r/HospitalBills • u/TortoisePDX • May 10 '25
Hospital-Emergency $1995 ER Bill for 4 stitches in my toe
Cut my toe pretty bad, tried going to urgent care but they were all closed (6:45pm on Sunday) so I ended up just going to the ER. Got 4 stitches and a nice hefty bill. Crazy to me.
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u/Puzzleheaded-Pie9653 May 10 '25
Better said you got 4 stitches placed by a person who college educated themselves 8+ years and then 3-4 yr residency at least, probably already 40 by the time started making money, in a hospital cared for by nurses and received a numbing agent and wound thoroughly cleaned all when everyone else had gone home from work hours ago and no longer available. You received this in a sterile environment using sterile technique with sterile stitches and equipment.
This isn't I got four stitches made of horse hair thread by Pedro Pascal with a rusty nail while taking shots of rum after getting bit by a zombie in a cow pasture.
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u/100mgSTFU May 10 '25
Point taken, but Iâll just add that whomever did the stitching is not getting much of that. Theyâre on an hourly wage and probably got less than $200-300 of this.
Most of it goes to the many many hands that are in that pie. All the supplies are stupidly expensive.
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u/HopefulCat3558 May 10 '25
Thereâs also a building that has to be paid for and all of the equipment and furnishings as well as the costs and people to run the place.
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u/EM_CCM May 11 '25
The idea that an ER doctor is making $200-300 for putting 4 stitches in your toe is downright laughable. If that were the case they would be making a million dollars a year, rather than a quarter of that. Itâs not the doctors making the money, nor setting the prices, nor billing you.Â
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u/100mgSTFU May 11 '25
I kinda assumed that they would be making roughly $300-$350/hr and that between intake, assessment, set-up, suturing, teaching, discharge, clean-up, and charting that one would be getting near the 45 min mark in time spent on that patient. Clearly not spending 45 min doing 4 sutures.
But I donât work in the ED. My broader point, which I think youâd agree with, is that those providing care are not driving the obscene costs.
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u/Ticklemextreme May 13 '25
Laughs at the 550k surgeon salary and 450k anesthesiologist salary. Yup doctorâs salaries have 0 effect in this right????? lol
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u/Macduffer May 13 '25
Doctor salaries are about 10% of the total healthcare system cost. Including inflation, they've actually been going down for about 25 years. So, not really.
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u/BlueLanternKitty May 12 '25
The amount billed to insurance, the amount insurance supposed to pay, and what the provider/hospital receives can be three completely different numbers.
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u/BottleNearby339 May 12 '25
Your argument can be applied to almost any other country minus the $1000+ bill
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u/KovyJackson May 12 '25
The person that did the stitches are not doing 8+ years and residency.
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u/Puzzleheaded-Pie9653 May 13 '25
You don't know what you are talking about. Occasionally you get a doc like me. Not always a mid-level. Yeah, it's 8+ years and five of residency.
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u/Cuberasnap May 14 '25
Yea, not because billionaires have 5 yachts, 7 airplanes, nuclear proof bunkers and 9 mansions. Riiiighhhtt. Youâre telling me youâre OK with billionaires being that rich, while working class people canât afford medical services? Instead of taxing those billionaires and funding those medical services?. We all pay a considerable portion of our wage in taxes, itâs ridiculous that our economy can afford billionaires to live like literal emperors, while working class people struggle just to get their feet stitched. Distopian. Also price gouging by insurances in the medical sector is well documented. Itâs common for something to cost 80 times the value of production. Thatâs just pure evil, itâs like theyâre saying âI know you need this to live and you canât get this anywhere else so Iâm gonna charge you 80 times what it cost me to make it, because I know youâll pay it or die.â Absolutely distopian. And the the largest corporations, who also own the media and our politicians, have convinced us, and you, that this is all normal.
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u/lifelong1250 May 10 '25
Fair. But I had similar care in a hospital in Vietnam by a doctor trained in France and the total was about 150 bucks.
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u/Virtual_Ad1704 May 11 '25
But that building in Vietnam costs the same as the electric bill of any major hospital in the US. Anyone in Vietnam doesn't have 24/7 access to majors hospitals, newest imaging, or most specialized care like trauma surgery or burns hospitals. Not only that but they dont get to sue for millions if they feel wronged or something goes poorly.
