ER Overcharges Bill Warrants Heart Attack

Seattle, WAIf you or a loved one find yourself in an emergency room, be careful about describing your symptoms: you might wind up facing unwarranted emergency room overcharges like Patrick and his wife recently did.

One month ago, the couple were getting ready for a trip overseas when Patrick’s wife, let’s call her Ann, felt a nasty pinching sensation in her left shoulder, arm and neck. Better to be safe than sorry, they decided to visit the Swedish Medical Center ER. “It was late at night so we couldn’t see our doctor and having pain on her left side, ‘heart attack’ came to mind,” says Patrick.

“It was really quiet at the medical center and hardly anyone was in the waiting room. It was very casual. I escorted my wife to a bed and she was given the rudimentary procedures: temperature and blood pressure check and the stethoscope checked her heartbeat. A nurse said it looked like a pinched nerve and a few minutes later, a doctor came in. He gave my wife a quick neck massage and concurred with the nurse. ‘You will be fine in a few days, just relax,’ he said. We were sent home with prescription-strength pain killers, and a muscle relaxant.”

Patrick was also sent home with a bill for the emergency room charge of $150. No other tests were done. Patrick said that at no time was there any sense of urgency. “We felt silly about going there but it gave us peace of mind, which didn’t last long…

“About a week ago I received THE BILL. I had a mini heart attack when I saw that we were charged $1,400, and that is the deductible charge that we have to pay! I couldn’t believe it and my wife started crying. She was sorry that we went to the ER for no reason.”

Apparently the Swedish Medical Center thought it was reason enough to charge thousands of dollars. Based on the symptoms described, they had admitted Ann at a Level 4 Triage. Patrick immediately phoned the clinic, wanting an explanation.

“I was trying to be patient with the person on the other end of the phone, I was trying not to flip out,” he says. “I explained that we were never rushed and she was definitely not treated like someone experiencing an emergency situation, such as a heart attack. The administration woman said, ‘If you are disputing the claim you will have to indicate that.’ ‘Yep, that is what I am doing,’ I said. ‘But I already know you are going to reject my claim, because you are in the business of making money. And you will side with the hospital, so what is the next step?’

‘You will have to file a formal appeal to the appeals office,’ she said.

“I got the rejection letter last week and I had to laugh. It said, ‘You came to us with Level 4 complaints and you have to pay for Level 4 care, including administration and patient communication fees.’ It was total bullshit. I replied that I will pay for services rendered, but no services were rendered and you shouldn’t be able to apply a sliding scale to pushing papers.”

Patrick understands that the administration and “patient communication fees” were also billed as a Level 4. In other words, paperwork also has a sliding scale. The admin woman told him that sliding scales are standard for hospitals and they are allowed to charge for different levels of service.

“This explanation really got my blood boiling,” adds Patrick. “They didn’t all of a sudden do a better job of sliding the paper across the desk. If this is the case, I should be able to walk in with a gunshot wound, ask for a bandage and stitches and get billed at a lower rate because I didn’t ask for Level 4.”

So who told the Swedish Medical Center to treat Ann at Level 4? She wasn’t given emergency treatment and she wasn’t given thorough tests, such as an EKG. Patrick argues that they should have been told right away that the Center was going to charge them at Level 4 rate. Patrick and Ann arrived at the ER around 11 pm and spent less than one hour there. Most of that time was spent waiting for the prescriptions.

Patrick says he submitted a formal dispute to Swedish Medical’s corporate claims office but has zero hope with them. He would rather dispute these emergency room fees with an experienced ER overcharges attorney.

From Patrick, December 29:
Nice work. Thanks so much for the help. Hopefully someone can put some heat on Swedish [Medical Center] that will urge them to be a little fairer in their business practices and charges. Unfortunately experiences like mine that seem to be the norm, not the exception. It's no wonder that there's such distrust and downright hatred toward the medical system. It's a disgraceful state that you're more scared of the bills than the actual health issues. I shouldn't be fearful of getting wiped out financially, but sadly hospitals care more about making money at the expense of it's patients.

Thank you, Patrick Hook