Emergency Room Rights

[bamboo harvester]

I had a pain in my lower left ab and went to my doctor and was diagnosed (correctly) with diverticulitis and was told to drink lots of water and avoid eating solid food for around 5 days. A week later I was throwing up and had a pain in my lower right ab and my doctor diagnosed me (again correctly) with a kidney stone. My doctor sent me off for an X-ray that showed I had a kidney stone and there was nothing that interesting about the stone.

The next day I noticed while trying to pass the stone that I could not urinate for a 12 hour period and my doctor advised me to go to the emergency room. I was stupid enough to go and when giving the blood and urine sample I noticed that I could urinate while sitting down. When I got to the E.R. doctor I told him my story and showed him that I had been diagnosed with a kidney stone and that my doctor had seen the X-ray and said it was no big deal. The E.R. doctor told me I needed a CAT scan and I said no and reminded him that I had been diagnosed with a kidney stone already. He became angry and said, "How does your doctor no that?". I reminded him about the X-ray and he still kept bugging me for the CAT scan. I told him I was uninsured and asked him how much it would cost and he said "I have no idea".I was on a lot of pain pills and had been though a tough time in the past week and finally gave in. He gave me the CAT scan and then forgot about me. I had to go looking for him and all he said was that I had a kidney stone and could go home.

I got the bill the other day and it was 10 grand and almost all of that was for the CAT scan. I called the hospital and told them what happened and that I had Asperger's Syndrome and have been unemployed for 7 years (the truth). They were not sympathetic and told me they could cut 10% off if I paid today. I do have savings, but the whole idea that I should have to pay for a CAT scan that I told a doctor twice that I didn't need, after he refused to tell me How much it would cost. Do I have any rights at all or should I just give up? I'm sorry I couldn't make this shorter.

[polly7]

1. Ouuuuwww .... the pain of both must have been horrible,

I hope you're doing much better. I don't know much about your health-care system so have no advice, but I hope someone can help you, because that's just insane.

[bamboo harvester]

3. Thanks

I'm not the smartest person on the face of the earth, but I never would have been dumb enough to go to an emergency room if I hadn't been hit with these 3 things at the same time. I have heard about E.R. horror stories and should have known better. It was the first time in my life that I could not urinate and it kind of freaked me out a bit. I tried everything and could just not do it. I still can't believe they should be able to get away with refusing to tell someone what a CAT scan costs if you are uninsured.

[polly7]

9. I worked in EMS and have taken in people dx'd with either diverticulitis

or kidney stones, it was all I could do to keep some of them on the gurney, they were in so much pain. Of course you weren't thinking clearly, who would be? Sorry you didn't have a more compassionate doctor.

[Newest Reality]

2. I was reading this and found that I had pain.

The pain of reading something with no paragraphs.

My surgeon told me that breaking things up in easily digestible ways was natural and organic and the pain suddenly went away. Some people still don't agree, but my affliction did pass.

[bamboo harvester]

4. I hope you feel better

I'm sorry about that, but I'm still in a state of shock over the bill. It must have affected my ability to make paragraphs. I went back and fixed it. I am starting to feel better knowing there are people like you in the world.

[Newest Reality]

12. Thank you for the

meaningful context as a response.

I now imagine myself going through what you relate and really flowing along in one paragraph if recounted experience! In that case, we can consider it valid and effectual, ey?

I really relate to that and hope that my words here will convince you that I share your shocking bill in so many ways. These are those kinds of time where bills can blow us away. Damn, faith-based tickets are a real trip and make us write long responses that have no break.

Good luck to you! Thank you for your kind response.

[Control-Z]

8. There is a time and place

for posts like yours. This was not it. Shame on you.

[Mnemosyne]

10. jerk n/t

[MyrnaLoy]

5. Did you

agree to have the CT scan? You do have rights and one of them was to say no to the procedure.

[bamboo harvester]

7. Agree to CAT scan

Like I said, I told him no several times about the CAT scan, but I did cave in eventually. I was on a lot of pain pills and not thinking that clearly.

[kickysnana]

22. Someone in pain and on pain meds facing an irate doctor has little choice.

If you cannot help at least don't harm. Geez.

[KT2000]

6. Geez - that is horrible

Can you call the billing dept again and ask about a reduced payment plan because you are low income? Don't be satisfied with the first person you talk to - try the supervisor.
That is about all I can think of. That doctors do no know the cost of the procedures they are prescribing is pretty bad.

Another thing you might try is writing a letter to the editor in your local newspaper. Maybe the hospital would not like the attention and settle with you.

