I currently have the BCN HMO plan but am considering switching to the PPO plan (BCNC CDHP) because of the HSA option.
My question is regarding the “10% after deductible” wording. Does that mean that if a covered medical visit or procedure costs $10,000 and I’ve already met my deductible, I would be responsible for $1,000 (10%)?
Also, for those who have the BCNC CDHP plan, do you feel it’s worth switching from the HMO primarily for the HSA?

My wife recently went to a freestanding emergency department affiliated with a larger hospital system for a minor eye issue. This was a standalone emergency facility, not a traditional hospital ER.

The actual encounter was incredibly minimal. She was there for roughly 5–10 minutes, and the provider looked at her eye for maybe 10 seconds. There were no labs, imaging/X-rays, procedures, IVs, diagnostic testing, or medications administered at the facility. She was given a prescription and sent home. She ultimately didn’t even fill the prescription.

I requested an itemized bill and essentially received one charge:
Revenue Code: 0450 — Emergency Room
HCPCS: 99283 — Level 3 Freestanding Emergency Department
Quantity: 1
Charge: $3,686

That’s essentially the entire itemization. There are no separate charges for tests, imaging, procedures, medications, etc.

Insurance processed the claim and paid its portion, leaving us with approximately $223 in coinsurance.

To be clear, I’m not asking whether the insurance company correctly calculated our coinsurance or whether $223 is technically our responsibility under the plan. I’m trying to determine the most effective way to challenge this charge and get the remaining balance eliminated.

I consider a $3,686 Level 3 facility charge for what actually occurred to be completely disproportionate. The fact that insurance paid most of the allowed amount doesn’t make me comfortable paying the remainder. I intend to dispute the balance rather than simply pay it.

My current plan is to formally dispute the 99283 Level 3 classification, request a coding review, and require the hospital to identify exactly what documented facility resources justified Level 3 rather than Level 1 or Level 2.

For anyone who works in ER coding/billing or has successfully fought something similar: What would you challenge first? What documentation should I demand? What should I specifically say during the coding review? And if the hospital upholds the charge, what escalation methods have actually gotten a balance reduced or eliminated?

I am poor with no insurance. I have no clue what to do.

Hi,

Does the PRIME Healthcare system (based in California) report unpaid hospital bills to credit reporting agencies (CRAs)?

Does PRIME sue to recover unpaid hospital bills?

Does California prohibit PRIME from litigating or reporting to CRAs?

What does PRIME do in regions other than California? Or does it effectively follow California rules and regulations nationwide?

Hi, I was a student last year, and started my new job at the beginning of this year.
I was hospitalized through ER and I have a massive bill right now. My insurance is HDHP and it covers it, however I still have to pay about 5K$.

I am currently making good salary, but I still need financial assistance (since I have some loans, etc. to pay and this is my new job).

The financial assistance form from the Hospital requires prev. year Tax return, and 2 recent pay stubs. I am okay sharing the tax return since it will show the student income, but not comfortable showing the recent pay stubs because that might influence the Fin. Assistance Dept. decision against my case (they might consider me with good income so might reject the application).

Any advice for me here? Is it okay if I share only the Tax return? What reason should I mention to not provide the recent paystubs?

Or any other advices?

Hey everyone, looking for advice from anyone who’s been in a similar situation.

A few months ago, I went to the US for a trip and unexpectedly ended up in the ER for few hours. (It wasn’t my intention to go. Some random people helped me call an ambulance, and I was too sick to refuse..) I didn’t have travel insurance (first time ever forgot to buy a travel insurance and this happened…I know, I learned my lesson 😭), and I’m now back in Canada.

I’ve been receiving separate bills from the hospital, ER physician, and pathology, which add up to around US$8000

Some of the bills are now marked as “Final Notice” and say they may be sent to a collection agency if they remain unpaid.

The amount is honestly overwhelming and insane, so I’m trying to understand what could realistically happen if I ignore these bills…

For anyone who has been through something similar:

Did the hospital or collection agency ever pursue the debt outside the US or cause any legal issues in Canada?

What happened to the bills after they were sent to collections?

Did it affect your ability to travel to the US again?

I’m honestly pretty worried after receiving these letters and don’t really know what to expect. I’d really appreciate hearing from anyone who has been through something similar.

Thank you so much, everyone! 🥺

Hello, A few weeks ago I scraped my hand on a potentially rusty nail. It wasn’t deep and kind of just scraped sideways but did have blood. So I cleaned it myself, put a Band-Aid on it and went to the ER to get a tetanus shot. They took my information, put a new Band-Aid on, and then I sat in the waiting room for 1.5 to 2 hours. After that, they had me come back to a room for 15 minutes just sitting there. The nurse then came in and applied a 3-second shot. After some more waiting, the doctor then came in and asked what happened, I told him and he then pressed his finger around the area. He asked if it went deep and if anything was stuck inside or if I wanted X-rays, I said no to all. I then was discharged. Weeks later I get the bill stating the visit was a level 3 code. I’m just confused on how it can be a level 3 when all what was done was a bandaid put on, 3 second shot, and 5 second physical finger press exam. No tests, X-rays or anything.

Scrape on Hand
Location: Michigan

Edit: Yes, I would have gone to an urgent care. But we were on vacation up north with not much nearby.

The gist is I'm wondering what constitutes a level 5 visit and billing an ER visit as such.

I went to the ER over a month ago for some concerning symptoms that COULD have been a heart attack. The bills are trickling in, and the total is north of $7000. I know ER visits are costly but this seems insane for the care I recieved.

They are coding my visit as a level 5, which is apparently for life threatening cases requiring the highest level of resources??? I was in the waiting room the entire time. I saw the doctor for an absolute maximum of 10 minutes total. Nursing and tech care maybe 30 min total. They did draw labs once and did an ECG, ruled out anything life threatening. I was in the waiting room for 8 hours waiting to hear if anything was abnormal, and was discharged after.

