I just got the bill for an ER visit and one night's stay in a non-profit hospital... $6000

[Leftist Agitator]

A little more than a month ago, I slipped on a patch of ice and cracked my head open. A passerby found me laying on the sidewalk bleeding profusely, and called an ambulance.

I woke up the next day in the hospital with no recollection of how I got there. They explained the situation, and said that they kept me overnight to make sure that my brain didn't swell.

The bill is $6000.

First of all, no, I don't have health insurance. I'm working part-time for slightly more than minimum wage and going to grad school. I don't have any savings. How in the hell am I supposed to pay a $6000 bill? I called the hospital and they said that they have a financial assistance program that would cover anywhere from 20% - 50% of the cost.

That's all well and good, but I don't have $3000 - $4800.

Should I file for bankruptcy? I don't really have anything worth suing me over, but I had planned to move to a larger city after finishing my Masters, and I know that in most urban areas, nobody will rent to you if you have bad credit.

Moreover, can they legally bill me even though I didn't give consent to treatment?

Does anybody have any experience with a situation like this?

[nadinbrzezinski]

1. You should qualify for Medicaid

that should cover most of the rest.

When you see the Financial Counselor ask about that... and before you go call your local medicaid office

[Leftist Agitator]

13. My state doesn't offer Medicaid to childless adults.

Thanks for the suggestion though.

[nadinbrzezinski]

18. Work on a monthly payment plan

they like those.

They get some of the money back, and you can handle it. Even if it is oh 20 bucks a month. Expect them to look at every nook and cranny of your financial life though.

[Leftist Agitator]

32. The hospital said that they no longer accept cash payments spread out over more than 2 months.

That was my first thought. They did refer me to some outside financing company, who I'm sure wouldn't acceot twenty dollars a month, which is about all I could afford to send anyway.

[nadinbrzezinski]

56. Here in San Diego there are programs

at the COUNTY level... find out whether those exist.

By the way, this is what is the problem with the medical system and how we finance it. I do have a hope that this reform will help with that too. Problem is, this is not helping you RIGHT NOW... so I do get it.

But try to find out if the COUNTY has a program for low income citizens.

[Indy Lurker]

59. My $10 bill

says "THIS NOTE IS LEGAL TENDER FOR ALL DEBTS, PUBLIC AND PRIVATE"

Sounds like they are refusing to accept payment.

Make sure you document all the stupid things lie this that occur.

[Statistical]

65. That statement doesn't mean what you think it does.

Nobody is required to accept cash.

The pertinent portion of law that applies to your question is the Coinage Act of 1965, specifically Section 31 U.S.C. 5103, entitled "Legal tender," which states: "United States coins and currency (including Federal reserve notes and circulating notes of Federal reserve banks and national banks) are legal tender for all debts, public charges, taxes, and dues."

This statute means that all United States money as identified above are a valid and legal offer of payment for debts when tendered to a creditor. There is, however, no Federal statute mandating that a private business, a person or an organization must accept currency or coins as for payment for goods and/or services. Private businesses are free to develop their own policies on whether or not to accept cash unless there is a State law which says otherwise. For example, a bus line may prohibit payment of fares in pennies or dollar bills. In addition, movie theaters, convenience stores and gas stations may refuse to accept large denomination currency (usually notes above $20) as a matter of policy.

http://www.ustreas.gov/education/faq/currency/legal-tender.shtml

If you think about it logically it makes perfect sense.
Otherwise every single payphone or vending machine in the United States is in violation of the law for not talking $100 bills.
If I purchased your house and came to settlement with a dumptruck full of pennies as payment for the home you would be breaking the law by not accepting it.

It would be chaos. Nobody is required to accept cash. That is an urban legend.

[Divine Discontent]

35. yeah, how nice, right? gotta force out some offspring to help, but like is said above me, a payment

plan will work. also, see the PM I sent you.

[Leftist Agitator]

37. I don't see a PM.

Perhaps it didn't go through.

[EFerrari]

2. In most venues, if you make monthly payments, that limits the damage

they can do to you. Maybe a call to a credit counselor would be helpful.

[GreenPartyVoter]

3. I wish I had a better answer than, "I hope you can work things out." But I don't have

any ideas here. :( :hug:

[treestar]

4. Talk to an ambulance chasing lawyer and see if there is a case

And/or check with medicaid.