[newfie11]

14. If it is a for profit hospital they can take your home

And things of value you own to settle the bill. I worked in one in MI and it was well know they did this. They also had no problem with anyone knowing they did this. Even sent a letter to one of the Radiologist's elderly mom telling her they were going to take her house if she didn't pay up. He raised hell, they didn't and I am sure he paid the bill. One more note, they did not accept assignment for medicare. So medicare patients had to pay whopping sums of money not covered.

[KT2000]

17. Our only hospital

is public and they take the house too.
They will reduce bills after they comb through your finances and put you on a budget they can live with.
I try not to go near the place but they are buying up the clinics too so they are the billing dept for them too.

[knitter4democracy]

24. We don't have for-profit hospitals in MI. It's the law here.

It's in our Constitution, actually, that all hospitals have to be not-for-profit. That doesn't mean they're always generous or nice, though. Just a quibble with how you wrote that.

[newfie11]

27. the hospital I mentioned was in Mi

So things must have changed after the 80's.
Edit for stupid cell phone inventing it's own words.

[Liberty Belle]

15. Complain to the AMA, your state medical board, and state regulators.

That may put pressure on the hospital to drop the bill or at least reduce it.

[knitter4democracy]

25. AMA's worthless. State medical board's better.

File a complaint on the ER doc, CC that complaint to the ER Dept Head of the hospital making sure to clearly state how you were harassed while on pain meds to agree to an expensive procedure that was not needed, get your doctor to write a letter about it (I'm sure he's not happy with it, either), and contact your state regulatory agency (might not be the state medical board--ask them whom to contact).

[Mnemosyne]

11. ...

:hug:

[newfie11]

13. Its called CYA

The doctor was not going to go by what you said without proof. Was the emergency room packed, was he the only doctor? No it is not right that you had have a CT for a known problem and an ultrasound would have been cheaper. If your x-ray ( I assume it was an IVP using contrast to show the stone and kidneys) was done at a hospital or clinic with PAC the doctor could have seen the exam at the emergency room. This is why it is important to have past medical tests available on line to different facilities. If that stone had blocked the ureter completely you may have lost a kidney and while you may not have sued, many would and rightly so. If your xray was done at the same place as the emergency room then they suck!

[flamingdem]

38. Good info. This makes me think I'll insist on copies of all xrays + scans in case nt

[bamboo harvester]

39. X-ray

The X-ray had been taken 2 days ago and they did not give me a copy of it. I brought the receipt for the X-ray and had the phone number of the place that took it and my doctors phone number. He had no interest in any of it.

[Sherman A1]

16. Simple solution to the billing

pay them $5.00 per week and tell them that is all you can afford to do. I suspect that they will be willing to negotiate a plan for you with greatly reduced fees.

Also contact your state medical licensing board and file complaints along with the local media. It's amazing what can happen when there is a "CC: The entire effing world" type of response.

[crikkett]

20. I agree with this. Complain loudly, get the local news involved. n/t

[sam11111]

18. NATIONALIZE all 4 corners of Hcare + set avg US income as dr's income

No other way to keep greedheads out. Those who want to HEAL will still go to med school as a "calling". Greedheads will go open payday loan stores.

Greedheads may pass the Board exams but care nothing about delivering that knowledge to the sick.

So we now get only...

"Sloppy with a snarl.. and a claw thru your wallet".

46 nations live longer than we do.

Swedish drs in 1990 were paid equivalent of 10,000 US dollars. So ours do not have to live like gods.
.

[MiaCulpa]

19. Call your state representative!

The ER doc wasn't out of line wanting you to have a CT scan, but, he certainly sounds as if he is missing a sensitivity chip! You were not out of line to ask the price, and someone should have given you the information. If you were charged thousands for the scan, that is completely unacceptable! I'd also recommend you call your state's attorney general's office.

When you have health insurance, if your plan has a 'network' of physicians and care providers that they work with, within that network they have prearranged pricing for everything from being seen in the ER, a cat scan, to a tylenol given to you in the hospital. The negotiated price is often as much as 50% lower than what someone without insurance is billed by the hospital.

Now, I'm just guessing here, but I think the reason that they won't negotiate further than a paltry 10% reduction from folks with no insurance is that they don't anticipate being paid the full amount, and their goal is to get as much as they can from you as soon as possible.

If your state AG or rep. will listen to your problem, (write them if you can't get someone to talk on the phone!) it's possible they could plead your case to the hospital, and get you a fair price on that CT scan (It should be under $1,000.00) and a reduced total on the bill.

