Understanding medical billing[{locked}]

[tloonya]

Child was taken to the ER with a foreign object in her nose.
She was in a hospital 40 min from the entry to the dismissal.
Doctor was called, put a glue on the stick and removed a bead.
No XR no nothing.

Bills came from 2 sources.

One bill is stating;
emergency DEPARTMENT VISIT $495
remove nasal foreign object $213

Another bill:
dermabond top adhesive 1 packet $70.20
ER level 3 W/procedure (though Hospital is tier 1 if it is matters) $918.75
Removal FB nasal $101.78

----------------------------------------

What am I supposed to do to dispute these seems too high charges? And double on ER visit?
Is there place I can go and plug in procedure code and see whats what?

Thanks

[Shooby]

You ALREADY received the services. So, you should pay for the services you received. And, yes, you can complain and/or go to an Urgicare or a different hospital next time.

BTW, everyone complains it is "too expensive". Well how much SHOULD a trip to the ER cost? How much SHOULD it cost for there to be doctors/nurses/xray/lab/anesthesia/surgeons/respiratory therapists ON Call 24/7?

[Deleted]

How many doctors saw the patient?

If one was a Resident, the hospital would bill for his or her services, and the actual Doctor would bill for theirs. That could be why there are two bills showing "ER visit".

Level 3 ER visit has nothing to do with what kind of hospital the service was rendered at. It has to to with history/exam/decision making done by the physician.

If you want to find out what the codes are, try googling "cpt 99283" and any of the other codes you were billed.  The amount charges is the "reasonable and customary charge" for your area.  

[NancysSummerSip]

May 12, 2014 9:00:22 GMT -5 tloonya said:

Child was taken to the ER with a foreign object in her nose.
She was in a hospital 40 min from the entry to the dismissal.
Doctor was called, put a glue on the stick and removed a bead.
No XR no nothing.

Bills came from 2 sources.

One bill is stating;
emergency DEPARTMENT VISIT $495
remove nasal foreign object $213

Another bill:
dermabond top adhesive 1 packet $70.20
ER level 3 W/procedure (though Hospital is tier 1 if it is matters) $918.75
Removal FB nasal $101.78

----------------------------------------

What am I supposed to do to dispute these seems too high charges? And double on ER visit?
Is there place I can go and plug in procedure code and see whats what?

Thanks

I'd ask about the two in bold...on a first read, it looks like you were billed twice. But one could be for hospital services and the other the doctor/technician who did the work.

The adhesive packet does look a little outrageous. But that's where hospitals make their money.

And this bill isn't so bad. Try having nuclear medicine-based tests, like my husband did last year. Five hours in the hospital, $9,000.

[Deleted]

Before getting up in arms about being billed twice figure out where the bills came from. Was one from the hospital and one from the doctor?  Both of them get paid for the service.

[NancysSummerSip]

May 12, 2014 9:15:27 GMT -5 @beerwench said:

Before getting up in arms about being billed twice figure out where the bills came from. Was one from the hospital and one from the doctor?  Both of them get paid for the service.

I thought that might be the case, which is why I mentioned it in my post. Actually, I've been billed three times for a hospital visit - the hospital, the doctor and the anesthesiologist. Looks strange unless you know how ERs work these days. My closest hospital contracts all their ER doctors for the night shift. Daytime, it's their staff. But they had so much trouble covering nights, weekends and holidays that they contracted with an outside service.

[Deleted]

Radiologists, Anesthesiologists, Pathologists and ER Doctors are not employed by the hospital. They are like independent contractors and they do their own billing and credentialing even though they do their work in a hospital.

[tloonya]

May 12, 2014 9:03:30 GMT -5 Shooby said:

You ALREADY received the services. So, you should pay for the services you received. And, yes, you can complain and/or go to an Urgicare or a different hospital next time.

BTW, everyone complains it is "too expensive". Well how much SHOULD a trip to the ER cost? How much SHOULD it cost for there to be doctors/nurses/xray/lab/anesthesia/surgeons/respiratory therapists ON Call 24/7?

So even if you billed twice you should be asking questions and just pay because some unreasonable and jittery people woke up pissed of?

And I would (and I am sure it is legion of us) who wants to know how much ER should cost. And why are they charging arm and leg to us and just a fracture of the bill (when you have an insurance) to insurance companies.

