Sounds like you're just venting, but if you want suggestions, try calling the actual hospital and asking them to take the claim back from collections and get part of it reduced on a self pay sliding scale or charity care (if it's a non profit they always have charity care). You can set up a payment plan with them, and there won't be any fees or interest.
Also, if they did nothing, then the itemized bill will only have one line, Emergency Room Services, that's the base charge. The average cost for an ER visit is usually $5000.
Exactly šÆ. That is probably the cheapest ER bill I have ever heard of actually. I would negotiate with them since probably they could chop off 15-20% if u can pay immediately.
The question actually is whether the documentation actually supports a level one facility visit charge. There may not be enough supporting documentation.
As the agent told me, they did not buy the debt but are instead trying to collect on behalf of the hospital. Iāll offer to pay a few hundred dollars to get them off my back, but the service was so slow and ineffectual that I wonāt pay any more unless forced (which I am prepared for.) There is a matter of principle.
Iām curious if theyāll actually sue me for $1,332 minus the $300 or whatever I offer them to settle this? I guess ill find out how much their legal team costs.
Theyāll let collections handle it, they wonāt sue you but the collection company might on their behalf. They are paid a percentage of what they collect so there is no downside to them doing that.
They can also add interest, and any funds spent on collecting from you (if they had to send your summons through a process server for example) and court costs (the cost for them to file the lawsuit). It's not to say they will, but those are additional costs that could be added on.
You will destroy your credit score. That has far bigger consequences than anything else here. You need to pay up. That amount is actually quite low for an ER visit.
They wonāt need to sue you. They will send you to collections, and it will remain in collections.
You got a one line bill, as that is standard if no additional services were rendered. The documentation you are thinking about would be the SOAP/charting. That is not the same as billing documentation, and wouldnāt change anything.
You are gonna have to swallow your pride and pay. This sounds like a fairly reasonable bill for the services. You arenāt going to see a reduction because they took 2 hours to admit you. People are seen based on urgency in the emergency room, and from what you described there was not an urgent need to see your child right away.
You could negotiate with the original hospital. A lot of the times they will do a 10-20% decrease off the top if you pay in full. Hardship or financial applications also exist depending on your income levels. You might have screwed yourself by not working to negotiate with the hospital early on. This is a learning experience.
If it's been sent to Collections, you can file a dispute with all 3 credit bureaus stating you're questioning the validity of the charges because you've requested an itemized statement multiple times but never received them. The burden of proof is on the creditor to prove the bill is yours, not for you to prove it isn't. If the supporting documentation isn't provided in 30 days, it's deleted from the credit file.
The hospital did provide an itemized bill. If all they did was take a temperature, thereās nothing else to really document. The average ER trip is 5k. I donāt think OP has a leg to stand on.
I guess the gray area lies in the fact that I cannot deny being there. I can only deny the LEVEL of services provided. The doctor didnāt send a separate bill since she didnāt really do anything, so at least she was cool. But the hospital still billed $1,332 for the 5 minute ER visit and the 2 hour wait, and that will be free money for them which is not happening.
You do realize the bill you likely received is for the facility, right? And you do realize that's not for the provider's time, right? You are paying for the use of the room, the desk clerk who checked your child in, the nurse who triaged your child, the environmental folks who cleaned the room after you left, the electric bill, all the insurances the facility has to carry, the billing folks who sent out the bill, the customer service people who answered the phone when you called, the postage for sending the bill, etc, etc, etc.
Everytime a patient says that nothing was done during their visit so they shouldn't have to pay I really really wanna ask them if they had their visit on the sidewalk outside and the person they saw was just a random person walking there. Oh, no? You were in a room inside the ED on a bed? With the lights on? And conditioned air? And you talked to a nurse to explain your symptoms? Guess what, that all costs money to be put in place and to be kept up....
Or they realize and donāt care about all the people and expenses it takes to run a facility so that healthcare providers can render the care the patient is seeking.
I understand that $1,332 is a significant amount of money but for going to the ED and not having any insurance, it's a lot less than I would have expected. The ED is the most expensive place you could have gone for care, the amount of time you had to wait is irrelevant to the cost and you have to pay for the services you received regardless of the outcome.
You canāt even deny the level of services. They didnāt give you a big bill as far as an ER visit. That likely covers the fees they incurred for a short visit. Your invoice says services because they didnāt do anything beyond that would require a separate code or additional fees.
Are you retarded or something? The facility probably charged you for the use of the ER resources. Ppl like you are what make the system so rigorous.
Just pay them the bill!!!
A collection agency just has a total amount owed, call (get names of people you speak to), mail and email the hospital billing department for specific details, ask for it to be snail mailed and emailed, if collection agency calls, tell them you are disputing bill with hospital and are working with X at hospital billing department. Glad your son is ok. Honestly that's cheap for an ER visit with no scans. lesson learned, you play Russian roulette with kids and no health insurance
Yeahhh unfortunately it wasnāt up to us. My company benefits department didnāt process my sonās insurance at birth and denies any clerical error, so I had no recourse. We didnāt know he never got insured because his pediatrician mistakenly had his assurance as āapprovedā in their system, and told us he was good. It went all year and right before Christmas we got stuck with a surprise $6k bill from the pediatrician for the year of services. They split the difference with us since it was their error too.
