ER Overcharges—No Rhyme or Reason

Orlando, FLDenise knows firsthand that uninsured patients are charged more than those insured for emergency room visits. She believes that some faith-based, not-for-profit companies that run hospitals actually profit from emergency room overcharges.

Denise is referring to Adventist Health, a huge non-profit network of healthcare providers that includes hospitals, home health agencies, nursing centers and other healthcare facilities. Its mission is to “demonstrate God’s care by improving the health of people and communities through a ministry of physical, mental and spiritual healing,” according to its website.

Unfortunately, Denise believes she didn’t fit into its mission of care because she was uninsured. All totaled, she had 11 emergency room visits to two Adventist hospitals with the same problem that always happened late at night or weekends when she couldn’t see her doctor.

“Every visit had the same outcome: they told me that I had a urinary tract infection and sent me home with antibiotics,” Denise explains. “My first attack happened in June of 2011 when I had partial insurance. After November 2012, I was uninsured and that is how I know the discrepancy in charges.”

Not only did they charge more, but Denise says that one hospital charged more for the room and less for the doctor than the other hospital. She has bills running from $975 to $1,020 per visit. “One doctor just came in and sat down by my ER bed, looked at his laptop and said there was nothing wrong with me and I could go,” she says. “That took about seven minutes. At that time my bills came to $9,000 for ER rooms and over $12,000 for the doctors. So far I have paid over $1,000, and I have no idea how much my insurance paid.”

And there was a huge difference in prescriptions and procedures. When she was insured, Denise was given a prednisone pill in ER and was charged $2. When she was not insured, the charge was bumped up to $10. A urine culture that was charged to her health insurance cost $25. This year she got a bill for $112 for the same test.

Combined with foreclosure on her home and medical bills, Denise filed for bankruptcy in 2012. She had previously asked the hospital to consider a payment plan (which a third-party handles), but once they discovered she was bankrupt, they weren’t interested, according to Denise. She received a letter from Adventist's financial company saying they were giving her account back to the hospital.

“I wrote to the CEO of Adventist telling him these bills were getting out of control and I wanted to discuss the charges with someone,” says Denise. She had since moved to Daytona Beach and went to the Florida Memorial Hospital with the same urinary tract problems. “They were nice enough to wipe out the ER visits, which just left the doctors’ charges.

“This is the interesting bit: I go to this second ER hospital with the same problem, over and over again. On August 19, I saw a physician’s assistant instead of a doctor. I told her about my continual UI problem and she started laughing. I am in pain, what is so funny?

“She said that I have never had a urinary infection, ever. ‘I looked at all the cultures and you have contaminants,’ she told me. In other words, I have bacteria on the outside of my body that can get into your urine. She further said they should be doing a catheterization but that isn’t hospital procedure. And the antibiotic was making me sick. Naturally I asked her why I wasn’t notified if something was wrong with the culture. She said they never contact patients directly.

“The last ER doctor I saw diagnosed me with cystitis, an irritation that can be brought on by stress or spicy food, or an antibiotic. I figure my first attack was stress related and everything else was caused by their treatments.

“I went to both hospitals and paid for all my medical records. The PA was right: the lab results indicate contaminants. Not only was I overcharged; I was hit with these emergency room charges for no reason! Now I want to file an ER overcharges lawsuit and a medical malpractice suit.”