“It’s not just about getting a patient’s individual bill reduced. I represent people who want to help change the process,” says ER Overcharges Attorney Barry Kramer. If you believe that what happened to you is wrong and unfair and want to make a change in the system, Kramer wants to hear from you.“ It’s not just about you, it’s about the system” he says.
Sure, the hospital my throw out your bill just so you will go away, but Kramer wants to nip these excessive overcharges in the bud. Too many people are hit with massive bills far beyond what they anticipated. The stress alone from getting such a hospital bill in the mail can put you back in the ER!
“The hospital industry goes out of its way to conceal their complex billing practices to begin with, and they virtually guarantee that it’s impossible for you to know what your charges will be,” says Kramer.
Anyone with or without insurance (not Medicare of Medicaid) can wind up with a grossly excessive bill. Hospitals are unlike many other businesses because they don’t have to worry about suing you to get paid. They simply file a collection action that can ruin your credit and force you to pay. And they can be very aggressive.
And why can’t you get some ballpark figure of the charges beforehand?
In the emergency room, the hospital doesn’t know all the costs before you have been examined and diagnosed. But there are fixed costs—your bill won’t itemize these charges unless you insist. The hospital wants to keep patients in the dark.
In a recent, major legal action seeking to promote pricing transparency and informed consent, involving multiple hospitals and hospital associations, the hospitals fought against pricing transparency but lost big time. “Hospitals were ordered to produce vastly more information on their websites. Unfortunately, they have continued to resist, making the website information so complex as to be meaningless to consumers trying to get a handle on what they will have to pay,” Kramer adds. Further, in an ER setting there is no way for a patient to look up anything online. Hospitals don’t readily provide any cost information, and emergency room staff is not trained to answer billing questions in advance, often resulting in huge, unexpected bills.
Hospitals and Insurance Carriers
And insurance companies are not always on your side either. They work, in large part, on a cost-plus basis, charging premiums for more than they pay out. Ultimately, the insurance industry goal is not to lower costs. This is why premiums go up each year. If hospital costs go up, the consumer absorbs the costs.
“For example, say the hospital sends an insured patient with a $5K policy deductible a $5K bill, which is substantial for most consumers,” Kramer says. “Often times the insurance carrier may end up paying little or nothing. This happens more and more frequently, because of increasingly large deductibles on insurance policies. In such a case, the patient winds up stuck for all or the majority of an outrageous bill, even where little or no treatment is provided.”
“If you want a policy that covers everything, the insurance plan will be very expensive, but most people cannot afford to pay for a Cadillac insurance policy. Say you buy a cheaper policy with a high deductible instead. This is great for covering a 50K bill, but with a $5K bill and a $5k deductible, the patient pays everything. The real solution is for the hospital to bill a reasonable amount in the first place.”
Kramer’s goal is to ultimately help reduce hospital pricing that is “grossly excessive.” The majority of hospitals say they are non-profit, but take a look online and it’s easy to figure out the non-profit status is a big scam. Kramer says that “not-for-profit” typically means that everyone involved gets higher salaries, hospitals buy new expensive equipment, expand and open new branches, and exaggerate the amount of community benefits they claim.
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Attorney Barry Kramer represents people nationwide who have been billed excessive emergency room charges. Typically, uninsured patients are uniform victims of hospital overcharging. And to compound the issue, emergency room costs are increasing.