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Healthcare - Negotiating Outrageous Emergency Hospital Bill Tips? Shoulder Dislocation
August 16, 2011 at
12:27 PM
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It was around 7 PM and I had a dislocated right shoulder and went to the E.R as I was in major pain
I have Blue Cross PPO 3500 insurance and my HOSPITAL bill was still $2700 for it.
I requested an itemized bill:
* 258 Pharmacy IV Solution *
Sodium Chloride 0.9% 1000ML Bag -- $146.23
* 239 Radiology Diag other *
Shoulder Comp Min 2 views - right -- $522
* 450 Emergency Room *
LEVEL 4 -- $1427
TX SHLDR DISLOC W/MANIP WO/ANS -- $341
* 636 Drug Spec ID Detail Coding **
Hydromorphone 2 MG/ML VIAL -- $67.19
Ondansentron 4 MG/2 ML VIAL -- $97.99
Ketorolac 30 MG/ML SYR; KETOROLAC INJ -- $103.07
______________________
Total: $2700~
And then there's the DOCTOR's bill:
Emergency Service -- $484.28 (but under the insurance negotiated rate is set to $140)
Surgery-Bone/Muscle -- $464.68 (the negotiated rate was $210 to simply push my muscle back in!)
_____________________
Total: $350
And then there was also a third bill for the x-ray readings:
Radiology-Extremity -- $45 ($10.44 after negotiated rate)
The hospital is charging me $341 extra under the LEVEL 4 fee ($1427), "as standard", because it was for shoulder dislocation -- even though THEY did nothing to it. When it's already costing $464 fee by the doctor who just pushed my muscle back in.
Isn't that double charging? That's clearly extra profit that they just want to take in.
Why is it that the doctor's bill has a negotiated rate, despite the deductibles, but the Hospital's outrageous fees do not?
When the nurse gave me the IV, she asked if I was still in pain and I said yes, so she injected more in me. Those drugs did absolutely nothing to my pain. I had to lay down on my chest and hang my arm to the side, which was an extremely painful position, and the doctor just pushed my shoulder in for less than a second and didn't say a word to me. I was there for less than an hour.
I don't understand what warranted a LEVEL 4 (2nd highest) when I wasn't even given immediate treatment or other major equipments were used.
In retrospect, I would have refused the X-ray and drugs and ask them to put me in a lower emergency care -- just have someone push it back in for me.
I know I still have to pay a big chunk because I haven't met my deductible, but these fees still seem unreasonable. I know hospitals/insurance companies are a business and they have to inflate prices so everybody wins, but I understand these things can be negotiated. How can I get it lower? What would be my best defense?
I have Blue Cross PPO 3500 insurance and my HOSPITAL bill was still $2700 for it.
I requested an itemized bill:
* 258 Pharmacy IV Solution *
Sodium Chloride 0.9% 1000ML Bag -- $146.23
* 239 Radiology Diag other *
Shoulder Comp Min 2 views - right -- $522
* 450 Emergency Room *
LEVEL 4 -- $1427
TX SHLDR DISLOC W/MANIP WO/ANS -- $341
* 636 Drug Spec ID Detail Coding **
Hydromorphone 2 MG/ML VIAL -- $67.19
Ondansentron 4 MG/2 ML VIAL -- $97.99
Ketorolac 30 MG/ML SYR; KETOROLAC INJ -- $103.07
______________________
Total: $2700~
And then there's the DOCTOR's bill:
Emergency Service -- $484.28 (but under the insurance negotiated rate is set to $140)
Surgery-Bone/Muscle -- $464.68 (the negotiated rate was $210 to simply push my muscle back in!)
_____________________
Total: $350
And then there was also a third bill for the x-ray readings:
Radiology-Extremity -- $45 ($10.44 after negotiated rate)
The hospital is charging me $341 extra under the LEVEL 4 fee ($1427), "as standard", because it was for shoulder dislocation -- even though THEY did nothing to it. When it's already costing $464 fee by the doctor who just pushed my muscle back in.
