the most expensive burrito ever
February 5, 2006 11:37 AM   Subscribe

Can I successfully dispute an exorbitant hospital bill?

A few months ago, I was visiting a friend in northern california. We went out to a restaurant and I got an absolutely horrific case of food poisoning: I was becoming so dehydrated so quickly that I became practically delirious. I really felt like I was going to die. My friend rushed me to the emergency room, where I (sorry, this is gross) immediately puked like two liters of liquid onto the floor. They treated me with a lot of intravenous fluid and gave me some morphine (which I asked for) at one point because I was so uncomfortable, and released me after about three hours. I didn't have any insurance at the time, and now they want 3700 dollars. Is this a reasonable amount to pay? How can I dispute that amount, and should I?
posted by clockzero to Health & Fitness (30 answers total)
Is this a reasonable amount to pay?

Believe it or not, that sounds about right.
posted by ThePinkSuperhero at 11:40 AM on February 5, 2006 [1 favorite]

Sounds like what's normally charged. You may not be able to legally get out of paying it, but regardless, consider writing to your elected officials and pointing out that there's something horribly wrong with a system that drops people into $3700 debt for eating the wrong thing, that since the charges would be lower if you had an insurance company paying it, you're essentially subsidizing (paperwork) for insured patients, and demanding that they fix it.
posted by duck at 11:54 AM on February 5, 2006

Can you go after the restaurant that gave you food poisoning for the money?
posted by ThePinkSuperhero at 11:58 AM on February 5, 2006 [1 favorite]

Yes, it does sound like a normal amount. I will say this, though, if you talk to the hospital's billing department, and just ask what your options are, they will usually knock off 20% or so right away, no questions asked. Your situation is almost exactly what happened to me last November. And another of the myriad reasons that I'm leaving this country in a month.
posted by greasepig at 12:01 PM on February 5, 2006

I'm no lawyer but I recall a resturant in near where I live in NY state being forced to close after a food poisoning outbreak due to the law suits even though they were cleared by the health department.
posted by joegester at 12:01 PM on February 5, 2006

Yep, this is (unfortunately) not a surprising charge to me at all. See here for more info why your bill's so high.
posted by scody at 12:04 PM on February 5, 2006

It sucks not having insurance. Be glad you didn't break your leg or somethig - that's much more expensive.
posted by k8t at 12:16 PM on February 5, 2006

From what I know, it's difficult to prove where food poisoning came from without DNA analysis or evidence pointing to an outbreak (i.e. lots of people got sick after eating at x restaurant), and this often allows restaurants to get off the hook.

Different types of foodborne illnesses have different incubation periods- so if you had a specific diagnosis (i.e. Salmonella, e. coli) that fit in with the timeframe, you might be able to argue for the liability of the restaurant. Were you diagnosed with a specific illness or did they just say "food poisoning"?

As for the hospital bill, yeah, that sounds about right. Were you able to tell the hospital staff you didn't have insurance? (Sometimes they will fudge things a bit to help you out- I had to go to a medical clinic for an emergency, and they didn't accept my HMO, so the doctor made sure to understate my treatment so that it'd cost less.)
posted by elisabeth r at 12:32 PM on February 5, 2006

They gave you morphine for food poisoning? After you asked for it? That's amazing.
posted by kindall at 12:41 PM on February 5, 2006

Response by poster: Yeah, it was pretty cool.
posted by clockzero at 12:52 PM on February 5, 2006

I'm curious why this "sounds about right". What exactly are they charging you for that costs so much?
posted by smackfu at 1:44 PM on February 5, 2006

labwork, supplies to start i.v., i.v. fluids, medications, cost of taking up space in the ER, paying the physicians and staff.

sounds about right.
posted by 6:1 at 2:04 PM on February 5, 2006

The cost of non-fatal emergencies such as this is really staggering. My father had a kidney stone a few years back- he was in the hospital for less than 24 hours in the evening hours. He has insurance, which is good, because the cost was *$11,000*.
posted by ThePinkSuperhero at 2:07 PM on February 5, 2006 [1 favorite]

labwork, supplies to start i.v., i.v. fluids, medications, cost of taking up space in the ER, paying the physicians and staff.