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u/Cuberasnap May 14 '25
All of that could be funded by your tax dollars and cost you nothing, we are getting robbed blind of our hard earned tax money and itâs being used to bomb Palestinians.
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u/Virtual_Ad1704 May 14 '25
Tell that to trump voters who want tax cuts for billionaires and cuts to Medicaid. Shit is about to get a whole lot more expensive for the average person
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u/ailema00 May 10 '25
That's a pretty good bill for the Er...
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u/AmbassadorSad1157 May 10 '25
why would insurance not pay anything? Hadn't met deductible? Sunday afternoon and no urgent care requires emergency treatment for suturing.
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u/noachy May 10 '25
Deductible would be my guess.
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u/pseudoseizure May 10 '25
Or out of network.
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u/swellloko May 11 '25
The no surprises act protects against anything higher than your in network cost sharing amount when seeing an out of network provider. See you are protected from balance billing.
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u/NYanae555 May 11 '25
Insurance probably has an existing agreement with the hospital system that this type of service is worth $691.14 and that's all they're obligated to pay. But either OP signed a balance billing agreement or balance billing is legal in their state. And now they're stuck with a $1,995 bill for stitches in a toe when no other medical care was available.
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u/Shitp0st_Supreme May 13 '25
Not exactly, itâs just a reduction in the bill, a fee the hospital waives in exchange for being in-network with the insurance. Itâs negotiated when they do credentialing and they have contracts.
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u/MNrunner19 May 11 '25
Vast amount of people have no idea how the billing for ER works or how their insurance coverage works. ER is obviously the most expensive route of care. In the ER you will have both the doctors professional charges and a hospital facility charge. That pays for the building, overhead, staff etc so the ER exists when you happen to need it. Then if the facility is contracted with your insurance and the ER charges more than the contacted rate, the difference between the billed amount and the contact amount is adjusted off by the facility as a contracted adjustment amount. Lots of people think this means their insurance paid. No, they did not. If you have a high deductible plan and most people do that allowed amount goes towards meeting your deductible and you pay that. Most people these days never meet their deductible or out of pocket max amount.
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u/Jrugger9 May 12 '25
I mean you are paying for emergent care. That being said the doc gets like 70-100 bucks for that at most. The hospital is also up charging you, youâre also paying the emergency premium for an ED to be staffed and stocked.
1995 is steep but there is also reason for that
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u/Secure-Solution4312 May 10 '25 edited May 10 '25
The ER isnât just a walk in clinic for stitches. Its a place where the CT scanner and MRI are ready and warmed up in case you have a stroke. The Vascular Surgeon, Cardiologist, Urologist, Neurosurgeon, Orthopedist and so forth are paid to be on call at any hour of the day. Teams are trained and on standby to resuscitate you if your heart stops. There is a blood bank to give you a transfusion should you need it and even a little antivenin stored heaven forbid you get bit by a snake. They can deliver your baby. They can surgically remove your baby if you die and resuscitate the infant. They can crack your chest and massage your heart to keep you alive. That stuff costs money. Yes, they do stitches too. But the cost to keep the lights on is quite a lot more than your local Doctorâs office
Iâm happy you tried urgent care first. Maybe the hospital has a payment plan they can put you on. Our local hospital will do that at 0% interest.
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u/moneymarkmoney May 11 '25
Not every hospital has even close to all these services/teams/surgeons/equipment/ability that you just listed. For all we know they could have gone to their local small hospital, which for anything other than those stitches wudda sent them out to another more advanced and able hospital, meaning they are not paying for any of that. If you can make assumptions, so can I.
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u/NYanae555 May 11 '25
^ THIS. Its bizarre that people think the average emergency department has all this available if needed. They don't. At best they'll stabilize you and tell you to go make an appointment with a specialist ( who won't be available for days, weeks, or months ). OR. They'll have you stay without officially admitting you because the MRI or CAT isn't available for a few days.
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u/xxPipeDaddyxx May 10 '25
To anyone refusing to pay medical bills, do you not think the doctors, nurses, techs, etc. deserve to get paid? Should they take care of your entitled asses for free?
