Fishhook removal at ER Why is the bills so high?

[Fishhook]

I live in a rural town without an after hours care clinic.  The local hospital and staff is in network.  My husband got a fishhook sunk deep in the back of his leg getting out of the truck.  I couldn't remove it, I drove him to the ER we were there all of 30 mins, no wait taken care of right away.  He received a tenus shot, novicane shot, they pushed the hook thru, cut off the barb with DIKES regular old plyer type dikes you can buy in a hardware store and pull it out. put a bandaid on it and sent him on his way.  $1100!  I have the itemized bill and want to know if they are billing me for services or things not received:

ER Level III (is there a level I & II?) - $503.00
IMM Admin 1 Vacc  (to administer a shot?) $83.00
Physician ACU III $226.00  (Doctor services)
REM FB SubQ Complex (what is this?) $152.00
Gauze Sponges $6.00 (outrageous, but used )
Surgiccal Tray (Dikes? and Hemostats?) $87.00
Decavac .5 ml DT Vac $31.00 (tetnus?)
Lidocaine 1% Inj $15.00 (yes, he received this)

I guess I am just completely shocked and as we don't have any after hours clinic in this small town, if this bill is line what were my other options?  Any help is GREATLY appreciated.  Thanks Fishook

[Amir Mostafaie]

Dear Fishhook,

I believe I can provide you with some information and background on the health care system that will help you understand why the high charges!  

Majority of the insured population in United States are covered under some sort of network plan like PPO (Preferred Provider Plan) or HMOs (Health Maintenance Organization.
Why insurers like offering these types of plans is because they are able to reach out to the majority of the provider population (like doctors & hospitals) & pre-negotiate discounted fees for all services & benefits including lab work, procedures, facility charges and prescription medications. Pre-negotiated discounted fees work like whole-sale prices and are one of the biggest advantages of PPO & HMO type plans to plan members too.

That said you can’t benefit from any of these discounts if you don’t have a network plan (PPO, HMO) or don’t have any coverage at all.

When hospitals & ERs deal with patients without a network type plan, they will charge them according to their “list price” which is high enough to cover the high cost of running an ER where a lot of people treated don’t have any insurance & never pay their bills.

In other words the paying patients pay higher prices to cover the overhead. That’s why Tylenol can cost you $18 in the ER!

Below are responses to some of your questions/comments;

ER Level III (is there a level I & II?) - $503.00
Yes, there are levels I & II
IMM Admin 1 Vacc (to administer a shot?) $83.00
I have addressed this in the Tylenol paragraph.  
Physician ACU III $226.00  (Doctor services)
Correct.
REM FB SubQ Complex (what is this?) $152.00
Remove Complex Subcutaneous fiber. (Subcutaneous means under the skin)
Gauze Sponges $6.00 (outrageous, but used )
Surgical Tray (Dikes? and Hemostats?) $87.00
Not sure what is the question!
Decavac .5 ml DT Vac $31.00 (tetnus?)
Tetanus shot.
Lidocaine 1% Inj $15.00 (yes, he received this)

Now this doesn’t mean that you can not contact the billing dept. of the hospital & negotiate with them. By negotiating, you are basically bargaining with the hospital about the charges.

When contacting the hospital to negotiate, remember the following tips;
Stay calm, collected & professional throughout the call,
Be courteous to the representative,
Don’t be afraid to escalate the call to a supervisor if you feel you have tried everything else,
Establish that you have every intention to pay your bills & that is why you are negotiating to achieve a reasonable amount, then only you can afford to pay them.
After you negotiate lower rates, ask for a payment plan with no interest.

Wish you the best,

Amir Mostafaie

[Amir Mostafaie]

Dear Fishhook,

Thank you for sharing your story. Sharing stories like this helps others prepare for unforeseen situations & learn how things work.

Wish you best of health,

Amir

[Fishhook]

That helps alot, we really had no other choice of a care facility, other than have him bite a piece of leather & me supress the nausea there really wasn't much else to do.  I wonder does a fishhook removal constitute a level I or II?  Level III seems extreme, although I guess my only option is to try to negotiate, however I doubt that will happen as I am subsidizing those that can't pay.  But a payment arrangement is definately in order, our portion is nearly $700.  It seems as though our coverage covers less and less and we pay more & more.  Right now I am fighting with the perscription folks to just fill the stupid script for thyriod, but alas that is another battle entirely.  Thank you for your advise on the ER bill at least we aren't being ripped off. (that's relative to one's perspective)  Have a great day!  :)

Fishhook