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Miscarriage ER Bill

1,110 Views | 17 Replies | Last: 1 mo ago by 91_Aggie
llondono12
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Two weeks ago my wife miscarried at home but was in severe pain, so I rushed her to the ER because she is O- and needed a Rogham shot. They did some lab work, two ultra sounds, an IV, and have her the Rogham shot. 2 weeks later we get the bill for $4,700. She was coded as a level 5 ED, which it is my understanding that is the highest level (think trauma, etc.)

The hospital is Memorial Hermann in Houston, Texas and does not have a reputation for lowering their bills. How can I approach this with the billing department? Has anyone else had a similar experience? My deductible is 6K so everything comes out of pocket. I realize we used a service but $4,700 seems excessive.
stanfitz
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2 weeks seem very quick to be getting a bill. As this would require them to send it to your insurance company and then get a response back.

What were the total charges as this should be the starting point and then based upon negotiated rates, what the allowable is.

If you do really owe 4,700 I would call their billing office, and offer a lump sum payment of 2k to see if they would take it and write off the remaining but you need to call to see what they would be willing to take.
llondono12
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It was very fast. The initial bill after the insurance "discounted rates" was close to 11k. Already tried negotiating but they won't budge (I let me temper show, may be why.) I plan on letting it go for some time and Lee trying to negotiate.
culdeus
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I mean you have insurance and didn't yet meet your deductible. Why do you really feel you deserve a discount? Sorry to be a dick here, but I don't get it.

BR 82
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First, I'm so sorry to hear about your loss. That really sucks and is so painful.

My wife and I had the same thing happen a few years ago, but she required hospitalization the day before her insurance came into effect, so we had an ER Bill, blood transfusions, and an overnight stay that wasn't covered under insurance. We got the bill for about $16K, but were persistent in calling their billing department and basically telling them there's no way we could afford that. There was a financial application we had to fill out, and they ended up lowering the bill to $2500. I then put that on a 12 month, interest free payment plan. It's been my experience that hospitals just want to be paid, they'll typically accept a lower amount as a lump sum or take a payment plan.

I agree with asking if they'll take a cash payment upfront and be done with it, otherwise, maybe your insurance can negotiate a better discount that you can pay off over time? I hope they can come down on that, it's ridiculous how much the ER charges.
selk
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You got more bills coming I would bet
The Pilot
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Medical stuff is stupid expensive, so the $5K emergency bill doesn't surprise me.

I had ACL surgery March 5, still haven't seen the bill. I've already met my out of pocket max ($3800) with the three doctor visits, 1 mri, 2 Xray sessions and about 10 PT appointments.
Absolute
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Terribly sorry to hear.

I have no idea what level that should be, but had an experience with fraudulent coding years ago with my daughter.

She was probably 3 or 4 on labor day. We were watching movies and eating popcorn. She stuck a kernal up, way up, her nose. Screaming commenced, we are not the freak out type of parents, but had no clue how to safely get the thing out.

Being a holiday we took her to the er of the local hospital. Lucky to get in at a low volume time. Went back in 10 minutes. Nurse came in shot her nose full of afrin. Explained the doctor would be in in 5 minutes to extract. Doc came in with a a little plastic probe and popped the kernal right out. We were literally home in an hour.

Paid like 1500 to our deductible to the first round of bills. 6 months latter we got a bill for like 3 grand detailing a level 5 procedure from the doctor.

I called and asked for an explanation as to how what we had been through could possibly be on the same level as a horrific car crash, gunshot wounds, whatever. They had no answer.

So instead of paying I wrote a letter requesting a detailed explanation of the charges and in particular the level 5 coding. I sent it certified return receipt. No response. A few months later I got the same bill. Sent back the same letter. Thus began about a 2 or 3 year process. They never offered any explanation, they just elsent the same invoice. I always responded right away. Would just change the letter to say 4th request, 7th request, etc

Never heard anything. But my understanding was that as long as I responded they could not take further steps. Finally I received an invoice with a 0 amount owed.

Not sure if it will help. But it worked for me. Again, so sorry for your loss.
llondono12
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This is great information. I will definitely try that approach.
rebag00
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Absolute said:

Terribly sorry to hear.

I have no idea what level that should be, but had an experience with fraudulent coding years ago with my daughter.

She was probably 3 or 4 on labor day. We were watching movies and eating popcorn. She stuck a kernal up, way up, her nose. Screaming commenced, we are not the freak out type of parents, but had no clue how to safely get the thing out.

Being a holiday we took her to the er of the local hospital. Lucky to get in at a low volume time. Went back in 10 minutes. Nurse came in shot her nose full of afrin. Explained the doctor would be in in 5 minutes to extract. Doc came in with a a little plastic probe and popped the kernal right out. We were literally home in an hour.

Paid like 1500 to our deductible to the first round of bills. 6 months latter we got a bill for like 3 grand detailing a level 5 procedure from the doctor.

I called and asked for an explanation as to how what we had been through could possibly be on the same level as a horrific car crash, gunshot wounds, whatever. They had no answer.

So instead of paying I wrote a letter requesting a detailed explanation of the charges and in particular the level 5 coding. I sent it certified return receipt. No response. A few months later I got the same bill. Sent back the same letter. Thus began about a 2 or 3 year process. They never offered any explanation, they just elsent the same invoice. I always responded right away. Would just change the letter to say 4th request, 7th request, etc

Never heard anything. But my understanding was that as long as I responded they could not take further steps. Finally I received an invoice with a 0 amount owed.