And of course the cost of supporting the bureaucracy necessary to deal with 30 different insurance companies and a billing department to hound the uninsured.
posted by duck at 2:09 PM on February 5, 2006

And the cost of hospital admissions, of course, runs even higher. About 9 years ago, when I had my thyroid taken out (cancer), the cost for the surgery and one night in the hospital (before the HMO insisted I be kicked out, even though I was undergoing radiation) was about $20,000. My jaw surgery and subsequent (and highly unexpected!) 4-day stint in ICU last year ran well into six digits. And all of those were insurance-negotiated costs that were coverage -- I imagine had I been without coverage, they would have charged me directly 2 or 3 times as much.
posted by scody at 2:17 PM on February 5, 2006

read: "that were covered"
posted by scody at 2:18 PM on February 5, 2006

Best answer: It's not "about right" in the sense that if you had insurance, the amount that the insurance company would actually pay to settle the account would be a fraction of that, and the hospital would write off the rest. So the bill is clearly padded with monopoly play-money, however that padding is standard if you don't have insurance. In that sense, it might be "about right".

If you wanted to try to haggle or whatever, I'd suggest getting the bill itemized, then finding out what the true going rate for those services is, as if an insurance company was paying. That isn't public information though, so other than calling a favor from a friend who works at an insurance (or medical) place, I'm not sure how you'd get that. Maybe someone else here knows?
posted by -harlequin- at 3:09 PM on February 5, 2006

Best answer: Definitely get an itemized bill, and ideally make someone in the hospital billing department go through it with you piece by piece. They stick all kinds of stuff in there, hoping you won't do exactly that.

And if you think something's unwarranted, or if you simply can't afford it all, absoutely try to negotiate with the hospital. One bright point in our #$%-ed up system is that hospital bills are negotiable. After all, they would rather get something than nothing, and if you can convince them that's all you have, then often they'll take it. I've had uninsured grad-school friends negotiate bills down to 10% of their original charge.

I did this a few years ago after an insurance snafu left me holding a huge surgery bill. I wrote the providers saying look, this is how much I can pay (about 60% of what the various bills were), here's a check for that amount, and if I don't hear from you within X days I'll assume the account is closed. Worked all around.
posted by gottabefunky at 3:17 PM on February 5, 2006 [1 favorite]

I had a similar experience when I was a graduate student, lo these many moons ago. I had the college's catastrophe insurance which was worthless in this case, and I made an embarrassingly small sum as a TA. When I ended up in the hospital for similar reasons, I had a bill that was almost two thousand dollars. I called the hospital's business office, told them my financial situation, and that I would not be able to pay the bill, and they knocked it down to $300, pretty much immediately. I don't know how common my experience was, but it may be worth a phone call.
posted by bibliowench at 3:17 PM on February 5, 2006

Best answer: That sounds about right. Just being seen by an ED physician costs around $1,000. Being diagnosed and treated for an actual illness probably gets you put into a "DRG" or Diagnosis Related Group, insurance or no. And yes, the hospital will get more money from you as a self-pay than if your health insurance paid.

There may be some remedy for you. Hospital billing departments have become aggressive in the last 5 years or so because so many hospitals have closed recently. Put it this way, when's the last time you heard of a new hospital opening? Any of the newer hospitals out there were built in the 70's, or were savvy enough during the HMO massacre of hospitals that they were able to expand. [/digression] As mentioned above, you may be able to get a discount right off the top. Attitude is everything--you will get more flies with honey than with vinegar. Begging poverty will get you farther than self-righteous outrage.

On top of this, ask the hospital if you could set up some kind of payment plan in combination with your discount. It doesn't have to be that much--$500 every six months or so for example, but as long as you're giving something you will be viewed with indulgence.

Its gonna be a bad day when HSA's, much as I like the idea, start taking off and people start to see the real cost of medical care. Not many people, doctors and hospital staff included, not to mention the patients are aware of how staggeringly expensive everything is in the medical world. Remember the $10 pencil and the $40 toilet seat? That's exactly how it is now in the medical world. Good luck.
posted by gilgul at 3:18 PM on February 5, 2006

Do you know what is amazing about this? I went to Ireland and got a case of food poisoning that sounds like it was even worse than this (I was hospitalized overnight), and my ENTIRE hospital bill (nothing was submitted to insurance) was 69 Euro. That included EVERYTHING I needed, including a private room, a number of shots, IV fluids, and tea, dinner, and breakfast for my mom, who stayed with me. Not to mention that the prescription medication I had to take to get on the plane the next morning cost 2 Euro from a local pharmacy.

