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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

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.

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.