Posted on 11/07/2015 9:03:59 AM PST by Kid Shelleen
I had an emergency room doctor sit with me for exactly 30 seconds while I told her my surgeon would be there in about 10 minutes. She promptly got up after acknowledging what I said to her.
I was billed $1200.00 for that 30 second conversation.
I can tell you all about that. I got a bill for $1000 from a doctor whose name I’d never heard, for a ‘consult’. Apparently, he came in, looked at me for 10 seconds and left without saying a word.
Ever notice that Docotrs , even your everyday General Practicioner, even within your network, never lists prices for survices rendered ?
You are at a greater billing threat whenever you enter any Emergency Dept. of any hospital as you may nolt be treated by a doctor in your network .
Its always a coin toss as to what your billing will be , and whats covered, and what is not covered !
Landed myself in emergency last January.
The hospital billed me.
The doctor billed me.
The doctor who stitched me up billed me.
The doctor who injected me for pain billed me.
The doctor who read the CT scan billed me.
Around 25k for a scan and stitches.
Thought that was unreasonable.
depends on what state you live in too
New York’s ‘no-surprises’ law takes hold to end balance billing
That law, which became effective April 1, significantly expands existing consumer protections.
http://www.healthcarefinancenews.com/news/new-yorks-no-surprises-law-takes-hold-end-balance-billing
Protection from Surprise Bills and Emergency Services
Health Insurance Resource Center
A new law goes into effect March 31, 2015 that protects consumers from surprise bills when services are performed by a non-participating (out-of-network) doctor at a participating hospital or ambulatory surgical center in your HMO or insurer’s network or when a participating doctor refers an insured to a non-participating provider. The new law also protects all consumers from bills for emergency services.
The following information explains what you need to know about these important new protections if: (1) you have coverage with an HMO or insurer subject to New York law; (2) you are uninsured or your employer or union provides self-insured coverage that is not subject to New York law; or (3) you are a health care provider.
Surprise Bills for Health Care Services
(Financial Services Law Article 6)
What You Need to Know To Protect Yourself From Surprise Bills If You Have HMO or Insurance Coverage Subject to NY Law (coverage that is not self-insured) —> view info
What You Need to Know to Protect Yourself From Surprise Bills If You Are Uninsured Or If Your Employer or Union Provides Self-Insured Coverage (that is not subject to New York law) —> view info
What You Need to Know About Surprise Bills If You Are A Health Care Provider —> view info
Emergency Services
(Insurance Law Section 3241(c) and Financial Services Law Article 6)
Hold Harmless Protections for Insured Patients. Your health plan must protect you from bills for out-of-network emergency services in a hospital if you have coverage through an HMO or insurer subject to NY law (coverage that is not self-insured). You do not have to pay non-participating provider charges for emergency services (typically for services in a hospital emergency room) that are more than your in-network copayment, coinsurance or deductible (this protection may only apply when your health insurance coverage renews after March 31, 2015). Let your health plan know if you receive a bill from a non-participating provider for emergency services.
Uninsured Patients or Patients With Employer or Union Self-insured Coverage. You may be able to file a dispute through the independent dispute resolution process if you do not have HMO or insurance coverage that is subject to New York Law (for example, if you are uninsured or your employer or union self-insures) and you receive a bill from a doctor for emergency services provided on and after March 31, 2015 in New York that you believe is excessive.
http://www.dfs.ny.gov/consumer/hprotection.htm
Baylor in Dallas was famous for that - you go to an in-network hospital then get hit with a huge bill from the out of network ER doctors.
Texas did enact a law requiring the balance billing ER doctors to submit to mediation if the additional charges were over $500. It has helped some.
Government’s purpose should be to prevent predatory behavior.
The way insurance had been partitioned, with narrow networks, exceptions, and high deductibles, is a recipe for predatory behavior against anyone who has some saved assets or private (including wage) income. If you’re on the dole... well, this stuff doesn’t happen.
