6 ms·

Talk to me when you get a $4000 bill for 2 hours in ER where the actual doc saw you for 5 mins and then the nurses did band-aid and over the counter burn ointme

Talk to me when you get a $4000 bill for 2 hours in ER where the actual doc saw you for 5 mins and then the nurses did band-aid and over the counter burn ointment. This with Insurance (biggest mafia). AMerican Healthcare system baby!!

FireBeyond 3y ago
I was in one hospital ER for a kidney stone, but they had no urology available, so they sent me via ambulance ("thankfully", as a paramedic, one of our company benefits was that if we were ever transported, they'd bill our insurance and waive any charges to us) to another hospital. Ambulance crew wheeled me into the ER bay, where a 'transport' gurney from surgery, was waiting, and I slid from one to the other, and was wheeled to pre-op. At no point did the ER staff ever talk to me. At no point was I in a room. Or in an ER bed, hallway or otherwise. Just ambulance, transport, and then to pre-op. But, because the transfer physically happened in the ER, that second hospital tried to bill my insurance for an ER visit to the tune of $2,800 which I appealed (successfully, at least).
- anon-sre-srm 3y ago
  My elderly disabled mom on a fixed income is being billed for an ambulance ride from a hospital to a long-term care facility because Medicare deemed it "unnecessary" even though the shuttle couldn't take her.
  - FireBeyond 3y ago
    I'm sorry. Hospital staff are notoriously bad for incorrectly filling out the paperwork that Medicare requires to justify ambulance transport, such that we (paramedics and EMTs) are constantly explaining it to them. Shock, horror, you actually need to read through the form and select the appropriate checkboxes (around ability to stand, need for oxygen, fall risk and hazard, danger to self or others, etc., etc.) Too many of them literally fill out patient demographics and a signature and say "here you go". We push back because our organization policy is that we will transport those patients, BUT we would also much rather bill Medicare than the patient (our billing staff and C-suite may disagree, but EMTs and paramedics wholeheartedly understand that routine privately paid ambulance transport is not a viable option for 99.998% of the elderly).
- sokoloff 3y ago
  > At no point did the ER staff ever talk to me. How did the determination that you needed urology, "oops, no urology available", and ambulance transport get arranged? It seems like some level of triage, routing, unable, re-routing had to have happened, right?
  - Someone1234 3y ago
    I think you misunderstood their story. They [rightfully] got charged for the ER at Hospital #1, but were mistakenly charged for the ER a second time at Hospital #2.
    - sokoloff 3y ago
      Indeed I did. It now says "second hospital" in the last paragraph. I can't know whether I mis-read or if it was edited to clarify, but I definitely did misunderstand the story.
  - FireBeyond 3y ago
    Present with abdominal pain, admitted, CT imaging, pain management. Imaging read, kidney stone diagnosis confirmed (and of such a size that it needed immediate management). No urology available at hospital one, and because of narcotics on-board, transferred to nearby hospital via ambulance that did have a urologist available, so I could go straight to theater. But yes, hospital two tried to charge me for an ER visit, as well as the surgical billing (which of course was reasonable).
- BenFranklin100 3y ago
  One of our employees decided to go to a random hospital ER room for a small cut on his finger. It only required a bandage, no stitches. The ER charged us $3,300. We are still fighting them.
  - alistairSH 3y ago
    Fighting the ER or the employee? Sounds like it could have been handled at a PCP or urgent care or with a bandage at home? Staffing a full trauma center is expensive, it should cost a lot to use it.
    - BenFranklin100 3y ago
      Fighting the ER. The employee screwed up and did not go to the urgent care per policy for minor cuts. Still, it’s bad optics to fight an employee.
      - lotsofpulp 3y ago
        It’s bad optics to employ someone who doesn’t know what emergency means.
        BenFranklin100 3y ago
        Lol true.
        rqtwteye 3y ago
        The system should not be that complex and full of traps. I rarely go to a doctor and when I have to go every few years I have no idea how things work and what to avoid.
        alistairSH 3y ago
        It's not. ER - life or death (if you can drive yourself, it's probably not an emergency) Urgent Care - you have the flu, and your PCP isn't available; minor emergencies (but you can still drive yourself) PCP - flu, check-ups, whatever The balance billing and OON charges are separate issues from over-use of the ER.
mjamesaustin 3y ago
My recent ER visit charged $5000 to walk in the door, without even accounting for any actual care.
- rqtwteye 3y ago
  Wow!
anon-sre-srm 3y ago
A long time ago, I was once charged for being browbeaten into entering a social security number on a keypad by a belligerent ER security guard at a hospital. Didn't even see anyone, but still charged.
- gnicholas 3y ago
  Did you pay the bill or fight it? I would think that if no services were rendered, it would be fraud to charge someone.
edm0nd 3y ago
Counter point, why did you even bother going to the ER if that is all that was required? That solution doesn't really scream "emergency" and seems like a waste of their time and resources...
- autoexec 3y ago
