On Why I Think Our Healthcare Costs So Much
A few weeks ago we made our final payment on the hospital bill from our son's visit to the local emergency room from May of 2018. After a year of conversations with representatives from the hospital, other medical providers the hospital contracts with, our insurance company, and even our state's Attorney General office, we can finally put the matter behind us. However, thinking about the entire experience continues to bring me unparalleled levels of frustration, and in my view indicative of why so many consider the healthcare system in the United States to be "broken". And I wouldn't even consider our case to be particularly traumatic, especially given stories of what other people, and families, have had to go through in attempting to navigate the convoluted waters of medical billing.
During my wife's benefit open enrollment in December of 2017, we decided to switch our health insurance to a high deductible plan with an attached health savings account. We were done having kids (as previously discussed) and hadn't been to the doctor much in the past few years beyond our annual check-ups. We figured what we might pay out of pocket for our few prescriptions and any unexpected doctor visits could be covered by the savings we would get from lower premiums and contributions to our HSA. Of course we should have anticipated that making such a change would result in unanticipated trips to the doctor for a variety of things. The most significant being a trip to the ER with our son.
I'll refrain from publicly calling out the health care organization whose medical facilities we typically use, but if you know where we live, you can likely connect the dots. If you live in the same area, odds are high you utilize their services too, as we don't have many options, despite living in a metropolitan area of 200,000 people. This is not to say that we've been dissatisfied with the service that we've received when seeing medical providers who practice under this particular organization. We've always been impressed with the level of care the medical providers have given us, and particularly our children. I've commented before that I'm tempted to write our children's pediatrician into our will. Unfortunately, the experience of dealing with the financial side of providing that care has underscored how even our local health care organization contributes to the "broken" system so many people bemoan, while undermining the work of the dedicated professionals who actually provide care.
The whole reason our son ended up at the ER wasn't even a particularly exciting story. He sustained a cut under his eye following a scooter injury. And it wasn't even an epic fall, which one could have expected given how he had taken to flying around on that thing, given us mild panic attacks at times. Instead, while he was attempting to turn around, his feet got tangled up in the scooter and he fell to the ground, with the end of the handlebar catching him right under the eye. He was even wearing his helmet, since I'm not a completely negligent parent.
Initially, I even questioned if I should bring him in to get checked out. He was awake and coherent. The blood from the cut seemed to be stopping, and the sympathy cries from his older sister were actually louder than his own. Like any good 21st century parent, I naturally hopped on WebMD to see what anonymous medical professionals from the internet suggested. It seemed apparent that stitches would be a likely scenario if I took him in, but my research informed me that the main purpose of stitches was cosmetic. Considering our new health insurance plan, and how much stitches might possibly cost, I pondered if it would really be worth it. The more I read though, the more I feared the location of the cut might impact his vision. A scar I could live with, compromising my son's vision because I was concerned about how much it might cost was something else.
So I opted to take him in^, his sobbing sister in tow. But in effort to keep the cost of the trip as reasonable as possible, I decided to start with the pediatric walk-in clinic, which treated kids for a variety of things, minor lacerations included. And when the pediatrician in the walk-in clinic recommended that we take him to the Emergency Room to be evaluated, I think he could sense my hesitation as he reiterated that they would be best able to look for damage to his eye sight, and that we should take him now - not tomorrow or whenever our next monthly contribution to our HSA was made.
We would like to think that the potential cost of care would not make us reluctant to bring our kids in to be seen for illness or injury, but it certainly plays a factor. There are countless stories of people forgoing care for themselves or their kids because of the anticipated costs of that care. Even my wife, herself a medical provider who would do everything possible to ensure our kid's health and safety, including sacrificing her own well being (or more likely her husband's), rhetorically wondered aloud how much a trip to the ER was going to cost us.
Initially we thought we might come out "not bad". One of the most frustrating things about health care in the US is that there is little transparency in the pricing. Under a new rule from the Center for Medicare and Medicaid Services, hospitals are supposed to post their pricing online*, and as I've learned from our state Attorney General's Office, patients can request an estimate of what a procedure will cost before consenting to it. Something to consider next time you are wheeled into the ER while bleeding profusely. We anticipated that any trip to the ER would be expensive, especially given our high deductible, but when the doctor looked at our son, determined that he didn't need any further attention - no stitches or evals for potential head injury - and promptly discharged him, we figured it wouldn't be "as expensive". Even though we really had no idea how much "expensive" and "not as expensive" would actually be.