So am I supposed to not to ask questions being concern that someone just spewing hate because there is something wrong with oneself?  

[tloonya]

May 12, 2014 9:29:44 GMT -5 @beerwench said:

Radiologists, Anesthesiologists, Pathologists and ER Doctors are not employed by the hospital. They are like independent contractors and they do their own billing and credentialing even though they do their work in a hospital.

ut why ER twice?
And I am not asking you to answer those questions - I am asking where should one go for an explanation of the charges.
that is all I am asking. EXPLANATION OF CHARGES!!!

[Deleted]

ER twice because the doctor gets paid for taking the thing out of the kid's nose and the Hospital gets paid for the bed that the kid sat on while he did it. 

So, if you don't want our advice, why did you start a thread about this instead of calling the phone numbers on the bills? 

[tloonya]

May 12, 2014 9:34:47 GMT -5 @beerwench said:

ER twice because the doctor gets paid for taking the thing out of the kid's nose and the Hospital gets paid for the bed that the kid sat on while he did it. 

So, if you don't want our advice, why did you start a thread about this instead of calling the phone numbers on the bills? 

No, I wanted an advice, I didn't want batshit crazy blasting for nothing like if I said I am not paying for services 'already received'...
(not related to your post, beery)

I merely wanted an advice on whom to go...while I am waiting for the billing department to call me back as they are so busy.
And I am almost sure they will not going to know what to tell me. I had been sent ways by them for 2 weeks now.
Every dept knows how to transfer you to another dept....

[Deleted]

You flatter me! But I am just someone in the field trying to help, is all.

[Shooby]

Oops my bad. I forgot that this was a one man show and no opinions and advice were actually desired! lol

[mmhmm]

Tloonya, if you have questions about your bill, call the hospital's billing department and ask them.  We have no way of knowing.  The two bills are perfectly normal. The first is the doctor's charges for his time and interventions.  The second is the hospital's charges for supplies and equipment, nursing care, and the cost of running an ER 24/7/365.  That's the breaks, I'm afraid. If you don't like it, you might take a look at your own culpability in this issue.  How was your child able to get her hands on a bead small enough to fit up her nose and how did she get it there? While none of us is a perfect parent and accidents do happen, some of them are certainly avoidable with due diligence.

[Deleted]

I would think that someone in college would know better than to stick a bead up her nose! 

[NancysSummerSip]

May 12, 2014 10:25:18 GMT -5 @beerwench said:

I would think that someone in college would know better than to stick a bead up her nose! 

Either that, or Loony has interfered intervened and rescued someone else's child. Or she's calling on behalf of someone whose child wound up in the ER, and the parent(s) don't speak sufficient English to ask the right questions.

[Deleted]

May 12, 2014 10:25:18 GMT -5 @beerwench said:

I would think that someone in college would know better than to stick a bead up her nose! 

I was just going to ask the same thing!  Looney isn't your daughter 19? 

[HoneyBBQ]

May 12, 2014 9:00:22 GMT -5 tloonya said:

What am I supposed to do to dispute these seems too high charges? And double on ER visit?
Is there place I can go and plug in procedure code and see whats what?

Thanks

Your bill sounds about right. ERs are expensive. Next time, try one of those 24 hour doc-in-a-box places. A bead in the nose is not really a dire emergency unless the person can't breathe. At the doc-in-a-box-- if you really need an ER, they will tell you to go there as they don't want anyone dying in their office.

As explained-- you'll get two bills. One for the physician and one for the hospital. And as also mentioned, you can google the code, and talk to the hospital billing line. That's about all there is.

[973beachbum]

You guys are so funny!  Actually answering Loony's questions seriously and not expecting to be yelled at for it.

[Abby Normal]

At the risk of being Captain Obvious-   It's called an emergency room because it's for emergencies.   A bead up a nose is not life threatening.  Next time, use an urgent care or your family doctor.

My guess it that this is not Looney's daughter-  but someone who was complaining to Looney about the bill and she got involved.

[Deleted]

I've had a lot of ER visits in our family in the past few years, and I can say I've never seen one less than $1000, they are spendy even with doing nothing but observing and checking you over.

[Deleted]

May 12, 2014 10:48:04 GMT -5 973beachbum said:

You guys are so funny!  Actually answering Loony's questions seriously and not expecting to be yelled at for it.