Nobody likes the cost of healthcare. Everybody knows insurance companies suck. Most people realize hospitals are in business to make money (yes, even the "not for profit" ones). But you should pay what you can. If you can't pay that's one thing. Failing to pay just to "make a point" though? Cmon... nobody is falling for that.
The irony is that in an effort to stick it to the system, you are paying your premiums and rewarding the biggest instigator of our healthcare mess. And instead you make everyone else pay more, and the hospitals charge more, because of your actions.
Entitled people suck.
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u/Still_Owl2314 May 10 '25
Hi. This isnât how the system works. I canât enlighten you because there are hundreds of variables at play. I can say without a doubt that your reasoning here is not one that would solve the issue of the medical industrial complex greed or bring costs down. I would be interested to hear your thoughts once youâve looked into medical facility pricing, separate from insurance involvement. Whatever anyone thinks about how much insurance companies suck, know that the medical facilities are even worse.
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u/xxPipeDaddyxx May 10 '25
It wont affect the cost for people with insurance because those rates are basically set by negotiating with insurance companies. So it affects the folks that can least afford it - those without insurance that do try to pay their bills.
Its all evolving though. There is consolidation of the market by insurance companies (many areas only have one or two payers) making "negotiating" with them impossible.
But there is also a trend of consolidation by the hospital systems as they buy out practices, thus increasing their negotiating power.
Lost in all of it is the idea of patients as anything but numbers, and that's the real damn shame.
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May 10 '25
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u/MoreRamenPls May 10 '25
I would like to think it would but I also this Big Insurance would think âHey, they can pay their bills. Letâs find the sweet spot to where they canât pay their bills and I get a bonus!!â
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u/xxPipeDaddyxx May 10 '25
It's all baked in. Do you think that hospitals are just going to eat the 5 percent of bad debt? Or do you think they will charge self pay people more to try to make up for it? They definitely track bad debt and factor it in when setting prices.
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u/saltyclover May 10 '25
Iâm a nurse and I donât get paid based off of people paying their bills. My company pays me. Same with the physicians, techs, pharmacists, respiratory therapists, environmental, ancillary, etc I work with. If we only got paid based on people paying their hospital bills no one would get paid ?
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u/SnooBananas7072 May 10 '25
I also work in Healthcare as well, and technically we do. That's how the hospital has money to pay us. It's just delayed and not in real-time. But if they don't get any reimbursement, they won't have money to pay us. That's how all companies basically work, Healthcare or otherwise. (This comment is for the US, obviously).
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u/usernametaken2024 May 10 '25
and now you know why we have so much federal debt. Not just because a few working age able people donât pay their bills, but mostly because taxpayer picks up medicare and medicaid bills for unprecedented numbers of aging ill longest living population by borrowing from other (China) countries.
so yes, we are paid by a giant credit card with an enormous balance
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u/wildcat105 May 10 '25
This. It blows my mind that people don't know this. Thank you for educating people as to where their paycheck comes from if people aren't paying their company for services rendered.
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u/PortlyPorcupine May 10 '25
This may be true for your group but itâs not universal. Iâm an ER doc and I only make money if a patient (or insurance) pays their bill.
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u/saltyclover May 10 '25
That sucks. Especially in the ER. Iâm in the ER too, a lot of families yell at me that theyâre not gonna pay their bill and I said ok I literally do not have anything to do with your bill nor do I know what will be covered under your insurance plan đŹ
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u/xxPipeDaddyxx May 10 '25
What? Where do you think the money comes from for the company to pay you?
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u/saltyclover May 10 '25 edited May 10 '25
I work for the largest health system in the mid Atlantic region of the US. Theres a lot of non-payers. I still get my raise every year along with all of the other 140k+ employees. Do you think hospitals are only funded by paid medical bills?
ETA: we also donât get reimbursed for bounce backs (patients returning to the ER following discharge within a certain time frame) and let me tell you after doing this for a decade of my life you cannot prevent bounce backs. Itâs so much more in depth than just âif you donât pay your bill the staff wonât get paidâ.
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u/ApprehensiveApalca May 10 '25
You have a high deductible, meaning your health insurance will really only save you money if you have some kind of catastrophic event
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u/EmZee2022 May 10 '25 edited May 10 '25
HDHP plans are, I've alrways said, fantastic if you're disgustingly healthy (rarely meet your deductible) or have a lot of issues (blow through your deductible and OOP fast every year). If you are on the healthy side, maxing out your HSA can be great in preparing for future years. If you are on the sicker side, paying a much out of pocket - vs using HSA funds - can also be good as much as you can manage.
