Posted by cassiewi on 10/8/07 12:01pm
Msg #215417

OT-Emergency Room Bill....is there anyone I can complain to?

My daughter fell off her bike (her friend ran into her and fell on top of her) in July and hurt her elbow. This was the first time I've ever had to take any of kids to the ER. I normally would have waited until the next day but her elbow just looked funny and my neighbor who is a nurse said I should take her in, to see if her DR could see her first (he couldn't). I get the bill and OMG around $1,000.00. She was there for 55 minutes. They didn't even wash her elbow. They took her for a Xray and it was just swollen, and wrapped it in an ace bandage. She didn't even see a "doctor", she got a physician assistant. To sit in a bed and get something wrapped in an ace bandage costs this much?

$513.00 Hosp Misc
$169.00 Hosp Misc
$ 13.00 Hosp Misc

$43.00 Xray
$258.00 for Physician

Thankfully, my we are covered under my husband's insurance, but we have a $500 deductible per person, $1,000 per family. So we will be paying $500.00 of this. Any suggestions?

Reply by Philip Johnson on 10/8/07 12:09pm
Msg #215418

Did you get an itemized bill?

If not ask for one. Once you get that, go over it and see what they charged you for,that you did not receive. At that point call the billing department and challenge it, most of these places will then make you an offer just to close it out. The problem will be that you are personally not saving any money, because every dollar you bring it down will only save the insurance company money. Of course by doing this you save us all money in the long run, but to spend anytime in the emergency room and only pay $500.00 can be loosely called a bargain.

Reply by Frenchie/TN on 10/8/07 12:14pm
Msg #215421

Re: Did you get an itemized bill?

You are entitled to view a detailed bill so you know what these misc. items are and then you can challenge any of the charges if you did not receive the service/product you were charged for. Most insurance companies will give you some kind of credit if you find you were overbilled for anything so you may want to call your insurer as well.
The upside of this is that your daughter is okay!!
Definitely look into that bill because hospital make a lot of billing mistakes and some are big ones.

Reply by cassiewi on 10/8/07 12:24pm
Msg #215427

Re: Did you get an itemized bill?

It will be interesting when I get it because the bed time and bandage cannot cost $795. Yes, she was OK, shaken up, but OK. We've never had to take any of the kids to the ER before and I don't take them to the Dr for every little cold they get. This was just shocking.

Reply by cassiewi on 10/8/07 12:17pm
Msg #215422

Re: Did you get an itemized bill?

I requested one for the Physician Services bill. I haven't received the Hospital one with the Hosp Misc on it yet, just the statement from my insurance. I don't even care if I'm only saving the insurance company money. This really ticked me off. The Xray, I'm not worried about. That seems like a normal charge. The other stuff if just ridiculous.

Reply by Lee/AR on 10/8/07 12:17pm
Msg #215423

Is there anyone I can complain to? You can try...

but you probably won't get anywhere. Couple years ago, I cut my hand over a 3-day weekend & needed stitches. Was in the ER for 9 hours for 9 stitches for $900...$100/stitch or hour~~take your choice. Pays better 'n stamping--that's for sure. Just be happy you didn't need an ambulance, too. Walk, crawl, drag yourself--but do not call an ambulance.

Reply by cassiewi on 10/8/07 12:22pm
Msg #215426

My goodness!

That's just as crazy. I'm going to see what I can do, she was fine, and I guess 11 years and only one trip to the ER is not too shabby. Just a little sticker shock. Good thing they didn't give her any tylenol! Another $200!

Reply by LarryTN on 10/8/07 12:20pm
Msg #215424

Sorry about your daughter's accident....Welcome to the world of overbearing insurance companies and overcharging medical facilities! The insurance companies have "bought" the laws allowing them to pay what they like, and the medical community is in cahoots with them! If I am airlifted from an accident to a hospital my insurance won't pay, but if I'm airlifted from one facility to another, they will pay! Their "rules" are endless!
I had water damage to my home and my homeowners insurance would not pay because the damage was not caused by "sudden and gushing water"...These are big, well known insurance companies too! It's so one sided it's pathetic!

Reply by cassiewi on 10/8/07 12:30pm
Msg #215430

Thanks everyone for the suggestions

I appreciate it. My daughter is OK and we were all very relieved. It also scared me because the friend who ran into and fell on her is a 12 year old boy who looks 14. I just needed to vent, so I appreciate you guys letting me and giving me some advice. You are all right, at least she was OK and didn't break anything.

Reply by Frenchie/TN on 10/8/07 12:31pm
Msg #215431

Cassie,
I just thought of another thing. Did you check if your policy has an ER benefit? A lot of policies have such a benefit (usually $250.00) where the deductible does not apply. If insurance pays that up front and then your deductible kicks in then you'd be out of pocket $250.00 instead of $500.
The way our medical system works is really pitiful: I had thyroid surgery a few years ago and for an overnight stay at the hospital the bill was in the $16,000.00 range. That would have been my cost had I been uninsured. When I received final statement United Healthcare had paid less than $3000.00, the balance was an "insurance credit".