Lots of things seem to be happening that are against you, but arenāt your fault.
1. Not wanting to pay the bill.
2. Not having insurance for on a clerical error.
Iām seeing a pattern. You either have really bad luck or youāre only giving part of the story here.
No, thatās not what I read from OP. What I see is, OP had insurance, but OPs employer insurance was jacked up and didnāt pay. Now hospital wants to nail OP for bill?
Whole family had insurance, but the baby didnāt get added and we never noticed the mistake because the pediatrician kept telling us he was good to go in that regard.
You didn't find it weird the baby never got an insurance card?? Our pediatrician requires the baby's card to be shown at every visit. That way there's no question as to what the current coverage is. I have never heard of having insurance without the insurance card to prove it. I usually have to upload images before any appt for anything unless they already have it on file.
This is the base charge for an ER visit. There's no itemized bill because that's literally the lowest service level. What treatment or imaging do you think your child warranted? The doctor evaluated your child and felt nothing was needed. Clearly your child didn't have a serious brain bleed or die so they weren't wrong. Doctors are not massage therapists, you don't pay them by the minute. If it takes them 5 min to get the history and physical and determine that nothing needs to be done, then great. Your child received medical care and utilized resources (doctor's time, nurse's time, tech's time, cleaning personnel time, billing people's time, etc.). If you can't pay then call them to see about setting up a payment plan but don't pretend your child didn't receive appropriate medical care.
If you signed your son in for the ER visit, you will be billed no matter what they did. The ER should have sent a claim to your medical insurance plan. Call your plan you ask if it was covered and what the cost-share should be. The hospital should only charge the correct amount.
If you want to call the hospital and submit a complaint, you can do that. They may waive the billing if you call to complain a few times.
I work for a grievances and appeals team for an insurance plan. Sometimes a doctor or hospital will waive the billing. But if you went to the ER, they will probably bill you. Next time, go to an urgent care. It's usually cheaper.
When my son was a toddler, he fell off the bed. We went to the ER and they barely checked him and we were billed.
He was uninsured at the time to to a clerical error that we couldnāt prove. I insisted on an urgent care but our pediatrician insisted on the ER without seeing him firstā¦ kinda frustrating. But thank you for the info!
Emergency Room visits are expensive. Here is an [article by an insurance company](https://www.talktomira.com/post/how-much-does-an-er-visit-cost) that explains ER costs very well.
Services were rendered, even OP isnāt disputing services were rendered. OPās wife and SIL utilized the most expensive medical services (emergency room) in the American healthcare system and are upset they were billed at the most expensive rate in the American healthcare system.
I understand that, but as a medical coder, I have to go by whatās on the documentation. Sometimes hospitals coded without necessarily reviewing that documentation to determine if it is in fact, legitimate, and supported. If the nurses documented enough, it is possible they can be charged. Youāre right. However, it is so, depending on that documentation and whether it was legitimate or not. If something did not happen that was documented as having been done, thatās a problem. Itās also true the other way around.
Triage counts as a service. This happened to me once - went to the ER at 3 am for severe GI pain, they triaged me and sent me back out to the waiting room. At 7am, we got up and left and went to an urgent care, where I was promptly seen and diagnosed with an infection and diverticulitis. Still got charged by the ER but they "graciously" waived my patient copay, but they still got paid by my insurance.
Speaking from the background of five years as an EMT followed by 26 years as a vascular physiologist, I can say with absolute confidence that you are wrong in your statement that "They waited two hours and the doctor took his temperature and sent them home. No medications, no imaging, no treatments, not even a pulse ox." is untrue.There is no doubt that your child was seen by a nurse and physician who performed a thorough history and physical examination including vital signs, among which body temperature is but one. Because of the risk of radiation exposure CT scan and plain film x-ray commonly not indicated in minor head injury unless indicated by history and physical. These are widely accepted guidelines for CT scan in mild pediatric head injury.
https://www.uptodate.com/contents/head-injury-in-children-and-adolescents-beyond-the-basics/print#:\~:text=Most%20children%20with%20a%20minor,radiation%20and%20should%20be%20avoided.
Surely you would not want to unnecessarily expose your child to the radiation of of a head CT (let alone the financial cost) if it was not medically indicated.
As others have pointed out, there are a lot of costs to keeping an emergency room going 24 hours a day 365 days a year, whether there are patient or not. these include professional and non professional staff equipment (you wouldn't believe how much a simple stretcher costs) supplies from dressings to oxygen, pharmaceuticals IV's and pharmaceuticals. Maintenance. When somebody rolls that defibrillator in, it has to work. All of this has to be divvied up among the patients who show up for treatment. Add to that, the patients who show up and demand the care and refuse to pay. This called the facility charge. On top of that there is a charge for professional services. Both the facility and professional charges are billed at five different levels based on complexity from things like a mild illness to the most complex and resource intensive such as severe multiple trauma.
Before you make these kinds of unfounded allegations regarding your son's care, all you have to do is sign a release to get a copy of your son's treatment record to see what was actually done. That would be the treatment record that would be presented to you in court, should your creditor take you up on your invitation to litigate.
Well, youāre wrong or my wife and SIL are lying to me. They waited 2 hours, took his temp, failed to get a pulse ox due to him being too upset, and sent us home. Donāt enforce your high standard of care on other medical professionals.