Whether that is the intent or not is open to debate (at least as to degree), but the operational result is that government, insurers, and providers have colluded to hide the real price of service, and to extract above insurance-level payments from those with any assets.
That’s why Obamacare is such a farce. If you’re getting free or heavily subsidized insurance—a Medicaid replacement—Obama claims your insured. But, if you’re working, paying (or have saved), your insurance has been made more expensive, provides less coverage, and less predictable coverage.
I had an ER visit to Mayo in August, and a follow-up stress test. Total bill: $8000.
12 years ago I went in and got six stitches in my knee and paid cash on the spot; $150
Another time I went to my doctor, got my chest xrayed and a pain shot $85
I went to WalMart, when they still did minor med, and got a tetanus shot $35. Recently went to a doc for a tetanus and they wanted $800.
I can no longer find doctors that work for cash nor any who do not charge insane amounts for services.
I shod a horse for a doctor recently, one that charged me a mint. I charge $2K to shoe the horse. Not my usual price. He was bent. I asked what an hour and a half in his office would cost me. He said he was more skilled. If that was the case, I said, he could shoe his own horse next time, it was still $2K.
So just how can you be cautions about seeking treatment when you go to the ER at 0300 with a kidney stone and can hardly crawl?
I had the same thing happen to me. I offered a more than reasonable settlement in compensation and they refused that. They ended up with nothing.
Here is one way to help someone. Tomball Regional Hospital uses “balance billing” for the ER docs. I’m sure there are lots of FR readers that use that hospital, not. But just in case you do.
It is outrageous.
Did you pay it?
How can doctors say they don’t make enough money?
That one time I went in there was a piece of trash down the hall brought in by the cops. he was on bath salts and cut himself up. I’ll bet he got a bill and paid it.
Yeah, right.
Dear Provider:
Thank you for saying hello and for doing X minutes of work.
I have computed what your yearly income would be at the charged rate for 2,000 hours and have come up with the figure of , which is clearly excessive.
Compare to the income of a judge, who has about as much education and also has to make quick and correct decisions.
As you may be aware, health coverage is now federally regulated.
PPACA
“SEC. 1302. ESSENTIAL HEALTH BENEFITS REQUIREMENTS
....
(i) coverage for emergency department services will be provided without imposing any requirement under the plan for prior authorization of services or any limitation on coverage where the provider of services does not have a contractual relationship with the plan for the providing of service that is more restrictive than the requirements or limitations that apply to emergency department services received from providers who do have such a contractual relationship with the plan; and
(ii) if such services are provided out-of network, the cost-sharing requirement (expressed as a copayment amount or coinsurance rate) is the same requirement that would apply if such services were provided in-network;”
At the time of your extremely brief visit, I was disabled and covered by the Americans with Disabilities Act, which provides for reasonable attorneys fees if a reasonable accommodation (such as accepting federally required health insurance) is not made.
My insurance required payment is enclosed and therefore my relationship with you is now closed.
Yours Truly,
Patient
[no copyright claimed - feel free to use and modify this - I hate greedy doctors]
GOOD FOR YOU!!!
I hope his damn horse comes up lame and he has to to to a vet.
Having had multiple recent experiences in ERs, I can attest to this being true. The bills from varying subcontractors are often difficult to reconcile with the treatment received. The required government coding is gibberish.
It would be very easy for an unscrupulous business concern to trick ER patients with bills containing appropriately medical-sounding terms for services never rendered.
They keep this s*** up they’re gonna need their own doctors.
Friends recently took their football player son (high school age) to a local emergency room.
A bit crowded, they were told it would be no more than a 30 minute wait. They signed in, waited...and, waited for almost 2 hours. They left and went to another ER.
They received a bill from the FIRST ER....that they weren’t even seen in....because they signed in.
Their insurance company is of course fighting these ridiculous charges.
That happens with just about every procedure anyone in our family has had. So and so doc (usually anesthesiologist) isn’t in network. BAM! Here’s your bill for thousands of $$.
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