Reply by cassiewi on 10/8/07 12:38pm
Msg #215435

We don't. We actually have to pay a $50 deductible if we go to the ER. But it won't hurt to call and check. Don't you love those discounts? Yes, bill the people who don't have insurance.

Reply by Dennis D Broadbooks on 10/8/07 12:32pm
Msg #215432

Where Did the Accident Take Place?

Depending on where it occurred you may have several options under homeowners insurance. If it happened on your daughter's friend's property & the parents have homeowner's insurance you can make a claim under their policy for medical payments. Under most policies & in most states med pay is a fault free payment up to the limits (usually between $1K - $10K) shown on the declaration pages of the homeowners insurance policy. There's also the possibility you could make a claim against their homeowners policy for liability if the accident took place off their premises. The viability of this type claim would be predicated on the negligence of your daughter's friend. There would have to be demonstrable negligence on the daughter's friend's part in order for a liability claim to be paid by the insurance company. Both of these options can be rather dicey when dealing with friends & I'd never make the carte blanche recommendation you pursue either of these avenues without careful consideration. Your daughter &/or you may not have a friend anymore when all is said & done if you do.

BTW, this is not intended to be legal or insurance advice even though I'm a licensed producer for P&C insurance in the State of Missouri. Consult a professional insurance agent in your state for a more definitive answer to your particular situation if you should decide to pursue this angle further.

Reply by cassiewi on 10/8/07 12:36pm
Msg #215434

Re: Where Did the Accident Take Place?

No, it was in the cult de sac across the street from my house and my 9 year old was to blame for it. He was trying to play red light green light with a light saber which distracted the friend who then crashed into Breanna. THe friend was OK. Of course, he had something to land on. And I don't think even if it was at someone's house I could do that. Thank you for the suggestion though. I appreciate it.

Reply by Todd/OH on 10/8/07 2:14pm
Msg #215450

You might as well be at the Ritz Carlton - -

My youngest rode his bike into a parked car once and fell off at a weird angle. He banged his head on the ground and it dug in a little. Squad came and took him to ER as a precaution. ER wrapped him up on a stretcher and called LifeFlight. $6,000 later !!!

Reply by Michelle/AL on 10/8/07 8:30pm
Msg #215509

Cassie, I worked for a Hospital Administrator/CEO for 2 1/2

years. You may call me at 256-503-6595 (Central Time) and I'll be happy to talk with you about some possible options. This week Tuesday & Thursday mornings would work best for a conversation.

Reply by Mia on 10/8/07 2:11pm
Msg #215448

Next time.....

Next time (hopefully there won't be one) take her to an Urgent Care. They don't
charge as much, and in some cases they only charge you your deductible (like when
you go to your primary care physcian office -- if that's how your insurance works).

Since your daughters arm wasn't broken, this really doesn't apply at the moment, but,
if her arm was broken they wouldn't have put a cast on it anyways.... they would have
put a sling on it (have to let the swelling go down) and told you to make an appointment with an orthopedic surgeon...... ah, they have to pass the money around to each and every
doctor they can, that's the medical system we have.

Some Hospitals have an online system that patients can access to see itemizations of their bill. You could call the patient accounts department at the hospital that you took your daughter to and see if they have this type of online system.

Also, some Hospitals have money that is alotted for people who can't pay their medical bills.
Hospitals usually have money making functions (ie - dances, bake sales etc.) to help people
who don't have the ability to pay their medical bills -- I've heard them called "Uncompensated Care Funds".

Anyway, glad to hear your daughter is doing fine.

...

Reply by JanetK_CA on 10/10/07 1:54am
Msg #215753

For what it's worth...

I recommend that you put all your requests in writing and document everything - then pray a lot, because it may not do any good. I've been fighting a hospital bill for over a year now. It was for a "just-in-case" needle biopsy which fortunately didn't find anything but fatty tissue. The statement from the insurance co. shows two charges for "supplies" at $368 each, plus another $169 supply charge that was for pathology. (Probably the slide...) I couldn't think of a reason why there should be a duplicate supply charge - especially of that magnitude. (BTW, the whole thing took about 10 minutes and I left with one of those little round bandaids on the site of the biopsy...) My bill - after insurance adjustment - came to just under $1600 (exclusive of the doctors' fees, pathology, etc.) just for the hospital. (I have a $2000 deductible. My total costs, once everything was added up, came to roughly $2500. Ouch!!)

When I asked for an itemization of the bill, it came back with even less information than I already had from the insurance co. They just combined the two charges that appeared to be duplicates with no further detail. Recently, I finally got someone to actually look at my chart and they admitted that it had been billed wrong, but not that the total is an error. I haven't yet seen the newly revised invoice so I don't know what, if any, adjustments they will make. (I've pretty much paid it all already, but I wasn't happy about it!)

I think one of the reasons costs are so high is that the consumer has very little exposure to what the real costs are. It's next to impossible to do price comparisons, and besides "the insurance is paying for it anyway". BTW, I think Mia's suggestion to find a decent urgent care facility is a great idea. I had a painful problem with a shoulder a while back and was referred to an Urgent care place next to the same hospital. It only cost me my co-pay. And I ended up seeing the best looking doctor I think I've ever been to!! ;> (That part didn't hurt a bit!!)