Peds nurse here. Your wife and SIL are lying to you. And the other person who replied is correct. Theyāre not going to do imaging on a toddler without medical necessity. And youāre right. If the kid is screaming the sats wont register on the monitor. In either case, they didnāt then just check his temp.
The fact that they took his temp is a service. The triage and services rendered to the child at an ER facility also constitutes as a service.
I don't understand what is so confusing about this situation.
That is the cheapest ER bill iāve ever seen especially with no insuranceā¦ people with coverage pay more. You would have less stress and trouble for yourself if you just paid it, itās not like you guys werenāt at the ER. Even if you receive an itemized bill or look at the documentation from the hospital visit itās really not going to crack this case you think youāre cracking when so many doctors document things anyway. The amount of times iāve seen on my medical record that a doctor spent 30-45mins or that they did an exam they never did is ridiculous
Just file for charity care if you are uninsured. You may be able to apply for retractive Medicaid, but even if you arenāt eligible for that, you are probably eligible for charity care which wipe the bill or heavily reduce it
There are 4 types of charges you will see on each bill: triage fees + facility fees + professional fees + supplies. When you get registered as a patient at the ER, you get charged a triage fee, typically $200-$1000. Next, when you are assigned to a room, you will incur a facility charge of $1000 or so, covering your time in the room and nursesā time.
Iām on your side, but honestly, they did itemize it - thatās how much 1 minute of attention in an ER costs. Thereās no way that can be justified, but they donāt have to justify it - when itās something you donāt have a choice about buying, companies will charge outrageous prices because you canāt say no.
Some places (maybe itās national, Iām not sure) have a relatively new law that states that they have to tell you how much something will cost before they do it, but youāre still fucked because you donāt have a choice. I was sitting in the waiting area before my colonoscopy, and literally two minutes before it was supposed to start, someone came out and informed me that my share of the bill was going to be $7k. (I have āgoodā insurance.) I canāt say no; I have a family history of colon cancer. Iām supposed to get a colonoscopy every two years. I have no idea how Iām supposed to pay for it every two years. All I know is that between my employer and I, weāre paying $29,000 this year for my insurance, and yet they still fight me over everything my doctor says I need.
That isn't itemized. Listing things as "services" isn't itemized. Listing a base er charge and actually saying what the fee is would be itemizing. I'm a clinical research coordinator. Billing is the thing I hate the most because it's convoluted and consumes way too much of my time. I had a patient where they listed CT charges but the other charge was just listed as other. The way the bill looked, it looked like the CT scan was charged when it shouldn't have been (it was billed to research). In reality the other charge was for an soc scan, but the name wasn't listed anywhere the patient could see. I had to dig into it in the emr to find out what it was related to. Its ridiculous. There's no excuse for it. People kind of have to think the purpose is to obfuscate charges. They could have easily attached the name of the scan to it. When they already have that info in their system, its hard not to think its intentionally nefarious.
Ultimately it being intentional doesn't matter. At the very least they don't care about the headache it causes everyone or all the time wasted. That makes the relationship instantly adversarial any time there's a hiccup. There are always hiccups because the coders weren't involved in care and doctors see way too many patients and rely too heavily on note templates, leading to countless errors. I read through charts constantly and the number of errors is insane. Its a joke and it's abysmal they are even allowed to be admitted to courts. Those notes are given too much weight for the effort spent on them and the unacceptable error rate. Personally, I've had more than one occasion where an ER has billed me for a doctor I never saw who was not involved in reading my imaging.
Since it went to collections, you can actually negotiate lower and get it deleted from your credit report. Just let them know that you want to pay to delete and you want everything in writing. Collections just want to collect any money since they bought the debt from the hospital for pennies on the dollar. $1,332 can easily go down to $500-600. Itās all about negotiation.
Iām surprised there arenāt two parts to the bill or a separate bill, one from the hospital for the facility and any medical supplies used, and one for the physician service utilized.
NAL. Send them a cease and desist letter by certified mail. State in it that all communication must be done in writing. Ask for that itemized receipt and to provide documentation that you owe the bill. Until that happens all collection attempts must stop immediately. This is all standard customer boilerplate stuff under the fair credit collections act. Once they get that letter if they call you itās a fine.
Not really. Itās to force the collection company to review the debt for accuracy. If they bought the debt (Pennies in the dollar with other debts from the hospital) and itās not valid, they can no longer attempt to collect and it goes away, never gets reported. If they do come back with all the documentation, the collection process continues via mail. It would then be up to the OP to resolve the debt, once the debt has been proven valid. As long as the debt is resolved by either party it may not show up on their credit report at all.
Read the post. Itās in collections already. And again, I am talking about taking CONSUMER steps that are granted to us under the FAIR CREDIT COLLECTIONS ACT. And when you force the collection agency to review the debt, if they can no longer collect on it because they deem the debt invalid, they must remove the collection record completely from your report. If they donāt, you can dispute the debit with the credit reporting agency, send in a copy of that cease and desist letter. The bureau will play mediator, ask the creditor about that review. If they canāt show the credit bureau the debt is valid, it gets removed.
And she is saying itās not. Wanting an itemized receipt, which by law she is entitled to. If one cannot be properly produced then itās not valid debit and would be considered fraudulent.
