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My kid cut her head open.

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    Posted: 19 February 2013 at 12:41pm
Might be a long one, and not sure who really even comes around to read these anymore, but thought I would share.
 
Back in September of last year my family and I were attending an away game for our HS football team. My daughter is a cheerleader and my wife is the cheer coach, so we pretty much go to all the games. At one point, I notice one of my younger daughters playing under the bleachers and tell her to get out from under them and not to play there anymore. Well as kids often do, she didn't listen too well and about 10 minutes later I see her walking up the sidewalk holding her head. As she gets closer I can see that there is blood. Long story short, she had about a 3 inch slice across the top of her scalp, defintely not something that is going to be able to put a butterfly bandage on and call a day.
 
There is always an ambulance at football games, so we take her to the ambulance to have the EMTs have a quick look and they confirm that she needs to get it stitched up and they can take her if we want. Now, as a kid I did a fair amount of stupid crap and ended up in the ER a number of times. My mother or grandmother always took me and never had an issue. The hospital was only 10 minutes way, so my plan was to ask them for some bandages, have my wife keep pressure on it and drive my daughter to the hospital. The ambulance people said it really wasnt and problem for them to take her and it might be better off since they could keep an eye out in case she went into shock. The driver and one of the EMTs even took me aside and said if I was worried about the cost, to just ignore the bills when they came. They explained that they were a volunteer dept and only did "soft billing". Essentially I would be sent a couple of bills and when they came back unpaid would get written off. I reluctantly agreed and off they went with me following right behind them. We arrived at the exact same time and they did not run with lights or anything.
 
Well, after sitting in the ER for neary 5 hours, my daughter finally got 7 staples and was discharged. Now the fun begins.
 
We did have insurance, so a fairly large portion of the bills were actually paid for by insurance. However, even after all was said and done, the portion due to us was nearly $1k out of pocket. And again, this is with a pretty decent insurance plan. I saw what the bills would have been without insurance and. just. wow! To add insult to injury, we have now received the 5th bill from the ambulance service for an oustanding balance of about $375. This is after the insurance company paid nearly $200! And they haven't stopped billing us after a couple of attempts. Tried calling the fire department, but can't reach anyone. My wife was also there as an employee, so we spoke with the school superintendent and asked about whether the school carries a policy to help with such expenses. He told her that if our insurance didnt cover it that he would call the other school and discuss it with them to see what they could do. Yeah, now he is totally backing off of this and saying we can contact them if we want, but that most likely they wont do anything because schools have some sort of exemption from liability when it comes to such things as people getting hurt on school grounds.
 
At this point, we do have a call into the other school asking what they can do and are wating on a call back. I am still trying to contact the fire department to speak with someone about why they would tell me to ignore the bills only to have a billing agency start to contact me now.
 
And what I am still absolutely astonished at is the fact that for a 3 inch cut and 7 stitches, the overall cost would have been close to $3k if we didnt have some sort of insurance policy. This just isnt right.
 
And before you say it, yes I realize our kid was totally in the wrong playing under the bleachers, but by the same token, shouldnt every effort be made to keep kids out of an area that is dangerous? On our home field bleachers, ours are actually chainlink fenced off. Kids can't get under them because the danger is recognized and averted.
"When I grow up I want to marry a rich man and live in a condor next to the beach" -- My 7yr old daughter.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tallen702 Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 12:50pm
And this is why the only ambulance I will take is one that has been sent by a 911 dispatcher. In MoCo here in MD, there's a fee, but the insurance companies are compelled by law to pay it. If you don't have insurance, you still don't pay it. Back home, an ambulance ride was free since the county service was paid by your tax dollars. But if you use a private service, well, they'll go after you big time. I always refuse medical treatment unless it's absolutely necessary, or there's a chance of after effects (concussion, etc). For this exact reason.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 12:53pm
Well, this was a volunteer department, and they said the fee would be essentially waived if we didnt pay it. Pretty put out by it all.
"When I grow up I want to marry a rich man and live in a condor next to the beach" -- My 7yr old daughter.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote RoboCop Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 1:13pm
Medical costs these days are rediculous. For some afrin at a hospital for a bleeding nose, we pretty much paid about $1k for using the ER and my grandmother drove me there. It's horrible.

