Dissecting an emergency room bill

Recently DC did what almost all DCs do at some point in their lives and stuffed a bead up hir nose.  Right before bedtime.  On my birthday.

Because it was a bead with a nice big hole in it, it wouldn’t sneeze out.

DH tried to tweezer it out but that just caused bleeding and an upset DC.

Google told us that things stuck up noses can be aspirated to the lungs and that can cause infections and abscesses and so on.  Google recommended the emergency room if home remedies didn’t work.  They didn’t.

So we paid the copay and a doctor and a couple nurses tried all the home remedies we tried to no avail.  Eventually they had to knock DC out so ze would stop squiggling and they could get the bead out.  Which they did.  DC will never ever do that again.  Only kleenex up noses from now on.

Weeks pass.  I dreaded seeing the bill (though not horrible amounts as we do have a tony emergency fund these days).  I figured it would be big, especially with the general anesthesia.

I did not figure quite on HOW BIG, however.  DH had had an emergency room trip for something much more scary a few years back and that only cost us something like $800 and there was lots of monitoring and stuff involved.

Cost?  $3000.  BC/BS bargained them to about half that.  Cost to us:  $1400.

But no indication of what that $3000 was for.  DH called up.  (And called up again a couple days later, and again until finally they called back.)  They told him that they could not tell him what the charges were for unless he showed up in person with proof that DC was his DC.  So he did, because we have general principal of not paying bills unless we know what they’re for.

$1400 just for going into a room at the emergency room.  That is the lowest amount they charge for just going into a room, a level 1 charge.  They also have a level 2 and level 3 charge!

$90 for the anesthesia (this I thought would be a lot more pricey)

$300 for a “minor ER procedure” (we think this was them poking around before anesthesia, tickling and attempting suction)

$870 for a “major ER procedure” (more people standing around while the doctor used suction, possibly also the post-anesthesia observation)

$280 for what we believe is the IV.

What was really interesting was the other info the lady gave us.  Her boss has been getting a lot more complaints about costs since these cost rules were put in place ($1400 just for entering a room!) and she can’t cut the cost of any one item, so no discounts there, but she has been settling debt for smaller amounts.  But, you have to make an appointment with her.  And she wasn’t there.  More hurdles.

After much agonizing about whether or not to try to set up an appointment with the “boss,” we decided to just pay the bill.  At least we’ll be getting 1% back from the credit card.  And hey, we’re halfway towards paying our family deductible… if there’s an emergency this summer we’ll at most have to pay $1500 for it.

DH recommends that you ask the doctor if it’s ok to wait for the next day to go to an Ear, Nose, and Throat specialist.  On the other hand, we were very happy to have the sense that all was right with the world at the end of the ER visit, and waiting another day would have been frustrating and probably not worth it for our sanity, even if it would have saved us several hundred dollars.

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31 Responses to “Dissecting an emergency room bill”

  1. Louise Says:

    wow! I am constantly gobsmacked at the US medical system! that is just incredible…

  2. First Gen American Says:

    Luckily our screw up the nose ER visit happened before our deductible insurance policy came into play, so it only set us back $50.

    Which reminds me, I should submit my out of network PT payments towards my deductible. Why didn’t I think of that sooner.

  3. Everyday Tips Says:

    I would have totally gone to the ER. I don’t think I could handle worrying overnight.

    When my daughter needed anesthesia, I had to pay $400, and that was years ago. Given it was for a longer period of time, but I am shocked they only charged 90 dollars.

    We have hit our deductible ($3000) already this year. I was so dumb because when I signed up for this health plan, I thought we could go the whole year without hitting the deductible and we would have great savings. I was wrong…

    • nicoleandmaggie Says:

      I actually did run the numbers between this plan and the lower deductible plan and given the difference in monthly payments we’re only losing a little bit of money between the two (in the tens of dollars), so far anyway.

  4. julier Says:

    Wow. And I thought $250 for an “in office surgery” at our pediatricians office was bad. I’m glad A chose to put a bead in her nose during regular office hours.

  5. Leah Says:

    I just had a doctor’s office visit that cost $1800. yes, $1,800 for one hour in the doctor’s office!

    Okay, to be fair, I had an ultrasound + uterine catheterization done. My insurance negotiated a tiny bit and paid for some. In the end, I owed $1,200.

    Still, ouch, that was pretty painful. I was not expecting that, especially since I asked the doc if the procedure was expensive and she said “I don’t think so, but I’ll have billing contact you if it is.” I wonder what she considers expensive. Most galling of all the charges was, I think, the $60 pregnancy test. Which they didn’t need to do, as I am definitely not pregnant (and I told them that and said I’d be happy to sign a waiver).

    On the bright side, I am fine, and having the procedure done cleared up my weird issue I was having somehow. Money has been pretty tight this year, and I’ve been way more tight than I even have to be. After I paid that bill, I went out and bought myself three shirts, as I’ve been running low on decent clothing that I can wear to teach. And wouldn’t you know — those three shirts cost the same as the damn pregnancy test.

    • nicoleandmaggie Says:

      You can call up the hospital and negotiate more… apparently a lot of people are doing that these days. It is definitely nice being able to have the luxury of making the decision whether to call up and negotiate or not. Thank goodness for emergency funds.

      Glad the procedure cleared up the problems you were having!

      • Leah Says:

        This was at my doctor’s office, and they weren’t willing to negotiate. They could do a payment plan, but why do a payment plan when I can pay it off right now and not have to think about it again?

        Yes, thank goodness for emergency funds. I saved up really well for this second round of going through grad school, and I am so glad I did. While the bill was frustrating, it wasn’t anything that threw me off track at all. So glad that I’m a saver :-)

  6. Lindy Mint Says:

    Wow, and I’ve been complaining about our $200 ER copay! And poor DC! At least you can always tell the story of the time ze stuffed a bead up hir nose and you had to spend $1400 to get it out.

