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AttyHeather
AttyHeather, Lawyer
Category: Legal
Satisfied Customers: 547
Experience:  15 years law practice experience
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Last November my husband went to the ER because he was still

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Last November my husband went to the ER because he was still having a significant amount of pain at the site of his vasectomy. It was Sunday, there was no urgent care available. His Doctor was not available and he was out of pain meds. We went to the ER because their posted price for a 'focused/straight forward' er visit was between $180 - $418. I couldn't quite tell because the pricesheet was unclear but $418 as a worst case seemed doable for us and reasonable enough for us to suck it up and go so that he wouldn't have to deal with this the next day, on the first day of his new job.
We waited in the ER for 30 minutes or so (it wasn't crowded) and then saw a triage nurse for 2 minutes and then a doctor for less than 5 minutes. The doctor recommended an ultrasound just to be sure, that could then be forwarded to his doctor for follow up when he was in the office but said he didn't see or feel and cause for concern. We told him that we were cash pay and asked what the cost would be to have this done. We actually do have a Temp Medical Plan but didn't expect it to cover much if anything. So, we described ourselves as cash pay. Again, my husband was worried about taking too much time out of the work day at a job he was just starting so our thought was, if we could just get the ultrasound done now, it would be one less thing to take away from his work day in the upcoming week.
We were ushered into a waiting room where we waited for someone in billing or administration to let us know what the cost would be. After waiting 30-45 minutes or so, someone from the hospital told us that just for walking in the doors our current charge was $2250 (ish) and for the ultrasound it would be an additional $400-600 dollars. Of course we flipped out and told them that this was in no way what was posted on their website and went back and forth for awhile. At which point she says that if we have an insurance provider, the negotiated rate would be significantly lower.
We gave her our Temp Plan info and she disappeared for another 45 minutes or so (we were still in a side waiting room) and then she came back to tell us, they were closed so she couldn't tell us exactly what it would be and that she had misquoted the ultrasound, it would actually be $1100 cash but again, it was all probably much lower if we went through our plan but she couldn't confirm until our Insurance was open tomorrow and she left us to 'think about it'.
In the meantime, my husband was in pain and out of meds. We'd been there several hours at this point (with only 5 minutes face time with any doctor or in any sort of patient room). We decided to just get the one ultrasound done and get him a prescription so he could follow up with his doctor during office hours in the up coming week, on the assumption that the insurance negotiated rates would be far less, even if we were going to have to pay it all out of pocket due to our deductible.
It took about 10 minutes to do the ultrasound. They gave him a shot for the pain and a single percocet. About 45 minutes later, the ER doctor came back, pulled him aside to a private wait room in the hallway and told him everything looked fine. They would forward the results of the imaging to his doctor and gave him a prescription for pain meds to get him through the next couple days in the meantime. We finally left.
Then we get a bill from the hospital for nearly $6000.
$2970 for a *class4 ER visit (their highest level of emergency - this is what they told my husband when he called to ask about the charge)
$1531.40 for an abdominal ultrasound
$1376.70 for a vascular ultrasound (the one we authorized, given the price $1100 - that was surely lower on your plan's negotiated rates)
$91.10 for pain meds administered (okay - whatever, we knew this was going to be silly)
Billed separately, we had a $418 bill from the ER doctor and $210 imaging bill from the imaging company (I assume for the tech- since the hosptial was already billing us for the ultrasound?).
We called the hospital and told them these charges were way out of line so they offered to complete an audit but warned us that could result in more missed charges and we'd owe more. I told them to proceed because I would not pay more than $1100 for the one ultrasound we authorized, $91.10 for the pain meds and $418 for the visit- the max for an non-complicated visit as posted on their website because our visit was definitely not their highest level emergency visit as charged*.
*They of course later denied giving us this information about the charge in our first conversation.
So, long story short - too late. I am working on negotiating what we pay and I do expect to pay for the visit but the charged amount is ludicrous. If they continue to refuse to work with us, do we have any kind of legal recourse we can threaten? File something with a commission? Anything? To get them to come to the table...
Submitted: 6 months ago.
Category: Legal
Expert:  AttyHeather replied 6 months ago.

Hi, I'm Heather, an attorney with 15 years practice experience, and I'd like to assist you for informational purposes.

You could write up a letter that contains the proof (maybe a photo of the posted price in the ER) of the charges you expected to pay, and send a check with the letter for the amount you were quoted. On the back of the check, you can write in pen (right above the endorsement line) something like: "Endorsement/deposit of this check constitutes settlement in full for all amounts due and owing on account # *****" I can't guarantee it will work, but if they receive a check, they'll probably want to deposit it, and you can use that to argue that those funds were only paid upon their agreement that it settled the debt in full. It is at least worth a shot and gives you a defense if they try to wreck your credit for not paying, or try to sue you later for not paying.

I'm not aware of a commission that you can file a complaint to, but I hope I've helped.

Expert:  AttyHeather replied 6 months ago.

Let me know if I have answered your question.

Thanks, Heather

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