A man crashes his bike and gets taken to the emergency room.

The bill is more than $20,000 for the visit, which lasts a bit over 2 hours. He was taken to the highest level adult trauma center near the site of the crash in the Austin, Texas, area — University Medical Center Brackenridge, which is operated by the Seton Healthcare Family..

So how much does an emergency-room visit cost? Since this is in Texas, and we have The Austin American-Statesman’s Mary Ann Roser on the job, we get a thorough story.

Mark Mitchell was the unfortunate biker. His
stateman.com article on sky high ER trauma fees“total ER bill was $21,731, not including an ambulance charge of $849, an ER physician charge of $897 and $172 for diagnostic imaging. Because he is a self-employed graphic artist, Mitchell’s health plan with Southwest Service Life Insurance Co. provides less coverage than what employees of a large company might have,” the article says.

“It didn’t cover the trauma activation fee, typically covered by larger insurers. A letter Seton sent March 27 puts Mitchell’s outstanding balance, after insurance, at $18,893. …

” ‘The whole thing is a money game between the hospital and the insurance, and we’re caught like a pingpong ball in the middle,’ said Mitchell, who wanted to tell his story to warn others.”

The hospital explains that its charges cover its costs. The insurance company says it’s covering what it is responsible for. Mitchell has some big bills, and he’s annoyed. (He’s also doing fine, thanks.)

“Some Seton surgeons receive up to $7,000 for on-call duty, whether they are busy all night or stay home, said Greg Hartman, a Seton executive and president and CEO of UMC Brackenridge. Those doctors also are responsible for the patients during hospitalization and follow-up, Hartman said.

“Trauma fees nationally ranged from $837 to $24,964 a visit, according to research led by the trauma center association and published in 2009. ‘Significant underused opportunities exist for enhanced revenue’ by charging such fees, the authors of the paper said,” according to the article.

Go, read, and don’t miss the comments.

Got an emergency-room experience? Tell us about it, either by comment or by email to info@clearhealthcosts.com

 

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...