Purdue has an oncampus ambulance that has free service to students. They can come and fix you up and offer to take you to the hospital and you can deny it if you are of age. If they do take you to a hospital, they can give you a voucher for a free taxi ride back. Pretty sweet deal.

Hope all works out well in the end.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 1:23pm
Originally posted by RoboCop RoboCop wrote:

Medical costs these days are rediculous. For some afrin at a hospital for a bleeding nose, we pretty much paid about $1k for using the ER and my grandmother drove me there. It's horrible. 

Truth. Second example that there are serious issues with healthcare costs are the approx $800 out of pocket I ended up paying from a visit to the hospital when my back went out. Someone said to go to the ER instead of the walk in medical place because it was cheaper and we got hosed. Couldnt get into my regular doctor, so had to find an alternative. Granted, I would have paid whatever amount of money they wanted at the time, $800 my cost for sitting in a room for 20 minutes, receiving a shot and prescription for meds seems a little extreme. Considering insurance paid money on top of this... Something just isnt right. Guess I am having to pay for all the people that walk in and never pay dollar one.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote *Stealth* Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 1:24pm
Typically - if you check into an ER - for anything - you'll immediately be billed for at least 1k.

Here's the amazing part:

Most hospitals, haven't been profitable for the past five years.


Remember, there are multiple industries involved here; each of which is practicing poor ethics.

Medical retailers charge out the nose for equipment, I mean - out the nose.

Insurance companies are also a critical part, they reject any and all compensations they possibly can. This leads to lower reimbursement rates for the hospitals, which yields overall higher costs per person in an effort to recuperate even the slightest amount of capitol.

It's a really screwed up game. 


Edited by *Stealth* - 19 February 2013 at 1:28pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 1:33pm
Originally posted by *Stealth* *Stealth* wrote:


Most hospitals, haven't been profitable for the past five years.
I would say the hospital we went to is pretty profitable. They have expanded and grown quite a bit over the years. IIRC, they are one of the top 5 employers in the area.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote *Stealth* Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 1:53pm
Originally posted by oldpbnoob oldpbnoob wrote:

Originally posted by *Stealth* *Stealth* wrote:


Most hospitals, haven't been profitable for the past five years.
I would say the hospital we went to is pretty profitable. They have expanded and grown quite a bit over the years. IIRC, they are one of the top 5 employers in the area.

Major metropolitan hospitals are sometimes doing well. Very isolated hospitals are likely doing decent.

There are also some instances of specifically "for profit" facilities, which I'm sure hold their own. But the majority of regional Not-for-profit hospitals have been on a financial freeze for the better part of the decade.

Not all, but most. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 5:07pm
Actually looked it up and they are listed as "non-profit." 
 
On topic, I called the billing company and they are supposed to have a rep contact me back when she returns next week. Sounds like a fairly small company. Person I spoke to said they typically are asked by the customer to send bills a certain number of times before they stop. She sort of said it off record, but intimated that this wasnt an account that was set up to have their non-pays sent in for collection.
 
When it comes down to it, I really wouldnt mind paying if I was told up front that it was going to cost me $400 out of pocket for the cool ride to the hospital. May main beef is when someone tells me not to worry about it and I get bills for 5 months in a row. I guarantee before I take a hit to my credit over this, I am going to make someone VERY unhappy.


Edited by oldpbnoob - 19 February 2013 at 5:12pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldsoldier Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 5:24pm
Still remember my dad and my boxing and youth hockey days. Back in the day when we did not wear helmets. I remember taking a puck in the face right above the center brow line. Skated to bench, Dad took a look at it, out comes the teething jell, smears it on the cut, the novacain in the jell stopped the bleeding and I didn't feel the pinch either, takes a hook needle from the team first aid bag, and three stitches, and a get back out there. You would probably go to jail for a parantal stunt like that today.

