Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Health Insurance (Expert Forum)
What can I do about these ER charges?
Answered by
Amir Mostafaie - health insurance, insurance
eHealthInsurance
Gold River - CA
This forum is for questions and support regarding health insurance issues such as Medicare, Medicaid, Long-term health insurance, COBRA, insurance portability.
What can I do about these ER charges?
by pucho30, Jun 09, 2009 08:00PM
Hello,
We got no insurance. My 2 yr old daugther cut her palate with a plastic tube. She was not bleeding you could only see the cut. We took her to her regular doctor and she advise to take her to the emergency room because she need it stiches on her palate!! We took her to the ER and a P.A saw her all she did is look at her mouth with a flashlight and told us she did not need stiches!! She gave us a presciption in case the wound gets infected (Augmentin) and Tylenol for the pain. Then she told us to clean her mouth every time she ate and only give her soft foods. I just got a bill today for $757.00, this is insane!! These charges are so wrong...any advise will be so appreciate it. I would like to dispute these charges.
We got no insurance. My 2 yr old daugther cut her palate with a plastic tube. She was not bleeding you could only see the cut. We took her to her regular doctor and she advise to take her to the emergency room because she need it stiches on her palate!! We took her to the ER and a P.A saw her all she did is look at her mouth with a flashlight and told us she did not need stiches!! She gave us a presciption in case the wound gets infected (Augmentin) and Tylenol for the pain. Then she told us to clean her mouth every time she ate and only give her soft foods. I just got a bill today for $757.00, this is insane!! These charges are so wrong...any advise will be so appreciate it. I would like to dispute these charges.
Doctor's Answer
by Amir Mostafaie, Jun 10, 2009 01:22PM
, Jun 10, 2009 01:22PMTo: pucho30
Dear pucho30,
I believe I can provide you with some information and background on the health care system that will help you understand the charges!
Majority of the insured population in United States are covered under some sort of network plan like PPO (Preferred Provider Plan) or HMOs (Health Maintenance Organization.
Why insurers like offering these types of plans is because they are able to reach out to the majority of the provider population (like doctors & hospitals) & pre-negotiate discounted fees for all services & benefits including lab work, procedures, facility charges and prescription medications. Pre-negotiated discounted fees work like whole-sale prices and are one of the biggest advantages of PPO & HMO type plans to plan members too.
That said you can’t benefit from any of these discounts if you don’t have a network plan (PPO, HMO) or don’t have any coverage at all.
When hospitals & ERs deal with patients without a network type plan, they will charge them according to their “list price” which is high enough to cover the high cost of running an ER where a lot of people treated don’t have any insurance & never pay their bills.
In other words the paying patients pay higher prices to cover the overhead. That’s why Tylenol can cost you $18 in the ER!
Now this doesn’t mean that you cannot contact the billing dept. of the hospital & negotiate with them. By negotiating, you are basically bargaining with the hospital about the charges.
Before you start your negotiation, obtain a breakdown of your charges, so you can find out a) if you are being charged for services you have received & b) so you can negotiate individual items on the bill.
When contacting the hospital to negotiate, remember the following tips;
Stay calm, collected & professional throughout the call,
Be courteous to the representative,
Don’t be afraid to escalate the call to a supervisor if you feel you have tried everything else,
Establish that you have every intention to pay your bills & that is why you are negotiating to achieve a reasonable amount, then only you can afford to pay them.
After your negotiation, ask for a payment plan with no interest.
Sincerely,
Amir Mostafaie
I believe I can provide you with some information and background on the health care system that will help you understand the charges!
Majority of the insured population in United States are covered under some sort of network plan like PPO (Preferred Provider Plan) or HMOs (Health Maintenance Organization.
Why insurers like offering these types of plans is because they are able to reach out to the majority of the provider population (like doctors & hospitals) & pre-negotiate discounted fees for all services & benefits including lab work, procedures, facility charges and prescription medications. Pre-negotiated discounted fees work like whole-sale prices and are one of the biggest advantages of PPO & HMO type plans to plan members too.
That said you can’t benefit from any of these discounts if you don’t have a network plan (PPO, HMO) or don’t have any coverage at all.
When hospitals & ERs deal with patients without a network type plan, they will charge them according to their “list price” which is high enough to cover the high cost of running an ER where a lot of people treated don’t have any insurance & never pay their bills.
In other words the paying patients pay higher prices to cover the overhead. That’s why Tylenol can cost you $18 in the ER!
Now this doesn’t mean that you cannot contact the billing dept. of the hospital & negotiate with them. By negotiating, you are basically bargaining with the hospital about the charges.
Before you start your negotiation, obtain a breakdown of your charges, so you can find out a) if you are being charged for services you have received & b) so you can negotiate individual items on the bill.
When contacting the hospital to negotiate, remember the following tips;
Stay calm, collected & professional throughout the call,
Be courteous to the representative,
Don’t be afraid to escalate the call to a supervisor if you feel you have tried everything else,
Establish that you have every intention to pay your bills & that is why you are negotiating to achieve a reasonable amount, then only you can afford to pay them.
After your negotiation, ask for a payment plan with no interest.
Sincerely,
Amir Mostafaie
