Skiers, MTBers, anybody active, beware

[Benny Profane]

The latest method of ripping off the American public by greedy hospitals. Trauma fees. It could happen to you, and your insurance won't cover it.

https://www.nakedcapitalism.com/2018...ill-18000.html

[old goat]

The case where the nurse's insurer negotiated a lower payment and then SFGH came after the patient is particularly egregious and probably illegal on the part of the hospital, the insurer, or both. My kid crashed his bike in Maryland--destroyed his helmet--and Kaiser got a hefty bill in which the billing didn't seem to reflect the level of care, but Kaiser asked us what care he received and then said they'd deal with the hospital. We never heard any more about it. Generally speaking your insurance will cover it but of course it drives up the cost of insurance. If the insurer does decide to pay a fraction and bill you for the rest a complaint with the insurance commissioner is worth a try.

If confronted by a trauma fee for minor ER care I would fight it aggressively. It might also be worth having an attorney write a letter to the hospital. We had a couple of contractors send fraudulent overcharges to collection. A lawyer friend said that the collection agencies won't do anything if a charge is under dispute. He sent the collection agencies nasty letters and they lost interest in collecting. Nothing on our credit report about it.

SFGH is not the worst. That would be UCDavis Med Center in Sacramento--highest ER fees in the country. While there is a legitimate reason for trauma fees, especially for smaller community hospitals that could not otherwise offer trauma center care, the big hospitals like SFG and UCD use the ER and trauma fees to finance expansion of other parts of the medical center.

I was on a jury panel for a personal injury case. The judge said that there would be testimony from UCD doctors X and Y and from the billing department and did any of us know any of these witnesses. I told him I knew Drs X and Y and that the billing department was crooked. He was not pleased with me for saying that in front of the other prospective jurors but I was tossed from the panel.

In the meantime stay away from the ER for minor stuff, if you do go to the ER try not to go to a designated trauma center.

[Benny Profane]

And try not to get put into the back of an ambulance, if possible. Not only the ambulance fee, which is pretty hefty these days, but, as stated in this article, an EMT can set the whole trauma thing in motion with a short call ahead.

[Core Shot]

An ambulance brought him to the Level 3 trauma center after a minor motorcycle accident, when he took a turn too quickly and fell from his bike. Records show that he was alert with normal vital signs during the 4-mile ambulance ride, and that the ambulance staff alerted the hospital that the incoming patient had traumatic injuries.

He was at the hospital for only about half an hour for a minor cut on his head, and he didn’t even need X-rays, CAT scans or a blood test.

“The only things I got were ibuprofen, two staples and a saline injection. Those were the only services rendered. I was conscious and lucid for the whole thing,” said Hausen.

But because the ambulance medics called for a trauma team, the total for the visit came to $26,998 — and the vast majority of that was the $22,550 trauma response fee.

[Kenny Satch]

We are so lucky in Canada to have universal health care.
Sure it's not perfect but it won't destroy us financially

[Benny Profane]

Yeah, but, I bet you have to wait so much longer for that ambulance.

[Thurgood Jenkins]

It is better to be uninsured than underinsured.

[old goat]

Trauma protocol in Sacramento requires anyone ejected from a vehicle to be taken to a trauma center, so when a 3 year old was ejected from a vehicle he was taken by ambulance to a trauma center--UCD was the only one at the time. He was duly charged the trauma rate of $27,000 (it was a long time ago, the fee would be much higher now) for trauma activation and management of his head injury.
The vehicle from which he was ejected was a tricycle.
The head injury required 4 stitches. There was no loss of consciousness and he was not kept for observation.

[cinnepa]

im thinking belgium or ireland looking better everyday.....i know my wife had it with this country..she'd jump tomorrow.

[Dantheman]

According to Medicare guidelines, the fee can be charged only when the patient receives at least 30 minutes of critical care provided by a trauma team — but hospitals do not appear to be following that rule when billing non-Medicare patients.
...

