Close Menu
    Insurance

    I AM TERRIFIED OF THIS MEDICAL BILL

    Two weeks ago I was in a motorcycle crash: got speed wobbles at a lower speed on freeway and lost control of the bike and crashed. Noone else was hurt, bike was totaled. I was unconscious until the Ambulance came. I was taken to the OHSU in Portland, OR. I arrived to the hospital around 9pm and was discharged around 4 am. The whole time I was conscious, they ran some scans and then 4 nurses started cleaning my wounds and putting bandages on. I don't have any broken bones just pretty bad road rash and stitches at one place on my right arm. I was sent home with some supplies to rewrap my wounds. Today I received the medical bill for $35k. How is this possible for not even whole night spent in the hospital? I'm literally desperate as I write this. I've attached my insurance policy breakdown and medical bills in the comments. From my understanding my insurance will not cover even half of this. I can't afford to pay this. I also have health insurance. From researching online seems like most ER visits are few thousand dollars not 35k. Can someone give me advice how to fight this. This seems extremely unfair.

    I AM TERRIFIED OF THIS MEDICAL BILL
    byu/ERJgirl inInsurance



    Posted by ERJgirl

    View 13 Comments

    13 Comments

    4. WhereMyMidgeeAt on

      Your motorcycle insurance covers injuries as a result of a bike accident- then health insurance is secondary. Have you contacted either policy?
      Or called hospital billing to see if they actually billed the policies?

    6. 16enjay on

      In NY i believe that medical bills as a result of single motorcycle accident are not covered under auto policy…I don’t know how it works in other states…call your insurance carriers 🤷‍♀️

    8. Open-Tomato8103 on

      Hey, double-check that bill for any mistakes and chat with your insurance folks. See if the hospital can cut you a deal or let you pay bit by bit. Maybe look into some help from charities or a legal pro.

    9. Tunafishsaladin on

      Hiya. Sorry this happened.

      1. Take a deep breath.
      2. Look at your HEALTH INSURANCE policy, not your auto. If you have an ACA-compliant healthcare policy (and I bet you do), you will be capped at an “Out of Pocket Maximum” that is FAR under $35k for emergency care. In general, almost all legit US hospitals are in-network for emergency care under ACA-compliant or employer provided plans. Could you share more info about your HEALTHCARE Insurance? For example, did you get an “Explanation of Benefits” (“EOB”) from your health insurance provider?
      3. Don’t pay until you’re certain your medical insurance provider has seen the claim and gives you this EOB.
      4. You will almost certainly not owe $35k. I know it’s scary, I know the bill will not be fun to pay, but it won’t be this high, so breathe.
      5. Lowest Tier ACA plan has an out of pocket max of **$9,450** per individual, double per family. Many plans will have far less.

    10. BuildingSomeShelves on

      The other information about insurance is correct, but I just want to point out as a healthcare provider that “most ER visits” involve stitches and a Tylenol, not a bunch of advanced imagery and arriving unconscious by ambulance. Actually look at what’s itemized on your bill. That’s why it’s $35K, not a few thousand. They prioritized you as a potential serious trauma and worked you up for what could have been an extremely serious injury, given you lost consciousness being flung off a motorcycle. They don’t refund you and treat you as a minor injury when your injuries fortunately turn out not to be serious. It appears based on your story and the bill that you were provided with appropriate care for what you presented with.

      I get that it’s super frustrating trying to work out who is going to pay, but please also consider that you left there with “only” financial debt, not major lifelong disability that is highly likely from something like this.

    11. RichardBonham on

      You are showing three screenshots from OSHU’s patient portal app, and not an insurance company Explanation of Benefits (EOB). It is not at all evident from the screenshots that OSHU has actually billed your insurance; 2 weeks is mighty fast for billing processes. These screenshots may simply be displaying what they’re going to bill your insurance.

      I think you need to go online to your insurance company’s website and see if they have been billed yet, and if so whether they have produced an EOB (whether online or by surface mail to you). This is where the insurance company acknowledges that they were billed by OHSU on the day they saw you (Date of Service) and to what extent you are/are not covered. I suggest you hold off on panic until you actually have a piece of paper.

      If this is your first medical encounter for this year, you are probably going to owe on your annual deductible. If you have an 80/20 plan, you owe on 20% of covered services (hopefully, everything done was a covered service provided by an in-network provider). Don’t accept any bullshit about the arrival to closest trauma care facility by ground ambulance: you were in a motor vehicle accident, the vehicle was totaled and you were unconscious. This is a medical emergency. Emergency personnel are ethically and legally required to transport you to the nearest appropriate facility regardless of your insurance status. Similarly, said facility is ethically and legally required to receive you and render all needed care in good faith regardless of your insurance status. (See Emergency Medical Transfer and Labor Act/EMTALA.)

      Also, check closely to see where your motor vehicle insurance comes into this. Medical providers typically bill your medical insurance provider. It’s on you to determine if your motor vehicle insurance pays towards this bill and your medical insurance only pays towards the balance.

      Do not hesitate to negotiate any patient-responsible billing with OSHU. The amounts that hospitals bill for any given service is to capture insurance reimbursements; they are not intended to be paid in full by all patients. They are well aware of the problem and are usually willing to reduce the size of the payment and work something out with you. Remember, they do not at all expect to get all the money they billed for from insurance companies. You may have heard horror stories of hospitals actually suing patients over unpayable medical bills, but they’ve generally fallen back from doing this because when the patients go to the local news stations it makes the hospital look very, very, very bad. Hospitals are incredibly sensitive about their public image and public good will.

      Also, there are people in the community who used to work in medical billing for hospitals and have gone “white hat” and now are in the job of helping patients figure out complex unpayable hospital bills and how to manage them.

      Hope this helps you!

    12. Basic_Stranger_27 on

      Your Med Pay will exhaust at its $15i limits, then your health insurance will kick in. You will be responsible for copays and deductibles after health insurance reviews and makes their payments. You won’t be responsible for the difference in what insurance pays (probably a fee schedule or network schedule) and what was billed.

      you will probably receive more bills too as the physicians, radiology and I believe labs bill separate from the facility. Make sure they all go to your HI to be reviewed for payment.

      $35k for what you described does not sound crazy to me, you didn’t say but I assume they did scans to rule out broken bones, internal bleeding, etc? Probably did an EKG and lab work as well.

    Leave A Reply
    Share via