That's just my rambling though, not relevant for the OP.
2K for a few stitches does seem high, even at ER prices.
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u/ApprehensiveApalca May 10 '25
I agree. Assuming you make financially sound decisions. However, most people choose a HDHP because is cheap, don't contribute to their HSA, and don't save for medical emergencies
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u/Turbulent-Pay1150 May 10 '25
Agree HDHP is the way of you have high or low utilization - you come out ahead. The HSA puts you much further ahead tax wise as well.Â
If you are in the middle on use every time Iâve modeled it the cost swings about 500-1000 one way or the other over the year sometimes the HDHP is cheaper, sometimes a deductible plan is cheaper. I still model it annually when making the choice but looking at my HSA balance now I donât think Iâd switch until the math changes much more solidly to the deductible bills favor. Saving 500-1000 a month in premium for me outweighs the very modest annual risk of 500-1000 in actual money out of pocket worst case scenario Â
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u/EmZee2022 May 10 '25
For me, the HDHP is better. I hit my OOP every year. Not so much for my husband. We're both covered through his job since theirs is better than my job's coverage.
I haven't redone that modeling in several years but you are right to do so, as the balance can change quite a bit.
Next year we will probably switch to a more traditional plan, as it's quite likely one or both of us will be on Medicare and you can't contribute to an HSA. That's actually why I haven't signed up for part A yet even though I'm 65 (we won't have a penalty because we have work coverage).
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u/Turbulent-Pay1150 May 10 '25
And every month in the premium you arenât paying which can be significantly less.Â
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u/PatriciaTorbed May 10 '25
My bill for 4 stitches and an x-ray of my thumb was much lower at an urgent care. Sorry you got stuck with a high bill, but try to only use the ER when there is no other choice or you might actually die. If this happened at night then I know the urgent care might be closed. I wish there were some open late at night, but there aren't by me.
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u/jprata May 10 '25
I wonder what the cash price would have been? Hospitals usually charge less if you tell them you donât have insurance. Insurance jacks up the price on us and weâre stuck with the bill.Â
Can you tell them you donât have insurance at first, see the price and then get insurance involved?Â
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u/Icy_Pass2220 May 10 '25
Yeah, thats called fraud.Â
The consequences of this are that should you develop complications for your cash pay injury, youâre now stuck paying cash for any care related to that.Â
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u/Fluffydoggie May 10 '25
Why is it saying your insurance hasnât paid anything? You might have this adjusted once the insurance covers their portion. Youâll be stuck paying your deductible and/or ER co-pay, if any of those apply.
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u/CaryWhit May 10 '25
Well I can assure you that the farm and ranch method is pretty unpleasant but you get beer!
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u/Difficult-Way-9563 May 10 '25
At that rate, Iâd probably just buy a pack of 3-0 or 4-0 nylon/silk and close with 4 sutures myself. Even if you had to pay $20 for a pack.
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u/OriginalOmbre May 11 '25
Looks like ya got a vaccine there too. I bet they were administered by highly trained personnel in a clean environment!
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u/DefinitelyNotWendi May 12 '25
Tetanus shot. Standard procedure if you donât know when your last one was.
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u/4ofheartz May 11 '25
What are your benefits for an ER visit. Copay/coinsurance? A few years my er copay with health insurance was a set amount.
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u/Adventurous_Ad7442 May 11 '25
I'm surprised that it's not more than that. So glad that you're okay.
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u/motaboat May 12 '25
Itâs unfortunate that your injury happened at a time that no urgent care facilities were open. But this required you to have medical care at an emergency room. While you may feel that the services you received or minor, you have to realize that the costs bill to you are the costs associated with maintaining a roomthat can provide much more extensive services than your four stitches. Consequently, your costs reflect that higher medical technology.
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u/Bitchfaceblond May 12 '25
Id ask the billing team why insurance denied it. Or call insurance.(Source: myself. I was a medical biller. I cleared up denied claims)
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u/g0d_Lys1strata May 13 '25
Insurance didn't deny it. It was adjusted to the contracted price with his insurer. The final amount due is likely because he has not yet met his deductible.