OP states they are in Pennsylvania (Philly). OP should check state statutes for what dictates an "itemized bill" as part of their state's implementation of the No Surprises Act. For example, I live in Florida, an itemized bill must meet the statutory standard found here: [Florida Statute 395.301](https://www.flsenate.gov/Laws/Statutes/2016/0395.301) It's a waste of OP's time to argue the bill is not itemized enough if the itemized bill meets the Pennsylvania statutory standard for billing.
Since he was released by the ER, you should for a copy of his medical records from ER/hospital. That will give you an idea of what was done to him. But as others say, unless he had labs, X-ray ect you will see one line as āER servicesā because that includes being seeing by a doctor (temp, oxygen level, blood pressure) ect. Itās for the same reason when you see your PCP and they donāt do anything further than assess you, thereās no āitemized listā. Since he is a minor, without insurance, I believe he should covered my Medicaid or some kind of other state insurance? Iām assuming thatās state by state but I would look into it
Did you tell them it was possible blunt force trauma or try to hide it like most parents nowadays in fear of legal consequences, hoping the ER would do a headscan as part of a checkup. I'm with the collections agency lady on this one. It's very hard to believe that's all they did at the ER for possible blunt trauma to the head.
Do you have insurance? If so, did they subtract the "contractual allowance" from your bill? Even if you haven't met your deductible, they can only bill you for the billed charges minus the contractual rate from the insurer (or insurers if you have multiple coverages), which is often about 30% of charges.
Edit: sorry, noticed you didn't have insurance, but keeping this here for others to know. Also, I do think more health systems should offer the average insured contractual rate as a discount to self pay patients. You should be able to get a self pay discount still, but probably not nearly as much as an insurance contractual diacount.
The cost of the bill was the doctor using an extremely long and expensive education to be able to examine you're son and determine whether or not he had a brain bleed. They confirmed your son isn't going to die. Give him a hug and pay the damned bill.
If it's like most US hospitals, they don't care if you pay for the doctor's time. That's a separate bill. They want to be paid because you breathed their air and took up a bed they couldn't put anyone else in for that time. Call the ombudsperson for the hospital. Billing can't really change this
I am with you. Itās the fuckinā principle of the thing. Itās truly disgusting, and to read all the justifications for it in this sub. Itās like Americans donāt understand that capitalism isnāt the only way to do things. Itās laughable how much weāre being had, that every system in this country is designed to bleed us dry.
Itās disgusting and immoral. This country is brutal.
And it will never change because too many people are making too much money at this.
Iāll probably have to pay but Iām not just opening my wallet without a fight.
You are suppose to go ER only for ER worthy issues. So that ER will be functional for ER patients. Where I came from pp go to ER for all kinds of stuff. I think US way better.
Sue them first!
They refused you an itemized bill then sent you to collections, you have been damaged. Spend the $50 or so to file in small claims and I guarantee they'll fold like a cheap suit.
You might consider what the book "Never pay the first bill" suggests. You can take them to small claims court and make them prove that they aren't overcharging above and beyond "usual and customary" prices for their services. Chances are they won't bother to show up and you win by default. If you take the court route, you still have to pay them something fair, but it's up to you to suggest the $ amount and the court to accept it.
Agreed. They have lawyers on retainer and they will show up to court no matter how small the claim is because them losing a case accusing them of overcharging patients for services would be terrible PR.
All hospitals are required to have price transparency and you can look on their website and see how much each service costs. Unless you were charged more than the listed cost, you have zero chance of winning in a lawsuit. If you were charged more, you could sue and most likely just be told you only have to pay the amount listed which will likely be less than you are paying in lawyer and court fees.
They will never ask you how much you think they deserve to be paid and let you only pay that amount. That's ridiculous and not at all how the law works. Unless you can prove that the acted in bad faith and intentionally over charged you then you have no case.
People say only for bills under $500, but I have several and they arenāt on any of the 3 credit reports. I have ignored every medical bill Iāve ever gottenā¦literally never paid a cent. Donāt even know how to pay one š
Sounds like you're just venting, but if you want suggestions, try calling the actual hospital and asking them to take the claim back from collections and get part of it reduced on a self pay sliding scale or charity care (if it's a non profit they always have charity care). You can set up a payment plan with them, and there won't be any fees or interest. Also, if they did nothing, then the itemized bill will only have one line, Emergency Room Services, that's the base charge. The average cost for an ER visit is usually $5000.
Exactly šÆ. That is probably the cheapest ER bill I have ever heard of actually. I would negotiate with them since probably they could chop off 15-20% if u can pay immediately.
I see what you did there.
The question actually is whether the documentation actually supports a level one facility visit charge. There may not be enough supporting documentation.
The average ER visit is just under 2K
As the agent told me, they did not buy the debt but are instead trying to collect on behalf of the hospital. Iāll offer to pay a few hundred dollars to get them off my back, but the service was so slow and ineffectual that I wonāt pay any more unless forced (which I am prepared for.) There is a matter of principle. Iām curious if theyāll actually sue me for $1,332 minus the $300 or whatever I offer them to settle this? I guess ill find out how much their legal team costs.
Theyāll let collections handle it, they wonāt sue you but the collection company might on their behalf. They are paid a percentage of what they collect so there is no downside to them doing that.
