r/HospitalBills • u/Swag_Scape • May 30 '25
Hospital-Emergency $2k Bill to lay on a stretcher in the hallway
My BIL got drunk downtown and the fire martial insisted he goes to the receiving hospital via ambulance instead of just letting me take him home. He was super nice about it and said “don’t worry he won’t get a ticket let’s just get him sober. The city takes care of these things.” So he goes to the hospital and I meet him there and I kid you not he was just laying on the stretcher in the hallway for 2 hours. No fluids or anything. Nobody in the medical field did nothing more than bring him some water. Once he woke up the doctor watched him walk around and said okay he’s good to go.
We got hit with a $500 ambulance bill, which we paid, and a $2k ER visit ($1k after insurance) and $100 doctor treatment bill.
We disputed the ER visit and asked for a breakdown which they sent and all it said was “ER visit - $2k.” They also sent mail saying the bill was accurate. So we disputed again and the billing office told us “even though it’s under dispute, you should still pay for the bill so it doesn’t go to collections.”
Can they really take him to collections if we are actively disputing a charge? Also, does $1k not seem insane for getting absolutely no treatment at all?
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u/Virtual_Ad1704 May 30 '25
2k is pretty damn cheap for wasting a bed in the ER. People with cancer or in severe pain have to sometimes wait for 3+ hours to get a bed because of all the intoxicated selfish AHs who get priority because they came via ambulance. They had a full team of doctors, nurses, techs, in case there was something wrong with him. He should learn how to drink responsibly and not expect the healthcare system to finance his bad decisions.2k is the bare minimum for fees and services for a place open 24/7 to deal with actual emergencies.
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u/Swag_Scape May 30 '25
I guess the fact that I was literally there with my car ready to take him home is what makes this a lot more frustrating. People drink and make mistakes, it happens. I was there to avoid him having to go to the hospital at all but was told “no” and now he got hit with this bill
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u/Careful-Fig-3709 May 30 '25
I think your issue is with the fire marshal then, although I’d be curious how they became involved. Once he did go to the ER, he was cared for by the knowledge and experience of the ED team. Sometimes that means you just get water and make sure you can safely walk. But if something had gone wrong, they were prepared for that too and that’s part of the charge. It’s an expensive bill, but hopefully a lesson learned.
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u/Aware_Economics4980 May 30 '25
Sounds like this is a better outcome for your BIL than a public intoxication ticket and a night in jail. I would stop complaining about having to pay medical bills and start asking your BIL why he was so drunk in public fire marshals need to be getting involved
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u/Virtual_Ad1704 May 30 '25
The fact ems or fire dept or police was involved at all means something happened, he either fell or was agitated or visibly intoxicated and incoherent, and they either arrest him or send him by ambulance to a hospital. Everyone has quite a bit of liability once they are summoned to the situation
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u/jamjamchutney May 30 '25
Take him home and then what? Were you going to stay awake and babysit him? Do you know what to do if someone aspirates vomit?
You don't explain what actually happened here or how the fire marshal even got involved, but based on the clues we have here, he was probably extremely intoxicated and in danger of aspiration or alcohol poisoning. It sounds like he was in a state where it would not have been safe for you to just take him home.
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u/Swag_Scape May 30 '25
There was a big event going on so cops and fire marshals were everywhere. And yeah he wasn’t that bad I knew all he had to do was sleep it off, which I was right about. Why is everybody in this thread acting like I said “my brother in law who gets hammered and throws up once a week got caught doing it again.” This isn’t normal for him, he made a mistake which happens to a lot of people.
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u/jamjamchutney May 30 '25
I didn't say anything about him drinking routinely. Drinking can often be more dangerous for people who don't drink often, as their tolerance is usually much lower. My point in my previous comment had nothing to do with how often he drinks, just that if he was extremely intoxicated, which it sounds like he was, then just going home could be dangerous. As for being right about it, just because nothing happened while he slept it off in the hospital doesn't mean there was no risk of anything happening while he slept it off.
If it was a big event, and cops and fire marshals were everywhere, how many people did they send to the hospital?
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u/DevynnKate May 30 '25
You know your BIL and that he could just sleep it off, but others don't. They may have been worried about alcohol poisoning and aspirating. They played it safe to make sure he was OK. Be thankful instead of trying to get out of paying for services.
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u/Ok-Seaworthiness-542 May 30 '25
First off, see if the hospital has a patient advocate. At a minimum they should be able to get your BIL on a payment plan. In many cases, even if you are paying a crazy small monthly payment they will not send you to collection.
