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/YogurtclosetOpen3567 21d ago

Wait are you saying the hospital contracts seperately or the hospital send you different bills under the same network

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u/Sloppysteaksslick 21d ago

So it can be both. Some hospitals employ all their providers themselves under the facility org. Some hospitals employ some of their providers under the org. but also supplement their providers with contracted providers not technically under their main org. Some hospitals don't employ any providers under their own main org and only contract.

Some hospitals bill all their services under one umbrella (facility, physician, lab/pathology). Some hospitals bill only their own facility fees and then contract out physician fees, etc . to a billing service which bill the patients separately from the hospital .Some might do this but vice versa but that would be rare.

Sometimes if the physician billing is separate from the hospital, and the provider is just a contract provider, there might even be another third party billing service.

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u/YogurtclosetOpen3567 21d ago

So how would charity care work under each of the theee scenarios you speak of?

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u/Sloppysteaksslick 21d ago

That depends. For example, I currently work for a physician side billing service and we do not provide any charity, that's all done through the hospital/facility side. So patients might get charity through the hospital and not realize that it only counts towards the facility fees. We do however, work with them and perform a "Charity" adjustment of 20% for the physician fees if they were approved for charity through the hospital.

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u/YogurtclosetOpen3567 21d ago

Wait so if they can’t afford and then you don’t have to provide charity care then do you take them to court and garnish their wages or foreclose on their homes?

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u/Sloppysteaksslick 21d ago

No. We do not. There are facilities who do. We have a committee that meets monthly to decide what to write off for patients in that scenario.

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u/YogurtclosetOpen3567 21d ago

Oh so you do provide charity care effectively? See that’s really interesting, my understanding is that the hospitals tend to be much more punitive but apparently physician groups more recently have been getting with debt collectors to sue?

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u/Sloppysteaksslick 21d ago

We only started recently reviewing all charity cases because of some new laws and regulations in my state. I wish we could just write everything off for everyone struggling.

It is considering charity write offs but it's not a taxing district charity type plan like the hospital provides.

The physician groups are getting paid less and less from insurance and yes, they've become the "bad guys".

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u/YogurtclosetOpen3567 21d ago

Oh I see so the state is requiring now that you do NOT provide charity care and so you only sue a certain amount of patients as opposed to hospital which is most?