Don't give up on this! If you have to call people in your state 100 times before they listen to you, you do it. In the meantime, pay whatever you can afford each month towards your bill (even if it's just $5.00) to keep them from trying to take your home or something.

If you feel you need to, as you have Asperger's...there is a group that provides legal representation:

http://www.specialneedsalliance.com/home

I don't know much about them, just googled to see if there was any assistance for people with Asperger's.

Keep us posted on how this works out.

Oh, one more thing, did you sign a consent for treatment for to have the CT scan? If not, be sure to mention that to anyone you contact for assistance. Yes, you do have rights! Hope you're feeling better now as well.

-Diane

[bamboo harvester]

21. Ct Scan bill

The CT scan bill alone came to about 6 grand. The Medical Imaging place I had my X-ray done the day before had told me that they charge about 500 dollars, but the E.R. visit happened late Friday afternoon and they would have been closed by then. I really would have been ok with a 5 or 6 thousand dollar bill, but 10 grand for a few hours of E.R. seemed a bit much. Thanks for all the kind responses.

[Pab Sungenis]

23. Ask about charity care.

If you have no income, they may be able to write it off. Or go through your state for Medicaid.

[JoeyT]

26. I thought you couldn't agree to a contract while intoxicated?

And opiate pain medication definitely fits the bill of intoxicated. Is it different at a hospital? I have no idea.
I'm sure we've got lawyers on here that will tell you how far that argument would get you.

[bamboo harvester]

28. Intoxicated

I don't think that argument is going to get me very far. It does seem like there should be a law where they have to tell you the cost of something massive, if you ask them for a price. I know E.R. doctors can't know the price of everything, but nobody is going to tell me that an E.R. doctor isn't going to know the price of a CT scan for an uninsured patient. It has to be one of the most expensive things they have in the hospital, and they tell everybody who comes in to E.R. that they need one. I just got a physician bill for 900 bucks. The total right now is up to about $11,000. I can only imagine what they would have charged if they had actually done something.

[JoeyT]

30. Good point.

I can think of very few industries other than medical where they not only refuse to tell you the total cost beforehand, but even give you the price of a single procedure. If there were a mechanic that gave estimates that amounted to "We'll tell you how much we charge after we've fixed it and you'll have no choice but to pay it." he/she would be out of business in pretty short order. And probably end up on at the very least the local news as one of those businesses to avoid.

[HysteryDiagnosis]

29. I take enzymes to assist with digestion issues.

http://www.lef.org/LEFCMS/aspx/PrintVersionMagic.aspx?CmsID=39762

One of America's pioneering biochemists and nutrition researchers, Dr. Edward Howell (1986), cites numerous animal studies showing that animals fed diets that are deficient in enzymes have an enlargement of the pancreas, as huge amounts of pancreatic enzymes are squandered in digesting foods that are devoid of natural enzymes. The result of this wasteful outpouring of pancreatic digestive enzymes is a decrease in the supply of crucial metabolic enzymes and impaired health.

How significant is an enzyme deficiency to overall health? For starters, organs that are overworked will enlarge in order to perform the increased workload. Those with congestive heart failure or aortic valvular disease often suffer from an enlarged heart, an unhealthy condition. When the pancreas enlarges in order to produce more digestive enzymes, there results a deficiency in the production of life-sustaining metabolic enzymes, as available enzyme-producing capacity is used in digesting food instead of supporting cellular enzymatic functions. The tremendous impact that the wastage of pancreatic enzymes can have on health, and even life itself, has been established in animal studies. The critical question is how this applies to human health.

For much of the 20th century, European oncologists have included enzyme therapy as a natural, nontoxic therapy against cancer, and almost all leading alternative cancer specialists treating Americans prescribe both food enzymes and concentrated enzyme supplements as primary or adjuvant cancer therapies. A New York City cancer specialist, Nicholas Gonzalez, M.D., uses very high doses of supplemental pancreatic enzymes as a primary antitumor therapy. His clinical successes have led conventional drug companies to seek to duplicate these natural therapies and offer them as adjuvant drug therapies. If pancreatic enzymes are effective in treating existing cancers, one might assume that maintaining a large pool of these enzymes in the body should help to prevent cancer from developing. Studies have shown that persons who eat fresh fruits and vegetables with high levels of natural enzymes have significantly reduced levels of cancer and other diseases. It has not been proven that the high enzyme content of these foods is partially responsible for their anticancer effect, but the evidence is compelling.

[SheilaT]

31. No one in the ER is going to have any real

idea what any procedure costs. Different insurance plans agree to pay different amounts for different procedures. Uninsured patients tend to get billed the most.

