Parents Negotiating ER bills?

[kimute]

I just got a $2,500 ER bill for my DDs broken pinky. Insurance has covered a whopping $675 leaving me with nearly $2,000 to pay on my own for some tylenol, an x-ray, and a splint. Ugh. The bill states that if I had been uninsured, they would have only charged me 40% of the $2,500!

I figure parents on this forum may have some experience with this. Has anyone had success negotiating ER bills? They keep offering a payment plan, but I'm holding out to at least pay the "uninsured" rate. Curious if they'll ever bend...

Thanks!

 

[Frase]

Oh my - I have no advice but just wanted to share my sympathy with you - whilst at the same time thanking our lucky stars for the NHS and free health care!

 

[Jenny]

Oh my - I have no advice but just wanted to share my sympathy with you - whilst at the same time thanking our lucky stars for the NHS and free health care!

I like to think of the NHS as being pre paid by my years of national insurance lol

 

[tooootsie]

Best advice... have accident insurance for the kiddos. I personally am a health insurance broker and I have a high deductible. But we have accident insurance to cover just that type of instance. I haven't needed to use it yet (knock on wood). I would suggest a payment plan with them I hope she is feeling better.

 

[B.Gold]

I can't guess your feelings on this, but having been in the industry, I know you can negotiate on the back end once the bill hits collections. As much as 40-50%. And many hospitals are non reporting agencies, in-other-words, wouldnt report your delinquency to the credit bureaus.

It would make good business sense to me that they would be willing to negotiate a settlement with you prior to the bill hitting collections saving themselves the agency fee.

 

[bogwoppit]

That is ridiculous. When I first moved to Quebec I broke my index finger, the same treatment your dad got cost me $100.

Tell then you will pay them 40%.

 

[Empowered]

At lot of this will depend on if the facility you went to was a for profit or non-profit hospital.

Most non-profit hospitals in the US have charity programs. They don't advertise them, but you can contact their billing department and if they do have such a program they will give you a financial packet to fill out to determine your "need." You can get a bill substantially lowered using this route, but you have to do much of the legwork yourself and you have to qualify.

Most for profit facilities will not negotiate or offer assistance, nor do they have to legally.

Seems like a very high bill either way - Did you go to a hospital out of your insurance network? I have never seen an ER bill that wasn't reduced substantially in the amount by the insurance company. Yes the hospital bills $750 for some x-ray, but per the contract Blue Cross only pays $175. The only time this doesn't happen is if you're insurance isn't contracted with the hospital. Even if your company paid nothing because you had a high deductible, the amount owed should still be lowered to the contracted rate.

Also be prepared, many facilities these days will bill you for the hospital/urgent care fee, but the actual doctors' fees are billed separately by them. You may be getting a second bill from the doctor that saw her.

 

[needcoffee]

Holy crap!!!! Sorry, I have zero advice. I knew health care was expensive in the U.S. I just didn't realise how much!!! Woah!! All of a sudden glad to be living in a country with free ER visits... I'd be broke!!

 

[profmom]

Have you pushed back on your insurance company? Some routinely deny things that are actually covered in the hopes that people will suck it up or fight it out with the providers.

 

[Quadqueen]

^^Thankfully not all health care in the U.S. is this outrageous. We have no deductables and great coverage. We would not have had to pay out of pocket for this (other than $15 co-pay).

Sorry, OP, you're going through this.

 

[refugee]

This has been an increasingly hot topic in our locale.
I'm not sure I have any suggestions on what you face, but hopefully others in the future may benefit here...

Not sure where you are, but since you used $, I'll assume you're in the US.

Did you happen to go to a standalone ER? These are built to and licensed to higher standards than medical clinics and urgent care facilities.

• They are almost all For Profit.
  
• Standalone ERs will tell you that they are approved under every insurance program.
  
• What they fail to tell you is that they are approved as an ER facility, and for your insurance benefits to apply, you have to fall within the ER guidelines of your policy. Almost every medical policy I've seen for the last 30 years says your ER benefits apply if you are admitted to the hospital.
  