    My son stuffed a coffee bean up his nose once. It was at a wedding and coffee beans were part of the table decor. Thankfully, I was able to push it out from the outside before it went fully into the nostril nether regions. It’s always fun when you get to do these things while underneath wedding banquet tables.

    • nicoleandmaggie Says:

      DC was remarkably brave about the whole thing. Totally trusted we would fix everything.

      When I did it (decades ago), it was a pea and much easier to get out without medical intervention! My mom doesn’t even remember it (though I remember it well).

      At least it wasn’t at a wedding! Everybody I know who has stuffed something up his or her nose did so while visiting San Francisco (including me)… so I thought we were safe until our next trip out.

  7. Dr. O Says:

    I cut halfway through my index finger tip last year while preparing dinner. We weren’t sure if I needed an ER, but the bleeding wouldn’t stop and we were going through gauze like crazy. Hubby was worried about long-term damage and the bleeding, and decided we should go to the ER. I tightly wrapped a huge wad of gauze around it, my finger ending up the size of a baseball when done.

    An hour later in the exam room, the doc unwrapped what my pale and no-longer bleeding index finger. He cleaned it off, put some super glue and a bandaid on it. Nothing fancy. No drugs. One doc. One nurse.

    The bill – about $2000. For superglue and a bandaid. And they’re weren’t even little cartoon figures on the bandaid. Totally gipped.

  8. frugalscholar Says:

    And this is WITH decent insurance. Let us pray for universal healthcare!

    • Jason@LiveRealNow Says:

      Yeah, that way, everyone can get screwed!

      A friend of mine has lived in Canada, England, Germany, and the US. 3 paragons of universal care. The US has the best care out there. Not the cheapest, but the best and most available. We’ve got equipment and personnel to cover everything that needs to be done, without committees, appeals, and multi-year waiting periods for necessary care.

      On top of that, the abomination of our current health care bill sucks. It only helps the people who don’t need it. The poor? Already have as much free care as they want and are getting more. The rich have as much expensive care as they want. Those of us in the middle are getting screwed by waivers and bad rules, but we still get to pay for it.

      • nicoleandmaggie Says:

        Except that poor people actually *don’t* get enough health care in this country. That’s the explanation for all those statistics where the US is doing worse than Cuba. The poor in the US are about equivalent to Barbados on most of those indicators.

  9. Rumpus Says:

    Noses obviously aren’t constructed correctly. I think would put in an air-controlled plunger pushed from the sinus region…and bonus: blowing one’s nose gets even more forceful.

  10. Carnival of Personal Finance #307: The Silver Edition | Live Real, Now Says:

    [...] from Nicole and Maggie: Grumpy Rumblings presents Dissecting an emergency room bill, and says, “Nicole and Maggie discuss how a recent bead up a preschool nose cost one of them [...]

  11. bogart Says:

    Oh, ugh. I am sorry. Just a heads-up on the “deductible” thing — don’t know how your health plan works, but what counts toward my no-really-you-won’t-pay-more-than-this-in-a-year-(oh-wait-yes-you-will) amount does *not* include co-pays or drugs, no matter how much they run. As PT co-pays run $45, when I broke my shoulder last summer and needed weekly PT forever (well, close — I’m still getting — and benefiting from — it), that meant … well, let’s just say that DH and I spent, literally (I have the spreadsheet to prove it!) $20K out of pocket last year on health care and we *have* “good” (haha) insurance. Now, $12K of that was an IVF cycle that mostly wasn’t covered and another $3K was shoulder surgery (my share of) and $3K was assorted dental work (several root canals and crowns) so the PT (etc.) ran “only” about $2K but believe me, I far exceeded my “out of pocket maximum (haha) and my insurance company does not care.

    Glad all turned out OK.

    Would that it were true that the poor in the US had access to health care … but of course you know that.

    • nicoleandmaggie Says:

      They sent us a note saying how much went towards and how much didn’t… we’ve got another $1275, and about 3 months. I’m hoping we don’t find out what the true limits are in that time as I’m kind of busy the next few months and am not interested in more health emergencies!

      Wow, you had a very busy year. Hope everything is settled down.

  12. Bret @ Hope to Prosper Says:

    Emergency room bills are out of control. I took my daughter in for a unrinary tract infection and got a bill for $4,300. They literally gave her an IV and Tylenol. I also asked for an itemized bill and found they charged us for Level 3, even though it was an obvious Level 1 problem.

  13. Sandy H Says:

    Doctors, hospitals and health insurance are all crazy. Sometimes these ‘savings’ plans aren’t really savings plans at all. And the deductibles are so high they are laughable, but the premiums keep going up and the deductibles keep going up and now we HAVE to have some sort of insurance by law. Which means the premiums are going to keep going up, the deductibles will keep going up, and the benefits will keep getting slashed.

    Healthcare is a terrible (though very needed) industry.

    I butt heads with providers all the time… But I’ve worked at processing health claims before and I always ask for an itemized billing that they send the insurance companies when requesting payment.
    I also have a boss who will always try to negotiate a deal if he pays cash on the day of service himself. He will get the insurance forms and mail them to the carrier himself for reimbursement. Usually the forms list the full price of the service instead of what he actually has paid.

  14. Answering Google Questions « Grumpy rumblings of the untenured Says:

    [...] Q:  how to get out of an emergency room bill [...]

  15. RBOC « Grumpy rumblings of the untenured Says:

    [...] stuffed animal is the one we got for ~$1500.  Ze calls it, “bead bear” in honor of the event and cuddles with it every night.  Dog, bear, and little bear have all been set [...]


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