even WITH insurance, doesn't it....

"Coming to ya from Florida"