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u/Bitchfaceblond May 13 '25
This is considered a denial because insurance didn't pay, regardless of the reason. Id have to go back and rework this claim if I were at my old job. Typically if it is a deductible it should say so on the bill, but that doesn't always happen. But we won't know until we see this person's explanation of benefits.
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u/g0d_Lys1strata May 13 '25
I've never had a single bill from a provider reflect that the balance due was due to my remaining deductible or coinsurance. I've only seen deductible balance mentioned on EOBs.
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u/Bitchfaceblond May 13 '25
Sometimes they will. Depends on the provider. I think they should all do it.
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u/MoJoCreatior May 12 '25
That's insane,
I had a laceration from glass in my foot pad,
Around 10-12mm long 3-5 mm deep,
I cleaned it, and did 4 stitches myself at home,
Cost me~5$ worth of medical supplies, And 15 minutes of time.
It's healed perfectly at this point.
Idgaf what other people are saying, Stitches are not brain surgery. It should never cost 2 grand for four stitches.
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u/Old_Draft_5288 May 13 '25
ER fees cover having emergency doctors and nursery available, they are high because itâs expensive as fuck to run.
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u/moosemoose214 May 13 '25
And for emergencies- not four stitches that urgent care can do.
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u/Old_Draft_5288 May 14 '25
Many urgent cares will not do stitches, they send you to the ER
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u/moosemoose214 May 14 '25
Other than the 96+% that do. What they donât do is complicated stitches but yes - urgent care does stitches
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u/TexasPete_Sauce May 13 '25
Donât pay it. It wonât go on your credit.
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u/TeHamilton May 13 '25
I think anything over 500 can and will
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u/TexasPete_Sauce May 13 '25
Must depend on your state Iâm in AL and just finished filing for bankruptcy I have years of hospital bills none where on my credit report
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May 13 '25
Unless it's the middle of the night or you are actively bleeding out, never go to the ER for stitches, go to urgent care. It's vastly cheaper and you aren't bogging up the ER for ACTUAL emergencies.
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u/moosemoose214 May 13 '25
You went to the er for four stitches in your toe - more urgent than emergency
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u/TeHamilton May 13 '25
Yea dont go to er unless its an emergency you coulda wrapped your toe and went to urgent care in the am
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u/Typical-Walrus-9474 May 13 '25
As a former e.r nurse I just use superglue these days if I need stitches. Because they charge 200$ for a Tylenol.. and 20$ for a pair of gloves.. America is crazy work. I'm so sorry.
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u/Southern_Body_4381 May 13 '25
Urgent care is the place to go for that. Not the ER.
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u/TortoisePDX May 13 '25
Yes it is. That's why I went there first only to be turned away because they were closed.
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u/Southern_Body_4381 May 13 '25
That sucks. I would've super glued my stuff shut for a day before I step foot in an ER. I better be dying to pay those prices I'm sorry
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u/SafeLongjumping2712 May 13 '25
The cost of a service depends on a negotiated rate. If you met your deductible your costs go down
This is a generalization..so please dont correct specifics.
The problem the rates depend on the negotiated rates and not the realistic actual cost.
Imagine buying a shirt and the amount you pay depends on what group you are a part of. Example. Teacher, Mormon, lawmaker, unemployed, retire, teenager, etc
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u/Gold_Telephone_7192 May 13 '25
You need to figure out why your insurance didn't cover any of it. Ask for an itemized bill from the hospital and call them and confirm that they billed your insurance and if so, ask why it was rejected. Then call your insurance to confirm they received the bill and if so, why they rejected payment. Don't pay this bill until you get your insurance to pay their portion. You are in no hurry to pay. It sucks that our system is like this, but you need to fight to make sure there wasn't a mistake in the process.
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u/ragdollxkitn May 13 '25
I donât pay if I already paid upwards of $2,000 like if itâs a procedure and they decide to bill me an extra 2k I am not paying that.
