Adventures in Outrageous E.R. Hospital Charges

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The Emergency: Head Injury

The Bill: $9,000

A few months ago, Amanda Harris, 27, of Morristown, N.J., fainted at work, hitting her head in the process. Due to liability concerns, her production company required Harris to take an ambulance to the emergency room, despite her refusal. “I didn’t even have a cut on my head, just a slight bump. No headache, no nausea, no confusion, nothing,” she says.

Harris waited for over an hour in the E.R. before her husband told the nurse that they were leaving. Minutes later, a doctor spoke to Harris for under a minute, confirming that she was fine to go. “He didn’t do any tests—no light in my eyes, no blood pressure,” says Harris. “I left thinking I wouldn’t even get a bill.”

But the bill did come—all $9,000 of it. The ambulance company charged $6,500, including a $300 fee for the linens and a $30 charge for aspirin. The E.R. billed the remaining $2,500. “My mouth literally dropped open when I saw the cost,” she says.

What This Patient Did: Harris called her insurer and fought the bill. Luckily, her insurance covered all but a $3,000 deductible—but she was too exhausted to push for more. “I’ve always heard emergency room visits were costly, but $9,000 for nothing more than a conversation that lasted one minute? That’s robbery,” she says.

What the Expert Says: Even though Harris didn’t want to take an ambulance, Salters says that her company’s suggestion was well-advised. “However, she should consider working with her employer to file the claim with her company’s worker’s compensation carrier,” says Salters. “Employers often try to stay away from filing a claim under worker’s compensation, so it does not impact their experience rating or trigger an [occupational safety and health administration] review, but it would save her money.”

How You Can Avoid Outrageous E.R. Bills (Really!)

When it comes to a trip to the E.R., the reality is that there’s usually no time to shop around and compare prices in advance. But if you do some research before an emergency happens, you could potentially keep costs significantly down.

Consider Urgent Care for True Non-Emergencies

If your medical problem isn’t life-threatening (think sprains, minor cuts and fevers), you can visit an urgent care center instead. An Annals of Internal Medicine study found that the average urgent care visit from 2005 and 2006 cost $156—compared with $570 for the same visit to an emergency room.

RELATED: Why an E.R. Visit Could Bankrupt You

Double-Check Your Bill

Hospital billing systems aren’t perfect, so it’s wise to keep track of any treatments that you receive in the E.R.—including time spent in the operating room, which can cost up to $200 a minute! To prevent billing mistakes, ask for an itemized statement before you’re discharged, so you can compare it with your own record-keeping.

Negotiate Your Health Care Costs

Most importantly, don’t be shy when it comes to bargaining. Two excellent resources—Healthcare Blue Book and FAIR Health—can give you estimates of how much health care services should cost in your area. Plus, your insurer’s website may also provide a tool that will allow you to compare costs.

The negotiation can seem like a lot of extra work, but the payoff can be tens of thousands of dollars in savings shaved off a potentially outrageous E.R. bill.

  • JenInBoston

    Some hospitals have separate Urgent Care (or “Ambulatory Care”) and an ER practically next to one another. Turning through one door could cost you $150. The other door could be $5,000! Don’t wait until you’re in a pinch. Take 5 minutes today and look up an urgent care location so that you’ll know where to go if you need it. Urgent Care is exactly the right place for things like suspected Strep throat on a Friday evening, or a UTI on a holiday, or a baby with a first fever on a day the pediatrician doesn’t have any appointments available.

  • swimmermom

    I have not had luck using Healthcare Blue Book, FAIR Health, and similar websites (the American Medical Association even has one of their own) that publish medical cost information to keep my own costs down. The groups billing me for my child’s ER visit for a broken collarbone seemed completely indifferent to the fact that they were charging me 10 to 20 times what those procedures supposedly ought to cost. They conceded only a little (10%) and only after I pressed really hard. I did find out from those websites that one of my bills had been “upcoded” — the ER physician’s bill coded it a Level 4 ER visit vs. the hospital’s bill which correctly had it at a Level 3. Even then the physician’s group refused to correct the code, saying that the doctor and the hospital don’t have to agree on how serious the visit is! It was a small difference in cost compared to the overall bills, but it still grated on me. I consider myself a savvy consumer and good negotiator, but I got pretty much nowhere trying to argue on my own behalf in this situation.

  • swimmermom

    (commenting separately to bring up a completely different point)
    I found that having a high-deductible health plan put me in a poor position to negotiate ER costs. With an HDHP you essentially pay out of pocket up to your deductible ($5K in my family’s case), so you have the same self-interest in keeping your bills reasonable as anyone else who pays cash. HOWEVER, the groups billing you for their services treat you as an insured patient — they do submit your bills to your insurance, after all (which may or may not result in some adjustments to your bills. Little to none in my case). Once that has happened, though, it’s as if the prices are permanently fixed in stone. The billing groups simply will not negotiate on items that have already gone through your insurance. So the consumer with an HDHP gets the worst of both worlds — paying OOP like an uninsured patient, but locked into insurance company prices as an insured patient, with no standing to negotiate.

    • Bas

      Ouch, I am in that same boat. My son had a delayed allergic reaction to a bee sting (of course delayed until urgent care and dr office was closed) and I needed a doctor to prescribe something for him. $1500 later ….

  • Abraham Garcia

    I need guidance…
    In my entire adult life, i have never step foot on a hospital or even talked to a doctor,
    I recently got a job that provides health insurance, so i decided its a good time to take care of my depression..

    So i went to the hospital, told them i got depression, everyone i talked to directed me to the ER.
    So i just did what they told me because i thought they know what the deal is.
    Once in, the doc(or whatever she was) told me i was in the wrong place for depression, and released me… Didnt do anything other than take my vitals… No meds, no exam, nothing…

    Long story short, i got an insurance claim in the mal saying i owe the hospital a thousand bucks for the ER stay..

    This is outrageous.
    I wouldnt mind paying if they actually did something for me, but i am now expected to pay literally for NOTHiNG!!!!