Huge Emergency Room Bill

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I feel honestly sorry for you. You can request an itemized bill and try to dispute or negotiate the charges, however you have received the service and will probably end up paying for it. Usually you give consent for any diagnostics or treatment "deemed medically necessary" by the attending physician (even if he doesn't even see or treat you!).

I have to say that I too feel that you got taken advantage of. This is the first time EVER that I hear of someone ordering an MRI to rule out appendicitis. What is wrong with doctors these days? Where do they get their MD's?

And anybody wonders why no one trusts the medical establishment these days?
Good luck!

I understand your frustration but if the doctors arent sure what the problem is they have a legal and ethical obligation to rule out more serious problems. If it had been the appendix and IF your daughters appendix burst, she would feel better for a while, then get much MUCH worse...and could even die. Had this happened and all the doctors did was give her a shot in her butt and send you home, you would be suing them for Malpractice.

I do know that you can negotiate with the hospital. Call up the number on the bill and let them know that you are paying this out of pocket (they seem to have discounts and reduced rates when this is the case; sometimes like 70% off)

Good luck!

I am a nurse as well and I agree that you would treat the symptoms and if that helped then most of the time the ER would say for you to follow up with your primary care doctor or come back to the emergency room if signs and symptoms worsen. You don't need a written consent to have a MRI done but they really should have explained what the test was for and to me it's unusual that would do a MRI for gallbladder or appendicitis as a primary diagnosis. Usually blood work is done first and can tell you if appendicitis or gall stones are an issue. I would fight that part of the bill stating they were not medically necessary and I did not consent to have these done to my child. Good luck!

hi-
I would suggest you talk to the hospital - you may have to go to the top. document everything about your conversations (e.g. time of call, who you spoke to, what they said, etc). here are some thoughts:
1) Double check admissions paperwork you signed - there maybe a statement that says that you authorize the hospital to run any test they deem necessary
2) Ask for a break down of costs and let them know you are disputing the bill since you did not authorize the tests
3) do research on the medicine they gave her and what the risks that you daughter would still have appendicitis/gall bladder issues if there were no longer symptoms after giving her the medication
4) if they are unwilling to completely forgive the bill maybe they will reduce it (let them know you have a $6000 deductible and insurance refuses to pay any of the bill).
** Most importantly be VERY courteous and nice throughout the process (if you get angry/mean they will be less likely to work with you) **

Here are some websites with additional information:

http://www.ehow.com/how_###-###-####_dispute-hospital-bil...
http://www.consumerreports.org/health/insurance/make-sens...
http://moneycentral.msn.com/content/Insurance/Insureyourh...

http://www.mayoclinic.com/health/appendicitis/ds00274/dse... (Appendicitis info)
http://www.gallbladderattack.com/gallbladdersymptoms.shtml (gall bladder info)

Good luck!

I understand that this is a big chunk of money, but your child was sick and needed to be treated. I don't mean to sound harsh, but you made an insurance choice, a bet if you will, that all would be healthy, and you lost the bet. You are responsible for that choice, as you are for the bill. You might try calling the business affairs office and negotiating with them - there is usually wiggle room, but ultimately they provided the service.

You say you don't "feel the tests were necessary" - honestly, unless you're an ER doc, are you qualified to say that? Of course she was fine then - she was shot up with meds. Let's turn it around - what if they had not done the tests and something was terribly wrong? Would you feel the same way then?

Step up, take responsibility and have gratitude that we're not in Haiti, or somewhere that has no options.

I would fight it....and then talk to billing and have them work with you on cash prices. That's ridiculous. The imgaing place I refer people to locally charges $550 for an MR and little more for CT. I told somebody to go there before going to the hospital, but the figured their insurance would help them. Here's what happened. Their MR cost $5000 and their co-pay was $1800. They were so mad. NO WONDER THE COST OF HEALTHCARE IS SO HIGH....THEY ARE RAPING US.

Next time, just so you know, Goldenseal root is a natural blood purifier and antibiotic and works WONDERS with food poisoning, along with a probiotic...PB8. I always have those things in my house. I've never had to go to the hospital for anything....and never taken an antibiotic in my life...and trust me, we'd had food poisoning to the point, we thought we were going to die.

When you signed her in at the front desk you signed a consent for her to be treated, that is your consent for testing to be done. The meds they gave her might be similar to ones I have had that relax the muscles in the intestines, stomach, and colon. Just because the pain had eased up that didn't mean that the cause was gone. They were just being cautious.

Should they have discussed it with you first? Yes, should you have to pay for the tests? I can't say yes and I can't say no. It doesn't seem fair that they didn't explain it better but on the other hand they were done while you were there and you could have asked more information about them.

Medical costs are outrageous and I can't say something shouldn't be done to make the medical system better but I don't know what would be a good solution for anyone.

Im so sorry youre in this situation. I realize $7000 is a lot of money, but what if she had felt better after the shots, they send her home and her appendix ruptured? When it comes to minors, they always try to play it safe and rule out other options. I think you should be grateful to have such a dedicated and thorough medical staff attend your daughter.

i think you can ask your insurance to at least file a 'grievance" because it WASN'T medically necessary the hospital may have to provide specifics on why they would run such tests. At the very least, this may help to lower your bill.

we got a statement (not bill) from our insurance showing that my daughter (3 years old) visited our family doctor (not her pediatrician) for some sort of "surgery". Totally false. The date of the "surgery" was on MY birthday and I know exactly where we were that day, FAR from the doctor's office..for sure!

