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Figuring out your ER Bill!

November 4, 2015

The issue of transparency in any business in general and in Healthcare in particular is taking front stage because of its critical importance to consumers. A good leading model such as ( Surgery Center of Oklahoma ) is forcing so many other healthcare facilities including hospitals to be transparent with their charges related to different procedures and services.

One good example , when Jon Doe was seen in the Emergency Room close to his residence ( he happens to be a physician) and after he signed in on I Pad all the forms electronically to initiate the services without being able to read anything , then he had an IV line put in and blood work drawn after brief evaluation by the ER doctor ( 45 seconds) , then had an X ray , then EKG .

Few minutes later , ( a Business office Representative in a suit) came along with a computer attached to him , then started asking questions about choices of payment , with best deal if paid in full while in the ER!.

When asked about the itemized bill, only few minutes after blood was drawn for labs, then noted to have a significant portion of the bill was due to CT scan ( Computed Tomography) test and patient then was offered to be admitted for 24 hour observation! , then it was clear when a certain blood  test was supposed to be added before the blood test results came back with additional ( $ 4300 ) charged to the bill!. Then patient asked to put a hold on the CT scan till a specific blood test was ordered and only if it is abnormal , then will justify doing the CT scan only then according to well known clinical protocol to be followed in these situations . The ER doctor knew that as he should not have been  reminded by an educated patient who happened to be a fellow physician!

Then the ER physician immediately backed off on doing the CT scan after the blood work came back negative and was no justification for the additional $4300  charges added and patient left ER to home feeling very disappointed that a fellow physician would attempt to sell an unnecessary test  which is costly and potentially harmful  with unnecessary exposure to radiation and IV contrast which could harm the kidney function and have possible allergic reactions!  All this for ( Job security) rather than doing what is supposed to be done which is taking care of patients according to established guidelines and protocols rather than bottom line revenue generation for the Employer!

The patient felt there was more business than medicine and he had to be put in a situation to fight the ER bill with the unnecessary expensive testing which has contributed to more stress when leaving the ER that when he first walked in even with supposedly good news with negative testing. It should not be this way. Transparent pricing for each service should be posted on the healthcare facility website to gain patient trust and business!

Dr Adel Eldin,MD, FACC,FACP
Board Certified Cardiologist
President, Clinical Appeals Services
Founder, CEO
Affordable Quality Healthcare Program
Founder, CEO
Wesley Chapel , Florida
President ,Society of Physician Entrepreneur, Tampa Bay Chapter

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