ER Room Overcharges Can Be Disputed

Los Angeles, CAIt goes without saying that worry and anxiety is palpable in most every emergency room. So getting handed a bill for emergency room overcharges adds insult to injury, to say the least. But most people don't realize that they can dispute medical bills.

Besides the obvious reason—an unexpected injury or accident—people wind up incurring an emergency room cost for a number of reasons. Perhaps you are a Medi-Cal patient unable to find a doctor to treat you. (Doctors can opt out of treating Medi-Cal patients but ER doctors are required by federal law to treat every patient who comes to the emergency room, regardless of whether they can afford the ER charges.)

Say you are in between jobs and you aren't covered for medical insurance. Some hospitals have been known to charge individuals without insurance their "retail rates" yet bill insurance companies "wholesale rates." People with assets or concerned with their credit rating are subject to be charged outlandish amounts.

Some people go to the ER for a non-emergency or a simple procedure because the walk-in clinic is over-crowded, having no idea they will wind up with medical bills that could lead to bankruptcy!

Rose (not her real name) had a heart attack and ended up in the hospital with no insurance and a bill for more than $80,000. "My family was forced to file for bankruptcy," she says in an e-mail. "I don't recall exactly how much of that charge was for procedures I had in ER but I know I spent several hours there before being admitted. The hospital closed about a year later but I do have the same cardiologist, and he says the doctors have no idea what any hospital procedures cost."

Rose did manage to get her bill reduced before the hospital closed. "After several attempts to call the hospital administration and someone explained that the CT Scan was the most expensive ER charge. Anyway, she agreed to knock off the co-pay, reducing the amount to about $1,100…"

It is possible that with the help of an attorney, Rose could reduce her bill even further and possibly find ER overcharges. She is in the process of getting her medical records, documents that are imperative to an attorney—medical records will determine any overcharges. For example, sometimes the same procedures have been charged twice.

Attorney Barry Kramer of the Law Offices of Barry Kramer advises that, whenever possible, read the hospital contract while you are waiting in the ER and see what you are required to sign. He has discovered hospital overcharging happens all too often with uninsured patients.

"Sometimes hospitals will word the contract vaguely, such as, 'We will charge you a reasonable amount for an emergency room procedure,' but what is that amount?" says Kramer. "The charges are somewhat dependent upon the hospital's contract so if it doesn't spell out specific rates, everyone who went through that hospital is in the same boat as you."

Kramer explains that a vague contract. i.e., "reasonable charges," means that you have more leverage to dispute your ER bill. If you have been overcharged and being chased for the money or you have paid way more than was justified by the amount of treatment received, an attorney can seek reimbursement of the excess payments on your behalf.