You are not considering at least one other possible outcome. The fire marshall could have had the police cart him off to the drunk tank at the jail. That easily could have cost more then $2k.
Police and Fire employees have responsibility to assess risk. They decided the level of risk they were comfortable with was a trip to the hospital. If you would have taken him home and he aspirated and died and then you decide to sue the fire department. That's an example of risk they don't want to accept.
I appreciate that you were there for your BIL. That's sincerely awesome. While we have the agency to make certain decisions we don't always have the agency to decide what the results of those actions are. $2k is a chunk of money but it's a cheap life lesson if it is learned.
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u/CenterofChaos May 30 '25
You can ask for the coding but frankly he went to the ER via ambulance for intoxication. They didn't want him to drown in his own vomit.
Whatever your BIL was doing to need the fire marshal involved was probably an offense worth jail or a heavy fine. Tell him to pony up for the bill and learn to lay off the liquor.
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u/kirpants May 30 '25
What code did they bill? What does the medical record show the treatment was?
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u/Swag_Scape May 30 '25
99283 ER Visit LVL 3. Not sure what the medical record says
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u/ElleGee5152 May 30 '25
I work in ER physician billing and a 99283 sounds fair for alcohol intoxication.
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u/kirpants May 30 '25
You should check what they listed in the medical record for what they documented as treatment for accuracy at the minimum.
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u/folk1211 May 30 '25
I would also scrutinize insurance, if they can get away with paying less they’re going to. Different coding coverages vary widely but is available easily in plan literature.
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u/justhp May 30 '25
What are you disputing? You BIL got services in an ER, even if those services were a once over look by the doctor and the nursing staff keeping an eye on your BIL.
It’s no one’s fault but your BIL’s. Pay the bill.
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u/Swag_Scape May 30 '25
Disputing $2k for him to lay on a stretcher in the hallway when he’s had ER visits for more serious circumstances that didn’t cost nearly that much
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u/justhp May 30 '25 edited May 30 '25
Ok, did he have the same plan when he went last?
What does his copay/deductible/coinsurance setup look like?
You mentioned a 99283- that is most likely the appropriate code for this type of scenario. There isn’t much that is needed to justify that code.
He didn’t just lay on a stretcher- he was monitored (even if from a distance for most of it) by highly educated professionals. And a doctor or midlevel used their extensive training and experience to decide that he was safe enough to be monitored without intervention, and eventually was safe enough to be discharged.
Sorry, but your BIL probably is out of luck here. Whether you choose to believe it or not, ER services were rendered here.
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u/Obvious_Band_8848 May 30 '25
ER level 3 is excessive, you can totally dispute this. The level is determined by how many resources are used. Ask to have it reduced to a 4.
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u/ElleGee5152 May 30 '25
A 99283 E&M is a lower level of service than 99284. For alcohol intoxication, a 99283 is very likely fair.
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u/Swag_Scape May 30 '25
Thank you for providing some actual feedback that’s helpful instead of just berating my BIL and calling him the worst person in the world because he got too drunk one time. These people are acting like I think it should be 100% free. It just seems excessive to me.
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u/Obvious_Band_8848 May 30 '25
I used to work in the ER (semi-retired RN now). Yes, it can be frustrating when non-emergency patients are in the ER. However, if every non emergency patient didn't seek care, the hospital would lose money. Also, intoxicated patients should be observed because the situation could've deteriorated quickly.
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u/jamjamchutney May 30 '25
Who called him the worst person in the world? Why are you reading so much into these comments that just isn't there?
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May 30 '25
[removed] — view removed comment
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u/jamjamchutney May 30 '25
Yeah, and they also have another comment about "nobody in this thread has ever made a mistake." That's not even the point, it's about paying for the mistakes. OP is getting reasonable replies and just doesn't like them.
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u/Swag_Scape May 31 '25
There are other comments from people who are calling out the bashing and downvotes in this thread. A lot of you guys have an annoying elitist mentality where you come off as “dude you fucked up, shut up and own up to it!” Nobody wants to get that kind of feedback when hit with a surprise bill over something we thought was supposed to be a non issue. If you think $2k to lay on a stretcher in a hallway to take a nap when I easily could have taken him home myself is fair then I don’t know what to tell you. My biggest issue with this whole thing was how they can still take me to collections when I’m trying to dispute it. But people in here are literally calling him an alcoholic and saying he needs to stop drinking and all this. I’d love to hear of ANY mistake you’ve ever made so I can give you the same type of criticism.