Is there any chance you qualify for Medicaid? Or is there some kind of Indigent Fund you might qualify for? The hospital should have a financial aid office to help you out.

[bamboo harvester]

32. Procedure costs

Like I said, I know that E.R. people can't know the price of everything, but I don't believe for one second that doctor did not know what they charge uninsured people for a CT scan. If he didn't know I don't think he would have been pressuring me to have a procedure that I didn't need in the first place. It does seem if your going to push for someone to have a procedure that costs 6 grand and then refuse to tell them how much it will cost, then you are violating that patients rights. I told him I didn't need a CT scan several times and it turns out I was right and he was wrong. Why should he get away with that and leave me stuck with a 11 thousand dollar bill for finding out I had a kidney stone. I told him I had been diagnosed with a kidney stone when I first met him.

[SheilaT]

34. The doctor is a whole lot more removed

from the billing part of the E.R. than are the people who do the paperwork, the ones that took your information when you first got there. Trust me, they haven't a clue.

I used to work registration at a hospital, and what I hated the most was when we had self pay patients and we couldn't give them any more than a rough estimate of the cost of the procedure, and that ONLY after digging laboriously through a program that was supposed to give such information. Much of the time I couldn't find the procedure that had been ordered. The doctors don't work with those programs.

Chances are the E.R. doctor is on salary with the hospital, so he has no reason whatsoever to know what procedures cost. Even the doctor in private practice probably has little or no idea what the cost is of whatever he does in the office. And, different patients get charged different amounts.

What happened to you was not right, but please don't be thinking the doctor has any idea what it was going to cost you. He or she has also drunk the Kool-Aid of "We have the best health care in the world", and since the doctors themselves get charged less than anyone as part of professional courtesy, they are singularly unaware of the true costs of health care in the is country.

[bamboo harvester]

35. What they know

I still think with an expensive procedure most doctors are going to know a ballpark figure about how much an uninsured person is going to get stuck with. It's all very nice to say that they are helping people and that they had no idea that they are wiping out some poor saps life savings, but I just don't buy it. If they are smart enough to graduate medical school, I think they should be smart enough to know their employer is taking these people for $6,000 a CT scan.

From the second I walked into E.R., to the second I finally caved in, the only thing that doctor was interested in was giving me a CT scan. He became angry when I told him my doctor had diagnosed me with a kidney stone and that I had already been X-rayed 2 days before. Then after he took the CT scan he forgot about me. He just mumbled I had a kidney stone when I tracked him down and told me to go home. Does that sound like a guy who had no idea that he made the hospital an extra 6 grand?

Anyway, this has already been said in about 10 other posts on this thread. I'm looking for help on how I can get my bill down to a semi-reasonable amount. I'm not one of those people complaining about being billed for a $1,000 by the E.R. I have no problem agreeing that I should pay 6 grand for being stupid enough to walk into the Emergency Room, but an $11,000 bill for telling me something I already knew is nuts.

[SheilaT]

37. I have to repeat: the doctor in the E.R. is going

to be almost totally ignorant of even a ballpark idea of the cost of any procedure he wants a patient to have. He simply is NEVER involved in the billing process.

Here's another problem that's related: It's important that the diagnosis the doctor gives as justification for the procedure ordered match in a way that the insurance will actually pay. This especially matters with the Medicare patients, because if the diagnosis won't cover the procedure, Medicare simply won't pay. And when the Medicare patient come to the hospital for whatever the doctor has ordered, we have to do something called "code scrubbing", which is to match up the diagnosis and procedure. If what we find indicates that Medicare might not pay, we have to give the patient something called Advance Beneficiary Notice (ABN) and have them sign that they understand Medicare might not pay and they might have to. If we don't do that, and Medicare does not pay, we can't go back and try to bill the patient. A lot of the source of this is that doctors do not learn anything about coding in medical school, and that's understandable. But it causes problems.

The whole system is needlessly complex. Ever since I worked inpatient registration at the hospital I have become more and more outraged at our health care "system" and believe we really should move to Medicare For All.

[murphyj87]

33. Move to Canada ...

You would have far better care and have not one cent of out of pocket costs for any physician or hospital care, regardless of whether are rich or poor, and regardless of whether you are 1 or 91. You get the same care with no out of pocket costs whether you don't have a cent or if you are the Premier of a province.

[bamboo harvester]

36. Canada

I feel like moving to Canada. It's about 110 degrees in Texas all the time and I don't think it's going to be livable down here much longer.