  In the US just because a person doesn't get much actual care at an ER that doesn't necessarily mean that they didn't have good cause to go there. Some ERs don't always provide the level of care that they should, some doctors/insurance companies require patients to go to the ER for anything they need after office hours, and sometimes there's a need to be seen for something because of perfectly reasonable and valid concerns that it might be more serious than it ultimately ends up being. While it's possible that the commenter's visit to the ER was a "waste of time and resources" I don't think it's fair to assume that from what was said.
- Someone1234 3y ago
  Medical providers are constantly telling patients not to self-diagnose/self-treat/play google-doctor, but as soon as there is a billing problem, everyone uses that to victim blame. Kind of messed up if you ask me. Personally I am not qualified to determine what a treatable and non-treatable burn looks like. Where I went to school they don't teach that.
  - gizmo686 3y ago
    The ER is not the only place you can go for medical treatment. My order of operations for medical treatment are: 1) Virtual consultation. Free through my insurance. If you need to pay full price, this about as expensive as option 2. Also worth skipping if you can tell that an in person visit will be needed anyway. 2) A clinic. I use CVS's minute clinic. Looking at their price list [0], a minor burn treatment will run you about $100-$150, which is about what I would expect for talking to a professional. 3) Urgent Care 4) Emergency Room [0] https://www.cvs.com/minuteclinic/services/price-lists https://www.cvs.com/minuteclinic/services/price-lists
  - macNchz 3y ago
BobaFloutist 3y ago
I mean I'm not sure that you shouldn't be charged ER prices for taking an over-the-counter-treatable injury to the ER. You probably shouldn't be charged 4000 for going to the ER, but just because you didn't actually need to go to the ER doesn't mean you didn't consume ER resources (the 24/7 staffing, the intake logistics, the trauma expertise, etc). Probably the biggest surprise there is that a doctor saw you at all instead of you being filtered out by a triage nurse and sent to urgent care.
- dghlsakjg 3y ago
  You have no idea what this person was being seen for. It is fairly common for someone to be advised to seek emergency treatment out of precaution to ensure that a minor symptom is not indicative of a severe problem. For example dizziness can be a completely nothing-burger inner ear problem treated with a bunch of motions from youtube, or it can be a stroke. The ER exists to make that distinction. Part of all those logistics and resources should be used to shunt people to the correct treatment center, but liability suits and extreme profitability mean that the incentive is to treat them in the ER. Put into other terms, if you were hospital admin incentivized on billing, and could bill someone $5k instead of $160 for a non-urgent issue, wouldn't you? The fixed costs are the same, the ER is running 24/7 with a trauma team, might as well make it profitable.
  - BobaFloutist 3y ago
    >You have no idea what this person was being seen for. I feel fairly comfortable assuming that they were being seen for a minor-to-moderate burn.
    - dghlsakjg 3y ago
      That was the treatment received, but perhaps they were referred to the ER by EMS for smoke inhalation. I don't know either, but the broader point is that people are referred to the ED by medical professionals for seemingly minor issues all the time, and that the incentives are all lined up to treat stupid shit in the ER rather than have someone tell them to go somewhere that makes more sense.
deleted 3y ago
[deleted]
jajko 3y ago
The sum is not a problem per se, the costs would be similar in many developed countries. Specialists can and do charge a lot (or hospital that employs them). What matters is who picks up a bill (or challenges hospital and negotiates). I see little protection in US between patients and healthcare corporations, but its true I look from afar.
gotbeans 3y ago
26k for an mri /w contrast last week because insurance decided it's not necessary despite the doctor asking for it. Now the doctor has to put an appeal to explain medical necessity, I'm at his mercy.
- arealaccount 3y ago
  Is insurance the villain on this one of the hospital charging insurance 26k for an MRI?
  - alistairSH 3y ago
    Possibly all of the above. An MRI shouldn't cost $26k, even with contrast, and at a hospital. If this was non-emergency, it should have been pre-cleared with insurance per their policy.
    - lostlogin 3y ago
      I’m an MR tech. You could fly to New Zealand, have a scan on a state of the art machine, get a good report, have 3 weeks holiday and fly home. You’d have heaps of money left over.
  - triceratops 3y ago
    $26k for a contrast MRI is outrageous. An MRI machine costs $1m at the high end. If you figure the procedure takes 2h and the machine runs 22h/day - which they tend to do - they're making over a quarter of the cost of the machine daily. It doesn't cost anywhere near that to run it; even if we're talking maintenance, salaries, and utilities.
Arrath 3y ago
I was in a multiple rollover accident and wanted to get a scan because, well, I was hanging upside down by my seatbelt for a while so I thought it would be prudent to make sure my neck or something didn't get fucked up. The ambulance ride alone from the accident site to the hospital (like, 5 miles) was several thousand dollars.