We were about to find out though, as upon bringing our son back to the car, he threw up all over himself. This sent my wife back into the ER with him to be readmitted (I had to head home with his sister to ensure his other sister wouldn't get off the bus from school to an empty house). This time they suggested a CT Scan to check for possible head trauma. Whether the doctor sensed any hesitation from my wife - based on the fact that CT scans emit some amounts of radiation or because they just sound expensive - he assured her that he would do the same for his own child. Luckily the imaging came back negative, and when he was eventually discharged, we felt confident knowing that he would make a full recovery after being treated by competent and compassion providers.
Then the bills came. I've read quite a bit about the current state of health care in the US, but I was still a little surprised when the first bill we got for our ER trip came not from the hospital, but an emergency physicians association. When another bill came, again not from the hospital but from a regional radiology clinic, I realized that our local hospital, like many others throughout the US, contracts out a variety of its services. Calls to the billing office at the hospital and these other entities, as well as our insurance, confirmed that this was the case. When I pressed as to why the billing was done this way, each entity acknowledged that the process could be better streamlined, but indicated that billing in such a manner was "industry standard".
So when the bill from the hospital finally came, I was a little confused to see two charges for things that looked similar to what the other bills I had already; an emergency room charge and a radiology charge. When I asked for a more detailed bill, I received one that now had three charges; two for emergency room fees (since he had been admitted twice) and one for the CT Scan. When I informed a not-so-friendly patient financial services representative that I was having a hard time understanding our bill and didn't feel comfortable paying it, she told me to follow up with the medical records office - a process that takes 4-6 weeks to get medical records released. When the records finally came, they provided an insightful, and at times humorous, narrative into the treatment our son received, but didn't shed any light on how that treatment translated into the charges on our bill. Another not-so-friendly patient financial services representative (maybe it was the same one) made it clear that the bills we received from the hospital were the most detailed that they could send us, and we would have to decide if we felt the amount we were charged seemed reasonable.
While this process played out, I did some research. I found out that the CT Scan they performed cost about 20% of the price the hospital negotiated with the insurance company - the cost we were being asked to pay in full because of the health plan we had, and because we had not hit our (astronomical) deductible. I also found out that had we been uninsured, we would have been given a 40% discount on that price. I also found out that it is considered insurance fraud, and subsequently illegal, to claim that you don't have insurance in effort to receive that discount. And while the price comparison might not be exact, I also learned that a local imaging clinic would have charged us about 25% of what the hospital charged for the CT Scan, with the reading of that scan included.
Now, I know what you are thinking. But there has to be a mark-up on a procedure, how else can they operate their facility. Plus you went to the ER, the most expensive place to get care. You can't really compare prices of a CT Scan at an ER with that of a scan at an imaging clinic. Valid points. But, given that there is no where else to compare your pricing, and only one ER in a 30 mile radius, that is where one would have to look to try to understand if they are being reasonably charged. Couple this with the fact that the hospital is already charging an ER facility fee, and the doctor fees and radiology reading fees are billed separately, it doesn't seem like the procedure cost should be that much more expensive. Yes, I would expect a mark-up, but a 5 time mark-up on a vulnerable audience, that seems, in the words of the medical director of the very ER we visited, "criminal".
Then the bills came. I've read quite a bit about the current state of health care in the US, but I was still a little surprised when the first bill we got for our ER trip came not from the hospital, but an emergency physicians association. When another bill came, again not from the hospital but from a regional radiology clinic, I realized that our local hospital, like many others throughout the US, contracts out a variety of its services. Calls to the billing office at the hospital and these other entities, as well as our insurance, confirmed that this was the case. When I pressed as to why the billing was done this way, each entity acknowledged that the process could be better streamlined, but indicated that billing in such a manner was "industry standard".
So when the bill from the hospital finally came, I was a little confused to see two charges for things that looked similar to what the other bills I had already; an emergency room charge and a radiology charge. When I asked for a more detailed bill, I received one that now had three charges; two for emergency room fees (since he had been admitted twice) and one for the CT Scan. When I informed a not-so-friendly patient financial services representative that I was having a hard time understanding our bill and didn't feel comfortable paying it, she told me to follow up with the medical records office - a process that takes 4-6 weeks to get medical records released. When the records finally came, they provided an insightful, and at times humorous, narrative into the treatment our son received, but didn't shed any light on how that treatment translated into the charges on our bill. Another not-so-friendly patient financial services representative (maybe it was the same one) made it clear that the bills we received from the hospital were the most detailed that they could send us, and we would have to decide if we felt the amount we were charged seemed reasonable.