They will take monthly payments, since they know they cannot get blood out of a stone. That may make Bankruptcy avoidable.

[Lance_Boyle]

7. A case for what? To sue the ER for treating?

Not even Lionel Hutz would take that one on.

[NJmaverick]

15. sue the property with the ice?

[Taverner]

40. I SECOND THIS

SUE SUE SUE!!!

[apples and oranges]

5. Is it worth 10 years of horrible credit to file bankruptcy?

Or can you make monthly payments through a credit repair agency? Employers also look at your credit score when making hiring decisions.

[Leftist Agitator]

20. Monthly payments with what money?

I barely make enough to pay my rent and bills. Getting a second job is out, because school takes up the rest of my time.

[Deep13]

34. The employers' concern is usually the threat of garnishment.

Bankruptcy removes that threat.

I'm not sure that a Chapter Seven makes ones credit worse than a lawsuit and collections efforts.

And let's not forget. The main purpose of credit is to enable someone to put herself in debt.

Also, credit counselling services for anything more than a couple thousand bucks are useless.

[mike_c]

61. absolutely-- don't let the hype on this one fool you....

I declared bankruptcy six years ago or so as part of my divorce proceedings. As far as I've been able to tell, it had zero negative impact on my life. I have financed two new cars since then. I haven't changed jobs or moved, but the bankruptcy had no impact on my present employment or housing (and yes, I rent).

The same is true of my SO-- she declared bankruptcy a decade or more ago, and says that she is unaware of any negative impacts on her life.

Neither of us uses consumer credit cards-- I suppose they might be impacted, but that's a non-issue for us.

[Lance_Boyle]

6. You don't have to consent to treatment in the ER when incapacitated

THEY have to provide treatment, though. And yes, they can bill you for services rendered.

Talk to the financial assistance people at the hospital again. The $6000 figure may be the cost they'd bill insurance, not the "discounted" no-insurance cost.

[Cal Carpenter]

14. Actually, its the insurers who get the discounts

Paying out of pocket usually means paying more. I had to pay out of pocket when I was uninsured for getting stitches at the ER. When I called the financial assistance office and told them of my situation and that I was amazed at the amount of the bills they said that my fee was actually higher than an insured person because the insurance companies have 'agreements' with the hospital. I told her I would like to propose an agreement in writing wherein I would pay 75% of what they wanted over 10 months. No go.

And at the time I was working full time for $9/hr and didn't qualify for any assistance from them.

[laughingliberal]

17. That is backwards for a lot of hospitals

The insurance companies have a lower contracted rate with the hospitals and uninsured pay full, nondiscounted rates. But most hospitals will settle for a percentage if it can be paid all at once.

[Statistical]

24. Sadly that is completely backwards.

Uninsured rates are generally 100% to 300% of what insurance companies charge. This is something that could have been fixed in HCR.

If you ever look at insurance statement (EOB). The first number is what provider requests. The second number is what insurance company agrees to pay. The third number is what insurance company pays. The last number is what the patient pays.

So for something like this it would be:
Provider Requests: $6,000
Insurance Company Max Payable: $4,000
Insurance Company Pays: $3,5000
Patient Pays: $500

Sadly the deck is stacked against the uninsured.

[WeekendWarrior]

8. I could be wrong, but

I believe this should be covered by Medicaid.

[harun]

9. See if your grad school's insurance will help you.

[enlightenment]

11. You haven't checked the prices on that lately, I suspect . . .

ouch.

[Statistical]

10. Where was the ice you slipped on?

Was it someone elses private property? Was it your employers property?
You may be able to file a personal claim against then.

You can be charged for services you don't consent to in most states if they were offered in "good faith" and medically necessary.


As far as BK. One step at a time. See what they reduce the amount down to. Let them know you are a student making part-time minimum wage. Bankruptcy is likely unnecessary. If you have no assets statute of limitations will take care of the bill long before a BK will come off your credit report.

Don't put it on credit cards. Don't borrow money from friends/family. Don't have parents put that on their credit cards. Discharging medical debt/collections in BK is relatively easy. Discharging credit card debt is far more difficult.

