Hospital Overcharging

[peterbo]

What is the name of your state (only U.S. law)? FL

In January a branch slashed my scalp and I went to the emergency clinic at the local hospital. I was there 30 minutes, had a local anesthetic and 3 staples put in. I was charged $1,500. My insurance paid $600 (need to check, but approx. right). I protested the amount and was informed in writing it was correct. I have paid an additional $200 or so but refuse to pay the rest.

This month, by coincidence, my wife slashed her scalp at work, went to the emergency clinic at a different hospital (same state, next county), had two staples put in, no local, and was charged $500.

Can I legally challenge my bill?

[wyett717]

Can I legally challenge my bill?

You can challenge anything you want, but you will have a difficult time proving why you don't owe that amount. Anesthesia is very expensive, so that charge is not unreasonable.

Also, perhaps your wife's bill was lower because your deductible (or part of it) had already been met.

[ecmst12]

Your insurance company paid the bill based on either a contract or the usual & customary charge. You are obligated to pay the amount your insurance company designated as your responsibility. The amounts charged for different services at different hospitals will of course be different and you have no expectation otherwise.

If you refuse to pay, your credit can be damaged and they can use all legal means to collect. They can also refuse to provide any further treatment until you have paid the bill.

[racer72]

Have you and your spouse considered the wearing of hard hats as part of your regular apparel?

[ariastar]

You: Slashed scalp, anesthesia, three staples (did they have to shave that part of your scalp, resulting in another medical supply needing to be replaced or sterilized?)
Wife: Slashed wrist, two staples

Different locations, different medications, different procedures.

Also the out of pocket from your injury could have met the deductible.

I know the cost of medical care is high, and that sucks. But the hospital did nothing wrong here. Hospitals don't have to try to meet and beat other hospitals' prices. Also some hospitals receive subsidies from the state enabling them to lower the costs of their care for patients.

Basically you don't have a leg to stand on.

May I suggest you both give up using sharp objects from now on?

[keymaker]

Yes you may challenge as to the difference in charges. However, maybe the procedure undergone by both of you were different or the medicines used were different, etc, etc.

When all things were the same then you may file a protest should you have the need for it.

[Proserpina]

Originally Posted by keymaker

Yes you may challenge as to the difference in charges. However, maybe the procedure undergone by both of you were different or the medicines used were different, etc, etc.

When all things were the same then you may file a protest should you have the need for it.

On what basis?

(Remember these are two different hospitals)

[ariastar]

Originally Posted by keymaker

Yes you may challenge as to the difference in charges. However, maybe the procedure undergone by both of you were different or the medicines used were different, etc, etc.

When all things were the same then you may file a protest should you have the need for it.

The procedures each underwent were different Each simply having staples in the end doesn't make them the same.

If you go to store A and a can of Del Monte sweet peas is $1.09, and store B charges $1.29, does this mean store B is overcharging, and should therefore be in the hook to anyone who shopped there? If the world worked that way, that any place charging more is in the legal wrong, then ever store would have WalMart prices, and everyone would be working at WalMart because they're the only store big enough to offer cheap crap so cheap. There's no crime in charging more than someone else. You can choose to use their services or not.

The OP used that hospital's services. He's on the hook.

[ShyCat]

Let's also point out that the two hospitals in question likely had different Trauma Level ratings. It is reasonable to expect that services at a Trauma I level ER will be higher than the same services at a Trauma II or Trauma III ER. Some states even use a Trauma IV rating.