While this process played out, I did some research. I found out that the CT Scan they performed cost about 20% of the price the hospital negotiated with the insurance company - the cost we were being asked to pay in full because of the health plan we had, and because we had not hit our (astronomical) deductible. I also found out that had we been uninsured, we would have been given a 40% discount on that price. I also found out that it is considered insurance fraud, and subsequently illegal, to claim that you don't have insurance in effort to receive that discount. And while the price comparison might not be exact, I also learned that a local imaging clinic would have charged us about 25% of what the hospital charged for the CT Scan, with the reading of that scan included.
Now, I know what you are thinking. But there has to be a mark-up on a procedure, how else can they operate their facility. Plus you went to the ER, the most expensive place to get care. You can't really compare prices of a CT Scan at an ER with that of a scan at an imaging clinic. Valid points. But, given that there is no where else to compare your pricing, and only one ER in a 30 mile radius, that is where one would have to look to try to understand if they are being reasonably charged. Couple this with the fact that the hospital is already charging an ER facility fee, and the doctor fees and radiology reading fees are billed separately, it doesn't seem like the procedure cost should be that much more expensive. Yes, I would expect a mark-up, but a 5 time mark-up on a vulnerable audience, that seems, in the words of the medical director of the very ER we visited, "criminal".
Now, I also know what you are thinking. But that is the insurance plan you signed up for. If you paid higher premiums, you'd have better coverage, and you wouldn't have to pay the full cost of the care. Again, a valid point. But this, in my view, is big part of why I think healthcare is so expensive in our country. Even if I am not paying that amount out of pocket, I am paying for my insurance company to pay that amount for the procedure. My insurance company can in turn, raise my premiums in subsequent years and reduce my benefits, as they typically do year after year, to cover the cost of this care. If a procedure cost seems excessive to me, given what it costs a medical facility to do and given what you could potentially pay elsewhere, or what the facility would accept if you were uninsured (and presumably unable to pay full price or afford insurance), then I would hope it would seem excessive to my insurance company, who is supposed to be "negotiating in good faith" with medical providers on behalf of their customers.
What this boils down to is that once someone pays to much for healthcare, we all pay too much for healthcare. Once an insurance company agrees to reimburse a certain amount for something, that sets the standard for what the procedure will cost, regardless of what insurance you do, or do not have. And while we might paying varying out of pocket prices for that procedure, we all inevitably pay full price for that procedure. Even when a facility offers a significant discount to someone who is uninsured, or is forced to accept a significantly lower reimbursement from Medicare or Medicaid, that cost is eventually dispersed amongst the remaining healthcare consumers, which is all of us.
I eventually paid the hospital bill. But not all of it. Taking the advice of one of those not-so-friendly Patient Financial Services Representatives, I made a payment of what I thought was reasonable, given the care our son received and the price of that care relative to its cost, and what seemed to me to be reasonable comparisons. I agreed to pay what an uninsured patient would pay for the CT Scan -essentially the cash price, along with one of the ER Facility Fees#. This came out to be about 60% of what our final bill was. With my payment, I included a three page letter on why I believed that amount to be sufficient, and informed the hospital I would be happy to speak with someone if they did not agree with my explanation. They processed my payment and I heard nothing from them, so I considered the matter closed.
Then I kept getting bills. I followed up with them again. Did they not see the letter? Hard to assume given that my payment was wrapped up inside it. A friendlier-than-the-last person I spoke with in Patient Financial Services indicated that there was no indication of them receiving the letter, and subsequently reading it. So I sent it again (I should have been taking off money for postage by this point). And then sent it again to someone in the Patient Advocacy Office, as well the Vice President for Billing, who might have read it (but it didn't seem like), but assured me that their billing procedures are accurate and I would continue to get bills until it ultimately went to collections.
Eventually I reached out to the Minnesota Attorney General's Office, a suggestion unknowingly made by someone in the hospitals Patient Advocacy Office (it was through that office, that I learned about the uninsured discount). After a cordial, but relatively unproductive conversation, a representative from the AG's office contacted the hospital on my behalf, and we essentially repeated the negotiation process over the next few months, this time with him as an intermediary. Eventually, the hospital offered to apply the self-insured discount for the remaining balance of the bill, bringing it down another 40%. By this point I was ready to have the process behind us, and we paid the balance - no lengthy protest letters.