• If you're not admitted and you simply visit the ER, then your normal benefit schedule applies. And most likely, the standalone ER is NOT a provider within your normal benefit program, so they you "out of network" and payment benefits are limited.
• Finally, depending on your state, the standalone ER may be allowed to "balance bill" you for anything not covered by insurance.

This is the sad state of healthcare in the US today. Increasingly, the corporate profit (greed) motive applies, at the expense of the common person. We have seen some really good, competent MDs leave practice because of this.

 

[gymgal]

That sounds awfully high, even for an er visit. I would be checking to be sure you are actually responsible for all of that. Have you gotten a finalized bill from the hospital or an EOB from the insurance company? If not, I would wait for that first. I would ask for an itemized bill and go from there. If your insurance had this hospital as in network, then there is no way it should be this expensive. If it was out of network, it still seems really high for just an xray and splint.

I know this doesn't help for this accident but for the future - find an orthopedic clinic that has an urgent care center. We have several around us. They are so much better for sports injuries than ER's. First, you are dealing with a specialist - even if you just see a PA, they still know more about these injuries generally than an ER dr and their costs are usually less than 1/4 of what you would pay in an ER. We just had to go for dd's knee. They charged around $250 for exam and xray. Insurance predetermined rates brought it down to $125.

 

[wallinbl]

If you have insurance and they're "in network", they may be contractually prohibited from offering you a cash discount. But, it doesn't hurt to ask if they have a cash discount.

As others have mentioned, I have accident insurance, mostly because DD is a gymnast. I think it runs me $6/paycheck. When she broke her elbow, we got a $1500 check, which was more than the total bill (incidents are paid according to predetermined amounts, rather that reimbursing your actual expenses).

 

[sleeping judy]

What? OMG! We didn't pay over $500 for a broken finger E.R. visit with subsequent surgery (pinning yikes!) and three weeks of physical therapy! I regretted going to the ER the moment we got there.

We have gone to Urgent Care prior to that and it is much less expensive. I waited and went to orthopedic with my broken ankle. $25 copay. yay me lol I guess hindsight is 20/20 :/

 

[profmom]

For other American citizens and residents on this thread, check into the coverage you have before you explore supplemental insurance. Ours is very good for accidents (though allegedly it sucks for cancer), so we'd be wasting money picking up a supplemental policy. We've now been through three broken bones in the family in the past five years, and I don't think we paid more than $200 combined, which included three months of biweekly PT for DD.

I wish that as a nation, we had the political will to impose much tighter regulations on insurance, since it seems that single payer is politically impossible. Some of the things that companies get away with are truly beyond the pale.

 

[MILgymFAM]

That's just ridiculous and terrible! That amount is so over the top for the service provided. When my one DD had her nose broken, and another time my other DD broke two fingers, we didn't pay anything at all for the ER visits. Originally the second hospital sent us two bills (as discussed above), but after a call to our insurance we were told to disregard- the hospital was required to accept the contract amount from our insurance. Have you contacted your insurance company yet?

 

[windydays]

No advice, but HOLY COW!!!

 

[Dr Maleficent]

I'm so sorry that you are going through this, and hope that it will be resolved soon. It sounds like an enormous fee for straightforward care. When people in the UK complain about the NHS this is what I explain to them, that they have no idea how lucky they are to have health care that is free at the point of delivery. In France it is a hybrid system- the state reimburses 70% and people have insurance to cover the other 30%. This seems to work well generally. It sounds like there is some very good advice above to try to prevent more incidents like this.

 

[Deleted member 14190]

Okay totally off the subject but next time just tape it to the next finger and call it a day....

 

[happychaos]

Many insurance plans will not fully cover ER visits for something that is not a true emergency. Emergency Room care is expensive to deliver, for a number of reasons. My guess is that your insurance company decided that this injury should have been handled outside the ER. If there is a compelling reason that you felt she needed to be treated in the ER, you should make an appeal with your insurance company.