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Getting Caught Can Reduce Emergency Room Overcharges

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Hospitals hit with emergency room overcharges lawsuits and shamed by media can help both uninsured and insured patients reduce emergency room fees

San Francisco, CALast year Zuckerberg San Francisco General Hospital reduced a patient’s emergency room charges from $20,243 bill down to $200—after the patient, Nina Dang, contacted the media. She broke her arm on the pavement in a bike accident. Can’t reach the media? Of course lawyers experienced with negotiating ER overcharges can also substantially reduce hospital costs, both for insured and uninsured patients. “It’s frustrating that I have to hire a lawyer, but so far it’s been worth it,” said another ER patient, Alexa Sulvetta.

Another emergency room patient had her bill reduced after contacting a health policy journalist. Alexa Sulvetta’s attorney has so far shaved $8,000 off her $113,336 bill she received for treatment at Zuckerberg San Francisco General Hospital (ZSFG) for a broken ankle after she fell from a rock-climbing wall. Her insurance only agreed to pay a portion of that which it deemed reasonable. And eight-month-old Park Jeong-whan was taken to ER when he fell off the bed in the family’s hotel room and hit his head. The baby was fine. He was treated for a few bruises with a nap and a bottle of formula, which cost $18,000.  After Vox published this story, Zuckerberg San Francisco General Hospital agreed to waive the $15,666 trauma response fee., in collaboration with Kaiser Health News, has uncovered hospital ER bill “secrets”  and compiled many case studies during a year-long investigation into ER billing practices. For instance, Vox reviewed five patient bills from the ZSFG emergency room, in consultation with medical billing experts, and found that the hospital’s billing can cost privately insured patients tens of thousands of dollars for care that would likely cost them significantly less at other hospitals.

“Priscilla and I believe that everyone deserves access to high quality health care,” Facebook founder Mark Zuckerberg said in a statement released when he and Chan made a $75 million donation to the San Francisco hospital. Clearly, Zuckerberg doesn’t understand that everyone – people who actually can afford private health insurance-- can afford “high quality health care”.

Out-of-Network, Out of Touch

ZSFG is the largest public hospital in San Francisco and the city’s only top-tier trauma center. Vox learned that the hospital doesn’t participate in the networks of any private health insurers, which is a nasty surprise for patients like Nina Dang, who assumed her health insurance includes a trip to a large public ER. Dang’s bill came to $24,074.50, but Premera Blue Cross, her health insurer, would only cover $3,830.79 of that, which it deemed appropriate to treat a broken arm. 

Dang didn’t know that ZSFG does not accept any private health insurance. A spokesperson for the hospital told Vox that this as a normal billing practice because the hospital’s focus is on serving patients with public health coverage — which can mean offsetting, or balancing, those costs with high bills for the privately insured.

Although California has some of the most consumer-friendly laws to protect some patients from surprise emergency bills, health plans like Dang’s don’t fall under those rules. Numerous senators have proposed legislation in the Senate to fix this problem, but patients for now end up appealing their bills to the hospital and their insurance plans. And when that doesn’t work, they hire an experienced attorney who will negotiate on their behalf or go to court. Or maybe they know someone at Vox.


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