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.

what's the biggest line item on the bill?

They will usually give you a 10% discount if you pay in full right away or let you pay the entire balance out over 36 months. You have to call them and they dont tell you that upfront. You just need to say you dont have the money to pay it. Can you do anything for us.

Note, if you are truly poor, they will write it off. They will just need proof that you are poor. Usually having good health insurance even with a high deductible does not help this situation.

But call in and see what you can get. Use your situation to your advantage and crying wont hurt you when on the call. I've learned their phone reps have a lot of power.

You can call and attempt to negotiate but based on what you are describing you are held to what your insurance prices the claim at. MH has to go off what the contract with the insurance states or they can get sued by the insurance company which UHC did a few years ago. What were the total charges on the claim if you don't mind me asking?

Memorial Hermann does have a reputation of being willing to sue patients who don't pay or can't afford to pay but do not qualify for charity. I actually have a friend I am helping now whose received a bill from MH for $5k. MH incorrectly coded the claim as a life flight transfer when it was actually a normal ambulance transfer. They have so far refused to change coding and are now threatening to send to collections. Sad thing is they have acknowledged the error but still can't get them to do it. Good care but terrible business. Not to scare you but just know their culture.

Bet it ends up being more than $4700

This. That's probably just the first of many bills

My heart goes out to you.

We had a stillborn child at 32 weeks into pregnancy in July 2017 and I ended up paying around $6k out of pocket and paid for a casket and headstone and burial plot.

That was pretty horrible all around and I just want you to know I'm praying for you and your wife.

And quite frankly if you are in need of some financial assistance please let me know. I will try to help you.

My wife and I have a goal of establishing a foundation someday to help pay these kinds of expenses

Get a detailed invoice and look up what Medicare pays for each service. Offer them 50% of that in cash. If they refuse let them send it to collections and settle there for <50% of the invoice. Healthcare prices are a scam.

I've had an $80 medical bill that was a duplicate charge go to claims and they wouldn't budge. How did you pull it off?

I am so sorry for your loss as well. And thank you so much for the offer, you have a good heart. A foundation for people going through things like these is a great idea and would benefit a ton of people.

We can pay it, I just want to understand everything before I just hand them the money.

Pelayo said:

---

what's the biggest line item on the bill?

---

Emergency Room Services for 3,688.25

llondono12 said:

---

Pelayo said:

---

what's the biggest line item on the bill?

---

Emergency Room Services for 3,688.25

---

Sounds like the 'facility' fee. I'd wait to see if more bills are coming before calling to make a deal.

Thank you

llondono12 said:

---

I am so sorry for your loss as well. And thank you so much for the offer, you have a good heart. A foundation for people going through things like these is a great idea and would benefit a ton of people.

We can pay it, I just want to understand everything before I just hand them the money.

---

We had a baby with a condition that caused him to die shortly after birth. Doc ordered a aminosentisous (sp) to confirm and the insurance didn't want to cover it.

They finally did after several absolute brutal beratings from me. They had wanted to charge $1700 for the test insurance price was something around $100.

Long story short they are the enemy treat them as such. Hold a very hardline with them because they may act nice but will tow a hardline. If they want to sue they will look like absolute demons in the eyes of any judge or jury because you are dealing with the worst kind of unnatural loss, the loss of a child.

My experience is that a doctor bill is not bad and normally reasonable for the service provided, which makes it harder to negotiate. Hospital stays are very inflated and testing or labs are ridiculously over priced (see above)

I do not have a problem paying medical bills that are fair but if I think I am getting ripped off I let them know as much and attempt to negotiate it down. Honestly it is hard and to truly get anywhere it may have to go to collections first.

I am sorry for your loss and pray for continued healing.

I'm sorry for your loss. Out of pocket healthcare costs are a joke in this country.

Formally dispute the claim (write a letter) and it will get hung up in pending claims.

Then, once you feel you can not negotiate any further, pay the amount over 30 years or so. $1.27 here $0.96 there another $2.37. As long as you're paying, you're fine.

Welcome to the reason why healthcare is so expensive. That consuela who takes their kids to the ER for a cough and never pays a dime is why the cost is burdened to the rest of us.

Hospitals are for-profit, no matter what their tax filing says.

Im very sorry for your loss. We, too, went through this (twice actually). One was more traumatic than the other and required medical attention. It took a physical and emotional toll. You will get through it though, so hang in there.

The bill is insult to injury. Its crazy what the insurance prices are for these things. You need ask them to verify the coding on the bill. I once had a $1000 bill that was coded incorrectly, and once it was cocorrected it was changed to $4. I learned then to always verify when something seems excessive.

Check the Coding!!!

Although it sounds like this bill is ball park reasonable. Ten years ago my wife spent 6 hrs in the ER to get Diagnosed, some fluids and a morphine drip to ease the severe pain she was in (she had a necrotic gall bladder).

We were sent homer (Friday) as the soonest her surgeon, that she wanted, was available was Monday, they offered her to stay the weekend, we opted not to.

The Initial bill was just over $10k for that ER portion. My wife immediately noticed a coding error that was about a 3k difference and we also had an out of network Dr, even though we drove across town to our Insurances preferred hospital for that sole purpose. We fought the OUT of Network ER Dr part and they eventual caved on that. I think in the end ours was about 4 thousand.

Sorry you are going through this. We really need to figure out how to bring hospital systems to justice on the misquote at the beginning, misbill/balance bill and then send-to-collections racket they have going on.

Can you go in and state you're a cash payer? Once you get the bill and negotiate it down can you then submit it to insurance? I've heard you shouldn't tell them you have insurance because they bill you accordingly but i'm not an expert.

Thanks guys, I appreciate all the support. I ended up submitting a formal letter asking for a review of the billing.

Sorry for your loss. Knowing too well what the charges are for an Er visit, $4700 (assuming the total all in) seem really inexpensive for what you are describing is a Level 5 charge, 2 U/S, Labs, and IM meds.

I have seen similar evals billed 10-15K

Sorry for your loss. Definitely wait for any potential other bills first and negotiate the hell out of it.

That being said, I can't think of a single other industry that's been allowed to keep their prices behind a veil of secrecy for so long. It's criminal, especially in non-emergency situations, to not know what price the service you're about to purchase is. A large part of this confusion and lack of transparency is how overly convoluted and complex the legal / financial side of the industry is, especially at a hospital.

A market-driven solution hasn't been established, largely because of privacy laws, so unfortunately need the government to step in.

llondono12 said:

---

Pelayo said:

---

what's the biggest line item on the bill?

---

Emergency Room Services for 3,688.25

---

Tell them you only speak Spanish and are not a US citizen. They will immediately write it off, and raise price on next US citizen.

Isn't the rhogam shot just to save the baby? I didn't think mother's were really at risk in that situation. Sorry for the tangent.

And also sorry for your loss

Dealing with the hospital on the bill will just add insult to injury I'm afraid.

exp said:

---

Isn't the rhogam shot just to save the baby? I didn't think mother's were really at risk in that situation. Sorry for the tangent.

---

to save the next baby