A few of our many users of the Prevent Consent have forwarded them to us. Here is a little collection. Most recent is Sunrise Hospital, HCA's largest. A patient (who wants her name used) got a bill for $27,000 for dehydration in Las Vegas causing a fall:
The amount owed was her deductible, $6,234.53
As Marshall Allen's book title says: "Never pay the first bill." Quizzify sent one letter and magically the second bill fell to an even $3000, not itemized:
They are hoping we go away, and if weren't HCA, we would, because we just got the lion's share of the savings with almost no effort. However, Quizzify would like to establish a precedent for the largest hospital chain in the US, so we ghostwrote a letter and we'll see what happens.
Speaking of which, this bill is from the late, great man himself, healthcare pricing uberguru Marshall Allen, author of Never Pay the First Bill. He published his experience here, and Jessica Brooks, CEO of the Pittsburgh Business Group on Health, added her friend's similar experience as well:
Most users, from other non-healthcare walks of life, would prefer that their names not be used but are willing to share their successes...
Yes, but are the bills always under $1000?
Unless a scan, compound fracture, stent, or a procedure by an on-call doctor is involved, the allowed total cost including provider fees will be under $1000. There are likely other rare exceptions that we haven't seen yet. Paradoxically, the higher your bill, the greater your savings vs. the commercially billed equivalent.
Here is a Level 5 ("99285," the highest-acuity code in the ER, often costing five figures!), coming in under $500, though we can't take credit for the cash discount.
Speaking of five figures, here is an in-network provider (with OON physicans) trying to bill more than $14,000 for a Level 4 Extended ER visit:
Initially, the hospital "forgot" they accepted the Consent, as is their wont. We had the bill repriced, as is our wont. Albeit this is an extreme example, we ended up saving 95%! It will surprise no one that this took place in Florida, the #1 state for ER billing.
The hospital caved entirely:
Occasionally a hospital does not cave, and we have to play hardball. This is the University of North Carolina Medical System. They refused to budge, despite the clear use of the Consent.
UNC assigned quite literally their chief, Harvard-trained, litigator for the entire UNC system (who presumably should have had better things to do with his time than get involved in a $3500 ER claim), and brought in a suit from the North Carolina Attorney General's office (ditto, plus I'm sure it was a violation of the AG office's rules to get involved in a dispute that wasn't even a case yet – on the side of the perps, no less) for the sole purpose of patient intimidation.
We laugh at patient intimidators. We didn't budge. They then wisely wrote off the entire bill, rather than rebill us correctly. They never even notified the patient of this in writing. That was wise on their part, not to create an audit trail. Also, wise not to rebill correctly, which would have created a precedent. Here is the initial bill and the final screenshot:
We caught Florida's #1 system, Baptist Hospital, dead to rights. They did not let our user enter the Consent, which is a clear violation of EMTALA. Further, if you look hard at their own Consent, you'll see it violates EMTALA on its face, as they use the same consent for emergencies as they do for electives. Consequently, we received a total write-off along with a semi-acknowledgement that we were right, and that they need to "review [their] policies and procedures."