Kids are expensive when they break, a simple ER visit like stated $1K easy before they get started.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote merc Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 8:23pm
that sounds crappy, at least with medical bills you can set up a very manageable payment plan and they cant do anything credit wise.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote SSOK Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 11:15pm
Originally posted by oldsoldier oldsoldier wrote:

Kids are expensive when they break,


Best quote of the thread.

oldpbnoob, hows your kid? People typically don't like being sewed.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote procarbinefreak Quote  Post ReplyReply Direct Link To This Post Posted: 19 February 2013 at 11:50pm
Yeah, hospitals are getting hit hard.  It may not seem like it, but just the lab system that I work for has $12 million to cut from our budget this year.  Reimbursements are being decreased, so they have to offset that somewhere.  

I've been a tech for 2 and a half years now and when I started, I thought I had pretty good job security.  Now, I've recently been looking to completely change my career and get the hell out.  
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Post Options Post Options   Thanks (0) Thanks(0)   Quote *Stealth* Quote  Post ReplyReply Direct Link To This Post Posted: 20 February 2013 at 12:12am
Originally posted by procarbinefreak procarbinefreak wrote:

Yeah, hospitals are getting hit hard.  It may not seem like it, but just the lab system that I work for has $12 million to cut from our budget this year.  Reimbursements are being decreased, so they have to offset that somewhere.  

I've been a tech for 2 and a half years now and when I started, I thought I had pretty good job security.  Now, I've recently been looking to completely change my career and get the hell out.  

I felt the same PCF, but I think we're just in an industry reshaping. The hospital I work for now posted profits for the first time in 7 years, and met budget. They did so well, infact, the CEO granted 2% raises for all 19,000 staff, regardless of position.

Some places are figuring it out, while others are still assessing the new paradigm.


Edited by *Stealth* - 20 February 2013 at 12:13am
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Post Options Post Options   Thanks (0) Thanks(0)   Quote stratoaxe Quote  Post ReplyReply Direct Link To This Post Posted: 20 February 2013 at 12:39am
ER prices are insane, and have been for quite some time. I worked in ER billing for a while.

This part is actually only partially true-

Originally posted by oldpbnoob oldpbnoob wrote:

And what I am still absolutely astonished at is the fact that for a 3 inch cut and 7 stitches, the overall cost would have been close to $3k if we didnt have some sort of insurance policy.


The thing is, hospitals and docs alike make their money billing the living crap out of insurance companies. So if you pay self pay, they'll quote you the insurance price then immediately cut in half or close to it.

ER prices generally work off of level. They'll classify from 5-1, 5 being a pill seeker and 1 being dead. So generally you'll actually only be 4-2, and most likely your child was a 3. The trouble with that is that is that your acuity level is set by the triage nurse and, more often than not, they'll just make everything but heart attacks and erectile dysfunction a 3 to cover their booties.

So alot of people pay for services they never received since a level 3 includes radiology, blood tests, pills, etc etc.

The other trouble with ER billing is that most doctors are contracted by the hospital, so when the registration rep comes in your room and you pay them (or at some hospitals they take you on your out, same person either way) they tell you that you're paying your whole bill but you're actually on paying the hospital's part. The doctor bills separately, and how he bills depends on how he's personally contracted with your insurance.

This part, however is spot on-
 
Originally posted by Stealth Stealth wrote:

Insurance companies are also a critical part, they reject any and all compensations they possibly can. This leads to lower reimbursement rates for the hospitals, which yields overall higher costs per person in an effort to recuperate even the slightest amount of capitol.


This is the major dilemma of the ER industry. Since most ED docs are contracted, you get this weird dilemma where, by law, the hospital is forced to do an initial eval on a patient at triage before they can turn them away as a non emergency, but the actual final decision to do that rests on the doctor. Since doctors aren't direct employees of the hospitals, they tend to just go ahead and treat the person involved anyway. So the docs refuse to take the time to do the medical screening required to discharge a person from the ER without treatment, the hospital ends up performing full services on people that didn't need it.