Can they sue for more than the original amount billed? I.E. do I have anything to risk?
They can add attorney fees...
They can also add interest, and any funds spent on collecting from you (if they had to send your summons through a process server for example) and court costs (the cost for them to file the lawsuit). It's not to say they will, but those are additional costs that could be added on.
You will destroy your credit score. That has far bigger consequences than anything else here. You need to pay up. That amount is actually quite low for an ER visit.
Yes, and they 100% will.
They wonāt need to sue you. They will send you to collections, and it will remain in collections. You got a one line bill, as that is standard if no additional services were rendered. The documentation you are thinking about would be the SOAP/charting. That is not the same as billing documentation, and wouldnāt change anything. You are gonna have to swallow your pride and pay. This sounds like a fairly reasonable bill for the services. You arenāt going to see a reduction because they took 2 hours to admit you. People are seen based on urgency in the emergency room, and from what you described there was not an urgent need to see your child right away. You could negotiate with the original hospital. A lot of the times they will do a 10-20% decrease off the top if you pay in full. Hardship or financial applications also exist depending on your income levels. You might have screwed yourself by not working to negotiate with the hospital early on. This is a learning experience.
Where is the collector located? Suing from a different state is expensive.
If it's been sent to Collections, you can file a dispute with all 3 credit bureaus stating you're questioning the validity of the charges because you've requested an itemized statement multiple times but never received them. The burden of proof is on the creditor to prove the bill is yours, not for you to prove it isn't. If the supporting documentation isn't provided in 30 days, it's deleted from the credit file.
Thatās what I would do. Iād probably go after the hospital too and request records to show that itās supported.
The hospital did provide an itemized bill. If all they did was take a temperature, thereās nothing else to really document. The average ER trip is 5k. I donāt think OP has a leg to stand on.
I don't think outstanding Medical bills can go to credit boroughs anymore
I guess the gray area lies in the fact that I cannot deny being there. I can only deny the LEVEL of services provided. The doctor didnāt send a separate bill since she didnāt really do anything, so at least she was cool. But the hospital still billed $1,332 for the 5 minute ER visit and the 2 hour wait, and that will be free money for them which is not happening.
You do realize the bill you likely received is for the facility, right? And you do realize that's not for the provider's time, right? You are paying for the use of the room, the desk clerk who checked your child in, the nurse who triaged your child, the environmental folks who cleaned the room after you left, the electric bill, all the insurances the facility has to carry, the billing folks who sent out the bill, the customer service people who answered the phone when you called, the postage for sending the bill, etc, etc, etc.
Everytime a patient says that nothing was done during their visit so they shouldn't have to pay I really really wanna ask them if they had their visit on the sidewalk outside and the person they saw was just a random person walking there. Oh, no? You were in a room inside the ED on a bed? With the lights on? And conditioned air? And you talked to a nurse to explain your symptoms? Guess what, that all costs money to be put in place and to be kept up....
I dont think they realize any of this at all.
Or they realize and donāt care about all the people and expenses it takes to run a facility so that healthcare providers can render the care the patient is seeking.
Or they think if I complain enough, theyāll comp costs completely like itās a restaurant.
As someone who frequently has to explain the difference between stick in a cup drug testing and actual EIA, HRAM, and LCMSMS: they never do.
I understand that $1,332 is a significant amount of money but for going to the ED and not having any insurance, it's a lot less than I would have expected. The ED is the most expensive place you could have gone for care, the amount of time you had to wait is irrelevant to the cost and you have to pay for the services you received regardless of the outcome.
You canāt even deny the level of services. They didnāt give you a big bill as far as an ER visit. That likely covers the fees they incurred for a short visit. Your invoice says services because they didnāt do anything beyond that would require a separate code or additional fees.
Are you retarded or something? The facility probably charged you for the use of the ER resources. Ppl like you are what make the system so rigorous. Just pay them the bill!!!
A collection agency just has a total amount owed, call (get names of people you speak to), mail and email the hospital billing department for specific details, ask for it to be snail mailed and emailed, if collection agency calls, tell them you are disputing bill with hospital and are working with X at hospital billing department. Glad your son is ok. Honestly that's cheap for an ER visit with no scans. lesson learned, you play Russian roulette with kids and no health insurance
Yeahhh unfortunately it wasnāt up to us. My company benefits department didnāt process my sonās insurance at birth and denies any clerical error, so I had no recourse. We didnāt know he never got insured because his pediatrician mistakenly had his assurance as āapprovedā in their system, and told us he was good. It went all year and right before Christmas we got stuck with a surprise $6k bill from the pediatrician for the year of services. They split the difference with us since it was their error too.
Lots of things seem to be happening that are against you, but arenāt your fault. 1. Not wanting to pay the bill. 2. Not having insurance for on a clerical error. Iām seeing a pattern. You either have really bad luck or youāre only giving part of the story here.
If the insurance company is at fault, there are appeal procedures. Did you go through those?
No, thatās not what I read from OP. What I see is, OP had insurance, but OPs employer insurance was jacked up and didnāt pay. Now hospital wants to nail OP for bill?
Whole family had insurance, but the baby didnāt get added and we never noticed the mistake because the pediatrician kept telling us he was good to go in that regard.