While this could be considered a (small) win for me personally, it likely won't provide any benefit to others who find themselves in a similar situation. If the hospital is only willing to bill a (somewhat) more reasonable price when people challenge that price (rather extensively), it will have little effective on making health care billing more transparent and ultimately more affordable in my view. I momentarily contemplated allowing the hospital to take me to collections, or maybe even sue me to collect the balance (as some hospitals have started to do to their own employees who can't pay their medical bills), but I knew the odds of any significant change coming about by my protests would be minimal (and likely much more costly on my end). I also contemplated, despite all of my protests, just paying the full balance of the original bill as a kind of "reverse middle finger".
So to (finally) get to the point of my subheading, this is why I think healthcare in the US is so expensive. Because it can be and we allow it to. And the only way that we can push back against it is to be the problem customers who complain and challenge when bills seem excessive, which they typically always do. This is not to say that providing healthcare isn't an expensive endeavor, or that we should expect life saving procedures to cost next to nothing. But for a vast majority of our medical needs (and specifically needs as opposed to wants), we are beholden to what medical providers charge - and often times the people who are actually providing the physical care have little to no idea how much the services they are providing actually cost. When we question charges, we assured that everything was billed correctly, which makes perfect sense, given that the people in that very office are the ones who determine what the cost will be.
I don't have a magic answer on how to make healthcare more affordable, or more effective, in this country. And apparently no one else really does either, particularly the health care execs who are supposed to be the "experts". But like a lot of things we gripe about, certain changes have to start with us. As a whole, we don't do a very good job taking care of ourselves. There is little coincidence that some of the top causes of death in the US are largely seen as preventable- heart diseases, certain cancers, diabetes, etc. We have also created an environment that precipitates a decline in well being, while doing little to incentivize people to live healthier lifestyles. As I mentioned in the midst of an intense, and somewhat alcohol fueled, discussion on healthcare this past weekend, no matter how healthy you try to be, your healthcare will always get more expensive.
But it is also up to us to push back on excessive charges and to demand transparency. At times this might cause people to question our commitment to our health, or that of our loved ones. However, there is a cost to the care that is provided, and just knowing that that care is going to be expensive, and possibly unaffordable, even with insurance, can lead to people rationing care for themselves or their loved ones as a consequence. If it seems cold to inquire about the cost of a procedure for yourself or your child, and wonder about the necessity of that procedure, before it being done, than should we not be able to scrutinize those charges after we get them, at times months after the fact? We shouldn't have to submit our excessive medical bills to media outlets in hopes that a public airing of those charges will result in a hospital drastically adjusting the bill.
Ultimately, I would like us to get to a point where people can get the care that they, or their loved ones need, without needing to worry about the financial consequences. We should also allow medical professionals to provide the care that is necessary to help their patients without being concerned on how they will be compensated for that care. We shouldn't live in a country where the number one reason people go bankrupt is related to a medical issue. Nor should we live in a country where doctors commit suicide at double the rate of the rest of the public. I believe that people would much rather be healthy, and would prefer avoiding receiving medical care as much as possible. But this does not mean that they should avoid receiving it when they need it because they cannot afford it.
Does this sound like free health care for all, as one of my weekend conversation partners suggested? Not necessarily. We already spend so much per person on health care in the US that some argue we could cover the cost of care for most everyone, especially since a vast majority of those dollars are spent on a small number people. Does that mean a more regulated system, that democratizes care across all Americans, regardless of their income levels? Probably. Does it mean health care rationing? Possibly, but as we know, that already happens in our current system. Does it sound expensive? Absolutely, but so is our current system, and it certainly doesn't show any signs of getting better.
As parents we want our kids to be healthy. We know we can't shield them from all pain, nor should we necessarily want to. But when they get hurt, if it seems serious enough for them to be seen by a medical professional, we shouldn't feel hesitation because we are concerned about the cost. When a trained medical professional suggests a certain type of treatment, we shouldn't have to contemplate what impact that might have on our finances. Or when we see our health insurance premiums rise year after year, while our benefits dwindle, we shouldn't wonder how that might effect our ability to put food on the table.
