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I just got an emergency room bill. I had a severe sore throat and fever for 2 weeks, step tests came back negative. Then at night my back side started hurting s

I just got an emergency room bill. I had a severe sore throat and fever for 2 weeks, step tests came back negative. Then at night my back side started hurting so I went to the ER. I paid $850 at the ER and today I received another bill for $850. The only thing on the Bill just says > "Charges": $11,680 > "Adjustmnets: $9,980 I just got off the phone with them and they say that it will take 10 business days to receive an itemized bill. However, that means the itemized bill will be delivered after the current bill is due. How are they going to charge somebody $1700 without an itemization? Furthermore, I am expecting another bill from the ER doctor that saw me because they bill separately and are not covered by insurance. The ER legally cant tell you if the doctor or the hospital accepts your insurance. Thats so crazy. My wife was absolutely mortified. In brazil I never carried insurance but going to the ER I just had to pay R$400 flat fee for a private hospital. Anything else for tests they would give me the prices up front. My wife about started screaming when the woman brought in the credit card machine while I was still in pain in the ER hospital bed. It was so embarrassing. All this is with the top insurance my company (a ~$500 million startup) offers and to make it worse it happened when I was on a company mandated trip.

henryfjordan 7y ago
Talk to a lawyer.
- cbanek 7y ago
  Also, talk to your company. If it's a company trip, they may be on the hook this.
opportune 7y ago
I am not a lawyer or financial advisor. But I’ve heard that you can’t be sent to collections if you make a good faith attempt to pay your (medical) bill. Which in practice might mean you just pay $5 while you wait for the itemization
- mehrdadn 7y ago
  That would "acknowledge the debt" or something like that from what I understand?
  - opportune 7y ago
    From what I understand it, it doesn’t mean you acknowledge that the entire bill is for the correct amount. Also if you know you’re going to have to pay at least $5 out of pocket anyway you’re not really losing money. But again IANAL I’m just parroting advice I read on Reddit one time
- djsumdog 7y ago
  Insurance companies negotiate a lot of this stuff away. The poster needs to call them first, see if they can arrange a $5 payment without addition interest while the itemized bill comes in (honestly, there is legal ground here for not even being willing to honor any of the bill with itemization). Get on the phone, try to keep cool, but realize you're probably going to yell at some poor customer service rep at some point. Apologize, keep going and get the full bill before you agree to pay anything. Then you gotta do the same thing with the full bill on ever bullshit charge, over and over again. Honestly, how the fuck can they admit you and treat you and then bill you without telling you what the prices are up front? That's fucking madness right there. Imagine having to agree to having car or bicycle service without an estimate? Imagine the total cost being $2000 over the estimate? Would people pay? Of course not; it's worth it at that point to call a lawyer.
  - journalctl 7y ago
    The trouble is that in an emergency or urgent situation, you can’t really shop around for service. “I’m having a heart attack, but can we try the hospital in the next town over? Their cardiologist is cheaper.” Bike service is a leisurely afternoon; emergency medical care is not. It shouldn’t cost that much in the first place. You shouldn’t need to shop around for health care, and you shouldn’t be bankrupted by an emergency. Why people aren’t marching through the streets right now is beyond me.
uptownfunk 7y ago
Any reasonable company should be taking out insurance for work mandated outings
sjg007 7y ago
Federal law means your insurance has to pay for emergency room care. They do like to try to weasel out of it by saying you actually have a true emergency though. You can push back and get your state insurance regulator involved.
- ocdtrekkie 7y ago
  Isn't this why the costs are so outrageous? The guaranteed insurance coverage means hospitals know they can charge whatever they want. This is why I'm not psyched about single payer healthcare solutions: It's not solving the problem, and may just mean huge government waste. It'd be far more effective to aggressively regulate hospital billing, wouldn't it?
  - asdfasgasdgasdg 7y ago
    > It's not solving the problem, and may just mean huge government waste. You should look into the efficiency of medicare and medicaid if you're really worried about this. It might put some of your fears to rest.
  - lumost 7y ago
    Depends on whether hospitals execute efficiently on the capital they raise from bad billing practices. If they are, regulating billing either won't change the final costs, or degrade service.
  - sjg007 7y ago
    ERs are mandated to provide emergency care to anyone regardless of insurance status. They get sweet tax deductions to do so and they get reimbursed by medicare as well. Also they have to take every insurance. There's a limit though, usually they will do enough to stabilize you out of immediate danger. So if you go to the ER with cancer and no insurance they may help you stabilize but they won't necessarily treat your cancer.
walshemj 7y ago
That Single visit @ 11.5 k is about my total tax bill for a year in the UK. This year I had sepsis and had a two week stay in hospital - o dread to think what that would have cost
zaroth 7y ago
A couple things you should know. First, there is no such thing as late fees or interest on a hospital bill. Second, if you have called to question the bill, they cannot send it to collections until they have fulfilled your reasonable requests for more information. If you really did just get the bill it will be several months (and several more copies of the bill sent to you) before a final bill would show up that would indicate the account is "PAST DUE" and heading for collections. IANAL but you can safely wait for the itemized bill. In the future to save on costs, you might try to find a 24-hour Urgent Care instead of full-fledged ER. Unfortunately the level of equipment that they have to keep in a full ER means just having someone in a bed costs them a lot of money, even if they are just swabbing your throat for a strep test.
- inferiorhuman 7y ago
  First, there is no such thing as late fees or interest on a hospital bill. Sure, just like you can't charge extra for using a credit card in California as payment in most scenarios (you can get a cash discount though). There may not be late fees, but the hospital will absolutely offer to settle for a hefty discount if you pay ASAP. By the time you get something claiming "PAST DUE" the hospital may be less willing to negotiate.
  - jacobmassey 7y ago
    That’s not necessarily true. They would rather get something than nothing.
    - inferiorhuman 7y ago
      That’s not necessarily true. They would rather get something than nothing. Who said anything about getting nothing? If the hospital sells your debt to a collection agency they get something. If the hospital deals with it in house they can act like UVA[1] and sue you to garnish your wages or take out a lien on your property. Playing chicken with the hospital billing department is a bad way to deal with medical debt. 1: https://www.washingtonpost.com/health/uva-has-ruined-us-health-system-sues-thousands-of-patients-seizing-paychecks-and-putting-liens-on-homes/2019/09/09/5eb23306-c807-11e9-be05-f76ac4ec618c_story.html?noredirect=on https://www.washingtonpost.com/health/uva-has-ruined-us-heal...
tingletech 7y ago
if it was a work trip on company business, why wouldn't worker's comp kick in?

