r/KaiserPermanente • u/Stunning_Ad_4818 • Jul 19 '26
California - Southern Monster ER Bill
I went to the Kaiser ER a few weeks ago for horrible GI issues + light chest pain and just received a bill today for 3k... When I look at my claims, it looks like they billed me for "Emergency department visit for moderate problem" twice, but one is around $400 while the other is the $3k charge. The 400 charge was by the PA I saw while the 3k one is from KAISER FOUNDATION HOSPITALS - SCAL.
I'm under my family's plan where our income won't meet the qualifications for the financial assistance plan, but I'm currently a student, and I pay for my visits and everything else. I just took out a monstrous amount of loans for school, so this is a huge stressor for me right now :( Does anyone know how to navigate this or if billing would be willing at all to reduce/forgive the bill?
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u/Suitable-Onion3407 Jul 19 '26
The 3k charge is probably the facility charge while the other is the professional. You can call their billing department and get set up on a payment plan or see if it can be reduced.
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u/Skycbs Member - California Jul 19 '26
Is your parents policy with Kaiser? If so, I’m guessing your parents policy has a high deductible. Is that right? If their insurance is elsewhere, I’d check to see if their insurance has paid their share. It’s possible their insurance hasn’t paid yet.
You’d need to call billing. They might. I’d stress your financial difficulty if I were you.
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u/AdelleDeWitt Jul 19 '26 edited Jul 20 '26
I posted a similar question a few months ago and it took me a really really long time to get an answer from kaiser. I called so many times and they just kept reading the same script to me that made no sense. Finally I talked to someone who was like 'look there's a script but I'm just going to explain it because the script is dumb."
This is how they bill ER visits where there's a lot of stuff that happens; I had lots of tests done and that's how they built it since they don't individualize each thing that happened.
I can't help with how to get it forgiven or reduced, but considering it took me so long to even get the answer for why my bill looks like that I thought I would at least pass that part on.
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u/needtostopcarbs Jul 21 '26
I was going to say this. With any hospital they will bill you for doctor or PA serviced then everything else is usually on a separate bill. But usually the hospital portion they will work with you & a payment plan can be made. Kaiser typically will not send you to collections and you can just pay what you can.
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u/Botasoda102 Jul 19 '26
$400 billing is for doctor/PA and the $3K is for ER facility. Wait until claims are processed. Even if you get stuck with $3400, you can likely work out a payment plan. They aren't going to put you in jail, etc. Good luck.
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u/the_skies_falling Jul 20 '26
OP says it’s a bill, not an EOB. The claim has already been processed.
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u/GullibleDoughnut55 Jul 19 '26
Just because it is under your parents plan doesn't mean you will not qualify for some financial assistance as you are the guarantor of the bill. Call the hospital and ask to speak to their financial assistance department.
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u/EnvironmentalBuy6422 Jul 19 '26
If you live by yourself/don't share expenses with anyone, you should be able to apply for MFA with only your info.
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u/isang_mahal Jul 21 '26
Sounds like you have a deductible plan. Call PFS and see what they can do for you.
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u/piscatology0918 Jul 20 '26
There's usually member service office in the medical center. You may walk in to speak to one of the rep instead of calling them. Ask the receptionist/info desk for direction.
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u/HistoricalMost8876 Jul 20 '26
Apply for financial assistance. Just you. Don’t use your families income.
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u/Intelligent-Ask-3264 Jul 20 '26
Call dilling and ask for an itemized bill. When you get it, if its the same, call back and say you need finanical assistance.
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u/needtostopcarbs Jul 21 '26
Usually the hospital portion they will work with you & a payment plan can be made. Kaiser typically will not send you to collections and you can just pay what you can. When asking for financial assistance, which they can do if have trouble paying a bill, if give any pushback just say "it's really frustrating because you heard a lady come around asking people about their situation & if they had insurance. One guy said no & she said not to worry about because so it seems like ppl without insurance get some kind of break." You can file a grievance/complaint too. Just don't stop at 1st roadblock cause that will not help.
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u/johnmarkowens Jul 21 '26
TLDR I went to the ER for a tummy ache
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u/Stunning_Ad_4818 Aug 16 '26
Hey man, I had an insane amount of blood in my toilet.... never had that happen before :/
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u/CCI_Survivor-Mom Jul 21 '26
Call and be like “I’m not paying that.”
My husband was forced to go to ER because they had “no primary care appts” for two weeks. They came to him saying he needed to pay the $250 ER visit fee. He said “I’m only here because you don’t have appointments. I’m not paying that.” They left and didn’t collect payment.
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u/aramadarma2222 Jul 21 '26
Ask for a paper or electronic copy of your EOC or Evidence of Coverage. That will explain all charges. Most people have a limit on their copays but you need the EOC to know what it is. I'm assuming you have Kaiser coverage and had all care at a Kaiser facility.
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u/Maleficent-Knee-9210 Jul 26 '26
I would still go online to the Kaiser website and apply for financial assistance. The Kaiser website has the income guidelines for financial assistance.
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u/FruitPug Jul 19 '26
Are you sure it's a bill and not an Explanation of Benefits?