Medical debt is the lowest from of debt. It is completely unsecured and not consumer credit.
Sorry for your situation this is yet another example of why we need real HCR.

Wait to see what they will reduce debt before making any decisions.

[Leftist Agitator]

16. I fell on a public sidewalk, not in front of a business.

Is this statute of limitations of which you speak longer or shorter than the seven years that a bankruptcy is on your credit history?

[sandnsea]

21. City sidewalk?

How long was it left icy? Any cracks in the sidewalk? There may be a lawsuit there.

[Leftist Agitator]

26. I don't know if it's a city-maintained sidewalk or one maintained by the state.

It was a day or two after a large snowstorm, but we had ice and snow on the ground all winter long.

[NJmaverick]

30. I believe the general concept is that one usually has 12 to 24 hours to make a walkway safe

after the snow or ice storm ends. If they failed to do that, you may have grounds for a negligence suit for the party who owns the side walk. With the ambulance run, you have at least some records indicating what happened. There may even be a police report if it was city or state owned property.

[Cal Carpenter]

38. 'open and obvious danger' doctrine

http://definitions.uslegal.com/o/open-and-obvious-doctrine/

Most of these lawsuits don't get anywhere. Unless it's a warm sunny day in June and somehow there's ice anyway, its tough to win those cases.

It's possible the person who was responsible for the sidewalk could get a fine but that wouldn't help the injured any.

[NJmaverick]

43. When I was a facility manager in NJ, I was on the losing end of a couple of these

law suits. So I am not sure where you are coming from. Although I would expect that it varies from state to state.

[Statistical]

28. Depends on the state where claim is made.

Also it depends on if the creditor (either hospital or who they sell debt to) is able to secure a judgment.

Most unsecured debt has a statute of limitations of 4 to 5 years depending on the state (some are as high as 10).
In most states judgments are good for 7-10 years (some are as high as 20).
Give me the state and I can let you know what SOL is.


However filing and securing a judgment requires court order and for people without assets it normally isn't worth the cost/time/effort for collection company to seek a judgment.

There is no "right answer". BK may be the best option but usually it is not. For someone without assets it is unlikely the massive hit to your credit is worth filing BK.

The hospital may be willing to accept a token amount while you are in school (like $20 per month). Even if you can't do that BK might not still be the best option.

Sometimes schools cover you under their health plan. As someone suggested you should check to see if you have any coverage through school.

[NJmaverick]

12. "Moreover, can they legally bill me even though I didn't give consent to treatment?"

You are treated under the concept of implied consent. The idea is that people who are unable to voice their wishes would want to be kept alive so they can treat people who are unconscious.

[pitohui]

22. the other posts in this thread are right on, esp. nj maverick's

would you really want a world where you were left to die because you couldn't give consent being unconscious and they couldn't find a health insurance card in yr wallet?

in louisiana, the usual "way out" besides bankruptcy would be to sue whoever had the icy sidewalk and hope that their homeowner's or business owner's insurance settles w. you quickly enough to pay off the debt -- otherwise if no one was at fault and you can't pay the bill, you will have to declare personal bankruptcy if they refuse to reduce the bill and refuse to accept reasonable payments

the uninsured pay much higher prices for the same services as the insured, at least in our state, because they don't have the benefit of a contract setting the prices

so when you got hurt and were unconscious, they were free to make up any kind of price since you had no insurance co. that previously negotiated a reasonable price for the service

one more reason why EVERYONE needs to have health insurance, even if they "think" they can't afford it -- if you don't have someone on your team negotiating a fair price for you, you're gonna get charged thru the roof

i'm really sorry you're going thru this

if you can't sue someone else for your injury, then your choices seem to be negotiate for a lower price (which they have no particular reason to give you, but maybe they will -- get it in writing if they do), declare bankruptcy, or somehow raise $$$ to cover the costs

"nobody will rent to you if you have bad credit" -- GET SERIOUS, the overwhelming majority of renters have bad credit, that's why they're renters and not home owners, don't let yourself be buffaloed by fear-stirring bullshit -- you're scared right now, not having money is scary, but lots of people have awful credit and almost all of them do rent

[sandnsea]

19. College insurance was cheap back in the 80s

Has that changed too? Go through the financial process, they'll direct you to any other assistance that is out there. Filing bankruptcy won't help your credit. Sometimes rental agencies will ignore medical bills and just look at your rental history.