I don't have the answers, but I know those scenarios, which many of us have likely been in, are not the ones that we want. Until those scenarios no longer exist, I will continue to advocate for more effective and affordable care for myself and my loved ones, and I will challenge and push back when I believe that is not the case. I would encourage you to do the same.
Thanks for staying with it. I know it got long. I've read a lot (probably too much) about health care. If you'd like to do the same, here are some additional resources I'd recommend.
Catastrophic Care by David Goldhill
An American Sickness by Elisabeth Rosenthal
If Our Bodies Could Talk by James Hamblin
Shots - Health News by NPR
VoxCare - Vox's Health Care Newsletter - Anything by Sarah Kliff (now with the NYT) or Ezra Klein is particularly insightful
Kaiser Family Foundation
What this boils down to is that once someone pays to much for healthcare, we all pay too much for healthcare. Once an insurance company agrees to reimburse a certain amount for something, that sets the standard for what the procedure will cost, regardless of what insurance you do, or do not have. And while we might paying varying out of pocket prices for that procedure, we all inevitably pay full price for that procedure. Even when a facility offers a significant discount to someone who is uninsured, or is forced to accept a significantly lower reimbursement from Medicare or Medicaid, that cost is eventually dispersed amongst the remaining healthcare consumers, which is all of us.
I eventually paid the hospital bill. But not all of it. Taking the advice of one of those not-so-friendly Patient Financial Services Representatives, I made a payment of what I thought was reasonable, given the care our son received and the price of that care relative to its cost, and what seemed to me to be reasonable comparisons. I agreed to pay what an uninsured patient would pay for the CT Scan -essentially the cash price, along with one of the ER Facility Fees#. This came out to be about 60% of what our final bill was. With my payment, I included a three page letter on why I believed that amount to be sufficient, and informed the hospital I would be happy to speak with someone if they did not agree with my explanation. They processed my payment and I heard nothing from them, so I considered the matter closed.
Then I kept getting bills. I followed up with them again. Did they not see the letter? Hard to assume given that my payment was wrapped up inside it. A friendlier-than-the-last person I spoke with in Patient Financial Services indicated that there was no indication of them receiving the letter, and subsequently reading it. So I sent it again (I should have been taking off money for postage by this point). And then sent it again to someone in the Patient Advocacy Office, as well the Vice President for Billing, who might have read it (but it didn't seem like), but assured me that their billing procedures are accurate and I would continue to get bills until it ultimately went to collections.
Eventually I reached out to the Minnesota Attorney General's Office, a suggestion unknowingly made by someone in the hospitals Patient Advocacy Office (it was through that office, that I learned about the uninsured discount). After a cordial, but relatively unproductive conversation, a representative from the AG's office contacted the hospital on my behalf, and we essentially repeated the negotiation process over the next few months, this time with him as an intermediary. Eventually, the hospital offered to apply the self-insured discount for the remaining balance of the bill, bringing it down another 40%. By this point I was ready to have the process behind us, and we paid the balance - no lengthy protest letters.
While this could be considered a (small) win for me personally, it likely won't provide any benefit to others who find themselves in a similar situation. If the hospital is only willing to bill a (somewhat) more reasonable price when people challenge that price (rather extensively), it will have little effective on making health care billing more transparent and ultimately more affordable in my view. I momentarily contemplated allowing the hospital to take me to collections, or maybe even sue me to collect the balance (as some hospitals have started to do to their own employees who can't pay their medical bills), but I knew the odds of any significant change coming about by my protests would be minimal (and likely much more costly on my end). I also contemplated, despite all of my protests, just paying the full balance of the original bill as a kind of "reverse middle finger".
So to (finally) get to the point of my subheading, this is why I think healthcare in the US is so expensive. Because it can be and we allow it to. And the only way that we can push back against it is to be the problem customers who complain and challenge when bills seem excessive, which they typically always do. This is not to say that providing healthcare isn't an expensive endeavor, or that we should expect life saving procedures to cost next to nothing. But for a vast majority of our medical needs (and specifically needs as opposed to wants), we are beholden to what medical providers charge - and often times the people who are actually providing the physical care have little to no idea how much the services they are providing actually cost. When we question charges, we assured that everything was billed correctly, which makes perfect sense, given that the people in that very office are the ones who determine what the cost will be.