henryfjordan 7y ago

Talk to a lawyer.

cbanek 7y ago
Also, talk to your company. If it's a company trip, they may be on the hook this.

opportune 7y ago

I am not a lawyer or financial advisor. But I’ve heard that you can’t be sent to collections if you make a good faith attempt to pay your (medical) bill. Which in practice might mean you just pay $5 while you wait for the itemization

mehrdadn 7y ago
That would "acknowledge the debt" or something like that from what I understand?
- opportune 7y ago
  From what I understand it, it doesn’t mean you acknowledge that the entire bill is for the correct amount. Also if you know you’re going to have to pay at least $5 out of pocket anyway you’re not really losing money. But again IANAL I’m just parroting advice I read on Reddit one time
djsumdog 7y ago
Insurance companies negotiate a lot of this stuff away. The poster needs to call them first, see if they can arrange a $5 payment without addition interest while the itemized bill comes in (honestly, there is legal ground here for not even being willing to honor any of the bill with itemization). Get on the phone, try to keep cool, but realize you're probably going to yell at some poor customer service rep at some point. Apologize, keep going and get the full bill before you agree to pay anything. Then you gotta do the same thing with the full bill on ever bullshit charge, over and over again. Honestly, how the fuck can they admit you and treat you and then bill you without telling you what the prices are up front? That's fucking madness right there. Imagine having to agree to having car or bicycle service without an estimate? Imagine the total cost being $2000 over the estimate? Would people pay? Of course not; it's worth it at that point to call a lawyer.
- journalctl 7y ago
  The trouble is that in an emergency or urgent situation, you can’t really shop around for service. “I’m having a heart attack, but can we try the hospital in the next town over? Their cardiologist is cheaper.” Bike service is a leisurely afternoon; emergency medical care is not. It shouldn’t cost that much in the first place. You shouldn’t need to shop around for health care, and you shouldn’t be bankrupted by an emergency. Why people aren’t marching through the streets right now is beyond me.