Glad you're okay.

[dflprincess]

23. Call the hospital and find you who you need to speak to about finances

You might be able to talk them down to what an insurance company would pay after their discount. Hopefully, that might be an amount that you could make payments on.

[stranger81]

76. deleted

[tammywammy]

25. Set up a payment plan

I'd offer something like $50/month. Don't file bankruptcy and don't sue anyone. Shit happens, people slip and fall. And yes they should have treated you. If you weren't treated and your brain had swollen up and you had permanent damage you'd be singing a different tune about being treated. Offer to pay what you can per month.

[Leftist Agitator]

29. The hospital said that they no longer accept cash payments spread out over more than 2 months.

They also referred me to some outside financing company who I'm sure wouldn't be willing to accept the twenty or so dollars that I could afford to send them every month.

And hell, even with no interest, at $20 a month it would take me 300 months to pay the bill, which is just over 25 years.

[Deep13]

36. I guess they're screwed then.

Change your phone number.

[DevonRex]

39. Something doesn't sound right here. You're in grad school yet anticipate only being able to afford

$20 a month for 25 years? Many people have tried to give you advice in this thread yet there's always a reason their advice doesn't help. What's up with that?

[Name removed]

42. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Obamanaut]

60. agree nt

[Dyedinthewoolliberal]

67. That's not what I read.

I read that the bill is 6K and they want the money today. He doesn't have 6k and probably most of us don't either, if it happened to us.
His story is whats wrong with the health care system.

[Name removed]

44. Deleted message

Sub-thread removed by moderator. Click here to review the message board rules.

[Leftist Agitator]

73. Let me clarify...

I anticipate being able to pay $20 a month, give or take, for the next year and a half to two years. Seeing as the hospital is referring me to an outside financing concern, which in all likelihood won't accept $20 a month in exchange for a loan, that is effectively where I'm at right now. They won't let me pay them in installments, and no lender worth their salt will let me pay at a rate that I can afford either.

I anticipate being able to handle a debt of this magnitude shortly after I graduate and get a job, which will be too little, too late, wouldn't you agree?

"Many people have tried to give you advice in this thread yet there's always a reason their advice doesn't help. What's up with that?"

Well, none of the wonderful advice that I have received thus far (and I mean it, everyone's advice has been top-notch!) was applicable in my situation at the time that you made your post. What, you sincerely believe that I would waste my precious time trolling DU? I have better things to do with my waking hours. Perhaps you don't, but I certainly do.

Maybe you should quit being such a suspicious Aloysius and go with Occam's Razor.




You are right about one thing though... Something doesn't sound right here. It sure as hell isn't right that an ER visit and an overnight stay just for observation, with minimal ACTUAL treatment should cost six grand. They didn't even stitch my head up, for Pete's sake! I suppose they had more pressing concerns, which I understand, but from where I sit, six thousand dollars is a bit steep just to ensure that someone who had an accident doesn't die.

Wouldn't you agree?

[pitohui]

45. then don't pay them even a penny, it makes no sense

you have no reason to pay any part of the bill at all, then, if you're going to declare bankruptcy save that money to pay the bankruptcy lawyer and get the bill discharged that way

otherwise find out your state's statute of limitations, for when the bill runs out, the clock always re-starts from the last payment you made on the bill, say it's 4 years and you give them $1 toward the bill, that's four whole years they can chase you around trying to make you pay, but if you haven't paid anything at all, it's four years from the day the debt was first incurred (varies by state obv.)

as the other guy says, just block their phone number and go on w. your life, i don't see what else you can do, paying a little only keeps the debt alive longer

[Statistical]

47. Exactly have a plan.

The medical bill is not credit so it isn't on your credit report.

If you don't pay then eventually they will sell it to a collection agency and it will be listed as a collections account will hurt your credit but substantially less than BK would.

So then it comes down to your life vs SOL clock.

Everyone's situation is different. Say the SOL is 5 years (depends on state). 5 years fro5m now you still might barely be making ends meet you will have no assets and debt expires unclaimed. On the other hand 6 years from now you might be making $150,000 a year and have a million in the bank which means likely you will end up paying it (collection agency will peruse a judgment against your assets).

