Big ER Bills for Little ER Visits

A couple weeks ago, I wrote a column about medical bills suggesting that you trust, but verify those charges.

A few days ago, I read about a type of emergency room fee that’s hard to trust. It’s being charged by many hospitals, seemingly without consistency, and it can add tens of thousands of dollars to your bill for even a minor ER visit. It’s called a “trauma activation” or “trauma response” fee.

You wouldn’t think that someone would be charged a “trauma” fee for going to an emergency room for MS-related treatment. After all, MS symptoms aren’t the serious injuries that you or I would associate with trauma. Neither did the Jang family from South Korea. Their 8-month-old son had fallen off a hotel room bed and onto the room’s carpeted floor in San Francisco a few years ago. Their story, reported in an article in the Kaiser Health News (KHN) e-letter, may change your mind about that.

$18,836 for formula and a nap

The baby wouldn’t stop crying, so his parents called 911 and he was taken to San Francisco General Hospital. The KHN story continues:

“The doctors at the hospital quickly determined that baby Jeong Whan was fine — just a little bruising on his nose and forehead. He took a short nap in his mother’s arms, drank some infant formula and was discharged a few hours later with a clean bill of health. The family continued their vacation, and the incident was quickly forgotten.

Two years later, the bill finally arrived at their home: They owed the hospital $18,836 for a visit lasting three hours and 22 minutes. …”

Of that total, $15,666 was billed as a “trauma activation” fee. This fee has been around since about 2002 and hospitals add it to emergency room bills to cover the cost of activating a trauma team, the medical specialists who handle very serious injuries. According to the KHN story, that fee frequently tops $10,000. Reporters Jenny Gold and Sarah Kliff also say that fee often seems to be applied arbitrarily.

“It’s like the Wild West. Any trauma center can decide what their activation fee is,” said Dr. Renee Hsia in the article. Dr. Hsia directs health policy studies in the emergency medicine department at the University of California, San Francisco.

Medliminal, a company that helps insurers and employers around the country identify medical billing errors, told KHN that trauma activation charges can range from around $1,000 at a hospital in Missouri to over $50,000 at a hospital in California.

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Trauma centers argue that these fees are necessary to maintain their expensive trauma teams, 24/7. A spokesman at San Francisco General, where the baby was seen, put it this way:

”We are the trauma center for a very large, very densely populated area. We deal with so many traumas in this city — car accidents, mass shootings, multiple vehicle collisions. … it’s expensive to prepare for that.”

What can you do about it?

According to an ER billing consultant quoted in the article, if a trauma team is alerted but the patient doesn’t need at least 30 minutes of critical care, the trauma center is supposed to downgrade the fee to a regular emergency room visit, which is a lot lower. So, it would seem to be worthwhile to dispute such a charge if you get billed for one if you visited the ER for something that wasn’t a traumatic injury.

The Jang family is using a patient advocate to try to negotiate its $15,666 bill. The New York Times wrote about these billing consultants several years ago, and a quick Google search turned up several other articles.

So, trust, verify, and then if necessary, fight.

You’re invited to follow my personal blog at: www.themswire.com.

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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.