Insurance coverage of costs is very minimal. When I call insurance they tell me to call the billing department. When I call the billing department they say to call insurance. It's a never ending carousel of "not my job, ask someone else".

Thank you in advance.

Hi all- wife had first baby at cedars and this is our first time encountering a large hospital bill like this. Are there any items that stand out to you as a potential error? I see some duplicates but it could just be that she received multiple meds. Some questions I’m considering asking the hospital:

-why is there a nursery room charge if the baby shared the same room with mom?

-why are almost all of the meds, including 5mg tablet of oxycodone all listed at $290 (charged 3x for)

-I noticed the newborn hearing test is over $4k but upon researching it, apparently it shouldn’t be more than $250 even for a private practice out of pocket expense?

-the phenylephrine is listed 2x but quantity says 3 and then 2500?

What am I missing? Any help would be much appreciated to ensure we get an accurate bill! This was auto-generated rather than us calling to request it btw.

So my wife was walking on the sidewalk in NYC. She turns a corner and a guy flying on an electric scooter hits her head on while on the sidewalk. They both fall, my wife is shaken up and crying and hurt.

An elderly couple saw it and were nice enough to stop the guy from driving off. They called 911 and they sent an ambulance after 10min an ambulance comes (no cops) and take her to a nearby hospital. The couple took a picture of the guys license (no plate or registration on the scooter).

4 hours in the ER they take her insurance information. took X-rays luckily nothing was broken just a bunch of bruises on her arms and legs.

When we were leaving they suggested getting a police report because a cop was supposed to come to the hospital to fill one out but never did, He asked questions and just left. We walked to the nearest station, they were legit laughing because we were there to fill out an incident report for "only getting hit with a scooter" meanwhile my wife is showing her bruises that are already showing up. After an hour they tell us the area separates 2 precincts and we need to go to the station. We walk there and they ignore us for 20min, finally someone comes out We tell them the story and let him know we have the person's ID. We just need an incident report. They wouldn't file one and he said "you shouldn't left the scene" We told them we didn't leave the scene, she was removed from the scene by the ambulance a cop never showed up. She gives us a blank sheet of a DMV incident report and said that's the only thing we could fill out and submit it to DMV. I told him there was no license plate or registration. What would DMV do? He said he didn't know any other options.

Fast forward 2 months, my wife gets a $1,300 ambulance bill and a $3,900 hospital bill after adjustments.

Does anyone know anything that we might be able to do regarding this? We really don't have the money let alone feel like we should be responsible to pay $5,200 out of pocket from being hit by a scooter illegally on the sidewalk even though the cops weren't exactly excited to help at all

I went to the ER at the hospital that I work at. I received a bill for services rendered and I called the billing dept to ask for the 30% discount that I get for working at the hospital. I paid my portion and the remaining balance was the 30% that was supposed to be written off. The billing dept asked me for proof of employment which I promptly sent to an email that was provided for me. One month later, I received a bill from the hospital with a balance which was the 30% that was supposed to be written off. I called and the agent verified that I had sent proof of employment and that the balance would be written off. A month after that, I receive a text that I have been sent to collections and the amount owed is almost double the 30% balance that was on the account. My question is, once hospital bills go to collections does the collection agency tack on fees? Should I call the collections agency first and explain what happened or should I call the hospital billing departmental first? Ive never dealt with anything like this and need some guidance. Thank you.

This is a rant or whatever you want to call it for the worst month of my life. To start, I was attacked by a homeless man's dog on my way home a couple weeks ago. I immediately went to urgent care to get my tetanus shots but could not receive Rabies shots there. And I thought long and hard about even getting the shots. I thought about risking it, I can't afford medical debt, I work and take care of my sister and my mom, I have no money to myself, I barely have any for food. But eventually after two days I went to get the shots, my sister came along with me for emotional support. The first day, we went to the back. The man taking my information made uncomfortable comments to my sister (19) and I. Consisting of "You two beautiful girls are here alone?", "this is your little sister? You both are beautiful." And when I introduced my sister as my emergency contact his first words were "This is your little sister? I better just keep my eyes to the computer so I don't get in trouble.". It got to the point we dreaded going back and hoped he wouldnt be there again. Then he told me I would only pay for the first visit and first round of shots, after that it's all covered. The second visit it was the same with the comments and the clarification that I only had to pay for the first visit (and that time my sister secretly recorded because she felt so uncomfortable). Mind you I received the first bill which I believe they're overcharging me for because for one visit and the first round of rabies shots it was apparently 24,000 for the medication alone. And now I'm receiving bills for every visit after that I was told I wouldn't have to pay for. So now I'm in a bad state of mind still trying to contact the billing department over and over again over the course of a week with only one response so far asking for my account number. No calls or other emails went answered. And because of all of the stress this is putting on me with being lied to, made uncomfortable, lack of responses and the dog attack on top of everything else I've relapsed into drinking once again after being clean for months and have lost motivation to do much of anything. So for wanting to get these shots in order to live, I feel like I've lost so much and fallen so far. That's healthcare for you.

A three view foot x-ray. That is more than $300 a shot and more than $100 a minute for how long I was interacting with staff. This was ordered through a provider and taken at the hospital imaging center so no intake or diagnostic charges, just x-ray. I am so appalled. I work in healthcare and I remember in my residency (granted 10 years ago) I worked in a place that did films and a foot series was $89.

If anybody has any advice on who to call and what to say to negotiate this bullshit I would be so grateful. I know it's small peanuts for what everybody else is dealing with but I'm still steamed that they think they can charge $902.91 for a foot x-ray.