Emergency Room Bill

[Corporate ORphan]

DH had a bad dream and fell out of bed last week. I ended up calling 911 because I feared he had a stroke. Long story short, after 20 hours in the emergency room, numerous tests, etc. He was sent home with the verdict that he had a concussion and three broken vertebrae in his back. Only treatment was a pain killer and advice to "wait it out". Could heal in 6 weeks or 6 months.


We got the bill today. $12,500 not including the ambulance!!! I kept saying we would meet our high deductible of $11,000 but I really didn't think we would. Silly me. We are both stunned.

My question to the group is how much of a discount will the insurance company get us? We have never used the policy since getting it a year ago.

Don't get me wrong. I am very happy they were there but I don't see how anyone can afford this.

I questioned most of the tests (after it was clear he was going to be ok) and they did ALL of them anyway. For example, an MRI to see if it was an "old" or "new" injury cost $3,100 alone. And after that they said it wasn't conclusive so they needed to do another Cat Scan to be sure.

They should tell you how much each test is going to cost you before they do it like any other service. (Like cutting a tree down in your yard.)

Anyone protesting to keep this form of health care in this country is nuts. You never know when your great "mega corp" insurance goes away either due them dropping it or dropping you (like what happened to me.)

Thanks for "listening"!!

 

[jazz4cash]

Thank goodness your biggest concern is the bill. Seriously hope it will heal on its own. Not knowing particulars of your coverage, but we've been through similar events a few times and the insurance discount is usually 40-60% and we generally pay a deductible if it applies plus 20% co-pay. I keep trying to explain to others that the biggest benefit of insurance is the pre-negotiated discount...especially in an emergency when there is no way to shop for rates. Good Luck.

 

[samclem]

Anyone protesting to keep this form of health care in this country is nuts.

You're in good company. You'd have a hard time finding anyone who likes the "system" (ha!) we have right now.

Well, the silver lining for you guys: If you've been putting off any medical exams or covered medical procedures, this would be a good time to go get everything done. You've maxed out your deductible so you might as well accomplish any "deferred maintenance" while you can get it done "cheap."

 

[Alan]

I'm pleased to hear that the health outcome was good even though the sticker price was a bit of a shock.

 

[FUEGO]

I would guess the insurance company's negotiated discount will wipe out half the bill and you'll end up owing $5000-6000. I would also fight with the billing dept and have some charges removed. Then see if they can accept partial payment for the remaining thousands. Give them a grief story about being hard up for cash, bad investments, economy blah blah blah. Maybe offer to pay 3/4 of the remainder after you dicker with them if you agree to pay it immediately.

And hopefully you have all the bills and there aren't more bills out there for random tests, labwork, blood work, radiology, diagnostics, 3rd parties, etc (other than the ambulance).

 

[Corporate ORphan]

Thanks for all the good wishes and advice. We are extremely lucky there shouldn't be any long term effects and we didn't have any travel plans.

It was one of the worst experiences of my life. I thought he had died in my arms waiting for the ambulance to come. I really feel for anyone that has happened to or who actually sees their loved one(s) hurt, etc.

I think I'll at least call the hospital next week and ask for a bill in "English". All their abbreviations are mostly un-understandable.

One thing I did notice when I logged onto BCBS' website they said we had fulfilled $3600 of our deductible but the fees from the hospital are still pending. Anyone know what is up with that? And how much does an ambulance rider cost anyway??

 

[Alan]

One thing I did notice when I logged onto BCBS' website they said we had fulfilled $3600 of our deductible but the fees from the hospital are still pending. Anyone know what is up with that? And how much does an ambulance rider cost anyway??

I think Health Insurance billing systems were designed by a finite number of monkeys typing on keyboards for a finite length of time.

If only they'd used an infinitive number of monkeys .....

 

[FIRE'd@51]

After the hospital files the bill with your insurance company and receives back their negotiated amount and any payment, they will bill you. Many hospitals will give a discount (mine gives 25%) if you pay your portion immediately, so be sure to inquire about this. This also has the effect of reducing your deductible and out-of-pocket maximum

 

[easysurfer]

Thanks for all the good wishes and advice. We are extremely lucky there shouldn't be any long term effects and we didn't have any travel plans.

