outrageous ER bill

[Dusch]

Hello everybody,

I found this forum during my research about my ER bill. I am a german citizen, working for a german company in West Palm Beach since around one year. I do have health insurance, yet a deductible of $ 5000,- through a german health care provider. 4 weeks ago my wife brought me to an ER because I felt terrible. The whole week I was lightheaded and dizzy and on July 4th it became so bad that I thought I was having a stroke. When I arrived at the ER they did what I guess they call the pre ER (blood pressure, hear rate ...) after this I was told to wait for a nurse to come and take care of me... . To make a long story short. they treated me in the waiting area, I did not occupy a bed. They gave me two antivert pills for the dizziness, they took blood and urin and performed  a Basic Metabolic panel, a hepatic function panel and a urin analysis and gave me a Multivitamin IV. Everything turned out fine, they diagnosed me with vertigo and sent me home after around 2 hours.

this week I received 3 different bills. the first over $ 125.00 what I believe is from the lab, a second bill charges for the Doctors $ 923,- I am not disputing these two bills, but I received a 3rd bill coming from the ER charging $ 4025,- .

I am shocked about this bill and since I am not from this country and never dealt with an ER bill before, i just want to  find out whether this is overcharged or not. I called the hospital and they sent me an itemized bill. Charges on it are as follows:

1 Hepatic function panel $ 1061.00
1 Basic Metabolic Panel $ 806.00
1 CBC Platelett Auto Diff: $ 391.00
1 UA WO Micro Auto $ 139.00
1 Emer Dept Level 3     $ 1122.00
1 IV Hydrat Init Up to 1 : $ 490
2 Antivert Tab 12mg: $ 16.00

I hope someone can give me an idea if this can be right or not and if not, what my options are to do?

Thank you very much in advance

Holger

[Amir Mostafaie]

Dear Dusch,

I believe I can provide you with some information and background on the American health care system that will help you understand the “outrageous 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.

I am assuming that your foreign health plan doesn’t offer any particular networks & therefore you didn’t get any discounts.

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 can not contact the billing dept. of the hospital & negotiate with them. By negotiating, you are basically bargaining with the hospital about the charges.

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 you negotiate lower rates, ask for a payment plan with no interest.

Best of luck,

Amir Mostafaie

[margypops]

Well that s what it is like here, I had no Insurance at the time and I went into th ER thinking I was having a heart Attack, they plugged me up to all usual things and after a few hours said I was not having a heart Attack then,I should have left the Hospital  but they went on to say they wanted to keep me in overnight as they werent certain of the cause, turns out I was having a reaction to 2 drugs my Doctor prescribed me,They kept me in and next day I had a stress test and a cat scan, nothing found. I went home , my bill was $8000 ,you itemised yours ,mine was down to the 1 tablet of Plavix and and other small details like 2 Aspirin.I learned the hard way you have tohave  insurance here.The  Hospitals are run like a buisness here.

[jethro12]

Unfortunately you found out the hard way .
If you can hold to see a physician then do outpatient
tests. You did say you had insurance but I am
guessing it doesn't work with the providers
here in america.What you  can do is call
the hospitals business office to see if they will negotiate
a better price for a lump sum payment.Some times you
can get up to 50% off your bill if you pay it within a certain time frame.
Those lab test are really overinflated  but when you go to the ER
they gouge you for their service.

[Dusch]

Hello,

thank you very much for the help and the explanations. I understand the problem and I will contact the hospital to "renegotiate" . I really appreciate the time you guys took to make me understand this.

However, I can not help to ease my mind and tell the world (or at least the people in this forum) that I am still shocked, not so much anymore about the bill but this system in general. Due to my profession I have lived in many countries throughout Europe and Asia and had some experiences with the health care systems and none has been as bad as here in the US, not even in India or Thailand. Margypops says that the hospitals are run like a business here, I disagree, if any business would do it like this, you will be out of customers very soon. This seems more like a criminal organization.
You can see I am really upset about this, if the bill would have been in any kind reasonable, if there was a cat scan or at least X Rays included I would not even dispute it, but I have been there for 2 hours and only got simple blood tests and a Multivitamin IV.  

Anyway, thanks again for taking the time to help me and i will try to stay calm when I call the billing center.

Hope everybody stays healthy here !!!

kind regards

Holger

[peekawho]

Healthcare is a business here.  And unfortunately, there is little hope of things changing, b/c hospitals will never be "out of customers".

There will always be a captive audience, so there is little incentive for hospitals to change.

I'm sorry for whats happening with you.