These self pay patients almost NEVER pay-I think we collected 12% or less of self pays in every hospital I've ever worked at. Rather than addressing this problem, they pressure the heck out of their admissions staff to meet ridiculous collection quotas in order to meet their evals (most of the department won't meet or exceed the goal as required so they don't get their raises) and the only real way to get collections is off of people with insurance because more often than not they have jobs and will pay.

Originally posted by oldpbnoob oldpbnoob wrote:

I would say the hospital we went to is pretty profitable. They have expanded and grown quite a bit over the years. IIRC, they are one of the top 5 employers in the area.
 
You have to remember that hospitals make most of their money from outpatient or elective procedures. The ER department almost always operates in the red, and the ER industry is really quite separate from the rest of the hospital.

More than likely any renovations done to the hospital were paid for by their scheduled procedures or else pulled from other, more profitable ventures in their network.

This is why, even as a conservative, I see a huge need for some kind of medical industry reform in this country. The way it's operating right now the doctors and insurance companies bank while the hospitals bleed money out every figurative hole.

ER's generally keep at least two docs on staff who make roughly 100K plus a year depending on the region of the country you're in, the average pay for an experienced nurse is 50K plus and they usually have at least 5 on staff over night (my hospital had substantially more than that), then you have the radiology, lab, the EMT staff, etc etc and you realize the sheer nightly operating costs. This is not including clerical staff which I was a part of. I cleared 30K last year working weekends simply managing the 30 employees I was over in admissions, some of whom made more than me (one of the ladies in my department had been there 20 years and was clearing 20 bucks an hour registering people.)

The ER department in staff alone is likely in the millions per year, and that's aside from the ridiculous amount of supplies and energy required to power it. A normal sized ER in a small city will run between 150-250 people a night and often times more than half are self pay. If you figure that only 12% of self pays actually do so...you can see where I'm going. It's a terrible business venture for sure

Regardless, sorry for your trouble and hopefully you don't have a repeat anytime soon. I've seen more insurance copay shock than I could count, it's never fun.



Edited by stratoaxe - 20 February 2013 at 12:40am
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldpbnoob Quote  Post ReplyReply Direct Link To This Post Posted: 20 February 2013 at 7:34am
I get what you're saying about them charging more due to insurance only compensating for so much. However, when I have to pay whatever insurance doesnt cover, isnt that still getting them the higher price? Its not like the accepted what insurance paid and moved on. They took the insurance companies money and billed me for the rest. They still got their $3k, just from two payers.
 
And yes, she's ok. This happended back in September and shes fine now. They actually stapled her instead of stitches. I think that actually made it easier. She also learned a pretty valuable lesson and has been less apt to not listen to us when we tell her not to do something. Expensive lesson.


Edited by oldpbnoob - 20 February 2013 at 7:36am
"When I grow up I want to marry a rich man and live in a condor next to the beach" -- My 7yr old daughter.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote FreeEnterprise Quote  Post ReplyReply Direct Link To This Post Posted: 21 February 2013 at 9:10am
Interesting read on this topic of exactly "Why" costs are so high for the uninsured. 

http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/


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Post Options Post Options   Thanks (0) Thanks(0)   Quote SSOK Quote  Post ReplyReply Direct Link To This Post Posted: 21 February 2013 at 1:53pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote JohnnyCanuck Quote  Post ReplyReply Direct Link To This Post Posted: 21 February 2013 at 9:26pm
I'm glad your daughter has healed, wild how expensive it can be, hope it all works out.  Here's an article that ranks right up there with FE's; at least I know how to link...:  http://truedemocracyparty.net/2013/01/aliens-back-obama-ufo-at-president-obamas-inaugural-tv-speech-2013-who-is-the-real-obama/
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