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u/jamjamchutney May 31 '25
Multiple people have tried to explain to you why taking him home would have been risky, and that he wasn't just lying in a hallway for no reason. Just because he turned out to be ok doesn't mean there wouldn't have been any risk in taking him home. I'm not sure why that seems so difficult for you to understand.
I see one commenter calling him an alcoholic, not "people." One. And again, it's not about not making mistakes. Of course everyone has made mistakes. Again, it's about owning your mistakes and their consequences.
You want to hear about mistakes I've made? Getting involved in this discussion and believing there was any chance of you listening to reason.
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u/Swag_Scape May 31 '25
That doesn’t matter. If I am able to take him home then I have every right to. He wasn’t being belligerent drunk or causing harm to anybody. I had every right to just take him home. If they actually rendered aid to him other than sit him in a hallway and “watched him” from afar then I wouldn’t be making this post. He literally laid on a stretcher to sleep and then left. He didn’t need to do that at all and that’s definitely not worth $2k. I don’t care that the hospital needs to make money somehow. They basically used the same amount of resources if he was or wasn’t there. That’s a bullshit charge no matter how you dice it.
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u/The_Ibiza_Icon May 30 '25
Was this a HCA hospital? Private Equity owned? Congress has allowed for profit healthcare, as the toothpaste is out of the tube and can’t be put back. $2k for babysitter is about right this days. Hospital CEO needs to maintain his beach house.
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u/whataweirdo711 May 31 '25
That sounds right. I’m not saying it isn’t expensive but it’s right. He was monitored whether it was to your standard or not. They did what was appropriate. Just let it be a lesson to him
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u/Polaryn Jun 06 '25
ER and Billing veteran. It is plain Bullshit that the breakdown said nothing more than "ER Visit" What was the charged level of care? Was there equipment used, bandages used? were labs ran....A Detailed itemized bill should have far more "detail" than just er visit.
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u/pizzaface20244 May 30 '25
It's not your bill so you shouldn't worry about it but tell your alcoholic bil to get help for his drinking so he doesn't take up space in an E.R. that is needed for truly sick and hurt people.
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u/DevynnKate May 30 '25
Just walking in the door, getting registered, having vitals checked initiates an ER visit facility code, even if all he received was water and visual monitoring. They levels are 1-5 with 1 being most emergent. You can try to see if they can code it down to a 4 or 5, but either way, services were rendered, the caregivers taking care of him, registration staff, EVS etc deserve payment for their work.
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u/Swag_Scape May 30 '25
No vitals or anything were checked. He was just rolled straight to an open spot in the hallway and wasn’t seen until he woke up.
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u/Emotional_Wheel_7140 May 30 '25
There’s no way. And if they did not take vitals and establish him as a patient of theirs and billing then that grounds for major legal liability. I bet they did take vitals. If they didn’t… you might be in luck.
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u/Swag_Scape May 30 '25
Maybe in the ambulance?
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u/Emotional_Wheel_7140 May 30 '25
Of course they took vitals in the ambulance. But if he wasn’t dropped off to the waiting room. He was triaged by a nurse. They would do vitals again and reassess and then place in a room if it’s an emergency , if not then a stretcher in hall is the call. But they absolutely have to be triaged once in hospital. If the ambulance just dropped him off at the hospital in a hallway and was not triaged. Then he wouldn’t be a patient of theirs hospital and just be waiting. So if the are charging you for an ER visit but did not triage than you have grounds to dispute this.
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u/DevynnKate May 30 '25
OK, well then being registered, occupying a bed/stretcher, using electricity and water, cleaning brings on a minimum bill. You're splitting hairs here. Try to see if they will down the code, otherwise have your BIL pay his bill. He received care to ensure he wasn't in immediate danger, this stuff isn't free (at least in the US)
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u/trondheim12 May 31 '25
His BIL is being charged $2k, you in defense of that bill are bringing up “electricity and water” but he’s the one splitting hairs?
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u/DevynnKate May 31 '25
Seriously? I'm simply giving examples of what a hospital facility fee is meant to cover, and yes that includes utilities expenses and everything else not covered by the dr fee. You want more? It also includes the nurses, MAs, registration staff, disposal supplies used, transportation staff, EVS and clean linen charges, security, etc.
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u/trondheim12 May 31 '25
But the prices are not a function of the cost. At all. There is zero relation between them. So why lie as if the cost security guards has anything to do with it?
Here, riddle me this. If you’re hospitalized there is a daily room charge. That’s presumably where you’re charged for security, electricity, the room nurse, charge nurse, and all the rest.
