6 ms·
Pretty sure 'surprise billing' laws that are coming down the pipe only apply to out-of-network bills, would not help cases like this. (per this https://www.cms
by awinter-py 5y ago
Pretty sure 'surprise billing' laws that are coming down the pipe only apply to out-of-network bills, would not help cases like this.
(per this https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bills https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bill...)
The hospital in the article has a price transparency page here https://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/price-estimate/price-transparency-disclaimer https://www.ssmhealth.com/resources/patients-visitors/pay-my... (behind multiple TOS of course). It seems to use epic / mychart. I used it to search for 'facility' and 'emergency' and got nothing. the embedded pdf bill calls this 'emergency services'.
My guess is that ER facility fee isn't a 'shoppable service' under CMS definitions because it can't be scheduled in advance, but the fact that it doesn't say 'abandon $800 ye who enter here' on the front door IMO should be a crime.
- sjg007 5y agoIn network hospitals usually can't charge a facility fee, but it will depend on your plan. Honestly, Congress needs to act on this. Most hospitals get Federal funding.
- awinter-py 5y agoI'm looking at the pdf embedded in the article -- on p5 the 858.92 charge is in the 'in net medical/rx combined' section -- I assume that means it's an in-network charge? this thing https://s3.documentcloud.org/documents/21177150/january-2022-bill-of-the-month.pdf https://s3.documentcloud.org/documents/21177150/january-2022...
- sjg007 5y agoYes. They should also ask the hospital and insurer for the CPT codes billed.