It was one of the worst experiences of my life. I thought he had died in my arms waiting for the ambulance to come. I really feel for anyone that has happened to or who actually sees their loved one(s) hurt, etc.

I think I'll at least call the hospital next week and ask for a bill in "English". All their abbreviations are mostly un-understandable.

One thing I did notice when I logged onto BCBS' website they said we had fulfilled $3600 of our deductible but the fees from the hospital are still pending. Anyone know what is up with that? And how much does an ambulance rider cost anyway??

I've got BCBS too. I believe the fullfilled amount is just a running total of how much you've paid towards the deductible for the year. For me, usually it takes several weeks before the bill get processed through.

 

[oldtrig]

I am sorry that happened to you and your husband. It makes one think when they take the trip to the emergency room.
I have a friend that got bit real bad yesterday by a Pit Bull. He was going to the persons house to repair their computer. He has no health insurance and said he would just have to wait and see how his leg healed. I would say law suit but he said the woman lived in a very old house trailer and has very little money. It is really sad that this country is being done the way it is with health care prices. I hope my friend does OK and no infection sets up. It was a really bad bite. oldtrig

 

[pb4uski]

After the hospital files the bill with your insurance company and receives back their negotiated amount and any payment, they will bill you. Many hospitals will give a discount (mine gives 25%) if you pay your portion immediately, so be sure to inquire about this. This also has the effect of reducing your deductible and out-of-pocket maximum

+1 on the discount from the hospital, but you need to call and ask for it. Also, after we agreed to the discount I put it on my credit card and got points for the charge with my credit card company.

 

[zinger1457]

Have to be a little careful with expecting to pay the insurance 'negotiated rate' since it doesn't always apply to all insurance policies. I had the AARP AETNA Preventive and Hospital Care HSA plan. The policy doesn't cover office visits except for preventive care (yearly physical, flu shot). Because of this any office visits that are not preventive care will be charged the full doctors rate, not the insurance company negotiated rate. I found this out when the doctor suggested I have an EKG during my annual physical. The insurance company said the EKG was outside their preventive care coverage and since it was not covered by my policy the negotiated rate would not apply.

 

[haha]

Have to be a little careful with expecting to pay the insurance 'negotiated rate' since it doesn't always apply to all insurance policies. I had the AARP AETNA Preventive and Hospital Care HSA plan. The policy doesn't cover office visits except for preventive care (yearly physical, flu shot). Because of this any office visits that are not preventive care will be charged the full doctors rate, not the insurance company negotiated rate. I found this out when the doctor suggested I have an EKG during my annual physical. The insurance company said the EKG was outside their preventive care coverage and since it was not covered by my policy the negotiated rate would not apply.

Whoa! Medicare may stink but it sure beats that.

 

[justplainbll]

So far we've been fortunate to have had limited direct personal experience with the health care industry. In addition to noticing Mercedes 500's in some doctors' parking spots, it seems that the medical industry smacks of racketeering and discriminatory pricing practices. The insurance aspect of health care appears akin to mob-like protection money extortion.

 

[frank]

I never knew you could negotiate the bill from the hospital. When i get the bill it has been reduced by the insurance discount and the insurance payment and then I get billed for what's left owing. is that negotiable?

 

[mickj]

I never knew you could negotiate the bill from the hospital. When i get the bill it has been reduced by the insurance discount and the insurance payment and then I get billed for what's left owing. is that negotiable?

absolutely, I routinely get 25% off for paying in full with a credit card over the phone.

 

[PaddyMac]

Is your hospital a participating Health Care Provider with BCBS? If so, whatever BCBS said the procedures were worth, and whatever amount BCBS said they owe the hospital, is the same amount that you owe the hospital (assuming that your deductible is not met). The hospital cannot bill you for the amount that BCBS did NOT pay. You are paying premiums to BCBS to get this discounted rate. Talk to BCBS if you are not sure of the correct amount before you pay anything.

from a typical glossary:

Participating Health Care Provider

A health care provider who has entered into an agreement with Blue Cross Blue Shield of North Dakota to accept established negotiated rates as payment in full for covered services. Participating Health Care Provider's will submit claims for such member directly to BCBSND.

