Adventures in Outrageous E.R. Hospital Charges

Adventures in Outrageous E.R. Hospital Charges
June 20 01:00 2013

It’s no secret that hospital bills in the U.S.—especially ones from the E.R.—can often hit astronomical proportions.

According to a recent cost study conducted by researchers at Stanford University, the University of Minnesota, the University of California, San Francisco and the Ecologic Institute, the median charge for an emergency room trip in the U.S. comes in at $1,233. But where it really gets interesting is when you look at the specific reasons for those E.R. visits: The researchers found that the treatment price for a headache could range from $15 to a whopping $17,797. As for a sprained ankle, it could set someone back a paltry $4 or up to $24,110!

So what gives with these wildly fluctuating price points?

For starters, most emergency room prices are inflated based on the rates at which insurance companies will reimburse the hospital on a patient’s behalf. That’s why a single aspirin can cost $30 per pill in the E.R., which is more than six times the price for a bottle of them at the drug store.

On the flip side, patients will often contact the hospital or surgeon’s billing office to ask for a cost reduction, further adding to the inconsistency in pricing. It’s a practice that often works in a patient’s favor, says billing advocacy specialist Sharon Salters of Medical Cost Advocate, a professional medical bill negotiation service.

And then there’s also the fact that most hospitals offer discounts to self-paying individuals—especially if there’s a risk that they might not pay at all.

So to help shed some light on the complexities of hospital medical billing for the average consumer, we asked three people to share their craziest emergency room stories, the even crazier bills that followed—and the steps they took to remedy them.

The Emergency: Severed Finger
The Bill: $83,000

Ryan Witten of Nyack, N.Y., was working in his garage one weekend last year when he severed his finger on a table saw. “Surprisingly, I stayed calm throughout the whole thing,” says the 54-year-old Witten, whose wife helped him pack his finger on ice and then drove him to the hospital.

Since Witten had recently gone to the emergency room for chest pains at a hospital that was out of his insurance company’s network—costing him $20,000 in out-of-pocket test fees—the Wittens drove to a different facility whose E.R. was in-network.

“We thought we had learned our lesson the last time,” he says, “but it turns out the plastic surgeon who reattached my finger was out-of-network.” So the contractor got a second dose of sticker shock when he received the bill for his emergency digit surgery: $83,000. Gulp…

Read full story at LearnVest
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