FireBeyond 3y ago

I was in one hospital ER for a kidney stone, but they had no urology available, so they sent me via ambulance ("thankfully", as a paramedic, one of our company benefits was that if we were ever transported, they'd bill our insurance and waive any charges to us) to another hospital. Ambulance crew wheeled me into the ER bay, where a 'transport' gurney from surgery, was waiting, and I slid from one to the other, and was wheeled to pre-op. At no point did the ER staff ever talk to me. At no point was I in a room. Or in an ER bed, hallway or otherwise. Just ambulance, transport, and then to pre-op. But, because the transfer physically happened in the ER, that second hospital tried to bill my insurance for an ER visit to the tune of $2,800 which I appealed (successfully, at least).

anon-sre-srm 3y ago
My elderly disabled mom on a fixed income is being billed for an ambulance ride from a hospital to a long-term care facility because Medicare deemed it "unnecessary" even though the shuttle couldn't take her.
- FireBeyond 3y ago
  I'm sorry. Hospital staff are notoriously bad for incorrectly filling out the paperwork that Medicare requires to justify ambulance transport, such that we (paramedics and EMTs) are constantly explaining it to them. Shock, horror, you actually need to read through the form and select the appropriate checkboxes (around ability to stand, need for oxygen, fall risk and hazard, danger to self or others, etc., etc.) Too many of them literally fill out patient demographics and a signature and say "here you go". We push back because our organization policy is that we will transport those patients, BUT we would also much rather bill Medicare than the patient (our billing staff and C-suite may disagree, but EMTs and paramedics wholeheartedly understand that routine privately paid ambulance transport is not a viable option for 99.998% of the elderly).
sokoloff 3y ago
> At no point did the ER staff ever talk to me. How did the determination that you needed urology, "oops, no urology available", and ambulance transport get arranged? It seems like some level of triage, routing, unable, re-routing had to have happened, right?
- Someone1234 3y ago
  I think you misunderstood their story. They [rightfully] got charged for the ER at Hospital #1, but were mistakenly charged for the ER a second time at Hospital #2.
  - sokoloff 3y ago
    Indeed I did. It now says "second hospital" in the last paragraph. I can't know whether I mis-read or if it was edited to clarify, but I definitely did misunderstand the story.
- FireBeyond 3y ago
  Present with abdominal pain, admitted, CT imaging, pain management. Imaging read, kidney stone diagnosis confirmed (and of such a size that it needed immediate management). No urology available at hospital one, and because of narcotics on-board, transferred to nearby hospital via ambulance that did have a urologist available, so I could go straight to theater. But yes, hospital two tried to charge me for an ER visit, as well as the surgical billing (which of course was reasonable).
BenFranklin100 3y ago
One of our employees decided to go to a random hospital ER room for a small cut on his finger. It only required a bandage, no stitches. The ER charged us $3,300. We are still fighting them.
- alistairSH 3y ago
  Fighting the ER or the employee? Sounds like it could have been handled at a PCP or urgent care or with a bandage at home? Staffing a full trauma center is expensive, it should cost a lot to use it.
  - BenFranklin100 3y ago
    Fighting the ER. The employee screwed up and did not go to the urgent care per policy for minor cuts. Still, it’s bad optics to fight an employee.
    - lotsofpulp 3y ago
      It’s bad optics to employ someone who doesn’t know what emergency means.
      - BenFranklin100 3y ago
        Lol true.
      - rqtwteye 3y ago
        The system should not be that complex and full of traps. I rarely go to a doctor and when I have to go every few years I have no idea how things work and what to avoid.
        alistairSH 3y ago
        It's not. ER - life or death (if you can drive yourself, it's probably not an emergency) Urgent Care - you have the flu, and your PCP isn't available; minor emergencies (but you can still drive yourself) PCP - flu, check-ups, whatever The balance billing and OON charges are separate issues from over-use of the ER.

mjamesaustin 3y ago

My recent ER visit charged $5000 to walk in the door, without even accounting for any actual care.

rqtwteye 3y ago
Wow!

anon-sre-srm 3y ago

A long time ago, I was once charged for being browbeaten into entering a social security number on a keypad by a belligerent ER security guard at a hospital. Didn't even see anyone, but still charged.

gnicholas 3y ago
Did you pay the bill or fight it? I would think that if no services were rendered, it would be fraud to charge someone.

edm0nd 3y ago

Counter point, why did you even bother going to the ER if that is all that was required? That solution doesn't really scream "emergency" and seems like a waste of their time and resources...

