'Something is wrong with the system’: Teacher says ER bill was too high for visit

'Something is wrong with the system’: Teacher says ER bill was too high for visit

CHARLOTTE — Ron Crider said he broke his leg more than 1 ½ years ago.

He said everything was fine until recently.

“I had just this massive pain in the back of my leg,” he told Action 9′s Jason Stoogenke. “And I was, like, ‘This is not right.’ I said, ‘Something’s really weird.’”

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He said his regular doctor was afraid it could be a blood clot and told him to go to the emergency room.

“I was there for all of 40 minutes max, and the doctor saw me for, I’d say 12 minutes max.”

Crider said doctors performed an ultrasound, told him everything was OK, and sent him home. Then he got the first bill.

“My portion is $2,200,” he said.

Crider is a French teacher at Porter Ridge High School in Union County and has insurance.

“I mean, I can pay it. It’s not like I can’t afford to pay it,” Crider said. “That’s not the point. I don’t understand how they can charge the fees they are charging for so little service. I am one person. I am fortunate. I have the means. I can pay it but it’s wrong. There’s something wrong with the system.”

Atrium Health said, "When a patient comes to an Atrium Health emergency department, our primary goal is providing the often life-saving care they need. Following the care they receive, charges are assessed based on several factors, including the level of care needed, tests required and the severity of the illness. There are also facility fees assessed for treatment administered in the emergency department of most hospitals, which are necessary to pay for the costs of the space, state-of-the-art technology and medical expertise in that area.

“While HIPAA regulations and patient privacy laws prevent us from sharing details of this case, patient out-of-pocket costs are often dependent on a number of factors, including co-pays and deductibles that are part of a patient’s personal health insurance benefit. We recognize healthcare expenses are often unplanned events for our patients and we work diligently to ensure our costs are consistent with the level of care we provide. Atrium Health is committed to empowering patients to make informed decisions about their healthcare and provide financial counseling and assistance for all eligible patients to help with their healthcare expenses.”

Crider’s ER visit was in-network. Many states have laws about what you can be charged out-of-network, including North Carolina but not South Carolina.

North Carolina laws protect people with HMOs or PPOs when it comes to emergency services for out-of-network doctors but not when it comes to out-of-network facilities, ambulance services or non-emergencies.

The Health Care Cost Institute released a major study last year.

It found the average ER bill went up 176% over the past decade, not including medicines or certain tests.

So what can you do about your bill?

  1. Ask for an itemized one. See exactly what you were charged for and if it’s accurate.
  2. If you see the actual medical codes, ask your insurance what those codes mean and, again, see if that’s the service you received. Coding can make a huge difference in price.
  3. Ask the hospital if you get a discount for paying sooner or paying partly in cash.
  4. Ask the hospital about its assistance programs. For example, Atrium Health has this program.
  5. Before you pay an out-of-network bill, run it by your insurance to see if it’ll cover more of it.
  6. If you see problems on your bill, be persistent. Some people hire lawyers to fight the tab but, obviously, you have to weigh that cost.
Action 9: Charlotte woman thought she asked right questions, still surprised by medical bills