Isn't that double charging? That's clearly extra profit that they just want to take in.
Why is it that the doctor's bill has a negotiated rate, despite the deductibles, but the Hospital's outrageous fees do not?
When the nurse gave me the IV, she asked if I was still in pain and I said yes, so she injected more in me. Those drugs did absolutely nothing to my pain. I had to lay down on my chest and hang my arm to the side, which was an extremely painful position, and the doctor just pushed my shoulder in for less than a second and didn't say a word to me. I was there for less than an hour.
I don't understand what warranted a LEVEL 4 (2nd highest) when I wasn't even given immediate treatment or other major equipments were used.
In retrospect, I would have refused the X-ray and drugs and ask them to put me in a lower emergency care -- just have someone push it back in for me.
I know I still have to pay a big chunk because I haven't met my deductible, but these fees still seem unreasonable. I know hospitals/insurance companies are a business and they have to inflate prices so everybody wins, but I understand these things can be negotiated. How can I get it lower? What would be my best defense?
91 Comments
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Otherwise ask for a payment plan... Or simply send them $5 a month.
Good luck
Also, balance billing (http://www.businesswee
<ikkenai> i don't have hard drives. i just keep 30 chinese teenagers in my basement and force them to memorize numbers
After you hit your $3500 deductible you shouldn't have to pay hardly anything out of pocket
MBA
I've been going back and forth with the insurance company and the hospital billing department. The hospital is adamant that their bill is final. One guy I spoke with with the Insurance company told me just confused me even more saying the Hospital bill was already discounted at the "negotiated below rate", saying it would have been higher than $2700, but that turned out to be a lie because Hospital told me they bill the same to anyone.
Shouldn't the insurance company be negotiating for me? Should I be complaining to them that the hospital bill is unreasonable for services I didn't even get from them, or do I just leave them out and deal only with the hospital directly?
Watch "Wag the Dog [imdb.com]"
Nazi's Reichstag fire + 9/11.
Enabling Act 1933 + Patriot Act 2001.
Bush = Hitler.
Also, balance billing (http://www.businesswee
Thanks for the info. Never had a PPO.
For future needs: go to an urgent care clinic.
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At a bare minimum tell them you're not paying for the Level 4 exam as they didn't do anything. Reminds me of when I took my car in for service and they wanted 6 hours worth of labor yet they called me after 3.5 and told me that only guy worked on it. They said that he was just fast which I responded to with "well great, means I pay less". Actually got them to knock the 2.5 hrs off the bill
Should probably add this just incase you have no idea what I'm referring to
1. make a $10 monthly payment
2. Go get a loan to pay off the bill if they are willing to deduct 50% off your hospital bill (but of course you are exaggerating about the loan part)
If you are worried about your credit over this, make sure the bill is marked "in dispute" at the credit bureau or else pay it all and then sue them for what you think was overpaid.
Back in the internet boom days, I worked for a big dot com that went bankrupt, and apparently at the end the company let the employee health insurance lapse because they couldn't pay the bill. During this time my co-worker's wife had a baby - everyone's insurance was lapsed, so he got hit with about a $60k bill (don't remember the exact amount, but it was eye-popping).
By this time the company had dissolved into chapter 7, so there was no way he was getting the money from the company. He called the hospital, let them know the situation and also let them know there was no way they were ever going to get $60k out of him. He offered to write them a check for $6k on the spot to cover everything & they went for it.
You have to be in the right mindset & have to talk to the right people, but it can be done. Hospitals know how much it costs to collect for non-payment, so sometimes they'll work with you to get whatever you can give them. You probably won't get a 90% discount like my buddy did, but there's potential to cut it way back.
When talking to the billing dept, don't argue specific points about what they did or didn't do - treat the entire bill as the issue and look for a large (like 50%+) reduction in the total amount in return for settling up right away.