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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 89572
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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This letter is being sent to document the reasons why I am

Resolved Question:

This letter is being sent to document the reasons why I am disputing the hospital’s charges for services rendered during my recent visit to CMHospital’s Emergency Room (ER).

On March 3, 2013, my wife took me to the ER for severe pain associated with the passing of a kidney stone. Here is the timeline of that event:

1:30 PM: My wife and I arrived at CM ER. I was immediately checked in and had my vital signs taken. When asked my pain level, I said it was about a 6 or 7. They directed us to go back out into the waiting room and we’d be called, shortly.

2:30 PM, 4:00 PM and 5:00 PM: My wife and I took turns going up to the front desk and asking, “When we could expect to be seen by the doctor?” They assured us that we were on the list and coming up soon. In the meantime, countless other people were ushered into the back room. It’s almost as if the ER room changed it’s population a couple of times while we were waiting.

IMPORTANT: I had NO PROBLEM giving up my position to accommodate anyone in a more life threatening condition, i.e., lady in a wheelchair rushed in looking like she was completely passed out, or the little baby that kept crying painfully. In short, I was cognizant enough to know priorities and had no problem giving up my place for another’s needs. What we didn’t understand was how the ER process was conducted. Why were we still in the waiting room at 5:00 PM?

6:00 PM and 7:00 PM: Went through a shift change, and again approached the front desk for some type of explanation. The new receptionist assured us we were on the list and would be called back, shortly. When asked, “Why it was taking so long?” she said that my case was serious, and would take a lot of time for the doctor to handle. They had to block out the right amount of time and resources for my condition.

7:30 PM: I was called back to a room. Once there, I was hooked up to an IV for fluids. I strongly protested because I was NOT ABLE TO URINATE, AT ALL, and knew this was going to put me in further crisis and pain.

9:00 PM: Finally the doctor came by to access my condition (kidney stone was at the very tip of the urethra tube). He instructed the nurse to give me a morphine shot, and to take me for a CT Scan.

9:30 PM: I’m wheeled down the hall for a CT Scan*.
* For a 74176-26 CT ABD & Pelvis Scan - Apparently without contrast

10:15 PM: I am given another morphine shot. It has NO EFFECT on me at all because the pain is over-the-top from having no relief ALL DAY LONG. And now I have a constant and painful urge to go to the bathroom, but I can’t because of the kidney stone.

10:45 PM: The doctor comes back in and says he can’t see any problems on my CT Scan. Being unable to deal with my specific problem, he recommends a urology group he wants me to see on Monday. He writes me two prescriptions and sends me on my way.

11:30 PM: We finally leave the ER and head out to find a Pharmacy open at night.

Points of Dispute:

1.) When I received your statement, I was astonished by the amount due of $7808.25 for the services rendered. Granted, the insurance adjustment brings the charges down to $4632.63. But before the insurance deduction, the hourly rate I was inline to pay was $1,952.06 per hour x 4 = $7808.25

2.) If one looks up the Healthcare Blue Book for pricing on Facility Services In Emergency Department, Level 3—it shows $1,511* for a moderate problem.

* This is the Healthcare Blue Book’s recommended price for health care services. The Blue Book price is based on the typical fee that providers in our area accept as payment from insurance companies. This is the fair price I should have to pay, even if Methodist Health System charges more.

3.) Mission Statement on wall of room I occupied posted this commitment —
“Our goal is to make you feel better.” Note I left feeling worse then when I arrived despite the fact that I’d received: (2) morphine shots, (1) bag of glucose, and (2) prescriptions for the kidney stone I still had.

Additional Costs Beyond Hospital Facility:

Addendum F: Note the charges from MedSolutions XRAY for another CT Scan needed by Southwest Urology Associates because the CT scan taken at the hospital didn’t have the “contrast” the doctors needed to read my current kidney condition.

7.) Addendum G: Monetary impact of my Kidney Stone health crisis.

Summary: I am not willing to pay $4,632.63 for services that rendered me NO relief. Instead, I request an opportunity to discuss my dissatisfaction with the hospital’s billing department after my case has been reviewed. The Medical Center Billing Dept. came back that I own the full amount of $4,632.63. 1) I have no statement showing what I am being charge for. 2) I feel like we have been over charge. 3) How can I handled this?

Your help and consideration of my position is greatly appreciated.
Submitted: 1 year ago.
Category: Legal
Expert:  Law Educator, Esq. replied 1 year ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking.

First off, I am sorry to hear you went through this as having just gone through the exact same thing I am aware of the pain and lack of concern of many hospital staffs (I sat from 8AM to about 6PM with nothing other than a rising blood pressure from anger at them making me wait in pain).

The first thing you need to do is contact the hospital billing department and speak with them. You need to first demand an itemized billing statement, which they must provide you. Once you get that billing statement you will know what every exact charge is for to allow you to be more informed for your next step. After you go through the billing statement you need to contact billing again and inform them you are disputing the charges (not the patient representative but billing). They will tell you that they cannot do anything about the bill and you need to inform them you believe it is incorrect and insist on speaking to a supervisor. The supervisors are the only one who can make adjustments. You need to be polite the whole time, but continue to stress the charge is well beyond the reasonable and customary charges and you are disputing what they are charging on the itemized bill (go through each item if you have to with them). While it might take you a couple of calls with them, in most every situation I have had like this they will generally agree to reduce these bills by at least 50%. You need to continue to stress the lack of service and lack of equipment necessary to even diagnose you properly when negotiating. You can even hint that their failure to properly diagnose and treat you could be malpractice (which many times gets them to negotiate easier).

Unfortunately, legally you are liable for payment of the bill from what your insurance did not pay and they can indeed take you to court for payment.

Your only other option is seeking to argue malpractice for their making you wait and then failure to properly treat your condition. The problem with this is before you can sue for malpractice under Texas law, you are going to have to have a doctor willing to write a report stating that the conduct of the hospital was below the reasonable standard of care for your condition. If you can get that doctor's report, then you could seek to sue them for malpractice for the pain and suffering you incurred because they failed to properly diagnose and treat your condition.

Legally, I am afraid that these are really the only options.



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Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 89572
Experience: JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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