People come to the ED for covid testing, get upset about the bill later.

[Dr Mantis Toboggan]

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I’d about 100% guarantee they were all told it was a regular ED visit and would be billed accordingly, probably multiple times.

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[Vandalia]

Well, the hospital where I worked required a COVID test before my wife's elective surgery this month.

They directed her to a tent outside a "specialty" hospital that was created in the system in partnership with a private surgical practice. This particular facility does not have an ED and has signs on the doors and in the parking lot that it does not offer emergency care. (It was also not where she had the surgery.)

The test was billed as an ED facility visit. It is apparently a loophole in the emergency regulations passed in the wake of COVID.

Nothing is too crazy when it comes to medical billing.

 

[AMEHigh]

Redirect Notice

I’d about 100% guarantee they were all told it was a regular ED visit and would be billed accordingly, probably multiple times.

That’s still very deceptive.
Most people don’t know how much a "regular" ED visit will cost. What is the definition of regular?

And in the article it says the hospital was even charging more for the actual test than other places.
In NYC there are PSAs everywhere about people should get tested regularly and also information saying testing is free even if you don’t have insurance. Then, they put a sign up advertising COVID testing...that’s so shady. And why our healthcare system is so messed up because health care organizations are just trying to make a quick buck.

 

[GeneralVeers]

It's all ridiculous when you consider this testing over and over and over of asymptomatic people isn't needed. Just the hospitals cashing in on hysteria.

IMO employers who demand a COVID test to return to work, which goes against CDC guidelines should have to pay out of pocket for test.

 

[Apollyon]

What is the definition of regular?

Signing in to the ED to be seen, whether for 2 years of occasional nausea after exposure to skunk scent, or crushing chest pain. Anything for which you are charged the facility fee for use of the ED.

 

[VA Hopeful Dr]

Our hospital has a central drive through testing site, free of charge for anyone and you can have a test for any reason without an order.

No idea why everyone isn't doing that.

 

[GeneralVeers]

Our hospital has a central drive through testing site, free of charge for anyone and you can have a test for any reason without an order.

No idea why everyone isn't doing that.

That makes way more sense. We had so many young people faking mild COVID symptoms just to get a test in the ED.

 

[AMEHigh]

Signing in to the ED to be seen, whether for 2 years of occasional nausea after exposure to skunk scent, or crushing chest pain. Anything for which you are charged the facility fee for use of the ED.

But people get different bills after ED visits depending on what they were seen for and what tests are done. So how would someone know what a regular ED visit charge would be?
It does not sound like they were telling people they would be charged X amount and make them pay up front for COVID testing. That is what I’ve been seeing private doctors offices doing for COVID tests.

The healthcare system is so confusing, that me even as a physician has a hard time navigating it. So why are people saying it’s the patients fault and not the hospital’s fault? If they’re advertising routine COVID testing and there’s going to be a fee charge people up front and call it a day.

 

[AMEHigh]

Our hospital has a central drive through testing site, free of charge for anyone and you can have a test for any reason without an order.

No idea why everyone isn't doing that.

Yes exactly.
It’s insane that Americans would think what is described in the above article is normal and ok. But I shouldn’t be surprised.

 

[VA Hopeful Dr]

Yes exactly.
It’s insane that Americans would think what is described in the above article is normal and ok. But I shouldn’t be surprised.

it depends. If they actually had to walk into the emergency department, then yes they should get a appropriate bill.

The freestanding tent described in the second post in this thread is an entirely different story.

 

[GeneralVeers]

After being banished to our FED and working a few shifts, it just seems like a huge scam to me. How can insurance pay ED bills for sore throats, stubbed toes, and work notes?? This stuff could and should be handled at PCP or urgent care for a fraction of the cost.

 

[wareagle726]

How can insurance pay ED bills for sore throats, stubbed toes, and work notes??

Because that sore throat of 5 days became a MERGENCY at 2am. Gotta rule out PTA, epiglottitis, etc... That stubbed toe is a fracture...could even be open...unless my magical X-ray says otherwise lol.

 

[bravotwozero]

At one of the FSEDs I work at, we do covid tests all day and bill as an ED visit, but no copay/out of pocket costs are incurred by the patient.

 

[RustedFox]

Because that sore throat of 5 days became a MERGENCY at 2am. Gotta rule out PTA, epiglottitis, etc... That stubbed toe is a fracture...could even be open...unless my magical X-ray says otherwise lol.

Exactly this.
It was a bubble from the start, and now the bubble has popped.
Its now just insurers and hospitals/CMGs fighting over the dollar and we're there as the stick to hit the piñata.

90% of jobs out there are CMG-owned, so their goal is to squeeze us as hard as they can and pay us as little as they can.
The remaining mix of academics (lolz), and SDGs (both good and bad) are going to become infinitely more difficult to get, if they're not already beyond possible to get.

