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Back t the THT Brain Trust - ER Visit Charges

Old 04-09-2019, 10:21 AM
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'Son is down in school in NC. Experienced severe abdominal pain over the course of a weekend. He drove himself to the ER in Boone late Sunday night. Ran blood tests, a Cat Scan and gave him IV fluids for 2 hours. Initially thought it was appendicitis but ruled that out. Turns out he was he was constipated......I know, cue the laugh track. He paid $100 as his co-pay when he went in. He asked about what they thought the bill would be - he says around $400 +-20% as a ballpark. Last week we got a bill for $400 so we figure we got out cheap. Today we get the 'real' bill. $5,723.23! Primary Insurance picked up $2,535.75, there were unidentified 'adjustments' of $1,716.04, and our earlier payment of $400 listed as 'secondary' insurance leaving us with a balance of $1,071.44. He's asked for an itemized breakdown so we'll see what that shows but geez this sounds nuts. We have BCBS plus an additional policy for him being an out of state student. Maybe I'm just out of touch.....Happy he's fine of course but I've just sent him a care package of ex-lax......
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Old 04-09-2019, 10:29 AM
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I hate our health Care system.

Always remember that the people working in health care billing are single cell organisms that would forget to breathe if it weren't on their checklist. A bigger group of morons does not exist.

Good luck, and tell him to lay off the gutbusting sammiches at macados.
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Old 04-09-2019, 10:37 AM
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Originally Posted by NCSUboater View Post
I hate our health Care system.

Always remember that the people working in health care billing are single cell organisms that would forget to breathe if it weren't on their checklist. A bigger group of morons does not exist.

Good luck, and tell him to lay off the gutbusting sammiches at macados.
Damnddest thing is he is in incredible shape being a health nut and competitive cyclist. He had to go on a 'wilderness' week long camping trip to some island in GA and could not access the food he generally eats - lots of grains, fruit and vegetables. He said it was a week of peanut butter and tuna which he thinks started the whole thing.
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Old 04-09-2019, 11:14 AM
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did he get to learn what digital removal means?

doesn't have anything to do with technology lol

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Old 04-09-2019, 11:18 AM
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Insurance companies have policies with higher deductibles now and patients are responsible for a larger amount of charges than before. This saves the insurance companies money by creating a disincentive for people to get testing done. Also, hospital "charge amounts" are inflated to try and capture pay from certain insurance carriers. The amount charged is usually very far from that collected.
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Old 04-09-2019, 11:21 AM
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Also remember that you are paying for the patients before and after your son. The ones that showed up at the ER without insurance.
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Old 04-09-2019, 11:21 AM
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I assume you were kidding on the ex-lax, but Senokot - S w/ a stool softener is a much better choice.
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Old 04-09-2019, 12:18 PM
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If he, and you, thought he was getting out of the ER including a cat-scan for $400 bucks I've got a bridge to sell ya.
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Old 04-09-2019, 12:30 PM
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Originally Posted by MonarkBoats View Post
If he, and you, thought he was getting out of the ER including a cat-scan for $400 bucks I've got a bridge to sell ya.
Did not think it would be $400 - but given the various insurance policies we have I thought we would have less out of pocket than $1,400 and the $5,700 figure seems outrageous. I have unfortunately been transported to the ER 2x in the past year via ambulance, discharged within hours one time and an overnight the second time, MRI each time. I paid our $100 ER co-pay each time and that was it nothing more came my way. Son is under the same policy plus an additional policy for out-of-state coverage since he goes to school out of the local network. They also told him upon discharge the fee would be within 20% of $400.
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Old 04-09-2019, 12:34 PM
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i would bet it has to do with the out of state part. the answer will be in the fine print of the additional out of state policy!
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Old 04-09-2019, 12:35 PM
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Originally Posted by mymojo View Post
'Son is down in school in NC. Experienced severe abdominal pain over the course of a weekend. He drove himself to the ER in Boone late Sunday night. Ran blood tests, a Cat Scan and gave him IV fluids for 2 hours. Initially thought it was appendicitis but ruled that out. Turns out he was he was constipated......I know, cue the laugh track. He paid $100 as his co-pay when he went in. He asked about what they thought the bill would be - he says around $400 +-20% as a ballpark. Last week we got a bill for $400 so we figure we got out cheap. Today we get the 'real' bill. $5,723.23! Primary Insurance picked up $2,535.75, there were unidentified 'adjustments' of $1,716.04, and our earlier payment of $400 listed as 'secondary' insurance leaving us with a balance of $1,071.44. He's asked for an itemized breakdown so we'll see what that shows but geez this sounds nuts. We have BCBS plus an additional policy for him being an out of state student. Maybe I'm just out of touch.....Happy he's fine of course but I've just sent him a care package of ex-lax......
Enema at CVS is $2
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Old 04-09-2019, 12:46 PM
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Originally Posted by mymojo View Post
Did not think it would be $400 - but given the various insurance policies we have I thought we would have less out of pocket than $1,400 and the $5,700 figure seems outrageous. I have unfortunately been transported to the ER 2x in the past year via ambulance, discharged within hours one time and an overnight the second time, MRI each time. I paid our $100 ER co-pay each time and that was it nothing more came my way. Son is under the same policy plus an additional policy for out-of-state coverage since he goes to school out of the local network. They also told him upon discharge the fee would be within 20% of $400.
what does your policy say about out-of-network co-pays and deductibles?
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Old 04-09-2019, 12:49 PM
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Gf just got a bill for a 1 mile ambulance ride. 7k! Lmao.
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Old 04-09-2019, 12:51 PM
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Originally Posted by mikefloyd View Post
what does your policy say about out-of-network co-pays and deductibles?
Looking into that now, just got to get my hands on the policy once my wife gets home as she is the record keeper around here, I'm just the bill payer.....
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Old 04-09-2019, 01:07 PM
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Originally Posted by mymojo View Post
Looking into that now, just got to get my hands on the policy once my wife gets home as she is the record keeper around here, I'm just the bill payer.....
I would get all your info, then call and offer them $250. Tell them he’s a college kid, take it or leave it. I just read an article about air ambulance, Bill was 40k, settlerd for 1k.
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Old 04-09-2019, 01:10 PM
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Originally Posted by WPBTH View Post
Gf just got a bill for a 1 mile ambulance ride. 7k! Lmao.
That is why I stick to uber...
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Old 04-09-2019, 01:14 PM
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Don’t pay the balance. Just wait for the collections and tell them you will give them 30 cents on the dollar they will negotiate I have done this couple of times. I had an 8k visit to the ER and settled with the hospital for 1200
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Old 04-09-2019, 01:33 PM
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Originally Posted by r.waddill View Post
Don’t pay the balance. Just wait for the collections and tell them you will give them 30 cents on the dollar they will negotiate I have done this couple of times. I had an 8k visit to the ER and settled with the hospital for 1200
I'm willing to pay whatever I can negotiate down to. It's in my son's name so I don't want to go down the collections route and have him get off to a bad start credit wise as he's soon to graduate and be looking for apartments, loans, job etc...
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Old 04-09-2019, 01:41 PM
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If you have BCBS, then the provider was more than likely in-network. They usually do not give any additional adjustments outside of the BCBSNC negotiated rates, but never hurts to ask. One piece you should make sure to watch, you said he has a secondary policy... IMO, carriers love to "pend" charges in order to coordinate with other insurances. You need to make sure every item is FIRST billed to BCBS and then have the charges billed to the secondary policy. Hopefully the household has an online account and can access all EOBs with BCBS online. Make sure to match every billed item against the BCBS EOB.
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Old 04-09-2019, 02:20 PM
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