uptownfunk 7y ago

Any reasonable company should be taking out insurance for work mandated outings

sjg007 7y ago

Federal law means your insurance has to pay for emergency room care. They do like to try to weasel out of it by saying you actually have a true emergency though. You can push back and get your state insurance regulator involved.

ocdtrekkie 7y ago
Isn't this why the costs are so outrageous? The guaranteed insurance coverage means hospitals know they can charge whatever they want. This is why I'm not psyched about single payer healthcare solutions: It's not solving the problem, and may just mean huge government waste. It'd be far more effective to aggressively regulate hospital billing, wouldn't it?
- asdfasgasdgasdg 7y ago
  > It's not solving the problem, and may just mean huge government waste. You should look into the efficiency of medicare and medicaid if you're really worried about this. It might put some of your fears to rest.
- lumost 7y ago
  Depends on whether hospitals execute efficiently on the capital they raise from bad billing practices. If they are, regulating billing either won't change the final costs, or degrade service.
- sjg007 7y ago
  ERs are mandated to provide emergency care to anyone regardless of insurance status. They get sweet tax deductions to do so and they get reimbursed by medicare as well. Also they have to take every insurance. There's a limit though, usually they will do enough to stabilize you out of immediate danger. So if you go to the ER with cancer and no insurance they may help you stabilize but they won't necessarily treat your cancer.

walshemj 7y ago

That Single visit @ 11.5 k is about my total tax bill for a year in the UK. This year I had sepsis and had a two week stay in hospital - o dread to think what that would have cost

zaroth 7y ago

A couple things you should know. First, there is no such thing as late fees or interest on a hospital bill. Second, if you have called to question the bill, they cannot send it to collections until they have fulfilled your reasonable requests for more information. If you really did just get the bill it will be several months (and several more copies of the bill sent to you) before a final bill would show up that would indicate the account is "PAST DUE" and heading for collections. IANAL but you can safely wait for the itemized bill. In the future to save on costs, you might try to find a 24-hour Urgent Care instead of full-fledged ER. Unfortunately the level of equipment that they have to keep in a full ER means just having someone in a bed costs them a lot of money, even if they are just swabbing your throat for a strep test.

inferiorhuman 7y ago
First, there is no such thing as late fees or interest on a hospital bill. Sure, just like you can't charge extra for using a credit card in California as payment in most scenarios (you can get a cash discount though). There may not be late fees, but the hospital will absolutely offer to settle for a hefty discount if you pay ASAP. By the time you get something claiming "PAST DUE" the hospital may be less willing to negotiate.
- jacobmassey 7y ago
  That’s not necessarily true. They would rather get something than nothing.
  - inferiorhuman 7y ago
    That’s not necessarily true. They would rather get something than nothing. Who said anything about getting nothing? If the hospital sells your debt to a collection agency they get something. If the hospital deals with it in house they can act like UVA[1] and sue you to garnish your wages or take out a lien on your property. Playing chicken with the hospital billing department is a bad way to deal with medical debt. 1: https://www.washingtonpost.com/health/uva-has-ruined-us-health-system-sues-thousands-of-patients-seizing-paychecks-and-putting-liens-on-homes/2019/09/09/5eb23306-c807-11e9-be05-f76ac4ec618c_story.html?noredirect=on https://www.washingtonpost.com/health/uva-has-ruined-us-heal...

tingletech 7y ago

if it was a work trip on company business, why wouldn't worker's comp kick in?