“I’m Fighting This ER Bill All the Way” Says ER Overcharges Victim

July 2, 2012, 1:30PM. By Jane Mundy

Corsicana, TXActing on the advice of a doctor at her local clinic, Robin went to the Dallas hospital emergency room with symptoms of food poisoning—nausea and diarrhea. Turns out, she simply had a urinary tract infection and was sent home after a few hours with two prescriptions. Then she received an ER bill for more than $3,000. “These Emergency Room Overcharges are ridiculous,” says Robin, “and it is fraudulent billing for services not provided.”

Adding insult to injury, three weeks ago she received another bill for $600, this time from the ER physician at the Navarro Regional Hospital Physician’s Group. It has the same billing address as the hospital in Dallas.

“This doctor saw me for about two minutes when I first got to ER,” says Robin. “He just stuck his head in the door and explained how they would hook me up to an IV because I was dehydrated and go from there. Just before I left he saw me again just to say I was being released and would get a few prescriptions, an antibiotic and a med for nausea." Robin also took home a signed consent treatment form stating she will pay whatever insurance doesn’t pay.

How could the hospital justify this exorbitant amount? Upon her request, the hospital mailed Robin an itemized bill. “For starters I was charged for four Zofran and one Depakote --a medication I take for seizures,” she explains. “One Depakote pill costs me 40 cents but they charged me $438 for one pill that wasn’t even given to me, nor was it given by IV.

“I phoned the hospital’s billing department and said these charges were outrageous and that I was willing to mediate for the services provided for the average price that you pay an insurance company. This woman said she would send me out a charitable form, but I am on SSDI and not eligible.” (Robin has a portfolio and retirement income, and she owns her home so she doesn’t qualify for SSI.)

Robin, a former pharmacy student and social worker for more than 22 years, knows what she is and isn’t entitled to—she used to fill out these charitable forms for her clients. In fact Robin’s clients had faced the same type of billing problems and services not rendered by this same hospital. “Most of my clients didn’t have the benefit of education; they were elderly and confused and had no idea where to turn,” Robin says. "These people certainly are unaware that they could dispute medical bills.

“Even though I had many clients I advocated for, I never thought it would happen to me,” she adds. “I used to call this hospital on their behalf and administration told me they would just write off the bill as charity. Or I would tell them they were on SSI and they would just write it off completely.”

Next up, Robin requested her medical records. “They asked me if I was sending my medical records to an attorney,” Robin says. “I told her they were for me but they might go to an attorney in the future. ‘In that case you have to pay $34,’ she replied. This had now become absolutely ridiculous.”

Then Robin called the Physicians Group and said she could pay them $50 per month. “They sent me another bill yesterday that says I agreed to pay my bill and this physician was available to treat me,” Robin adds. “They are trying to guilt me into paying. Doctors at this hospital receive an average of 35 percent of patient payments, according to the Texas Department of Health and Services.

I also checked out Texas Price Point, which gives the average price per hospital per average stay. And my friend, who works here in Texas for Blue Shield, is going to look up the average settlements. He thinks he can mediate and get it down to $1500. I believe I shouldn’t pay more than $500 so I need an experienced attorney to dispute this bill. And I’m going to stick to my guns.

The hospital asked if I wanted to set up a payment plan but that would be admitting to their charges. I’m not worried about my credit rating either because I’ve had a perfect credit score all my life. It is reassuring that others have filed ER Overcharges lawsuits. I’ve fought many a hard battle in my career; people tell me I need to choose my battles and these ER overcharges has pushed me too far."