If SOL on debt runs out of time before you have any substantial assets then it is better to not make payments and let clock run out.

Worst possible thing to do if just keep making small payments on a debt in collections. All it does is reset the SOL clock and ensures you will pay it forever.

If hospital doesn't accept monthly payments that means they intend to sell the debt after 60 days. Don't make small monthly payments to debt collection agency. You will go nowhere. 5 years from now you will owe more than you owe now and each payment resets the SOL clock.

[anigbrowl]

50. Well, after you complete school...

you'll have more time available and one presumes that your qualification will enable you to earn a higher income ina job your were not able to apply for without said qualification. So your present financial position is not necessarily a guide to your future financial position, for good or ill.

Anyway, you should not be taking legal advice on DU. A personal injury lawyer will usually give you 20 or 30 minutes of consultation for free to establish whether you have a case or not, and by virtue of their profession is fully informed about the legal rights and responsibilities of you, the hospital, and whoever is charged with maintaining the safety of the sidewalk. I have been in a quite similar situation to you but rather than just repeating my story as if it were interchangeable I strongly advise you to consult someone who is actually expert on the subject and on the various state and local laws which might apply.

The opinions of non-experts, which include your good self, are of no value whatsoever. talk to someone whose business it is to know this stuff, and who has extensive experience in assessing and advising people about where their interests lie and how best to pursue them. You look up some numbers, then pick up the phone and say 'I experienced an accident in which I believe I am not at fault, but am now facing a large medical bill and do not know what to do. Does your office offer a free consultation?'

When you reach someone who is nice and offers you an appointment, take them up on it and then go there and listen. You can save both them and yourself time (and possibly money) by printing out your OP which summarizes the situation and then letting them ask you whatever else they need to know.

[JVS]

64. Tell them to go fuck themselves.

[newfie11]

27. Their not for profit

Pay them 5 dollars a month but don't ever be late.

[Mz Pip]

31. You might want to check with

your school. You might have some coverage through the school and not know it.

I have some vague recollection that when my kids were in college they had to provide proof of inusurance or take the coverage offered through the university.

[Statistical]

33. Yeah in some schools the coverage is blanket and included in tuition & fees.

Worth at least checking into.

[yodoobo]

41. How do they know who to bill

If you didn't consent?

Odds are, you did consent when you filled out the paperwork indicating who you are.

[pitohui]

46. this person was unconscious, they checked his wallet for his ID/insurance card i guarantee

he didn't consent to pay any $6K, nobody does, they treat you first in an emergency and come back w. some big bullshit bill later

i did know a homeless girl who possessed no ID who just walked out of the hospital when she "came to," similar thing, she fell and hit her head on the sidewalk (prob. drunk, she was an alcoholic)

they never sent her a bill, they literally had no name on her and had to treat her as a "jane doe"

her boyfriend called the ambulance and just possed as a concerned passerby rather than bust her and give the name and cost her a lot of money

but most of us civilians have ID, they're gonna find out who we are

[yodoobo]

55. that makes sense

They literally pick your pockets.

[Midlodemocrat]

48. Get hold of the social worker in the hospital

and ask about their indigent program.

Then, contact the CFO of the hospital and state what you can and are able to pay and ask them to take that.

Most will do so.

Been there.

PM me if you need more assistance with this. Don't panic.

[shraby]

49. Offer them 50 bucks a month and tell them it's either

that or nothing and they just might negotiate..I ran into a similar situation and they took the deal. I told them they can't get blood out of a stone and that's all I could muster.

[anigbrowl]

51. Consult an attorney.

You had a medical problem, and the best person to treat that was a doctor. Now you have a legal problem, and it's time to speak to an attorney. If you have never had to do this before you may be intimidated by the idea, but when you actually try it the chances are it will not be as complex or difficult as you imagine.

If you don't know where to start, look up the number of the state bar association, tell them where you live, and request a referral to a personal injury attorney that offers a free consultation. I am 99% sure from the way you state your problem that you have never had to do this before, and equally sure that whatever preconceptions you have about doing so will turn out to be different from the reality of the experience. Indeed, the process might even alter your outlook on such matters.