 

[ronocnikral]

after a car hit me on my bicycle last summer, I had to fork out $1000 just for the 2.5 mi ambulance ride (which included "strapping material" to secure me to a body board, which the paramedics complained of being the cheapest of duct tape). Also, a "student" or whatever the pupils are called, was "practicing" on me while checking for internal bleeding. I received 4 bills: ambulance, hospital, doctor and one for the student.

glad all is ok, and expect this process to take a good 6 months or so. and ask what you get for paying right then and there when you finally do get a bill. if they balk, start talking payments...

 

[pb4uski]

absolutely, I routinely get 25% off for paying in full with a credit card over the phone.

+1, but if you don't call and ask, you won't get it. I usually call the billing office and politely ask if they offer any additional discount for immediate payment and they usually offer 20-25%. Then I ask, can I put that on my credit card right now and they say yes, and I give them my cc info. Works like a charm.

 

[JOHNNIE36]

+1, but if you don't call and ask, you won't get it. I usually call the billing office and politely ask if they offer any additional discount for immediate payment and they usually offer 20-25%. Then I ask, can I put that on my credit card right now and they say yes, and I give them my cc info. Works like a charm.

+2. The hospitals have better things to do than hound people for their payment. Saves them a lot of trouble if you just offer to pay it now, cash or credit card. They even take American Express. I've never failed to get a discount.

 

[Sarah in SC]

Sorry this has happened to you, but glad he's okay now.
I've only paid for one ambulance ride, and it was 15 years ago for DH, who took a gainer off of a pool slide headfirst. The ambulance ride was $350 back then, of a total of about $900 for the whole ER experience. And the glare from the ER doc when he reported DH's BAC was free. Sigh...boys!

 

[ratto]

We got the bill today. $12,500 not including the ambulance!!! I kept saying we would meet our high deductible of $11,000 but I really didn't think we would. Silly me. We are both stunned.

Holy grief! Do hospitals and doctors charge an outrageous upfront amount because they know the bill will be at least halved by insurance companies, or they want to make up any possible losses from patients who can't pay, or just both? This is absolutely insane.

 

[MichaelB]

Holy grief! Do hospitals and doctors charge an outrageous upfront amount because they know the bill will be at least halved by insurance companies, or they want to make up any possible losses from patients who can't pay, or just both? This is absolutely insane.

I have found labs to have the highest uplifted price. The average price reduction that our insurance (UHC) applies to LabCorp is 90%. A reasonable explanation is beyond me.

 

[audreyh1]

Holy grief! Do hospitals and doctors charge an outrageous upfront amount because they know the bill will be at least halved by insurance companies, or they want to make up any possible losses from patients who can't pay, or just both? This is absolutely insane.

That's the impression I get.

 

[Corporate ORphan]

BCBS got the bill down to about $3500 from 12,500 for the hospital.

DH is feeling better so he tried to go over it to see if we are getting billed for what he actually got. No way we can tell. The hospital's itemized bill uses a bunch of medical jargon. We called the hospital and got the run around. No one can go over it and explain the charges listed. They suggested we call the doctor's office (he doesn't have one) or get DH medical records.

Here's the kicker... the hospital will charge us 52 cents a page to copy the records. They can give us the estimated copy costs after they get a signed HIPPA form through snail mail from DH. My guess we are talking about 100 pages since some of the blood test results I have gotten from doctors have been 10 pages long and he had numerous tests done. Some are listed on the bill just as "lab test".

Bottom line we have to pay more than a nominal fee just to see if the bill is correct. What a racket.

I told hubby, it probably isn't worth his time to pursue this (which I guess is why they charged $12,500 to begin with so we woudl feel $3500 isn't much to pay). Especially, if I can get it kicked down another 25% by paying the bill right away when we get it.

Have any of you been able to get a hospital to explain their bill? If you did, how did you do it?

Thanks again!