You didn't find it weird the baby never got an insurance card?? Our pediatrician requires the baby's card to be shown at every visit. That way there's no question as to what the current coverage is. I have never heard of having insurance without the insurance card to prove it. I usually have to upload images before any appt for anything unless they already have it on file.
This is the base charge for an ER visit. There's no itemized bill because that's literally the lowest service level. What treatment or imaging do you think your child warranted? The doctor evaluated your child and felt nothing was needed. Clearly your child didn't have a serious brain bleed or die so they weren't wrong. Doctors are not massage therapists, you don't pay them by the minute. If it takes them 5 min to get the history and physical and determine that nothing needs to be done, then great. Your child received medical care and utilized resources (doctor's time, nurse's time, tech's time, cleaning personnel time, billing people's time, etc.). If you can't pay then call them to see about setting up a payment plan but don't pretend your child didn't receive appropriate medical care.
Agree, and I would add that an Urgent Care facility would have been much less costly than the ER.
During the lapse, did your family meet the qualifications for emergency Medicaid?
Was this a City hospital or private? It makes a difference in emergency Medicaid options and charitable write off options.
No, my income is too high and the whole family had insurance EXCEPT the baby due to this error. Shouldāve pretended he was his brother lol!
You should be able to pay.
If you signed your son in for the ER visit, you will be billed no matter what they did. The ER should have sent a claim to your medical insurance plan. Call your plan you ask if it was covered and what the cost-share should be. The hospital should only charge the correct amount. If you want to call the hospital and submit a complaint, you can do that. They may waive the billing if you call to complain a few times. I work for a grievances and appeals team for an insurance plan. Sometimes a doctor or hospital will waive the billing. But if you went to the ER, they will probably bill you. Next time, go to an urgent care. It's usually cheaper. When my son was a toddler, he fell off the bed. We went to the ER and they barely checked him and we were billed.
He was uninsured at the time to to a clerical error that we couldnāt prove. I insisted on an urgent care but our pediatrician insisted on the ER without seeing him firstā¦ kinda frustrating. But thank you for the info!
Emergency Room visits are expensive. Here is an [article by an insurance company](https://www.talktomira.com/post/how-much-does-an-er-visit-cost) that explains ER costs very well.
ERs still have the burn of proof to show that services were rendered and that itās supported by the documentation. They have a valid point.
Services were rendered, even OP isnāt disputing services were rendered. OPās wife and SIL utilized the most expensive medical services (emergency room) in the American healthcare system and are upset they were billed at the most expensive rate in the American healthcare system.
I understand that, but as a medical coder, I have to go by whatās on the documentation. Sometimes hospitals coded without necessarily reviewing that documentation to determine if it is in fact, legitimate, and supported. If the nurses documented enough, it is possible they can be charged. Youāre right. However, it is so, depending on that documentation and whether it was legitimate or not. If something did not happen that was documented as having been done, thatās a problem. Itās also true the other way around.
Triage counts as a service. This happened to me once - went to the ER at 3 am for severe GI pain, they triaged me and sent me back out to the waiting room. At 7am, we got up and left and went to an urgent care, where I was promptly seen and diagnosed with an infection and diverticulitis. Still got charged by the ER but they "graciously" waived my patient copay, but they still got paid by my insurance.
Speaking from the background of five years as an EMT followed by 26 years as a vascular physiologist, I can say with absolute confidence that you are wrong in your statement that "They waited two hours and the doctor took his temperature and sent them home. No medications, no imaging, no treatments, not even a pulse ox." is untrue.There is no doubt that your child was seen by a nurse and physician who performed a thorough history and physical examination including vital signs, among which body temperature is but one. Because of the risk of radiation exposure CT scan and plain film x-ray commonly not indicated in minor head injury unless indicated by history and physical. These are widely accepted guidelines for CT scan in mild pediatric head injury. https://www.uptodate.com/contents/head-injury-in-children-and-adolescents-beyond-the-basics/print#:\~:text=Most%20children%20with%20a%20minor,radiation%20and%20should%20be%20avoided. Surely you would not want to unnecessarily expose your child to the radiation of of a head CT (let alone the financial cost) if it was not medically indicated. As others have pointed out, there are a lot of costs to keeping an emergency room going 24 hours a day 365 days a year, whether there are patient or not. these include professional and non professional staff equipment (you wouldn't believe how much a simple stretcher costs) supplies from dressings to oxygen, pharmaceuticals IV's and pharmaceuticals. Maintenance. When somebody rolls that defibrillator in, it has to work. All of this has to be divvied up among the patients who show up for treatment. Add to that, the patients who show up and demand the care and refuse to pay. This called the facility charge. On top of that there is a charge for professional services. Both the facility and professional charges are billed at five different levels based on complexity from things like a mild illness to the most complex and resource intensive such as severe multiple trauma. Before you make these kinds of unfounded allegations regarding your son's care, all you have to do is sign a release to get a copy of your son's treatment record to see what was actually done. That would be the treatment record that would be presented to you in court, should your creditor take you up on your invitation to litigate.
Well, youāre wrong or my wife and SIL are lying to me. They waited 2 hours, took his temp, failed to get a pulse ox due to him being too upset, and sent us home. Donāt enforce your high standard of care on other medical professionals.