Hospitals were supposed to come up with the fee for this service by looking at the actual costs of activating the trauma team, and then dividing it over the amount that their patients are likely to pay. Hospitals that see a lot of uninsured and Medicaid patients might charge more to patients with private insurance to make up for possible losses. But soon, Potter said, some hospitals began abusing the fee by charging an exorbitant amount that seemed to be based on the whims of executives rather than actual costs.

Single. Fucking. Payer.

It is better to be uninsured than underinsured.

Only if you have no job and no assets.

[Kenny Satch]

Yeah, but, I bet you have to wait so much longer for that ambulance.

Not at all but it can take 8 hours before you get treatment .As for serious trauma there is no waiting.

[reckless toboggan]

Yeah, but, I bet you have to wait so much longer for that ambulance.

That's a lie.

[Dantheman]

Benny knows that, that's the joke.

[Benny Profane]

Um, yeah.

[Sirshredalot]

im thinking belgium or ireland looking better everyday.....i know my wife had it with this country..she'd jump tomorrow.

Yeah, man. I occasionally see potential work in Dublin for me. It's tempting. The wife would be 1000% on board.

[Elkhound Odin]

All I learned from this is don't go to an emergency room withing a 100 mile or so of San Francisco.

[reckless toboggan]

MURICA! FUCK YAH!

[grinch]

Well the the alternative would be socialism. Socialists go to HELL!! HELL I SAY!!!!!

[snapt]

I've seen it go both ways, we have 3 levels of trauma activation here. I'll withhold if a patient is fine even if the mechanism justifys the lowest tier to save them some funds. Even so the hospital can still call the activation upon arrival.

I've also been working in an ER where a dude was stabbed, EMS said he was stable, vitals fine, and the wound was superficial so no Trauma activation was in place. Upon arrival he promptly coded and we found a nicked vena cava. Suffice to say we were all caught with out pants down.

It's a slippery slope for sure, a lot goes on in the back end for trauma activation to justify the costs in many cases. You have to page out a Trauma team who may or may not be there, including surgeons, CT/Radiology, Pharmacy etc.

[Benny Profane]

Well, great, but, I'm afraid were going to hear more stories like this. Sad.

https://www.huffingtonpost.com/entry...b09e4a8b283583

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[Jong Lafitte]

Benny knows that, that's the joke.

LOL, and a funny one at that.

"THEY HAVE TO WAIT LONGER FOR KEEER!!!!"
"THEY TOOK OUR JAAAHHHBS!!!"

[old goat]

Generally speaking hospital billing is done by coders--people with no medical training--who are trained to look through the medical record for certain words and phrases that justify an upcharge and submit bills based on that. Often these words are taken out of context or don't reflect the actual care given. That's why bills can often be successfully fought--by someone with medical training who also understands the coding process; IOW it's tough to do. Likewise, the people at the insurance company have no understanding of the medical care; they're just looking at the same words and phrases.

Most doctors haven't a clue about how hospital coding works; they may or may not understand how the coding for their own professional services works. They are trained to write medical records that reflect the medical facts and have no idea how their choice of words affects billing. Now that the electronic medical record, which relies on doctors filling out template, is primarily a billing tool, the problem is worse. These records are often autopopulated with data, much of it erroneous. For example, an initial diagnosis, perhaps one of several considered, can propagate through the medical record even after it's been discarded. For example--a patient with a headache might have brain tumor considered and ruled out but brain tumor may autopopulate the medical record right up to discharge even thought the patient actually had a tension headache.

The cure is simple--abolish fee for service medical and hospital care so there is no more billing.

[Beaver]

Yeah, but, I bet you have to wait so much longer for that ambulance.

I call bullshit. I got hit by a car riding my bike this year. A witness called 911, the ambulance was there in about 3 minutes. I was admitted, x-rayed, treated and released in about 3 hours. Not too bad for shitty universal healthcare.

[Cono Este]

Oh nooo Benny, you should never suggest such things or post such links. Doctors are above the clergy in a community and can do no wrong.


I typed that trash while sitting in a patient waiting room for an 1 1/2 hrs after my appt.

It all needs to be socialized.


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[johnnyg82]

We are so lucky in Canada to have universal health care.
Sure it's not perfect but it won't destroy us financially

I agree, it's nice.