Not sure if it will help. But it worked for me. Again, so sorry for your loss.
I had a very similar ER visit with my daughter, except Baylor in Dallas was more responsive when I called and asked about the coding, which was initially listed at level 4 for a plastic bead up a 3 year old's nose. The ER Dr. didn't even physically touch her, he walks in and says "try this first." I had to do all the work (hold the unblocked nostril closed, blow hard in mouth and out popped the bead). The nurses did all the normal nurse stuff (BP, temp, verify the bead in the nose, etc...). We received a bill for $3,000 about 6 weeks later. I called immediately after I looked up the coding of "moderate to severe trauma." They got back to me within a couple weeks. New bill was $350, which I paid. I never submitted anything in writing. I was firm but polite over the phone.

I got another bill about 3 months later from the ER Dr.'s billing company. I was unaware they had a different billing system from the hospital. It was just for the Doctor. I called and explained the situation, told the billing agent over the phone what happened and to look it up in the patient records. I received a $0 balance bill about 3 months later. All in all it was about 8 months from ER visit to $0 balance on both bills.
llondono12
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That's crazy. Glad you got it worked out! I was fully expecting to pay $2000 - $2500, but when I received the first bill for double what I had in mind, I hit the pause button. I haven't even gotten the bills for the doctors yet. Apparently this $4,700 bill is just for using their facilities.
Absolute
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Yeah keep good records of what you get and who you pay or insurance pays. I wish I could believe my situation was an honest mistake. I was perfectly willing to pay a fair amount. But the experience left me with the unfortunate but firm belief that they saw someone with insurance and income and figured they would throw it and see if it stuck. I pretty firmly believe they were trying to screw me.
Watchful Ag
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Years ago I was speaking with the COO of Memorial Hermann. He was telling me that they write off approximately $12M a year for people without insurance ...

Not to throw gas on the fire, but it makes me angry to think there's probably no way out of OP's bill yet people walk in and get all types of treatment with no expectation of paying anything ...
Woods Ag
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Took my infant to the ER last month. $15k bill to run xrays, catscan, and ultrasound. They determined he's just pissy.
AggieGunslinger
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We learned with my dad that the hospital will bill you and your ins. initially in an attempt to get as much money as quickly as possible and then take their sweet time to reimburse any over payment after they sort out insurance. My mom quit paying bills until they showed up on colored paper, saved her thousands.

She also went through the fraudulent billing process more than a few times and did the same thing Absolute did and made them defend their reasoning, it always ended up in her favor.

llondono12
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Thank you all, I appreciate all of the responses. I ended up going the route that Absolute suggested. Submitted a formal letter asking for a detailed explanation of every line item. We'll see what happens next.
bigtruckguy3500
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One of my guys was in Singapore and got hung up on an aircraft tow cart, dragged a bit, and almost had his leg crushed under the skid of a helicopter. Went to an ER in Singapore, had x-rays, got meds, had his wounds cleaned and bandaged, got a set of crutches, etc., and the entire bill without insurance of any type came to $140.

And Singapore has one of the best healthcare systems in the world. Something is very wrong in this country, and we refuse to fix it.
91_Aggie
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rebag00 said:

Absolute said:

Terribly sorry to hear.

I have no idea what level that should be, but had an experience with fraudulent coding years ago with my daughter.

She was probably 3 or 4 on labor day. We were watching movies and eating popcorn. She stuck a kernal up, way up, her nose. Screaming commenced, we are not the freak out type of parents, but had no clue how to safely get the thing out.

Being a holiday we took her to the er of the local hospital. Lucky to get in at a low volume time. Went back in 10 minutes. Nurse came in shot her nose full of afrin. Explained the doctor would be in in 5 minutes to extract. Doc came in with a a little plastic probe and popped the kernal right out. We were literally home in an hour.

Paid like 1500 to our deductible to the first round of bills. 6 months latter we got a bill for like 3 grand detailing a level 5 procedure from the doctor.

I called and asked for an explanation as to how what we had been through could possibly be on the same level as a horrific car crash, gunshot wounds, whatever. They had no answer.

So instead of paying I wrote a letter requesting a detailed explanation of the charges and in particular the level 5 coding. I sent it certified return receipt. No response. A few months later I got the same bill. Sent back the same letter. Thus began about a 2 or 3 year process. They never offered any explanation, they just elsent the same invoice. I always responded right away. Would just change the letter to say 4th request, 7th request, etc

Never heard anything. But my understanding was that as long as I responded they could not take further steps. Finally I received an invoice with a 0 amount owed.

Not sure if it will help. But it worked for me. Again, so sorry for your loss.
I had a very similar ER visit with my daughter, except Baylor in Dallas was more responsive when I called and asked about the coding, which was initially listed at level 4 for a plastic bead up a 3 year old's nose. The ER Dr. didn't even physically touch her, he walks in and says "try this first." I had to do all the work (hold the unblocked nostril closed, blow hard in mouth and out popped the bead). The nurses did all the normal nurse stuff (BP, temp, verify the bead in the nose, etc...). We received a bill for $3,000 about 6 weeks later. I called immediately after I looked up the coding of "moderate to severe trauma." They got back to me within a couple weeks. New bill was $350, which I paid. I never submitted anything in writing. I was firm but polite over the phone.

I got another bill about 3 months later from the ER Dr.'s billing company. I was unaware they had a different billing system from the hospital. It was just for the Doctor. I called and explained the situation, told the billing agent over the phone what happened and to look it up in the patient records. I received a $0 balance bill about 3 months later. All in all it was about 8 months from ER visit to $0 balance on both bills.


Man. This brings back memories. Our 2 or 3 year old middle.daughter (been a while) came to my wife and said "i got a ball stuck in my nose". Panic sets in for wife and me for possible ER bill. Fortunately we were able to hold other nostril and she was able to blow it out. Huge sigh of relief.
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