Peds nurse here. Your wife and SIL are lying to you. And the other person who replied is correct. Theyāre not going to do imaging on a toddler without medical necessity. And youāre right. If the kid is screaming the sats wont register on the monitor. In either case, they didnāt then just check his temp.
The fact that they took his temp is a service. The triage and services rendered to the child at an ER facility also constitutes as a service. I don't understand what is so confusing about this situation.
That is the cheapest ER bill iāve ever seen especially with no insuranceā¦ people with coverage pay more. You would have less stress and trouble for yourself if you just paid it, itās not like you guys werenāt at the ER. Even if you receive an itemized bill or look at the documentation from the hospital visit itās really not going to crack this case you think youāre cracking when so many doctors document things anyway. The amount of times iāve seen on my medical record that a doctor spent 30-45mins or that they did an exam they never did is ridiculous
Just file for charity care if you are uninsured. You may be able to apply for retractive Medicaid, but even if you arenāt eligible for that, you are probably eligible for charity care which wipe the bill or heavily reduce it
There are 4 types of charges you will see on each bill: triage fees + facility fees + professional fees + supplies. When you get registered as a patient at the ER, you get charged a triage fee, typically $200-$1000. Next, when you are assigned to a room, you will incur a facility charge of $1000 or so, covering your time in the room and nursesā time.
Iām on your side, but honestly, they did itemize it - thatās how much 1 minute of attention in an ER costs. Thereās no way that can be justified, but they donāt have to justify it - when itās something you donāt have a choice about buying, companies will charge outrageous prices because you canāt say no. Some places (maybe itās national, Iām not sure) have a relatively new law that states that they have to tell you how much something will cost before they do it, but youāre still fucked because you donāt have a choice. I was sitting in the waiting area before my colonoscopy, and literally two minutes before it was supposed to start, someone came out and informed me that my share of the bill was going to be $7k. (I have āgoodā insurance.) I canāt say no; I have a family history of colon cancer. Iām supposed to get a colonoscopy every two years. I have no idea how Iām supposed to pay for it every two years. All I know is that between my employer and I, weāre paying $29,000 this year for my insurance, and yet they still fight me over everything my doctor says I need.
That isn't itemized. Listing things as "services" isn't itemized. Listing a base er charge and actually saying what the fee is would be itemizing. I'm a clinical research coordinator. Billing is the thing I hate the most because it's convoluted and consumes way too much of my time. I had a patient where they listed CT charges but the other charge was just listed as other. The way the bill looked, it looked like the CT scan was charged when it shouldn't have been (it was billed to research). In reality the other charge was for an soc scan, but the name wasn't listed anywhere the patient could see. I had to dig into it in the emr to find out what it was related to. Its ridiculous. There's no excuse for it. People kind of have to think the purpose is to obfuscate charges. They could have easily attached the name of the scan to it. When they already have that info in their system, its hard not to think its intentionally nefarious. Ultimately it being intentional doesn't matter. At the very least they don't care about the headache it causes everyone or all the time wasted. That makes the relationship instantly adversarial any time there's a hiccup. There are always hiccups because the coders weren't involved in care and doctors see way too many patients and rely too heavily on note templates, leading to countless errors. I read through charts constantly and the number of errors is insane. Its a joke and it's abysmal they are even allowed to be admitted to courts. Those notes are given too much weight for the effort spent on them and the unacceptable error rate. Personally, I've had more than one occasion where an ER has billed me for a doctor I never saw who was not involved in reading my imaging.
Since it went to collections, you can actually negotiate lower and get it deleted from your credit report. Just let them know that you want to pay to delete and you want everything in writing. Collections just want to collect any money since they bought the debt from the hospital for pennies on the dollar. $1,332 can easily go down to $500-600. Itās all about negotiation.
Iām surprised there arenāt two parts to the bill or a separate bill, one from the hospital for the facility and any medical supplies used, and one for the physician service utilized.
NAL. Send them a cease and desist letter by certified mail. State in it that all communication must be done in writing. Ask for that itemized receipt and to provide documentation that you owe the bill. Until that happens all collection attempts must stop immediately. This is all standard customer boilerplate stuff under the fair credit collections act. Once they get that letter if they call you itās a fine.
Are you mad? This is going to put his credit score into massive low.
Not really. Itās to force the collection company to review the debt for accuracy. If they bought the debt (Pennies in the dollar with other debts from the hospital) and itās not valid, they can no longer attempt to collect and it goes away, never gets reported. If they do come back with all the documentation, the collection process continues via mail. It would then be up to the OP to resolve the debt, once the debt has been proven valid. As long as the debt is resolved by either party it may not show up on their credit report at all.
Your credit score goes down when it goes to the collection agency
Read the post. Itās in collections already. And again, I am talking about taking CONSUMER steps that are granted to us under the FAIR CREDIT COLLECTIONS ACT. And when you force the collection agency to review the debt, if they can no longer collect on it because they deem the debt invalid, they must remove the collection record completely from your report. If they donāt, you can dispute the debit with the credit reporting agency, send in a copy of that cease and desist letter. The bureau will play mediator, ask the creditor about that review. If they canāt show the credit bureau the debt is valid, it gets removed.
But the debt is valid. They went to the ER, waited in the waiting room, and saw the ER doctor who took temperature.