Clockzero, I suggest that you go back to the restaurant that you ate at and talk with the manager. They could be really good people that understand your situation and may want to share the cost of your hosptialization. I was given GHB at a bar in Chicago, and I ended up in the hospital; I went back to the bar and explained what happened (mainly because I had left my credit card and an open tab when a friend called an ambulance) and they paid 1/2 of my hospital fees. They were really stand-up folks who really had no reason to pay at all.
posted by MeetMegan at 3:20 PM on February 5, 2006

Response by poster: Wow, thanks for all the helpful suggestions, everyone! I will probably call the hospital tomorrow and see if I can get it knocked down. Oh, btw MeetMegan, I probably couldn't do that since the restaurant is 500 miles away and this all happened months ago, but maybe I could try somehow.

AskMe is such a boon to humankind.
posted by clockzero at 5:06 PM on February 5, 2006

I had a quick case of pnuemonia set on without insurance. Instead of the ER, I hit up the less expensive, closer Urgent Care center. They informed me that my antibiotic shot alone was $400. Tacking on x-rays, a meeting with the on-call doctor and a diagnosis, and my bill came up to about $800. (The moral being that "urgent cares" are usually cheaper than ERs.)

Anyway, they informed me that they offer those of us without insurance 50% off if we pay within 30-days. I whipped out my credit card right then.

Push them for it. They're a hospital. They're used to having people duck out entirely most the time. Ask if you pay in a timely manner, if there's something you can do payment plan wise.
posted by disillusioned at 5:58 PM on February 5, 2006

Oh, btw MeetMegan, I probably couldn't do that since the restaurant is 500 miles away and this all happened months ago, but maybe I could try somehow.

Write a letter and include a copy of your restaurant receipt and hospital discharge form, as proof that you genuinely were treated for food poisoning after eating there. If you did get it there, it's hilghly likely that you're not the only one who got sick, and therefore not the only person who's contacted them. In which case, they would probably be very relieved to make a quick offer to avoid lawsuits or unfortunately publicity. Worth a shot. You really have nothing to lose by asking, and potentially they have a lot to lose by turning you down flat. Like the hospital bill, consider it a negotiation.
posted by nakedcodemonkey at 7:01 PM on February 5, 2006

At our hospital, it literally costs $268.00 to walk through the doors, then the bill starts adding up. Even if you are just registered, no prescription or diagnosis, if you leave even before you see a doctor, it's still $268.00. Not only that, but at our hospital, doctors, x-rays, and blood work are all billed seperately since they are pretty much outside contractors. A few weeks ago (as an ER employee) I became severely dehydrated and had to check myself in. I was there for 6 hours, had one bag of IV fluids and my bill was over $1600 AFTER the employee discount. Yes, $3700 sounds right but you should (and will) be able to negotiate to pay much less.
posted by Ugh at 9:27 PM on February 5, 2006

I too, can't believe they gave you morphine for food poisoning, especially after you asked for it. In most hospitals you would have been labeled as someone who was looking for drugs. Not saying you are but it is weird. I agree with everyone else that this bill sounds just about right, your best bet would have been to go after the restaurant, but it's probably too late for that now since so much time has passed.
posted by katyggls at 11:47 PM on February 5, 2006

Before you start hounding the restaurant, know that very very few cases of food poisoning are from the last meal you ate before you got sick. Most food borne illnesses have a 3 day to 2 week incubation period. Did your friend with whom you were eating also get sick? Was the public health department notified and/or did they do an investigation? How do you know what you had wasn't a viral infection? If, in fact, a restaurant made you sick, they should be culpable for your injury - but at this stage not only is it not fair to blame some restaurant that likely wasn't the cause - it would be almost impossible to find who or what the culprit was.
posted by Wolfie at 9:48 AM on February 6, 2006

See post here.
posted by radioamy at 6:27 PM on February 6, 2006

I can just see a group of MeFits chartering a plane to Ireland on the basis of the MeetMegan situation descibed above! I hate to state the obvious but emergency care is free in most European countries. What you paid is an amount instituted to try and get people to go to their family doctor in non-emergency situations. And it's 69 Euros now!! Sheesh! I paid £15 in old money just 5 years ago.
posted by Wilder at 2:22 AM on February 7, 2006

I had meningitis a few years while I was in grad school and while I had insurance, I still had significant bills. I echo that you should ask for a cut based upon your situation. Also, most medical providers will put you on an interest-free payment plan (at least they used to). Also, ask about a forbearance. I asked and they waived my last $800. They might want you to start a payment program first. But, I was very happy when I went in to pay my bill and they told me that my account was cleared. In the end, it did take me a couple year to pay down the one remaining bill. But, it didn't ruin me.
posted by robabroad at 8:05 AM on February 8, 2006

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