After California passed AB-72 Health care coverage: out-of-network charge, many following healthcare reform in California breathed a sigh of relief. However, California’s fight for emergency healthcare billing reform is far from over. There’s another issue driving up the costs of hospital visits that is being cited in recent reports: for-profit emergency room staffing companies.
Once an emergency room staffing company, such as EmCare, takes over a hospital’s E.R., the cost of emergency healthcare jumps dramatically, according to recent reports. In an article by the New York Times, one small hospital reported that “before EmCare, about 6 percent of patient visits in the hospital’s emergency room were billed for the most complex, expensive level of care. After EmCare arrived, nearly 28 percent got the highest-level billing code.” Doctors cite unnecessary and expensive tests ordered by emergency room staffing companies as the reason for this spike in billing costs. Worse, when hospital staff raises objections to these tests, some staffing companies may resolve the situation by firing them. Though California’s new bill will prevent you from being charged out-of-network rates, it does nothing to stop companies like EmCare from charging you exorbitant rates for emergency healthcare. California cities from Los Angeles to San Jose — Fresno, Stockton, Modesto, and Santa Barbara — are staffed by EmCare.
If you’re in a car accident in California and bring a lawsuit to recover medical expenses, you can only sue for “reasonable value”
Say you’re driving in San Francisco and you get into a car crash with a driver who was drinking or texting behind the wheel and it leaves you with broken bones and medical bills. You decide to bring a lawsuit against the driver to get back the costs of your medical bills. When a personal injury attorney sues for damages in California, they are only able to sue for the “reasonable value” of services provided by a hospital. So when companies like EmCare pressure physicians to perform expensive and unnecessary tests on you, in many cases, it becomes very difficult to regain the full cost of your medical bills. Even well-reputed hospitals like San Francisco General Hospital or UCSF Medical Center often include charges that are very difficult to support as reasonable or necessary in court. It’s sometimes impossible to successfully sue for the full cost of medical bills.
What can you do to avoid expensive, unnecessary medical testing if you’re sent to an emergency room in the Bay Area?
Clearly, this raises the question: what can the average person do to avoid surprise billing or unnecessary tests? Of course, the most obvious answer is to take care of your health. Eating healthy, exercising, drinking water, and obeying all California traffic laws are the best ways to keep you out of the hospital. Other than that, the answer to the question “what can I do?” is, unfortunately, not much. Stay informed and aware as much as possible about what procedures and tests doctors are performing on you during your hospital visit. California does not protect you from unnecessary and expensive bills hospitals may charge you for. If you are concerned about this issue, call or email your local congressman and tell him or her that reform of hospitals’ healthcare billing system is important to you. If you’ve already been a victim, it may be time to talk with a lawyer.
Request a free case consultation with a top-rated San Francisco injury attorney
If you’ve been the victim of a medical mistake or injury, please don’t hesitate to contact us at our offices in San Francisco. We’ll be happy to review your case to make sure you know your rights. We take pride in making sure each client receives personal attention from our experienced lawyers. If you have any questions about a car accident, bicycle injury or possible medical malpractice, ask for a free case review.