r/HospitalBills • u/ConsequenceOver9269 • 21d ago

Hospital-Emergency scam or not?

last month i went to fl for a week and went to the ER for a uti, as that is the only place to take my insurance. i received a bill from the ER already for $50 after insurance covered 2.5k for lab, ER and pharmacy. today i received a bill from physicanbillpay.com for $1,261 and a bill from east coast pathology of florida for $40 from my UAC. i was wondering if these 2 bills are scams. they came in about 2 weeks after my ER bill.

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u/EmZee2022 21d ago

For emergencies, but also the situation where you are receiving services at an in-network facility, but some of the staff (anesthesiologists etc.) are contractors and not in-network. You have no real control over such providers.

Friends of mine got a 4,000 dollar bill for anesthesiology for a colonoscopy. Having had a few of those myself, 4K is about triple the "rack rate" my place bills for that, and about 10 times what the provider actually receives. In theory, the practice could have demanded the full 4K (they actually wrote of the bulk of it) as this was long before NSA. With NSA, the anesthesiologist could not collect more than the 400 dollars or whatever that they'd have paid an in-network provider.

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u/Sloppysteaksslick 21d ago

Believe me. I work in the field that created the law and worked with those who drafted it. It was created initially to protect patients from "surprise" out of network bills in emergency situations. It has since, luckily expanded within certain healthcare systems due to the gray area of what constitutes an emergency.

I'm happy that your friend got their bill taken care of appropriately.

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u/EmZee2022 21d ago

Good to know!!

From what I see in the forums, the ambulance industry managed to lobby enough to get excluded from the bill :-(

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u/Sloppysteaksslick 21d ago

Yes. They truly suck! Most of the ambulances in the U.S are privately owned and operated with just a contract between them and the hospitals. It's a big scam.

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u/EmZee2022 21d ago

I'm curious as to how ambulance billing works if it's a municipally-provided service. If I dial 911 here, I get someone showing up in a vehicle branded with the county's fire department logo. Luckily we've never needed to test this out.