I think it was miacomet who said it first, but: "I'm embarrassed to have matched into this specialty."

We serve at the whims of our CMG overlords, classified as independent contractors, so they can avoid treating us like equals.
Meanwhile, their middle-manager ranks swell with MBA/RNs and used-car-salesman-types who all get their 4 weeks vacation, 401K match, stock options, and (health insurance).

Every time I mention to a muggle that I have to buy my own health insurance on the market at 1600/month for me and the wife, they look at me like they've been punched in the solar plexus.

I shared to my therapist that if I were to take time off to take care of myself as a human being (say, to crawl out of depression, or spend some time with my dad in his last years), that I wouldn't have a job to come back to. He first said: "But... can't you take PTO or FMLA or something?"

We get none of those considerations. Yet, without us - the greedy pigministrators wouldn't have a teat to suckle from.

Pigs. Dogs. Sheep.

Pink Floyd's "Animals" album seems so appropriate.

The Pigs are the hospital admins.

Big man. Pig man. Ha-HA. Charade you are.
You well-heeled big wheel.
... pig stain on your fat chin.
Saying... Keep on DIGGING...


The Dogs are the CMG middlemen.

And after a while... you can work on points for style.
Like the club tie...and a firm handshake.
A certain look in the eye and an easy smile.
You have to be trusted by the people that you lie to.
So that when they turn their backs on you.
You'll get the chance to put the knife in.


Us docs? We're the sheep.

Hopelessly passing your time in the grassland away.
Only dimly aware of a certain unease in the air.
You better watch out! - There may be dogs about!
I've looked over Jordan, and I have seen
Things are not what they seem

What do you get for pretending the danger's not real?
Meek and obedient you follow the leader;
Down well trodden corridors into the valley of steel.

 

[WilcoWorld]

Exactly this.
It was a bubble from the start, and now the bubble has popped.
Its now just insurers and hospitals/CMGs fighting over the dollar and we're there as the stick to hit the piñata.

90% of jobs out there are CMG-owned, so their goal is to squeeze us as hard as they can and pay us as little as they can.
The remaining mix of academics (lolz), and SDGs (both good and bad) are going to become infinitely more difficult to get, if they're not already beyond possible to get.

I think it was miacomet who said it first, but: "I'm embarrassed to have matched into this specialty."

We serve at the whims of our CMG overlords, classified as independent contractors, so they can avoid treating us like equals.
Meanwhile, their middle-manager ranks swell with MBA/RNs and used-car-salesman-types who all get their 4 weeks vacation, 401K match, stock options, and (health insurance).

Every time I mention to a muggle that I have to buy my own health insurance on the market at 1600/month for me and the wife, they look at me like they've been punched in the solar plexus.

I shared to my therapist that if I were to take time off to take care of myself as a human being (say, to crawl out of depression, or spend some time with my dad in his last years), that I wouldn't have a job to come back to. He first said: "But... can't you take PTO or FMLA or something?"

We get none of those considerations. Yet, without us - the greedy pigministrators wouldn't have a teat to suckle from.

Pigs. Dogs. Sheep.

Pink Floyd's "Animals" album seems so appropriate.

The Pigs are the hospital admins.

Big man. Pig man. Ha-HA. Charade you are.
You well-heeled big wheel.
... pig stain on your fat chin.
Saying... Keep on DIGGING...


The Dogs are the CMG middlemen.

And after a while... you can work on points for style.
Like the club tie...and a firm handshake.
A certain look in the eye and an easy smile.
You have to be trusted by the people that you lie to.
So that when they turn their backs on you.
You'll get the chance to put the knife in.


Us docs? We're the sheep.

Hopelessly passing your time in the grassland away.
Only dimly aware of a certain unease in the air.
You better watch out! - There may be dogs about!
I've looked over Jordan, and I have seen
Things are not what they seem

What do you get for pretending the danger's not real?
Meek and obedient you follow the leader;
Down well trodden corridors into the valley of steel.

Great album!

 

[Birdstrike]

I saw a woman in the ED once, who had no symptoms and just wanted a pregnancy test. I told her, "You can get the same test at the dollar store. For a dollar. If you get it here, it'll be much more expensive." She could have signed out free of charge at this point. She insisted, so I ordered the test. She was happy.

A few weeks later I get pulled into my directors office because I got a "complaint." He started threatening and pressuring me. The complaint was from her. She was pissed off that she got a massive ED bill and now it was 'my fault.'

 

[RustedFox]

I saw a woman in the ED once, who had no symptoms and just wanted a pregnancy test. I told her, "You can get the same test at the dollar store. For a dollar. If you get it here, it'll be much more expensive." She could have signed out free of charge at this point. She insisted, so I ordered the test. She was happy.