Why then is every aspirin billed at $50? Why? Other than a bloated provider who should be trimming half its staff is instead screwing over anyone it can, so keep the bloated staff well-paid, and the doctors making 8x the OECD average.
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u/DevynnKate May 31 '25
You almost got it -The ED visit charge is basically the equivalent of the Inpatient room charge you mention. It is to cover overhead to run the facility.
Most providers do not work nor get paid by the hospitals, that is why you receive a separate provider bill. They have privileges to practice medicine at the hospital, that they have to pay for actually. They don't set the prices or even care really what the hospital facility fee is and get nothing out of it. They bill the patient separately for their service.
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u/trondheim12 May 31 '25
This billing separately thing is another invention of a system designed to screw patients. In no other industry, or country, would this insanity be tolerated. The doctors didn’t walk in from the street. They have arrangements with the hospital. The hospital could have sent a single bill and paid the doctors itself. But that would make life too easy for the consumer. So nah.
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u/voodoobunny999 Jun 03 '25
(1) Prices are the outcome of a negotiation between provider and insurer. Insurers used to negotiate a flat percentage discount, but changed so that underwriting could better predict costs. Prior to that prices could be reflective of costs. With each insurer having their own preferred payment methodology, providers have to divorce price from cost. i can’t emphasize this enough: 100% of providers would prefer the old percentage discount methodology. It is insurance companies which have caused the disconnect between cost and price.
(2) The answer to your riddle is that different insurers use different methods to reimburse hospitals for drugs which can result in wildly different amounts. All of those insurers, however, have language in their contracts which limits hospital reimbursement to the lesser of billed charges or the negotiated amount. If the hospital’s billed charge for that aspirin is $1.00, but the insurer contracted to pay $49.00, the insurer will pay $1.00. Essentially, the hospital is leaving $48.00 on the table and they have counted on receiving the full $49.00 when negotiating that contract.
Both hospital and insurer have negotiated that rate in concert with rates for all other services and they both model likely total reimbursement based on those rates. Maybe that $49.00 aspirin is in a contract with a low CT rate or a low daily room rate relative to other insurers. You don’t know because you’re not privy to that contract, although there is now some transparency on hospital rates and insurance company rates. You should know, however, that neither the billed charge nor the contracted rate are arrived in a vacuum.
Here are some rules of thumb gained from many years of experience: Providers prefer percent of charge contracts and they like them precisely because it allows them to set prices based on costs and realize a known gross profit margin. Insurers prefer fixed rate contracts because their finances are based on units of services per member per month (which is very predictable) x the contracted rate per service. When the rate per service is fixed, the calculations around cost become simpler which makes rate-setting for their customers much easier, and more predictable. You can see that the preferred reimbursement methodologies are diametrically opposed to each other. If you want to know who’s responsible for the screwed up pricing in American healthcare, just look at which methodology is used in the vast majority of insurer-provider contracts. It’s the methodology preferred by the insurers.
(3) Yes, doctors can make a substantial amount of money relative to doctors in other countries. The doctors in those countries don’t graduate from medical school with hundreds of thousands of dollars of indebtedness because, unlike in the US, medical school tuition is paid or subsidized by the government.
US medical graduates have 4x as much educational debt as Canadian medical graduates and 12x as much as Australian med school graduates. Additionally, malpractice insurance in the US can exceed $200,00 per year. Do you know of any other OECD countries where that’s true? There aren’t any even remotely close.
In the UK, the government indemnifies docs at no cost to the physician. Most Australian physicians pay under $20,000. Many OECD countries have no-fault systems that result in drastically lower malpractice premiums. Doctors in France pay less than $1000. You can see why doctors in the US might demand higher compensation, right?
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u/pizzaface20244 May 30 '25
Before you said he wasn't even seen. Now you're saying he was. Which is it? They absolutely did do vitals on an alcoholic brought in by ambulance.
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u/Swag_Scape May 30 '25
He’s not an alcoholic. And yeah all he did was lay in a stretcher in a hallway for 2 hours. That doesn’t warrant a $2k bill
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u/pizzaface20244 May 30 '25
We already know you're lying. In a another comment you said he saw a doctor. In your original post you said no one in the medical field did anything except give him a cup of water. And he is an alcoholic. Only alcoholics drink that much.
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u/Swag_Scape May 30 '25
I’m not lying and I said the doctor saw him walk and called him good to go. That’s not being “seen by a doctor” and no he’s not an alcoholic
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u/pizzaface20244 May 30 '25
Doctor did more then watch him walk around. And yes he is an alcoholic. It's not your bill anyway so nothing you can do. Tell bil to put down the alcohol and Start paying the bill. He caused resources to be used because of his alcoholism.
