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ER Overcharges Outrageous

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Houston, TXLast New Year's Eve, Vladimir's son wound up in the hospital ER room complaining of severe abdominal pain. Now Vladimir has ER overcharges amounting to almost $100,000. Wait, it gets worse! His son had a perfectly good appendix removed and he is still experiencing abdominal pain!

"As soon as we got to ER the doctor suspected appendicitis, so Anton, my 19-year-old son, had a CAT Scan, he was hooked up to IV and had a strong painkiller," says Vladimir. "Nothing showed up so he was admitted. I stayed with him most of the night and returned the next morning—a doctor finally saw him at noon the next day.

"She said nothing was wrong and he likely had stomach cramps, but I wanted a second opinion. Several hours later the second doctor ordered another CAT Scan and determined that he did indeed have appendicitis. That night Anton had surgery and we took him home next day.

"The pain never subsided and then I got a massive headache: a bill for the hospital stay—two days and six hours—and diagnostic tests totaled $48,489.00!

"I phoned my insurance company and they explained that I was billed the 'retail rate' because I have some insurance, but I still have to pay almost half, and the hospital is aware of that."

There are several issues that Vladimir is dealing with:

A third party sent him the invoice—they have been contracted out by the hospital to do the billing. "Even after I spoke with my insurance rep, I still receive bills saying I am responsible for the entire amount," he says. "My insurance paid according to the contractual agreement and I am responsible for a lesser amount. I can't figure out why they are still billing me the full amount."

Vladimir spoke to the administration department at the hospital but he just got the proverbial runaround. This bill hasn't gone to a collection agency yet, but Vladimir thinks it is coming to that.

And another:
"What bothers me most is their claim of services provided—services my son did not receive," adds Vladimir. "I was there, by his bedside, almost the entire time. I barely saw anyone in his room the entire time."

Third issue:
Vladimir requested from the hospital an itemized list of services provided and has yet to receive it, but he did get the retail price for one CAT Scan: $17,000! "That is what they are trying to charge people without insurance and that is why insurance in the US is so screwed up," says Vladimir. Other hospitals charge less than $1,000 for the same CAT Scan.

That isn't the end of the story.

About two months after Anton's appendix was removed, the symptoms returned. Vladimir took him back to the same ER and the doctor said he had appendicitis!

"Anton had yet another CAT Scan and the doctor said he might have some kind of liquid in his lower abdomen. Anton was admitted again and they ran one more CAT Scan, but still couldn't figure out what was wrong. More tests followed, including a colonoscopy and x-rays. They also put him on lots of painkillers, including morphine. After five days Anton was still in a lot of pain. His doctor called and said Anton was to be released as they didn't know what was wrong with him.

"I was told to follow up with our family physician. I took him home with a lot of antibiotics and his pain level decreased, but it never went away. He was back at high school and up until now we still don't know what is wrong. We are seeing two other doctors not related to the hospital. They have several ideas but it's a process of elimination—it could be a liver problem.

"We found a gastroenterologist, not associated with the hospital, and he asked if we got a pathologist report about his appendix. We gave him permission to request the report and that is how we found out that they removed a healthy appendix. They never even told us the second time he was admitted, even though they knew it."

Vladimir is also suing the hospital and doctors for medical malpractice. He is currently compiling all the paperwork and medical reports, including the pathologist's report.

"I feel quite bogged down and a bit lost and really need the help of an experienced attorney," says Vladimir. "I recently got a bill from the hospital for the second stay. To date, my insurance has paid $8,000 and I am facing a bill of just under $100,000.00. Anton has lost a healthy appendix and he is still suffering from something that no one can determine—these emergency room overcharges have to be curtailed."

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