What is an ER specialty facility?

Investigate insurance companies.

Next time don't give them your real name!

Old Army Ghost said:

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B-1 83 said:

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I GUARANTEE they didn't send back the insurance payment.

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you call your insurance company to report the theft or nah?

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This was a "spurter" to the bone. No glue would have done it, trust me.

I believe it.

More than a decade ago I had a hospital charge me several thousand dollars to remove a few staples. Done by what I assume was not even a nurse but more of a med tech type.

For the few of you that are not familiar, a child could do the job with a pair of snipping pliers.

Did you take an ambulance to the hospital for 4 stitches? That may be why the $15K.

redcrayon said:

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What is an ER specialty facility?

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https://mdpremier.com/calallen-annaville-emergency-room/?utm_medium=paid%20search&utm_source=google&gad_source=1&gad_campaignid=23404233264&gbraid=0AAAAAC8DKwjPtZpkY7blIncrYLkUsvAfB&gclid=EAIaIQobChMIk8m76uv3kQMVzDbUAR2ZDzUlEAAYASALEgJC2vD_BwE

I went to the ER on 12/19 for suspected optic neuritis, ended up staying for 4 days to get IV steroids. Had 2 MRIs, lumbar puncture and tons of labs. Hospital bill looks to be $67K, with another $6K for other stuff.
All in about $75K and my share may be around $5K.

Just crazy how this stuff is priced and what happens internally with insurance.

AJ02 said:

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Weird. I went to urgent care for stitched and it was nowhere near $15k billed to insurance.

Best bet is to NEVER go to an ER for something minor that can be handled by urgent care.

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This. Best to try to find a good urgent care when you have the time, then remember it for future reference. Something bad happens, you drive there.

One time my mother decided to do a head plant straight into parking lot pavement. Split her forehead open. We immediately ruled out the ER, and there was an urgent care right down the street.

It wound up being excellent, where a nurse practitioner was able to stitch her up. We were probably there about an hour. She looked horrible with a black-and-blue face, but it actually healed quite well with no visible scar.

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I GUARANTEE they didn't send back the insurance payment.

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Your insurance company did not cut them a $15k check.

Laceration repair has a 10-day global period. That means that if you are seen by the same facility within 10 days after the initial repair and for anything related to the initial wound, you cannot be charged and insurance cannot be billed.

This is why I carry dismemberment insurance, 13k per finger. Just need to find away to lose a few "accidentally"

Seamaster said:

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Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

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Well, that and time shares.

Hospital billing, medical insurance and the repeated finger pointing between the hospital and insurance persists because there is so much money to be made.

Efficiency in billing would make a lot of very wealthy people unhappy. Therefore it is allowed to happen.

Psycho Bunny said:

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This is why I carry dismemberment insurance, 13k per finger. Just need to find away to lose a few "accidentally"

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Hook 'em!

Seamaster said:

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Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

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This is where they get you - technically, that isn't true. You can ask for the costs from your insurance company and doctor up front and they have to provide it for you. The problem is that there are so many codes and so many layers of BS that nobody actually does because it would be a nightmare to try to really assess the costs prior to services.

Emergency services are a different animal, those you truly don't know until the ER or hospital sends you and the insurance company the bill.

Doesn't help that every insurance company has different pay rates for the same procedures, and that the same insurance company will also negotiate different payouts for the same procedure depending on the doctor, hospital, etc. It's an absolute convoluted mess that is pure garbage for the consumer in the end really.

Ol Jock 99 said:

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I GUARANTEE they didn't send back the insurance payment.

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Your insurance company did not cut them a $15k check.

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Bill 15K receive 5K, take 10K off of the taxes as a "loss". I wish I could operate like this.

Yeah, the insurance contractual was WAY less than that. Look at the EOB, it's probably not the ER clinic but a billing (semi-scam) service doing it. Doesn't take very many to sneak by for big $$$

This is government's fault.

1) Doctors and hospitals can charge whatever they want because they know insurance will pay for it.
2) #1 happened because they are tied to employers and are difficult for their customers to "fire" and they can just pass the cost on.
3) #2 happened because it is excluded from income tax, so it behooves employers provide it to maximize compensation for employees without the tax hit.
4) #3 happened because FDR froze salaries encouraging employers to provide health insurance to get around it, and taxing that was politically untenable.

Seamaster said:

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Medical care is the only financial transaction that we consent to without having any inking of what it's going to cost.

I can't believe we put up with it.

Imagine going to a restaurant or buying an appliance and not knowing the cost until they bill you. Sounds nuts? But that's what we do with healthcare.

The whole system is beyond broken.

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What has broken it so badly is an economic system that is so amoral that it believes that making a profit from saving someone's life is a good thing. Take the profit motive away, and the nutty parts go away.

I am helping a family member deal with a long term medical issue right now. Medical billing is beyond frustrating. So far the "cost" of the care received is about $47k, but about $34k has just evaporated because of whatever is negotiated between insurance and the providers. Out of pocket costs have been about $2200. I am tracking all this based on the EOBs received. It thought some of this legislation was supposed to make all this more understandable, but I guess not.

One particularly aggravating issue is getting a bill after 30 days because one provider provided service. The we get a second bill 60 days later for the same visit, but it has a different provider listed. When I called billing to get an understanding of this they said, "it is because they use a team approach and bill separately". I have taken the strategy that if they can wait 60 days to bill, they can wait another 60 days for me to process payment. At that, they may only get paid $10 so that they can't say I didn't make an effort to pay something. They will eventually get paid in full.