I'll be her verbal whipping post if it helps ease her anxiety over her woefully unprepared for life daughter! 

[NancysSummerSip]

May 12, 2014 10:48:04 GMT -5 973beachbum said:

You guys are so funny!  Actually answering Loony's questions seriously and not expecting to be yelled at for it.

Hey now, we're just a buncha cockeyed optimists here.

[tloonya]

May 12, 2014 10:23:00 GMT -5 mmhmm said:

Tloonya, if you have questions about your bill, call the hospital's billing department and ask them.  We have no way of knowing.  The two bills are perfectly normal. The first is the doctor's charges for his time and interventions.  The second is the hospital's charges for supplies and equipment, nursing care, and the cost of running an ER 24/7/365.  That's the breaks, I'm afraid. If you don't like it, you might take a look at your own culpability in this issue.  How was your child able to get her hands on a bead small enough to fit up her nose and how did she get it there? While none of us is a perfect parent and accidents do happen, some of them are certainly avoidable with due diligence.

mmhmm,
I was actually looking for that you wrote and nothing more.

Like I said I did not just got the bill and post the question here.
I had been dealing with it for 2 weeks now.
And it is funny you are assuming my 19 y/old child will stick a bead in her nose  it is another person's child who are just starting out and I was trying to help. However their hospital keeps running me in circles. So I had asked. Nothing in my post called for 'shut us and pay'.

I do appreciate all the other posts, I had learned something as always. Calling the hospital.

[tloonya]

May 12, 2014 10:25:18 GMT -5 @beerwench said:

I would think that someone in college would know better than to stick a bead up her nose! 

Again...you are assuming things and there is a saying for it. Not a nice one. I will not post  I think you know...

[Deleted]

"Comedy gold"?? 

[tloonya]

May 12, 2014 10:31:26 GMT -5 NancysSummerSip said:

May 12, 2014 10:25:18 GMT -5 @beerwench said:

I would think that someone in college would know better than to stick a bead up her nose! 

Either that, or Loony has interfered intervened and rescued someone else's child. Or she's calling on behalf of someone whose child wound up in the ER, and the parent(s) don't speak sufficient English to ask the right questions.

THANKS!
Why is it not immediately 'assumed' or understood by people knowing what environment I am working at.
I am always having to call someone and do something for people. As someone is calling it 'sticking my nose into someone's business'...

[NomoreDramaQ1015]

Something you need to be aware of is that ER's charge for the room anywhere from every 15 minutes to every 1 hour. So all that time you sit waiting to see the doctor. ..you're being billed for it. You're basically renting the ER room for the time you are there, the longer you are there the more you will be charged.

The bill sounds about right from the multiple ER bills I've had to pay. I've finally convinced my husband that you DO NOT need to go to the ER for things like migraines and rocks up the child's nose.


After our second visit to the ER for rocks up the nose the doctor told us an easy trick. Pinch the clear nostril and then put your mouth over the kid's forming a seal. Then blow really hard. It'll shoot whatever is up there right out.

You'll also have to poke the kid's eyeballs back in their head.

[tloonya]

May 12, 2014 10:46:16 GMT -5 HoneyBBQ said:

May 12, 2014 9:00:22 GMT -5 tloonya said:

What am I supposed to do to dispute these seems too high charges? And double on ER visit?
Is there place I can go and plug in procedure code and see whats what?

Thanks

Your bill sounds about right. ERs are expensive. Next time, try one of those 24 hour doc-in-a-box places. A bead in the nose is not really a dire emergency unless the person can't breathe. At the doc-in-a-box-- if you really need an ER, they will tell you to go there as they don't want anyone dying in their office.

As explained-- you'll get two bills. One for the physician and one for the hospital. And as also mentioned, you can google the code, and talk to the hospital billing line. That's about all there is.

Another civilized answer! Thanks.
I wasn't there, they called me from on the way to the Hospital, so I did not really know myself about doc-in-the-box thing.
And I did google the code. I couldn't find anything I could understand...but thanks anyway.

[tloonya]

May 12, 2014 10:48:04 GMT -5 973beachbum said:

You guys are so funny!  Actually answering Loony's questions seriously and not expecting to be yelled at for it.

When have I yelled at you...in this post?