[suzie]

68. He/she could also ask to purchase an hour of an attorney's time to request advice.

But, you're correct, consulting an attorney is the important thing.

Would it be possible to find out who the college uses as their attorneys and ask them for low-cost/pro bono advice?

[anigbrowl]

72. True, but since OP says they're broke and PI lawyers often work on contingency .nt

[Dappleganger]

52. If you can't pay you can't pay.

This is not your fault.

I'd not pay them a dime and not worry about the credit report. People everywhere are renting via Craigslist and getting nice places with NO problem, all you need is cash deposit. You have to LIVE. Rent, food, utilities, transportation come first. Finish your education. Stockpile cash in a safe place.

Normally I think that everyone should pay something but not in this case. Look at this as a business/survival decision.

[Obamanaut]

53. If there was a patch of ice, one must imagine the temperature

was fairly low.

Don't you just hate it when some random passerby interferes with what may have been death by freezing or bleeding out. And they were aided and abetted by the hospital.

Shame on them.

[Xenotime]

54. Sickening

[cbayer]

57. Here is a suggestion - Offer to pay them what they would get from an insurance company.

The "rack rate" that hospitals charge uninsured patients is generally at least 3 times what they get from their insurance contracts.

There has been some legal precedence for challenging a bill like this. If you can, look up the various components on the Medicare payment schedule and offer them that.

To be fair, the consent to treatment argument is not very strong. They may have saved your life. If you had had a bleed, you might have very well died.

:hi:

[gmoney]

74. yes... the "repriced" amount

My gall bladder operation was "repriced" from $13K to about $3K a few years ago, and just a few weeks ago, $5000 "worth" of blood tests were repriced to less than $250.

Also, can't you sue the owner of the property where you slipped and fell?

[Indy Lurker]

58. Try this

IANAL

Pay $10 or $20 a month. This should keep it from going to collections for a while, and if you end up it court, it looks better for you. Once it goes to collections, state you are disputing the charges and mail back the collections letter. Do this for every collections letter. If you are disputing the charges, it takers much longer to go against your credit score. Eventually (4-5 years) they should settle for a fraction, or stop sending letters all together and give up to clear their books.

[Krakowiak]

62. You should qualify for charity care at your wage and asset level

Call and request a charity care application.

[Krakowiak]

63. edit double post - no message

[Dyedinthewoolliberal]

66. I have an idea!

let's reform the Health Care system. :)
Seriously, your story and the stories of thousands of others this happens to on a daily basis is what the reform is all about.
Try getting the Limbaughs and Hannitys to bring you on to talk about it though. Won't happen.

[The Midway Rebel]

71. Ha!

Reform the health care system?! Why that's crazy talk!



:toast:

[Name removed]

69. Deleted message

Message removed by moderator. Click here to review the message board rules.

[The Midway Rebel]

70. Been here, done this.

In short. Out bicycling, shattered clavicle, two ribs, nondisplaced fracture of c-7 vertabrae, no insurance at all. ER 90 minutes, x-rays, CT scan, expert diagnosis, "that looks like it hurts, have some morphine and see you later here is your coat, you really should see a orthopedic surgeon for that bone sticking out there and a neurologist for that spinal cord injuruy OK see ya' bye!"

Had no money for further care, so I soldiered through and hoped for the best. It was the worst pain of my life...for weeks. My left hand index finger is still numb from the SCI and the wreck was 16 months ago.

After reading your story and being aware of mine and hundreds of others, I feel lucky.

My bill was divided between the ER docs, the hospital, the X-ray comapny and the CT machine company. Grand total was over 7K.

I started a letter to plead for charity that the hospital offered. I hate begging so, I got on the phone and negotiated with AR instead. I got a 2k discount for being uninsured and set up a payment plan of 75 bucks a month with no accruing interest on the debt. Got a statement today and I have them payed down to 3k.

I learned two things from my experince.

1. I am too old for cyclocross racing.

2. With or without insurance, the health care system in America is a godamn racket.

(No offense intended to those who truly labor and serve humanity in the health care field.)

Yup...I feel lucky.

[MilesColtrane]

75. Hate to say it, but unless your credit rating is bottom of the barrel, you'll probably be forced...

to borrow money to pay that bill.