When youÃ¢â‚¬â„¢re being rushed to the emergency room after a car accident or broken bone, itÃ¢â‚¬â„¢s not likely that you have the time to shop around for the best price. After all, medical care costs what it costs, right? Well, not necessarily.Ã‚Â Out-of-pocket patient costs for common emergency room procedures can vary dramatically, according to a recent study from the University of California, San Francisco.
Researchers analyzed data from the 2006-2008 Medical Expenditures Panel Survey, which included the total charges for 8,303 patients between 18-64 years old (patients over 65 were excluded, as they are typically covered by Medicare). Nearly half of these patients were privately insured, and all of them were treat-and-release patients, meaning their diagnoses did not result in being admitted to the hospital. Then they looked at the ten most common outpatient diagnoses in emergency rooms across the country (everything from a sprain to a UTI), and found huge variations in patientsÃ¢â‚¬â„¢ total bills. For example, the total cost of treatment for kidney stones in the ER ranged from $29 to $29,551!
So whatÃ¢â‚¬â„¢s with all the jacked-up prices? Ã¢â‚¬Å“There is a discrepancy in what hospitals charge for the same service,Ã¢â‚¬Â says co-author of the study Renee Hsia, MD, assistant professor at the University of California, San Francisco School of Medicine. Ã¢â‚¬Å“There is no regulation for hospitals about what they can charge.Ã¢â‚¬Â But thereÃ¢â‚¬â„¢s another reason why two people with a broken leg might leave the hospital with very different bills: Ã¢â‚¬Å“Patients will require different things depending on their type of presentation,Ã¢â‚¬Â says Hsia. So if you were in a horrible car accident, your provider may order several pricey tests to make sure that youÃ¢â‚¬â„¢re okay, before ultimately diagnosing you with a broken leg. But another person may come in after a nasty fall and be discharged after a single X-ray. The patient with multiple tests would naturally have a higher bill, even though their final diagnoses were the same.
Ã¢â‚¬Å“A lot of people will say, Ã¢â‚¬ËœAbout how much is this going to cost?Ã¢â‚¬â„¢ ItÃ¢â‚¬â„¢s a totally reasonable question, but the hospital administration probably wonÃ¢â‚¬â„¢t be able to tell you,Ã¢â‚¬Â says Hsia. And that means that every time you go to the hospital, you may be leaving with sticker shock (even if you have insurance!). Since you canÃ¢â‚¬â„¢t exactly find a Groupon for your next ER visit, try these tactics to fixÃ¢â‚¬”or avoidÃ¢â‚¬”an outrageous bill:
Help your doctor help you You know that additional tests can mean the difference between a three-figure bill and a four-figure bill (or larger), so you want to make sure youÃ¢â‚¬â„¢re as specific as possible when explaining your symptoms. Of course, donÃ¢â‚¬â„¢t keep hush about something just to avoid an expensive lab cost, since that may cause them to miss something major. But if youÃ¢â‚¬â„¢re not entirely sure if your nausea is due to nerves or a related symptom, offer it up. When doctors are already on the fence about a test, having more input from the patient is always helpful, says Hsia.
Scout out the financial services office Before you even leave the hospital, find out where the financial aid office is so you can go talk money. If you arenÃ¢â‚¬â„¢t privately insured, you may qualify for a financial assistance program that you didnÃ¢â‚¬â„¢t even know existed, says Hsia. And in some states like California, there are mandates that require hospitals to offer you a discount if you fall below a certain percentage of the federal poverty level. The catch: ItÃ¢â‚¬â„¢s unlikely that anyone is going to just offer you this information, so youÃ¢â‚¬â„¢ll need to seek them out to tell them about your financial situation.
Get an itemized billÃ¢â‚¬”and inspect it carefully Once you receive your hospital bill in the mail, immediately request an itemized version, says Pat Palmer, Founder of Medical Billing Advocates of America. Not only will it help you see how much each procedure cost, but it may also clue you in to potential errors, like a medication you didnÃ¢â‚¬â„¢t take or an X-ray you never ended up getting. Other things to look out for include equipment or services that should already be factored in to the cost of your room or procedure (like the hospital gown or the warm blanket they give you) and discrepancies when it comes to the time you spent in the recovery or operating room. Ã¢â‚¬Å“They might know they were actually ready to leave the recovery room after an hour but no one was there to get them. You donÃ¢â‚¬â„¢t want to pay for that when it wasnÃ¢â‚¬â„¢t your problem,Ã¢â‚¬Â says Palmer.
DonÃ¢â‚¬â„¢t give up so easily If you find that something is off when looking at your bill, donÃ¢â‚¬â„¢t hesitate to contact them about it. First, notify the hospitalÃ¢â‚¬â„¢s billing department immediately (in writing, just to be safe) that you plan to dispute your charges and ask that your bill be put on hold for 30 days, says Palmer. That way you wonÃ¢â‚¬â„¢t be taken to collections while you get everything in order. Then send the billing office a detailed request in writing of the charges you are disputing. Ã¢â‚¬Å“Ask them to supply you with a correct bill or, if there are items they donÃ¢â‚¬â„¢t correct, you want a detailed written response for their basis for charging for that,Ã¢â‚¬Â says Palmer. Ã¢â‚¬Å“A lot of times, after much negotiation and appeals, they may end up giving you some discount on the bill,Ã¢â‚¬Â says Hsia. Ã¢â‚¬Å“But it takes a lot of perseverance.Ã¢â‚¬Â
Keep negotiating It may sound crazy to barter when it comes to your healthcare, but according to Palmer, it never hurts to ask. Even if your insurance covers most of your costs and youÃ¢â‚¬â„¢re left with a somewhat manageable bill, call the billing office to see if theyÃ¢â‚¬â„¢ll give you a Ã¢â‚¬Å“prompt pay discount,Ã¢â‚¬Â which essentially means youÃ¢â‚¬â„¢re paying in full right away, so they should cut you some slack. Ã¢â‚¬Å“For example, if I owe $200, I could call and ask if they would accept $120 if I paid in full within 10 days,Ã¢â‚¬Â says Palmer.
Get help if you need it If youÃ¢â‚¬â„¢re still facing charges that you donÃ¢â‚¬â„¢t agree with and youÃ¢â‚¬â„¢re not getting anywhere with the billing office, seek out an advocacy group like Medical Billing Advocates of America. Most will offer a free phone consultation to discuss your situation and how they might be able to help. Ã¢â‚¬Å“The need for advocacy is increasing and itÃ¢â‚¬â„¢s getting to the point where no one should pay a bill without having a representativeÃ¢â‚¬”just like we do with our taxes,Ã¢â‚¬Â says Palmer.
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