A few weeks later I get pulled into my directors office because I got a "complaint." He started threatening and pressuring me. The complaint was from her. She was pissed off that she got a massive ED bill and now it was 'my fault.'

I've had this experience, too.

The abuse that we endure from both patients and administrators is enough to make you go batty.

Americans need to learn some hard lessons.

 

[GeneralVeers]

I saw a woman in the ED once, who had no symptoms and just wanted a pregnancy test. I told her, "You can get the same test at the dollar store. For a dollar. If you get it here, it'll be much more expensive." She could have signed out free of charge at this point. She insisted, so I ordered the test. She was happy.

A few weeks later I get pulled into my directors office because I got a "complaint." He started threatening and pressuring me. The complaint was from her. She was pissed off that she got a massive ED bill and now it was 'my fault.'

How was it your fault she got a massive bill? Technically you aren't allowed to discuss cost with her up front without an MSE as that's an EMTALA violation. Was your director instructing you to commit EMTALA violations?

 

[Birdstrike]

How was it your fault she got a massive bill?

It wasn't.

Technically you aren't allowed to discuss cost with her up front without an MSE as that's an EMTALA violation.

Technically the MSE started and finished when she said, "I have no symptoms of anything. I just want a pregnancy test." No EMC at that point, so no EMTALA violation.

Was your director instructing you to commit EMTALA violations?

No. He was hyper aware of EMTALA. For all his faults, that wasn't one of them.

 

[GeneralVeers]

It wasn't.

Technically the MSE started and finished when she said, "I have no symptoms of anything. I just want a pregnancy test." No EMC at that point, so no EMTALA violation.

No. He was hyper aware of EMTALA. For all his faults, that wasn't one of them.

We don't have the ability to do an MSE and document the MSE without billing the patient. Once I start a chart to document anything -------> massive bill generated.

 

[southerndoc]

If your director tells you about every complaint (like this one), then you need a new director or a new ED. Patients have numerous meritless complaints. Many of them feel that a complaint will get them out of a bill, which is not true at all. You'd be surprised at the number of complaints a physician may get that a good director will shield from the doc. If you tell your docs about every single complaint, you will beat them down into oblivion where they become dissatisfied with their career and will subsequently generate more complaints. This will create an endless cycle until the doc becomes burned out. We have enough pressures on us that meritless complaints shouldn't be thrown into the mix.

 

[turkeyjerky]

If your director tells you about every complaint (like this one), then you need a new director or a new ED. Patients have numerous meritless complaints. Many of them feel that a complaint will get them out of a bill, which is not true at all. You'd be surprised at the number of complaints a physician may get that a good director will shield from the doc. If you tell your docs about every single complaint, you will beat them down into oblivion where they become dissatisfied with their career and will subsequently generate more complaints. This will create an endless cycle until the doc becomes burned out. We have enough pressures on us that meritless complaints shouldn't be thrown into the mix.

Been there, can confirm.

 

[emergentmd]

I prob tell a doc 1/10 complaints and do it with soft gloves making them feel that the issue could happen to any of us. I must have been lucky to never have a malignant RN director and always had a good relationship with multiple ones.

But those were the by gone days of Pre CMG/HCA Takeover. The pressure on these RN manager from above can be unbearable so they take it out on the docs.

Bad times to be in any hospital based specialty. Go ask your Anesthesiologist, rad, hospitalists friends.

 

[Birdstrike]

My father decided not to be a pharmacist because when he was young (1960's) the owner pharmacists were being overrun by corporate pharmacies. Owner-pharmacists are now few and far between. My father didn't want to be anybody else's employee, because he knew how that would feel to him. He decided to become a veterinarian and owned his own practice with one other guy. He had a good career, worked hard.

Fast forward 60 years and it appears the corporate takeover of human medicine is in full swing, although not 100% complete.

 

[emergentmd]

If you don’t want to be a widget and don’t want someone to tell you how high to jump then own your own business.

If you are an employee, no matter what you are a widget with little say.

I own my real estate portfolio so if I want to cut someone’s a deal, fix something, raise tent then I do it. No one tells me what or when I need to do something.

I am a primary partner that runs our FSER. if I want something done, someone hired, someone fired then I get final say.

Either you are the widget or the hammer.

All of our owners have different positions and equity but at the end of the day they are a hammer. Almost impossible to make them do something.

I choose hammer. Sometimes I get splinters but at the end of the day I am still the hammer.

When you are a valuable widget, at the end of the day you are still someone’s widget and they are the hammer.

Better to be a low level hammer than a high level widget. Trust me I know. I was once a high level widget telling low level widgets what to do. But I was replaceable and was replaced quickly without much reasons bc the hammer thought I didn’t follow all their rules.