A Colorado family went to Swedish Medical Center's emergency room (ER) and found that a concussion check, which lasted about five minutes, resulted in an itemized statement of more than $5,000.
After Matt Lindner's 15-year-old son bumped his head on the ice after hockey practice last summer, they went to the ER at Swedish Medical Center to check for a concussion. Lidner said he was expecting a bill of about $200 to $300.
"He was with the doctor for about five minutes," said Lindner. "He felt his head, and he had him follow his finger and told him to take some aspirin when he got home. That was about it."
The teen did not have a concussion and did not have any imaging or other treatment done.
Lindner later received a statement of services showing his insurance would be billed $5,000 for the short visit and he would have to pay more than $900 out of pocket. So he asked for an itemized list of charges.
"It's only got one line. It just says Level 3 emergency department: $5,033.80," Lindner said. "It's amazing to me that it's gone through a whole system of people, and there's nobody that's actually stepped in and said, 'Wait a second. Like, this can't be justified. Like, we need to do something about this.'"
In a statement to Contact Denver7, a Swedish Medical Center spokesman defended the charges.
"It is worth noting that it is common for patients to receive a variety of billing related correspondence following a visit, including an Explanation of Benefits from insurance companies. Only correspondence clearly indicating an amount owed is considered a patient’s bill...
When patients present to the emergency department, we follow the American College of Emergency Physicians Level Guidelines which is how we determine care and also how billing is ultimately derived.
The amount patients actually pay for emergency department services has more to do with the type of insurance coverage they have than '"prices" or “charges” of the hospital. Our pricing is competitive and varies based on a number of factors, including the health status of the patient, the expertise of physicians, and the technology and equipment used in providing care. We do not determine a person’s deductible or coinsurance; this is determined by their health insurance. The move toward higher-deductible insurance plans has put a strain on many of our patients, but we understand their choice to pay a lower monthly premium, and we also understand their frustration with the larger out-of-pocket expenses they may experience as a result."
"Emergency department charges are representative of the costs associated with receiving 24/7 expert emergency care."
Dan Vedra, a consumer protection attorney, said even though the charges may be correctly coded, the cost represents a larger issue many patients experience with hospital billing.
"I don't know how they come up with the dollar figure for a level one fee or a level five fee. It's just as much of a mystery as to why they're charging $12 for an aspirin," Vedra said. "I mean, $12 for two aspirin really seems outrageous. You know, $5,000 to be seen for 40 minutes in the emergency department seems equally outrageous. You're not using a ton of resources, and what you are using is really minimal."
Lindner said after Contact Denver7 became involved, he received a letter offering to reduce the out-of-pocket cost, but said it still seemed outrageous.
"After you reached out, they did reduce it by 50%," Lidner said. "We've teased our son about it a little bit. Like, we're not taking you to the emergency room unless you've got, like, an arm dangling off or something."
Contact Denver7 checked costs for Level 3 emergency services at other hospitals, which provided self-pay pricing. At Denver Health, it's $792.96. At UCHealth University of Colorado Hospital, it's $825.
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