So we called the insurance and they called the office and has since filed what they call, a GRIEVANCE. I know our situation is not the same, but I think that the insurance should still be able to do this since you are disputing the necessities of those tests.

Not 100 % sure on this, but when you sign the consent paperwork for treatment, you agree to whatever the ER doc finds appropriate to run. There is a std. protocol to follow for a head injury, for abdominal pain, for high fever....etc.....
Doctors really need to follow the protocol and cover all the bases, or risk getting sued every time they treat someone. I think you can thank your ambulance chaser lawyers for all that.

I would sit down calmly with the business manager and try to work something out. Ask for a line item explanantion of every charge. Sometimes they find things.....in their review.

If you are calm and agreeable, they are much more likely to work something out than if you are freaked out and hysterical.

write a letter to your insurance then call the clinic and ask for the bill to be lowered. My insurance has always paid when I write to them a grievance letter. Call to ask the procedure. Takes a bit of time and well worth the effort.

Just an aside, I find it interesting that in Calif. the limit to file in small claims court is $7,500, and the limit for corporations is $5,000. You said your bill is $5,000? Curious...
Yes, negotiate, get on a payment plan, hospitals can be flexible.
Goodluck,
Wendy

Hmmm. Why won't your insurance pay any of it? The deductible is $5,000 but they won't pay any of what went over the deductible. Is that because they didn't feel the MRIs were medically necessary? Ask them why they aren't paying and getting them to send you a letter saying that the MRIs weren't necessary. Then you can show that to the hospital. They might be able to re-code the MRIs so the insurance will pay some of it. (Last year I had something denied because the doctor put the wrong code in because I was in a new age range and they had to put it in for my new age range, really.)

If it isn't about the insurance denying the MRIs, then I would work with the billing department - which I know everyone else said. When my Mom passed away, my brother asked for an itemized bill and there were several items that weren't hers. She also didn't really have insurance. They double-checked and removed the items. They also worked with him on the cost.

Finally, once you can get the amount lowered as much as you could lower it, being as sweet as sweet can be and documenting everything - names, days, times, quotes, etc., then explain you want to pay what is now owed but you will have to do it in payments. A lawyer told me once that with each and every payment, you write a note explaining how you want to pay your debt but this is all you can afford this month, and that you will keep making monthly payments until it is paid off.

Good luck with everything.

I agree with AJ. An itemized bill is a great way to start. Sometimes you can find things that never should have been charged to you, or items that you can dispute. Another option is seeing if they will "settle" the bill with you. Sometimes if you cannot pay the bill you can enter into an agreement on paying a lesser amount.

Goodluck, that is a tough spot to be in. At the very least you can set up a payment plan so as to not bankrupt you as you pay this bill off.

Many hospitals will lower the bill if you negotiate with them.

Just a note-if you decide to negotiate the amount-you will likely get a better rate if you are able to pay the negotiated amount in full rather than making payments. For example, you can tell them you will pay them $x and the check will be received in 5 days.

Also, wanted to comment on some responses as to why your insurance isn't paying anything-you stated you only have major medical. Normally, when you only have major medical coverage-this means inpatient coverage. If you're not admitted, then the ER visit isn't covered and you're responsible for the bill.

I am so sorry to hear about your expensive bill. I would suggest that you call the hospital billing, & let them know you received the bill and would like a discount because you are cash paying patient. Most likely, they will be willing to work with you. Reason is, they would rather get some pay then no pay. Unfortunately, because our world has come to taking everyone to court for just starring at someone (sarcastic), some doctors these days want to rule out everything to avoid missing some medical diagnosis and sending your daughter home sick. They do this to avoid a possible lawsuit. I see it both ways. If your daughter had appendicitis and was sent home undiagnosed, she can get very sick & worst cause scenario die from a ruptured appendix. So the doctor orders tests to cover his butt really. If you have a problem, you can always talk with the senior biller, or even administration. I hope it works out, but I am sure it will. Good Luck!

Hi P.,

I used to do medical billing and know how hard ins companies can be to deal with. The insurance will not pay for your deductible, but you can perhaps negoiate with the hospital. You can ask for a finacial waiver because of hardship. Be aware that they will want some proof of your financial situation. They may write off all or part of it, depending on your situation.

For the amount over the deductible, you need to find out why they denied it. Usually somewhere on the Explanation of Benefit there is an explanation. Sometimes they need corrected paperwork from the hospital. Sometimes they deny it and require that the hospital write it off and NOT bill the patient. If you cannot understand the EOB, call the insurance company and ask them to explain it to them. Often the call center is overseas and they often only know how to read what is written on the EOB, not to understand it. Ask nicely to speak to a supervisor.

Once you understand what the insurance requires you can go from there. If they need more information from the hospital, work with the billing department to get it to them. If it is supposed to be written off, show this to the billing dept. Mistakes in posting do happen sometimes, EOBs are not standardized and even reading them for a living, I occasionally had trouble reading them.

I once got a bill from an Urgent Care stating I owed hundreds of dollars. I had an issue with them, and with no doctor of my own at that time, did the follow up with them. I went through the EOBs and found they had written off what I owed and billed me the amount that was to be written off. I took everything down there and went over it with the biller. I showed how I actually owed less than $100. Once they corrected it, I wrote them a check for what I did owe. It takes time, but it can be done.

Best of luck to you.

you can probably negotiate with the hospital but more than likely you signed a consent to all treatment necessary when she was admitted. Who is your doctor?? many private practice dr. have call lines and can be paged 24/7 for questions and inquiries. SInce your ER is so high in general it may be a good idea to find a doc like this. good luck to you.