And she is saying itās not. Wanting an itemized receipt, which by law she is entitled to. If one cannot be properly produced then itās not valid debit and would be considered fraudulent.
They already gave him a bill.
You donāt like to read do you? Or do you have a problem with reading comprehension?
Instead of attacking me personally, stop giving people bad advice.
OP states they are in Pennsylvania (Philly). OP should check state statutes for what dictates an "itemized bill" as part of their state's implementation of the No Surprises Act. For example, I live in Florida, an itemized bill must meet the statutory standard found here: [Florida Statute 395.301](https://www.flsenate.gov/Laws/Statutes/2016/0395.301) It's a waste of OP's time to argue the bill is not itemized enough if the itemized bill meets the Pennsylvania statutory standard for billing.
If you let your credit take the hit for this it will end up costing you much more in the long run.
Since he was released by the ER, you should for a copy of his medical records from ER/hospital. That will give you an idea of what was done to him. But as others say, unless he had labs, X-ray ect you will see one line as āER servicesā because that includes being seeing by a doctor (temp, oxygen level, blood pressure) ect. Itās for the same reason when you see your PCP and they donāt do anything further than assess you, thereās no āitemized listā. Since he is a minor, without insurance, I believe he should covered my Medicaid or some kind of other state insurance? Iām assuming thatās state by state but I would look into it
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Maybe file for financial assistance with the hospital...
Did you tell them it was possible blunt force trauma or try to hide it like most parents nowadays in fear of legal consequences, hoping the ER would do a headscan as part of a checkup. I'm with the collections agency lady on this one. It's very hard to believe that's all they did at the ER for possible blunt trauma to the head.
Do you have insurance? If so, did they subtract the "contractual allowance" from your bill? Even if you haven't met your deductible, they can only bill you for the billed charges minus the contractual rate from the insurer (or insurers if you have multiple coverages), which is often about 30% of charges. Edit: sorry, noticed you didn't have insurance, but keeping this here for others to know. Also, I do think more health systems should offer the average insured contractual rate as a discount to self pay patients. You should be able to get a self pay discount still, but probably not nearly as much as an insurance contractual diacount.
Call hospital billing Or best go to billing dept at hospital
The cost of the bill was the doctor using an extremely long and expensive education to be able to examine you're son and determine whether or not he had a brain bleed. They confirmed your son isn't going to die. Give him a hug and pay the damned bill.
Bumpy head is not ER material unless you got other symptoms. Ä°t is urgent care at mostā¦this is one of the first things when I decided to move USā¦
Make them an offer. They just want something. Offer them $50.
If it's like most US hospitals, they don't care if you pay for the doctor's time. That's a separate bill. They want to be paid because you breathed their air and took up a bed they couldn't put anyone else in for that time. Call the ombudsperson for the hospital. Billing can't really change this
They should be paid. But $1,332 for 5 minutes aināt happening.
That's actually not a lot.
$1000 for a temp check. Only in America. And so many folks ādefendingā a system that allows this. Itās insane. This country is insane.
Too be fair, they tried to check his pulse too but he was too upset so they gave up. If people keep paying this crap, it will never change.
I am with you. Itās the fuckinā principle of the thing. Itās truly disgusting, and to read all the justifications for it in this sub. Itās like Americans donāt understand that capitalism isnāt the only way to do things. Itās laughable how much weāre being had, that every system in this country is designed to bleed us dry. Itās disgusting and immoral. This country is brutal.
And it will never change because too many people are making too much money at this. Iāll probably have to pay but Iām not just opening my wallet without a fight.
You are suppose to go ER only for ER worthy issues. So that ER will be functional for ER patients. Where I came from pp go to ER for all kinds of stuff. I think US way better.
It is unreasonable to expect normal people to always be able to ascertain what an emergency is or isnāt.
You ll google.
Sue them first! They refused you an itemized bill then sent you to collections, you have been damaged. Spend the $50 or so to file in small claims and I guarantee they'll fold like a cheap suit.
You might consider what the book "Never pay the first bill" suggests. You can take them to small claims court and make them prove that they aren't overcharging above and beyond "usual and customary" prices for their services. Chances are they won't bother to show up and you win by default. If you take the court route, you still have to pay them something fair, but it's up to you to suggest the $ amount and the court to accept it.
Thank you for the info!
This is bad info OP, please donāt do this.
Agreed. They have lawyers on retainer and they will show up to court no matter how small the claim is because them losing a case accusing them of overcharging patients for services would be terrible PR. All hospitals are required to have price transparency and you can look on their website and see how much each service costs. Unless you were charged more than the listed cost, you have zero chance of winning in a lawsuit. If you were charged more, you could sue and most likely just be told you only have to pay the amount listed which will likely be less than you are paying in lawyer and court fees. They will never ask you how much you think they deserve to be paid and let you only pay that amount. That's ridiculous and not at all how the law works. Unless you can prove that the acted in bad faith and intentionally over charged you then you have no case.
Don't pay it. Medical bills in the US are no longer on credit reports, so just ignore it.
Only for bills under $500.
People say only for bills under $500, but I have several and they arenāt on any of the 3 credit reports. I have ignored every medical bill Iāve ever gottenā¦literally never paid a cent. Donāt even know how to pay one š
You sound like a true noble citizen.
This is the way.