I don't have a magic answer on how to make healthcare more affordable, or more effective, in this country. And apparently no one else really does either, particularly the health care execs who are supposed to be the "experts". But like a lot of things we gripe about, certain changes have to start with us. As a whole, we don't do a very good job taking care of ourselves. There is little coincidence that some of the top causes of death in the US are largely seen as preventable- heart diseases, certain cancers, diabetes, etc. We have also created an environment that precipitates a decline in well being, while doing little to incentivize people to live healthier lifestyles. As I mentioned in the midst of an intense, and somewhat alcohol fueled, discussion on healthcare this past weekend, no matter how healthy you try to be, your healthcare will always get more expensive.
But it is also up to us to push back on excessive charges and to demand transparency. At times this might cause people to question our commitment to our health, or that of our loved ones. However, there is a cost to the care that is provided, and just knowing that that care is going to be expensive, and possibly unaffordable, even with insurance, can lead to people rationing care for themselves or their loved ones as a consequence. If it seems cold to inquire about the cost of a procedure for yourself or your child, and wonder about the necessity of that procedure, before it being done, than should we not be able to scrutinize those charges after we get them, at times months after the fact? We shouldn't have to submit our excessive medical bills to media outlets in hopes that a public airing of those charges will result in a hospital drastically adjusting the bill.
Ultimately, I would like us to get to a point where people can get the care that they, or their loved ones need, without needing to worry about the financial consequences. We should also allow medical professionals to provide the care that is necessary to help their patients without being concerned on how they will be compensated for that care. We shouldn't live in a country where the number one reason people go bankrupt is related to a medical issue. Nor should we live in a country where doctors commit suicide at double the rate of the rest of the public. I believe that people would much rather be healthy, and would prefer avoiding receiving medical care as much as possible. But this does not mean that they should avoid receiving it when they need it because they cannot afford it.
Does this sound like free health care for all, as one of my weekend conversation partners suggested? Not necessarily. We already spend so much per person on health care in the US that some argue we could cover the cost of care for most everyone, especially since a vast majority of those dollars are spent on a small number people. Does that mean a more regulated system, that democratizes care across all Americans, regardless of their income levels? Probably. Does it mean health care rationing? Possibly, but as we know, that already happens in our current system. Does it sound expensive? Absolutely, but so is our current system, and it certainly doesn't show any signs of getting better.
As parents we want our kids to be healthy. We know we can't shield them from all pain, nor should we necessarily want to. But when they get hurt, if it seems serious enough for them to be seen by a medical professional, we shouldn't feel hesitation because we are concerned about the cost. When a trained medical professional suggests a certain type of treatment, we shouldn't have to contemplate what impact that might have on our finances. Or when we see our health insurance premiums rise year after year, while our benefits dwindle, we shouldn't wonder how that might effect our ability to put food on the table.
I don't have the answers, but I know those scenarios, which many of us have likely been in, are not the ones that we want. Until those scenarios no longer exist, I will continue to advocate for more effective and affordable care for myself and my loved ones, and I will challenge and push back when I believe that is not the case. I would encourage you to do the same.
 |
| I think his pride (what little a 4 y/o has) was hurt the more than anything else. While he was very anti-selfie for the next few weeks, he was back on the scooter the next day. |
Thanks for staying with it. I know it got long. I've read a lot (probably too much) about health care. If you'd like to do the same, here are some additional resources I'd recommend.
Catastrophic Care by David Goldhill
An American Sickness by Elisabeth Rosenthal
If Our Bodies Could Talk by James Hamblin
Shots - Health News by NPR
VoxCare - Vox's Health Care Newsletter - Anything by Sarah Kliff (now with the NYT) or Ezra Klein is particularly insightful
Kaiser Family Foundation
^When you have a sick or injured child, "taking them in" tends to become shorthand for bringing them to be seen by a trained medical professional
*This came into effect at the start of 2019, so it wouldn't have helped us in May of 2018 for our particular visit. I did find the information on hospitals website though, and the price list for procedures looks as though it was basically lifted from a medical coding textbook. I challenged representatives in the Billing Office of the hospital to point out on the list what procedure our son had undergone. I never got a response.
#The Emergency Physicians Association that provides the doctors for this particular ER had a policy of not billing for multiple ER visits in a given day. This seemed to make sense to me, and I figured if the doctors the hospital contracted with did this, the actual hospital should do it to.
#The Emergency Physicians Association that provides the doctors for this particular ER had a policy of not billing for multiple ER visits in a given day. This seemed to make sense to me, and I figured if the doctors the hospital contracted with did this, the actual hospital should do it to.