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u/SkyLow4356 May 13 '25
U can thank the âaffordableâ care act. here
Findings
Distribution of expenses for emergency room visits In 2003, the average total payment from all sources (e.g., private insurance, Medicaid, Medicare, out-of-pocket payments, and other miscellaneous sources) for an emergency room visit was $560 (figure 1). However, there was substantial variation across visits in emergency room expenses. For example, expenses for about 10 percent of visits were less than $42 (10th percentile) while, at the other extreme, expenses for the top 10 percent of visits were greater than $1,246 (90th percentile). The highest expenditure visits have a disproportionate impact on the average. Consequently, the median expense for an emergency room visit of $299 was nearly 50 percent lower than the average expense ($560)
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u/Rule12-b-6 May 14 '25
You could have traveled to find an urgent care clinic that wasn't closed. Even an Uber ride for a couple of hours there and back would be way cheaper than the ER for 4 stitches.
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u/Remarkable-Round-227 May 14 '25
Thatâs why I bought a medical grade staple gun for $50. Iâm not paying thousands for a few stitches, no way.
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u/JoNarwhal May 14 '25
I'd be relieved if I went to the ER and the bill was only 2600 pre-insurance.Â
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u/pogmathoin May 14 '25
All the more reason for single payer in America. Healthcare insurance time has passed, just like the buggy whip.
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u/Cuberasnap May 14 '25
I donât think that makes sense. How can the type of system that we have be irrelevant to the price of a bill, when the parameters of said system are specifically what determines the price of the bill to begin with? Your argument is utterly unconvincing tbh. The specifics of a healthcare system are actually crucial to the explanation for the cost of a bill. And I get what youâre saying I probably donât know the specific costs of medical services, but I donât think that matters as much as the very well documented price gouging. almost every medical service and product in the US undergoes price gouging and itâs really easy to research and find out that medicines that cost cents to produce are regularly sold for $800. Mind you this is incredibly illegal in the majority of western nations, the United States being an outlier. So unless you independently researched the cost of production for medicines and supplies, separate from your employment in the health field, unless you address the elephant in the room of price gouging, I think youâre incredibly underprepared to talk about this subject. And either way, if you would have researched price gouging in the medical sector, you would probably just agree with me: bills are so high because we are being robbed by billionaires who own the means of production in the medical sector, while corrupt politicians lining their pockets, allow them to do it.
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u/Secondhand-Drunk May 14 '25
Damn son. I got an xray and like 20 stitches.. wow... 15 years ago or some shit. Damn.
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u/NaiomiXLT May 15 '25
This is why I like Kaiser. UC is 24/7 and waaaay cheaper than an ER. $30 for a breathing treatment after insurance. Insurance paid just under $500. most was physician fee. if I had to pay a deductible like op, still 4x cheaper.
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u/Bro-what-r-u-sayin May 15 '25
The real problem is all the bureaucracy and overhead costs of staffing all the other people than the nurses and doctors
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u/dirtymoose408 May 15 '25
This comment section makes me sad for our county. Our healthcare system needs to be better.
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u/Specialist_Dig2613 May 17 '25
Under the No Surprises Act, it can't be balance billed unless it was within your deductible.
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u/HamIsntKosher May 10 '25
That's cheap. Call the hospitals billing dept and start negotiating down. Most of that could be wrote off if you are persistent enough.
You can Google search some good tips on how to negotiate a medical bill. OHSU and Providence are typically much easier to deal with than Legacy. Kaiser can kick bricks. They will get blood from a turnip.
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u/Odd_Theory4945 May 10 '25
Healthcare and health insurance here in the US is ridiculous. We pay premiums for the insurance, then we have a super high deductible, then we have to pay the coinsurance. I'm a conservative, but definitely feel we need single payer healthcare. Allowing for profit companies to run health insurance is nothing more than a scam
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u/PandemicPandaBear May 11 '25
Curious to know if you the $400 pharmacy bill you received was for Tylenol, ibuprofen, or 1 dose of actual narcotic pain medicine.
Please, do tell.
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u/TortoisePDX May 11 '25
The only medicine I received was lidocaine. I got a TDAP shot but that's listed separately.
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u/PandemicPandaBear May 11 '25
Fuckkkkk. Who would have thought some lidocaine cost $400 nowadays?
I'm sorry for the loss of your hard earned money if you choose to pay the bill.
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u/DCRBftw May 10 '25
Complains about cost of medical bills... suggests not paying medical bills... which is the reason medical bills are so high.
Peak America.