autoexec 3y ago
In the US just because a person doesn't get much actual care at an ER that doesn't necessarily mean that they didn't have good cause to go there. Some ERs don't always provide the level of care that they should, some doctors/insurance companies require patients to go to the ER for anything they need after office hours, and sometimes there's a need to be seen for something because of perfectly reasonable and valid concerns that it might be more serious than it ultimately ends up being. While it's possible that the commenter's visit to the ER was a "waste of time and resources" I don't think it's fair to assume that from what was said.
Someone1234 3y ago
Medical providers are constantly telling patients not to self-diagnose/self-treat/play google-doctor, but as soon as there is a billing problem, everyone uses that to victim blame. Kind of messed up if you ask me. Personally I am not qualified to determine what a treatable and non-treatable burn looks like. Where I went to school they don't teach that.
- gizmo686 3y ago
  The ER is not the only place you can go for medical treatment. My order of operations for medical treatment are: 1) Virtual consultation. Free through my insurance. If you need to pay full price, this about as expensive as option 2. Also worth skipping if you can tell that an in person visit will be needed anyway. 2) A clinic. I use CVS's minute clinic. Looking at their price list [0], a minor burn treatment will run you about $100-$150, which is about what I would expect for talking to a professional. 3) Urgent Care 4) Emergency Room [0] https://www.cvs.com/minuteclinic/services/price-lists https://www.cvs.com/minuteclinic/services/price-lists
- macNchz 3y ago

BobaFloutist 3y ago

I mean I'm not sure that you shouldn't be charged ER prices for taking an over-the-counter-treatable injury to the ER. You probably shouldn't be charged 4000 for going to the ER, but just because you didn't actually need to go to the ER doesn't mean you didn't consume ER resources (the 24/7 staffing, the intake logistics, the trauma expertise, etc). Probably the biggest surprise there is that a doctor saw you at all instead of you being filtered out by a triage nurse and sent to urgent care.

dghlsakjg 3y ago
You have no idea what this person was being seen for. It is fairly common for someone to be advised to seek emergency treatment out of precaution to ensure that a minor symptom is not indicative of a severe problem. For example dizziness can be a completely nothing-burger inner ear problem treated with a bunch of motions from youtube, or it can be a stroke. The ER exists to make that distinction. Part of all those logistics and resources should be used to shunt people to the correct treatment center, but liability suits and extreme profitability mean that the incentive is to treat them in the ER. Put into other terms, if you were hospital admin incentivized on billing, and could bill someone $5k instead of $160 for a non-urgent issue, wouldn't you? The fixed costs are the same, the ER is running 24/7 with a trauma team, might as well make it profitable.
- BobaFloutist 3y ago
  >You have no idea what this person was being seen for. I feel fairly comfortable assuming that they were being seen for a minor-to-moderate burn.
  - dghlsakjg 3y ago
    That was the treatment received, but perhaps they were referred to the ER by EMS for smoke inhalation. I don't know either, but the broader point is that people are referred to the ED by medical professionals for seemingly minor issues all the time, and that the incentives are all lined up to treat stupid shit in the ER rather than have someone tell them to go somewhere that makes more sense.

deleted 3y ago

[deleted]

jajko 3y ago

The sum is not a problem per se, the costs would be similar in many developed countries. Specialists can and do charge a lot (or hospital that employs them). What matters is who picks up a bill (or challenges hospital and negotiates). I see little protection in US between patients and healthcare corporations, but its true I look from afar.

gotbeans 3y ago

26k for an mri /w contrast last week because insurance decided it's not necessary despite the doctor asking for it. Now the doctor has to put an appeal to explain medical necessity, I'm at his mercy.

arealaccount 3y ago
Is insurance the villain on this one of the hospital charging insurance 26k for an MRI?
- alistairSH 3y ago
  Possibly all of the above. An MRI shouldn't cost $26k, even with contrast, and at a hospital. If this was non-emergency, it should have been pre-cleared with insurance per their policy.
  - lostlogin 3y ago
    I’m an MR tech. You could fly to New Zealand, have a scan on a state of the art machine, get a good report, have 3 weeks holiday and fly home. You’d have heaps of money left over.
- triceratops 3y ago
  $26k for a contrast MRI is outrageous. An MRI machine costs $1m at the high end. If you figure the procedure takes 2h and the machine runs 22h/day - which they tend to do - they're making over a quarter of the cost of the machine daily. It doesn't cost anywhere near that to run it; even if we're talking maintenance, salaries, and utilities.

Arrath 3y ago

I was in a multiple rollover accident and wanted to get a scan because, well, I was hanging upside down by my seatbelt for a while so I thought it would be prudent to make sure my neck or something didn't get fucked up. The ambulance ride alone from the accident site to the hospital (like, 5 miles) was several thousand dollars.