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u/Highstakeshealthcare May 30 '25
That does sound like a lot. I know people in here are bashing on your BIL but I'm sure they've all made mistakes. You're likely going to have to pay it and actually, be thankful your insurance paid part of it. Most wouldn't. BUT - that doesn't change the fact that hospitals WAY over charge and typically non-profit hospitals are worse than for-profit hospitals. All while they pay their CEO's millions and fly them around in private jets.
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u/Swag_Scape May 30 '25
Thanks man. And no, nobody in this thread has ever made a mistake in their lifetime apparently. I came here for feedback on the bill not for people to tell me my BIL needs to grow up or whatever. Shit happens.
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u/Highstakeshealthcare May 30 '25
Yeah - I try to live by the "he who is without sin cast the first stone" so I don't cast any. LOL We're human - shit happens. Expensive lesson but it could have been worse. Be thankful for that.
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May 30 '25 edited May 30 '25
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u/DevynnKate May 30 '25
No, it's that for a facility visit code, there is no itemization. It is for the reg staff, wristband and other disposable supplies., electricity, water, cleaning and security costs for the hospital. It is a bundled charge.
It sounds like that is all he had done for him. If he'd had an x-ray or given meds, those would be line item charges they could ask for.
Not even the most ambulance chasing malpractice attorney will see someone over a $2k bill. Not good advice for the OP.
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May 30 '25 edited May 30 '25
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u/DevynnKate May 30 '25
Free consultation is free, but an attorney is not going to take a case or even talk to someone where at most they get 1/3 of $2k. Especially to do all the things you've listed. Talk to witnesses, the ambulance drivers, the fire Marshall etc. Not worth it, especially when the patient was drunk (not bashing him for having a fun night out, just saying, he would be almost useless as a witness) I work parallel with medmal law, trust me, the OP wouldn't even get a return phone call and frankly there is nothing nefarious about this, they took him to a hospital to sober up, he could've spent the night at the drunk tank in the local jail.
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May 30 '25
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u/DevynnKate May 31 '25
Because in this case, the plaintiff was drunk and would be an unreliable witness to what happened to him. OP themselves state he was asleep/passed out most of the time.
If it wasn't for that fact, I may agree with you that a call doesn't hurt, but in this particular case, no, it would be a waste of time imo.
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May 31 '25
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u/DevynnKate May 31 '25
LOL, this is not how it works at all. The OP is an in law who has no legal standing to refuse or consent care for drunk guy and it sounds like they were trying to help the guy not get a ticket or sit in jail for public intox and/or make sure the guy was OK and didn't have alcohol poisoning or not. Nothing illegal happened here. It's $1000 bill for being cared for and made sure he was OK and OP is trying to find ways to get out of paying and you think they should sue. Why not be grateful that the fire Marshall and EMTs cared enough to make sure he was OK? I can't believe this is even a discussion, next time should they just leave him drunk on the sidewalk or let some random person just take them home because they claim they are a family member?
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May 31 '25 edited May 31 '25
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u/DevynnKate May 31 '25
LOL you don't know anything about me. I work in medmal risk mgmt on both sides of the issue for 30 years. I've worked with folks like OP and medical facilities over the years, so I do know a bit about this.
I'm frankly interested why you think public servants watching out for drunk guy and sending him to be checked out over the objection of an in law who has zero legal standing to consent care warrants a call to a lawyer? No good deed goes unpunished I guess.
Not basing on just a paragraph. Reading OPs other comments reads more into what actually happened.
Sounds like we will have to agree to disagree friend
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u/DevynnKate May 31 '25
So because I have a new account that means I don't know anything about this subject? Everyone has a start date on here buddy, this isn't a job where my start date doesn't mean I have no experience in this. So you, please carry on.
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u/Sguru1 May 30 '25 edited May 30 '25
You did get treatment. He was monitored by nursing staff, seen by a doctors, vitals were taken, the facility used electricity, a cleaning person kept the surrounding area sanitary, security guards secured the area, he recieved food and drink. ER’s are expensive to run. Sorry the fire marshal scammed you. There’s like a very minority of circumstances when it makes sense for a drunk person to go to the emergency room.
If he laid there, aspirated on his own vomit, choked and got pneumonia and died you’d probably thing you had grounds to sue. He sat there, recieved the only care indicated which was babysitting. And everything went according to plan. They now have grounds to charge you money.