If you have ever been treated in a hospital emergency room, and you did not have health insurance, you may have been subjected to emergency room overcharges. The emergency room bill for patients who are uninsured, and do not qualify for Medicare, Medicaid, Medi-Cal, or any other type of coverage funded by the state, is usually much greater than the bill that is given to the insurance company for insured patients.
Hospitals are required to charge a person without insurance the same rate as a person with insurance. However, hospitals are ignoring this provision and at most times overcharging the patient excessively for ER procedures that were not consented to or provided at any time during the ER visit.
By law a patient is obligated to pay the rate of the emergency room charges for services if the patient:
- Consented to receive the services in the emergency room and
- The patient actually received the services
However, a patient is not legally obligated to pay for any emergency room services that they did not actually receive or consented to. If the patent was overcharged during the emergency room visit, they can dispute the charges made.
You know you have been overcharged for an emergency room bill if your bill is two to four times the rate that is charged to insured patients for the same treatment. In order for you to make this comparison, you will have to find out the rate for insured patients and determine the amount by which it differs from the rate you are being charged.
For example, while an uninsured patient can be charged $15,000 for an overnight stay that includes diagnostic tests, such as x-rays and scans, as well as treatments and medication, an insurance company will usually be charged $3,000 – $5,000 for the same overnight stay and treatment.
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Yes, you can sue a hospital for any excessive emergency room charges that you did not consent to or receive. Many attorneys have filed lawsuits against hospitals claiming that patients have been overcharged for emergency room since a patient is not obligated to pay for any services that they did not consent to.
Here are some ways to prevent and deal with emergency room overcharges:
- Request an itemized statement of the charges to see if what you actually were treated for;
- Have your doctor review the statements;
- Ask the hospital to audit your statements;
- Ask the billing department for adjustments for anything that you didn’t approve or do; and
- Have a patient advocate negotiate with the hospital to reduce the payment and amount owed.
Yes, you can file a lawsuit for emergency room overcharges. During the years 2006-2008, about 1 million patients were the recipients of refunds or adjustments to their hospital bill as part of class action settlements. Hospitals refunded nearly $1 billion to patients who were overcharged, principally for emergency room care.
In June 2013, a lawsuit was filed against Swedish Health Services, alleging emergency room overcharges, and the case became a class action. The lawsuit states that the hospital charges patients who are uninsured, about three times the usual reimbursement amounts from insured patients for the same emergency treatment.
You may be eligible to join the class action lawsuit if you were treated in the emergency room anytime during the six-year period prior to the date on which the lawsuit was filed, which was July 31, 2012.
If you think you have suffered emergency room overcharges, you should consult a personal injury attorney. An attorney can help you dispute the charges if you were overcharged and reduce the bill. An experienced attorney can also file a claim against the hospital if the hospital refuses to remove any of the charges that were not done or consented to by the patient