Home Forums Hunting & Shooting Hunter's Campfire Pay attention to Doc in the box scam

I just got off the phone with Trans Union, a credit reporting agency evidently based in India, from the accent of the guy I talked to. Only problems on my file - which they have been reporting in a damaging way, were two from an ER Corp for services my wife had that BCBS paid, and told me were paid in full, I did not owe anything more. Of course the (hospital) ER wants to charge more than BCBS wants to pay, and foolishly thinks they will get it from me.

But, yes, if appears medical bills can be reported and affect your credit.

Thanks, I always assumed that they were a cheaper alternative to the ER.

I was told as long as you were making regular payments it couldn't be turned over to a credit agency.

it appears if that was true, it isn't anymore

I did see on the news a few months ago that supposedly as soon as you clear a medical claim (pay off) then its gone from your credit report in a matter of days

Some are. Lots of them are no more expensive than a regular doctor's visit...cheaper actually. But the ones with "Emergency" in their names bill like an actual emergency room..higher actually.

JB, you're misunderstanding what the purpose of the medical screening exam (MSE) is. It doesn't "allow them" to bill for an "emergency", even if it's not a true emergency. They are allowed to bill a higher rate because they are legally classified as an Emergency Facility. This means that they can charge 3, 4, even 10 times as much for the same service provided in a non-emergency setting such as a clinic.

What is killing most hospital-based ER's is rampant misuse of the facilities by Medicaid and uninsured patients who get care for ordinary illnesses/injuries. The EMTALA law passed during Reagan's presidency requires that anyone who presents to an Emergency Facility must be given a MSE regardless of ability to pay. Nearly all hospitals take Medicaid, and Medicaid pays only a fraction of the cost of Emergency care. But in order to preserve their Federal and State funding, hospitals have to keep their Medicaid ER patients happy, and as such they treat any illness or injury and eat the cost.

The free-standing ER's deliberately refuse Medicaid (and Medicare), because they're not eligible for Fed/State money, so there's no incentive to treat Medicaid patients. Thus they use the MSE to avoid the whole mess of patients whose Medicaid will only pay 10 cents on the dollar for the cost of their care.

So they do an MSE, which satisfies the EMTALA law. They can then legally look at your ability to pay. If you have Medicaid, they tell you they won't treat you unless you pay up front, because it "isn't an EMTALA emergency". And they're legally covered. They save money by not treating those people.

If you have private insurance, they tell you "it's an emergency if YOU think it's an emergency", and then they require you to put your insurance card down, and they bill your insurance (and you, for the copay/deductible) based on YOUR say-so that this is an emergency. And they're legally covered. They make more money by billing insured patients for high-dollar care. They also make money by referring their surgical patients to their parent hospital, which makes better profits by operating on more well-insured patients.

It's a win-win for the FSERs, and a lose-lose for everybody else.

I hope that clears that up.

You're wrong. They can, in fact, receive state funds. They are an emergency room just like any other. Some don't accept Medicare and Medicaid while others actually target those patients.

And you're wrong about the way things work. Since Obamacare came along, there are more and more so-called high deductible plans. The way to make money is to bill Medicare and Medicaide because you know that the government will pay.

On the other hand though they billed a lot to my wife's insurance, they haven't collected a dime yet.

OK. I guess we're done discussing this then.

Thanks Doc,

for all that info. I personally have not seen the "free standing" ER's yet. I'll be looking out for them and warning my wife. Only thing I have seen is a somewhat burgeoning population of "Urgent Care" facilities.

My only question, (and maybe a medical provider such as yourself has an idea as to an answer) why does our medical system have to be this way?

Is it related to your earlier post regarding the only entities to benefit are the insurance companies and the govt?

I'm pretty upset with the system this year, not cost wise, but care wise. 4-5 years ago I was imaged and diagnosed with back problems and was told they weren't going to get any better, come back when they are really impacting your life and we'll discuss options. This past fall things got worse, trip to GP, explain situation, ask if perhaps I'm due for more images to see how things have progressed. Nope, here's a script for phys therapy and some muscle relaxers. Short version of things, 6-8 weeks at $50 a week co-pay, not much help, yes time for imaging, x-ray first, yep you need an MRI. MRI shows things worse, now we can discuss pain mgmt etc.

Some other things came up as a result of the imaging, which would have benefited from finding out about 3-4 months earlier when I first asked to get imaged. And the delay in getting the care I needed meant losing out on a much desired hunt in February, and having to be responsible enough to only put in for points on another draw I would rather have tried to draw a tag in. I'll have to wait another year to try for that AZ elk hunt I guess.

If my truck was "diagnosed" with worn ball joints, good for another year maybe, and I went back later with a shaking front end, would the mechanic then forget the earlier diagnosis and think perhaps we should try new shock absorber or a tire rotation "Before" re-evaluating the ball joints?

The whole system is in need of a serious rework, in my mind at least. Now how to go about it so the providers (not the corporations, but the Docs of the world) get the compensation they deserve and the patients get the care they deserve.

Perhaps we could get back to the "Thanks for coming out to the farm Doc, I'll bring you a chicken for your Sunday dinner when I come in for supplies on Saturday" good old days

You seem like a fairly nice fella, Doc, so this in no way is meant to put a bad light on you.

Thanks for your informed posts on this and other subjects.

Geno

If you go to a hospital to the ER that is in your network for your insurance, no guarantee that the DR. who sees you is in that network. Your insurance will pay the hospital but may not pay the Dr. leaving it up to you, or only pay 80% for being out of network etc...

Well, you're premise will work if you explain the utility of billing $2,500 to someone with a $4,900 deductible.

Like I said it is like Cool Smiles and the like. They actually cater to these people because they know government will pay and you have ghetto kids getting baby teeth capped. Someone like me on the other hand will raise hell and they may not see a dime.

The most important thing, is that folks realize there is a difference between an "urgent care" center and a "free-standing ER".

You can get out of an urgent care for $100-$200 for some things. You're gonna have a hard time getting out of a FSER for less than $1500...

Google "free-standing ER", and you will find TONS of articles/stories, most about ridiculous charges for minor issues. If you have a real emergency, go to the hospital. If you have a small problem, go see your doctor or go to an urgent care. Avoid the free-standing ER's!! Not only do many NOT accept medicaid/medicare, many are out-of-network on private insurance.