$2,600 for an hour at the SouthPark ER? I pushed to lower my hospital bill, and you can, too.

By Michelle Crouch

This article first appeared in the Sept. 23, 2019, edition of the Charlotte Ledger, a 3x/week e-newsletter focused on Charlotte business news. Sign up for free here.

When my husband’s doctor sent him to the emergency room for a CAT scan after he hit his head on a Sunday, we knew the bill would be high.

But when we opened the bill from the Atrium ER in SouthPark, we were shocked at the total: $4,386.  After the insurance adjustment (we have a high deductible plan), we still owed $2,597!  

That was the cost just to walk into the ER. It did not include another $1,000 charged by the radiologist who read the scan or the reasonable $243 fee charged by the ER physician.

Was it an error? We thought it must be a mistake. When my daughter had gone to the ER a year earlier for a broken nose, the fee had been closer to $2,000 — and she had emerged with six stitches. How could they charge more for my husband’s visit when he had received no medicine and no treatment — just a quick exam before getting the scan? We had been in and out in less than an hour.

We decided to fight. It wasn’t easy. But with a little research and multiple phone calls, we finally got some relief: a $1,000 discount.

Ready to dispute your own sky-high medical bill? Here’s what worked for me:

• Request the itemized bill.  The first bill I got from Atrium provided no explanation of what the fee covered. Unfortunately, that’s a common practice on medical bills. By some estimates, as many as 80% of hospital bills have errors, but you can’t spot one unless you can see exactly what you’re being charged for. I called the billing department and asked for a detailed, line-item bill. I also requested they extend the bill’s due date, because I was planning to dispute it. (You don’t want your bill to go to collections during a dispute.)
• Do your research.  The itemized bill for my husband’s visit listed only two charges: one for the CT scan ($2,013) and another for a “Level 4” emergency department visit ($2,372). A quick Google search revealed that most hospitals “level” ER visits based on the intensity of hospital resources required for the visit, with 5 as the highest intensity. I also checked the healthcare cost-comparison tool at FAIR Health and learned that local averages are significantly lower than what Atrium was charging: The in-hospital CT scan average is $794 (60% less than the amount on our bill) and the average for a high-severity ER visit is $1,553 (34% less).
• Build your case. The next time I called Atrium, I had a pointed question: Why was my husband’s visit, which required a minimal amount of staff and resources, coded a level 4, the second-highest level? “A CT Scan is automatically a level 4,” the rep said, adding that Atrium’s prices were “competitive.” Her answer helped me formulate my two big arguments for a price reduction:
  • We shouldn’t have to pay for a “high-intensity” level 4 visit when all we did was walk in and ask for a CT scan.
  • Atrium prices were actually not “competitive” but dramatically overpriced compared with similar services in the area, and we simply couldn’t afford to pay such a big bill.
• Keep asking for supervisors. The person answering the phone in a medical billing center often lacks the authority to reduce a bill. So when I wasn’t getting anywhere with her, I asked for a supervisor. At first, she said no one was available. When I insisted, she said I might be on hold for a long time. She was right: I waited 14 minutes to talk to a supervisor, who reiterated the bill was correct. I had read that billing centers will sometimes give you a discount if you offer to pay immediately rather than set up a payment plan, but the rep refused. “You have insurance so you don’t qualify for any discounts,” he said. That’s when I asked for his supervisor. (I kept detailed notes of each conversation that included the date, who I spoke to and what they said.) 
• Be pushy, but human. I left a voicemail for the next supervisor. When she called me back, she insisted the hospital was following “guidelines” that called for any visit with a CT scan to be coded as Level 4. I seized on the word “guidelines” and pointed out that by its very definition, a “guideline” is not a hard-and-fast rule. She said things like, “We have already audited your bill and verified that the code is correct,” and “I’m not going to debate the level. We are consistent in the way we apply these prices.” I kept pushing. I mentioned that our medical costs are high because my husband is a brain tumor survivor still under a doctor’s care. And I noted that we were already in debt to Atrium over my daughter’s broken nose. Still, no dice. It was time to ask for her supervisor. I left a message for him.

I received a call from an Atrium assistant vice president a few days later. After hearing my story, he reiterated the charges were correct according to hospital guidelines. But then he said the words I had been waiting for: “However, I would be glad as a courtesy to adjust $1,000 off your bill.”

Victory, at last. It had not been easy, but by investing a few hours and refusing to back down, I saved $1,000. I share my story in the hope that you, too, can get some bill relief!

Michelle Crouch is a freelance journalist in Charlotte who covers health, personal finance and parenting. Her work has appeared in a variety of local and national publications, including Reader’s Digest, Real Simple, Prevention and AARP.

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